Patient care after stroke: basic principles
A stroke is a severe neurological disease that often leads to death in the acute period, but still the majority of patients due to the internal reserves of the organism and timely medical care to survive, but the quality of life after suffering a vascular accident in the brain is greatly reduced. As a rule, patients after a stroke have some functional limitations until the complete loss of legal capacity.
It is important to understand that patients, stroke victims, are certainly not safe. In addition to the repeated cases of disease that occur very often, if not to resort to secondary prevention, the weakened body is exposed to various complications, especially for people who because of the stroke, lost the ability to active movements and have a long time to be in bed.
To protect the person from complications that can be even cause death, as well as speed up his recovery and
Basic principles of care
Very often it happens that after the patient is discharged home after a stroke, the family of the people do not know how to care for it, you should pay attention. However, it is very simple. In this article we will not discuss the principles of restoring lost functions, and it will be just about caring for the sick person and the features thereof.
In the basis of care for post-stroke patient includes the following items:
- prevention and suppression of sores;
- prevention of thromboembolism;
- struggle with muscle contracture;
- warning the stagnant phenomena in lungs and pneumonia;
- establishing digestive processes;
- caring for a person with impaired function of the bladder;
- feeding the patient in violation of swallowing function;
- the proper organization of leisure of the patient;
- prevention of recurrent stroke.
Video about caring for someone after a stroke:
The fight against pressure ulcers
Decubitus is local necrosis of soft tissues on parts of the body where it creates the maximum pressure in the supine position. Bedsores most often appear in places of a projection of the bony protrusions – heel, the area of the sacrum, iliac bones, shoulder blades, coccyx, elbows.
It is important to know! The appearance of bedsores is a sign of poor care or lack of such.
The basis for the development of this complication is the following mechanism. If a person lies long in one position, then in the above sections, the pressure is so strong that it exceeds the pressure inside blood capillaries. This leads to a shutdown of the microcirculation in a certain area of soft tissue to ischemia, which results ina necrosis (necrosis) tissues that do not receive the necessary amount of blood. Theoretically, in order to form a pressure sore, sufficient duration of ischemia about 2 hours.
Depending on how long exposed to negative factors (increased local pressure) developed necrotic changes of various degrees, from mild to severe.
Bedsores are a direct threat to life. They can be the entrance gate for infection, which often leads to sepsis and death. Because prevention of this condition is in the first place when caring for immobile patients.
- it is necessary to change a person's position in bed every 2 hours;
- it is important every day to inspect the skin on the subject of the first signs of occurrence of sores;
- carefully monitor the hygiene of the skin, special attention should be paid to areas of high pressure;
- regularly clean the skin with an alcohol antiseptic solution;
- to monitor the hygiene of bed linen, changing them often to prevent creases in bed, crumbs and other foreign objects, which will create increased pressure on the soft tissue;
- it is advisable to purchase a special anti-bedsore mattresses or functional medical bed;
- the use of rubber backing circles under the region of maximum pressure of the body;
- regularly take a course of tonic treatment, massage, medical gymnastics.
If the sore has already appeared, it is urgent to begin treatment until the infection has spread. For this purpose, use various antiseptic and antibacterial local funds.
The fight against thromboembolic complications
Due to inactivity, which is present in all patients on bed rest in the lower extremities begins to stagnate the venous blood. As you know, is a risk factor of blood clots, which with the veins of the lower limbs and can migrate through the vascular system and cause severe complications, e.g. pulmonary embolism. This is a medical emergency that can result in instant death. Because prevention of stagnation of blood in leg veins and, accordingly, thromboembolism, occupies a very important place in the care of post-stroke patient.
- compression stockings or elastic bandaging of the lower extremities;
- regular intake of drugs that thin the blood, but these drugs are appointed only by the doctor and under strict regular supervision, as an overdose can cause bleeding;
- regular performance of passive and active treatmentgymnastics;
- the use of prophylactic intermittent pneumocompression (special inflatable air bags that suit and is inflated periodically in the lower extremities).
Prevention of congestive pneumonia
Similarly, stagnation in the lower extremities may occur and stagnation of blood in the lungs during prolonged bedrest. This contributes to violation of drainage function of bronchial system and increased risk of development of pneumonia. Thick and sticky mucus, which does not depart, is a perfect environment for the growth of pathogenic and conditionally pathogenic microorganisms. This pneumonia is difficult to treat even with the use of massive antibiotic therapy.
- regular performance of breathing exercises (passive and active), the easiest way is letting off air through a straw for cocktails in a glass of water
- drainage and vibration massage of the chest
- prophylactic purpose of the expectorant drugs and broad-spectrum antibiotics during prolonged bedrest.
Activation of digestion
Often in intensive care from experienced doctors can hear the phrase: “the Gut works – it means to live.” To some extent this is true. All people who are on forced bed rest, a decrease in the motility and peristalsis of the intestine. With this problem associated with many complications. So first of all it is necessary to achieve activation of digestion.
To do this, in the diet of a sick person always enters the fiber, which is found in plant foods (vegetables, fruits, cereals). For some reason people can not eat coarse food, for example, impaired swallowing after a stroke, that all pharmacies can buy ready-made fiber in the form of powder supplements. It can be diluted with juice, yogurt, milk, yogurt or water to the state of calici and regularly give to the patient. Per day is enough 2-3 tablespoons of fiber.
Also be sure to give choleretic drugs on the basis of ursodeoxycholic acid. It stimulates peristalsis and is a wonderful way to prevent constipation and other digestive disorders.
Thus, to create comfortable conditions for the rapid recovery of the person after stroke easy. It is more important to pay particular attention to the special rehabilitation program and the prevention of recurrent stroke.