Track topics on Twitter Track topics that are important to you
Older adults with a disability tend to spend greater periods of time in bed each day and often over a mealtime. To make it safe for them to eat in bed, the patient is placed in a high Fowler's position. This means that the head and the foot of the bed are raised to sit the person up.
Sitting up in bed increases pressure over the buttocks which can lead to the development of a pressure ulcer. The purpose of this study is to evaluate the impact of the positional change called "the trunk release" on pressure over the buttocks, on breathing and on comfort.
Primary Hypothesis - Performing the trunk release with an older adult population at low risk for pressure ulcer will result in a 5mmHg decrease in the peak pressure index over the sacral-coccygeal area as measured by the peak pressure index using a Force Sensitive Applications (FSA) Pressure Mapping System.
Secondary Hypotheses - Performing the trunk release with an older adult population at low risk for pressure ulcer will result in:
- Improved ventilation as measured by a 0.5 liter increase in slow vital capacity.
- Greater comfort as measured by a two point change on a horizontal numeric scale with word anchors combined with the Wong-Baker faces scale (Appendix D).
- A four-centimetre displacement of the trunk as it extends up towards the head of the bed.
Two research assistants will conduct the study. Experimenter A assists with recruitment of subjects, sets up the test environment and performs the trunk release. Experimenter B acts as the primary data collector and will be kept blind to the purpose of the study.
The randomized allocation indicates if the subject is in the intervention or control group. Experimenter A sets up the study hospital bed fitted with a visco-elastic foam mattress, a fitted sheet, a flat sheet and the torso pressure-sensing mat. For standardization, the mat is aligned with markers set on the bed frame. Subjects will wear hospital pajamas over undergarments. Experimenter B records height, weight, age and gender. Subject is seated in a chair and is instructed in the spirometry maneuver. Once the subject is comfortable with the maneuver, Experimenter A asks the subject to lie supine with their body centered on the bed and with their hands resting on their abdomen. Experimenter A reminds the subject to remain completely immobile for the duration of data collection. Experimenter B takes a baseline measure of discomfort as per protocol. Experimenter A places the subject in the High Fowler's position by raising the foot of the bed to its highest position, 50 degrees, and the head of the bed to its highest position, 60 degrees. Experimenter A sets the timer for 8 minutes as per pressure mapping protocol. For more stable values, a "settling time" of 8 minutes is required to factor in creep of the pressure mapping sensors and mattress. Experimenter A aims the laser beam to the top of the scapulae where the subject's shoulder meets the mattress surface. Experimenter B initiates a FSA file with the subject's number, takes a pressure reading once 8 minutes is up, measures the trunk displacement, obtains spirometry readings as per protocol, and takes a measure of discomfort. Experimenter B leaves the room, Experimenter A sets the timer for 5 minutes and opens the allocation envelope.
The Principal Investigator will conduct random spot checks to ensure consistency in set-up.
Allocation: Randomized, Control: Placebo Control, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Investigator), Primary Purpose: Prevention
The Big Squeeze
Vancouver General Hospital - Banfield Pavilion
University of British Columbia
Published on BioPortfolio: 2014-07-23T21:13:36-0400
The patients will be submited to a vaginal squeeze pressure measurements before and after surgeries for urinary incontinence.
The purpose of the SQUEEZE Trial is to determine which fluid resuscitation strategy results in the best outcomes for children treated for suspected or confirmed septic shock. In this study...
There is a bimodal distribution to the new onset seizures with one peak occurring in the very young and the second peak occurring in persons over age 65 years. The presentation of seizure...
This is a controlled, open-label, randomized phase- II trial (1:1 randomization) investigating 5-FU + aflibercept and 5-FU + oxaliplatin in elderly and frail elderly patients with mCRC sch...
A randomized trial has been designed to determine if this complex intervention can significantly decrease the risk of unplanned readmissions in this very elderly population, compared with ...
The prevalence of various diseases in the elderly has increased the use of drugs, which is coupled with age-related physiological changes and places the elderly at risk for multiple side effects. The ...
The concept of self-care in the elderly has been frequently associated with autonomy, independence and personal accountability. Self-care practices are a result of individual lifestyles and paths adap...
To examine factors associated with frailty among the young-old elderly (YOE) and old-old elderly (OOE).
Inadequate hydration in the elderly is associated with increased morbidity and mortality. However, few studies have addressed the knowledge of elderly individuals regarding hydration in health and dis...
Increase in the elderly population and early retirement imposes immense economic burden on societies. Previous studies on the association between medical expenditure and working status in the elderly ...
Housing arrangements for the elderly or aged, intended to foster independent living. The housing may take the form of group homes or small apartments. It is available to the economically self-supporting but the concept includes housing for the elderly with some physical limitations. The concept should be differentiated from HOMES FOR THE AGED which is restricted to long-term geriatric facilities providing supervised medical and nursing services.
Exudates are fluids, CELLS, or other cellular substances that are slowly discharged from BLOOD VESSELS usually from inflamed tissues. Transudates are fluids that pass through a membrane or squeeze through tissue or into the EXTRACELLULAR SPACE of TISSUES. Transudates are thin and watery and contain few cells or PROTEINS.
A chronic and relatively benign subepidermal blistering disease usually of the elderly and without histopathologic acantholysis.
Older adults or aged individuals who are lacking in general strength and are unusually susceptible to disease or to other infirmity.
A disease of elderly men characterized by large osteophytes that bridge vertebrae and ossification of ligaments and tendon insertions.