The occipital and sacral pressures experienced by healthy volunteers under spinal immobilization: a trial of three surfaces.
BACKGROUND
The development of a pressure ulcer is of great significance to the life-long rehabilitative management of the person with a spinal cord injury, and may indeed delay and repeatedly interfere with that process. That the period preceding admission to the specialized spinal injury unit is crucial with regard to pressure ulcer development is evident in the professional literature. Both anecdotal and empirical evidence indicates that a significant number of pressure ulcers occur as a result of management provided prior to admission, and that such ulcers are more likely to occur in those patients who have undergone a transfer process from a hospital distal to the specialist unit on a hard spinal board.


OBJECTIVE
In consideration of this and of the fact that, in Ireland, the interhospital transfer of spinal injured patients has usually involved the employment of such spinal boards to achieve immobilization, this study sought to identify whether or not the pressure experienced by individuals at two anatomical locations was dependent on the support surface employed.


METHODS
Pressure under the occiput and sacrum of three healthy volunteers immobilized on three support surfaces was measured using air-filled pressure-measuring sacks. The surfaces employed were an uncovered spinal board; a spinal board with inflatable raft devise; and a full-body vacuum splint.


CONCLUSIONS
Marked reductions in pressure were measured when using the inflatable raft and the vacuum mattress. The results of this study will provide a basis for a larger study and, through that, the formulation of recommendations for standardized practice along a national care pathway.
Sheerin
Fintan
F
School of Nursing and Midwifery Studies, University of Dublin, Trinity College, Dublin, Ireland. sheerinf@tcd.ie
de Frein
Ruairi
R
D000328:Adult; D001513:Beds / Q000009:adverse effects; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D015400:Clinical Nursing Research; D019091:Critical Pathways; D004638:Emergency Treatment / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D007103:Immobilization / Q000009:adverse effects / Q000295:instrumentation; D007494:Ireland; D008297:Male; D009777:Occipital Bone; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D011312:Pressure; D003668:Pressure Ulcer / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D012447:Sacrum; D013119:Spinal Cord Injuries / Q000150:complications / Q000628:therapy*; D013165:Splints / Q000009:adverse effects; D014187:Transportation of Patients; D014618:Vacuum