Therapeutic positioning of the multiply-injured trauma patient in ICU.
Critically-ill patients who have sustained multiple traumatic injuries have complex, and often conflicting, physiological needs. These have profound implications on the way in which nursing staff approach the physical positioning of these patients to minimize the risks of further physiological injury and damage, maintain homeostasis and promote optimum recovery. This article reviews and discusses the evidence base underpinning therapeutic positioning of the multiply-injured trauma patient within the intensive-care unit (ICU), focusing on patients with a known or suspected unstable spinal injury, pelvic injury, traumatic brain injury, chest injury, or multiple limb fractures. Included are guidelines on the therapeutic positioning of the multiply-injured trauma patient within the ICU, based on the current available evidence and also drawn from practical experience within the author's own place of work. There is also a brief discussion of how such guidelines may be introduced into clinical practice.
Adult Intensive Care Unit, The Royal London Hospital, Whitechapel Road, London.
Robert James
RJ
Christie
D001510:Bed Rest / Q000009:adverse effects / Q000379:methods* / Q000451:nursing*; D001930:Brain Injuries / Q000451:nursing; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000451:nursing; D019317:Evidence-Based Medicine; D050723:Fractures, Bone / Q000451:nursing; D006801:Humans; D007103:Immobilization; D055370:Lung Injury; D009104:Multiple Trauma / Q000451:nursing*; D015403:Nursing Evaluation Research; D009989:Orthotic Devices; D010347:Patient Care Planning; D010384:Pelvic Bones / Q000293:injuries; D011187:Posture; D017410:Practice Guidelines as Topic; D013124:Spinal Injuries / Q000628:therapy; D013898:Thoracic Injuries / Q000451:nursing