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Nasogastric tube insertion
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Anesthesia for Neurotrauma, 2018
The hands are washed and an apron and gloves are worn to minimize the cross infection. The patient is placed in a semi-upright position (high Fowler’s position) with the head supported in a slightly forward position. This position assists swallowing and helps prevent tracheal placement if the swallowing is compromised.
Enteral Feeding
Published in Susan Carmody, Sue Forster, Nursing Older People, 2017
The head should be raised 30 degrees (in a ‘semi-Fowler’s’ position) when the person is sitting in a chair or propped up in bed. The person should not be isolated while feeding, and some interaction is required. As with mealtimes for other people, feeding is a social time of the day for those who are reliant on enteral feeding.
Redo carotid endarterectomy
Published in Sachinder Singh Hans, Alexander D Shepard, Mitchell R Weaver, Paul G Bove, Graham W Long, Endovascular and Open Vascular Reconstruction, 2017
Following intubation, the patient is positioned with a scapula roll and extension and rotation of the head to the side opposite the operative site. Excessive cervical spine extension and rotation should be avoided to prevent possible kinking of the vertebral arteries and muscle strain. The table is generally placed in a relaxed, semi-Fowler’s position with slight head elevation. The author recommends prepping one of the groins and thighs for saphenous vein or superficial femoral artery (SFA) harvesting in cases where interposition grafting is anticipated.
Early mobilization in clinical practice: the reliability and feasibility of the ‘Start To Move’ Protocol
Published in Physiotherapy Theory and Practice, 2022
Mariana Hoffman, Beatrix Clerckx, Kristel Janssen, Johan Segers, Inge Demeyere, Bregje Frickx, Else Merckx, Greet Hermans, Isa Van der Meulen, Tessa Van Lancker, Natalie Ceulemans, Marine Van Hollebeke, Daniel Langer, Rik Gosselink
Each level of the protocol contains a number of predefined possible interventions that include body positioning and physiotherapy. The body positioning possibilities are two hourly turning, splinting, Fowler’s position, passive or active transfer from bed to chair, sitting out of bed, and standing with or without assistance. If a passive transfer from the bed to the chair is not allowed because of a neurological, surgical or trauma condition, the patient is considered too weak or unstable to leave the bed and is assigned to level 1. If only a passive transfer for sitting out of bed is allowed because of obesity, neurological, surgical, or trauma condition, the patient is assigned to level 2. According to the score on the MRCsum,LL and the M-BBS score the patient is assigned to levels 3 to 5 (Figure 1A). Body positioning and transfers were jointly organized with the nursing staff. The physiotherapist covered passive and active range of motion, resistance training for arms and legs, active leg and/or arm cycling in bed or chair, walking with assistance/frame, neuromuscular electrical stimulation, and activities of daily living.
A new treatment (the affected-ear-up 90° maneuver) for benign paroxysmal positional vertigo of the lateral semicircular canal
Published in Acta Oto-Laryngologica, 2019
We found that the affected-ear-up 90° maneuver is an effective treatment for lateral canalolithiasis. So, why is it effective? The main reason relates to the functions of the vestibular dark cells. Several researchers have reported that the dark cells of the utricle are involved in the absorption and demineralization of otoconia [16,17]. Therefore, we use 90° rotation to treat lateral canalolithiasis, as it is anatomically appropriate. Although the 270° and 360° maneuvers are effective, the 90° maneuver has the advantage that it can be performed quickly. In addition, it is surprisingly hard to get patients (especially stout old ladies) to adopt a prone position. In order to ensure that the pathological debris settles in the utricle, post-maneuver instructions (maintain an upright position with the chin down until going to bed) are important, and we recommend that patients sleep with their upper bodies elevated (Fowler’s position). However, the success rate was not 100% in the present study. Three patients developed cupulolithiasis within a week after the treatment, and one patient exhibited transient GEO at the second visit. We speculate that the maneuver was ineffective in these cases because the causative debris had not adhered to the dark cells.
Quantitative evaluation of the consciousness level of patients in a vegetative state using virtual reality and an eye-tracking system: A single-case experimental design study
Published in Neuropsychological Rehabilitation, 2022
Cheolhwan Hyun, Kyungmin Kim, Soolim Lee, Hyun Haeng Lee, Jongmin Lee
Visual stimuli were presented to the patient using an HTC Vive head-mounted display (HTC Corporation, Taoyuan City, Taiwan). Binocular eye movements and eyelid distance were quantified and recorded by a computerized infrared eye-tracking module (Visual Camp Corporation, Seoul, Korea) built on HMD. An example of the set-up and equipment is shown in Figure 1. Eye movement was recorded at 60 Hz. The experiment was repeated until over 80% of an experiment session was recorded. When it was not possible to track eye movement after three repeated sessions, the evaluation was postponed to another day. Each patient was tested in a sitting position or a semi-Fowler position, with pillow or neck support applied if needed.