- Back care:
a) Patient should lie in lateral position.
b) Change left to right lateral position and back to left lateral every 2 hourly.
c) After changing posture, tap patients back with palm for 1 minute to remove any saliva or mucus in throat and chest. This helps in preventing pneumonia.
d) Apply Doctor’s spirit all over back, leave for 30 seconds for drying, and apply Nycil powder all over back and buttocks (two times daily 8 a.m. and 8 p.m.)
e) When patient is awake, make the patient sit for 1-2 hours with help of pillows or someone can sit behind for support.
f) Air or water filled mattress can be used.
- Feeding through feeding tube:
a) Prop up patient’s head and back by putting 3-4 pillows behind.
b) Raise the tube nozzle end above head level. Open feeding tube nozzle cap.
c) Connect 50 ml syringe (with plunger). Aspirate (suck out) fluid through the tube. Goal is to make the stomach empty before giving fresh feed.
d) Remove plunger of syringe. Syringe will now work as a funnel.
e) Pour liquid feed upto 50 ml mark and let liquid drain down the tube. Do this 3 times so that 150 ml total feed is given.
f) Do not push liquid using plunger of syringe and let liquid drain by gravity.
g) Pour 50 ml plain water in syringe to clean the tube.
h) Close nozzle cap.
i) Patient should be kept in propped up position for 1 hour more so that liquid descends from stomach to intestines. Any air going inside stomach will come out with belching. This will prevent regurgitation.
j) Tablets should be finely crushed and then dissolved in 20-50 ml water.
k) If tube gets blocked: attach syringe filled with 10 ml water, first try to suck and then gently push water. This will dislodge the blocking particle.
l) Feeding tube can be changed after 1 month.
- Urine tube (Foley’s catheter) care:
a) After washing hands, clean the portion of tube where it meets the genitals with warm soapy water. Rinse again with clean water and then dry it. This should be done daily.
b) Urine tube should be changed after 2-3 weeks
- General care
- Patient should pass stool every 1-2 days. Use bed pan for stools.
- In case of constipation, laxatives like Syrup Cremaffin or Duphalac can be given.
- Physiotherapy of paralyzed limbs should be done two times daily by a trained physiotherapist. In between, patient and relatives can do active and passive exercises as advised by the physiotherapist.
- Daily mouth cleaning with saline water, and if possible teeth brushing should be done.
- Patient should be sponged with lukewarm water daily. Do clean underarms and genitals daily.