Moving a patient with head injury

[PhysioArgos]

Hi to all,

the patient is stable and in a coma since 2005. As a part of his dayly routine I want to see if it is possible to start moving him outside from his home by car. Now, everytime we need to move him for long distances, we have to get an ambulance -so his is in liying possition.

The parents have a car sitable to suit a weelchair. My consern is how we can stabilise his body -especially his neck- in the weelchair and if is right to move a comatose patient in a sitting possition in a car.

Thanks you all,
Argos

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[Fyzzio]

Hi,
just a few questions first :
Does the patient have a wheelchair already? And if not, why not?
Why does he have to be in the lying position for transports?
What is his current sitting regime or is he lying in bed all day?

For any seated activity, you will need a customised wheelchair. Not sure about Greece, in NZ we have specialised Wheelchair and Seating Assessors (usually Physios or Occupational Therapists), who can perform an assessment and then advise on and trial suitable chairs.

And if your patient is lying flat since 2005, you will have to start on a very slow and gradual process of sitting habituation = getting the brain, the heart, the joints and the skin used to changes in blood flow and pressure, before you can even think about taking him for outings. Bone density, in this case, might also be a problem, so I would get medical clearance first.

Regards,
Fyzzio

[PhysioArgos]

Hey Fyzio,
many thanks for your help.

I'm very sorry I didn't explain mayself in a better way The patient is using a weelchair of course and we have being out of home many-many times. He is also capable to stand (straped in that machine which name I don't know in English ) for more than 30 min without any problem.

I see that I can secure his weelchair in his parent's car but my problem is that I can't find a satisfactory way to stabilise his neck -I'm very concerned for a ,most unfortunate, car accident. Minerva neck brace is what I'm thinking so far but I don't have any experience on that field yet...

[PhysioArgos]

Hi,
just a few questions first :
Why does he have to be in the lying position for transports?
What is his current sitting regime or is he lying in bed all day?

I didn't answer your questions!

-The patient have never before traveled in sitting position because, being in a comma, he can't control his neck. Thus the ambulance crew always found easier/safer to move him lying.

-He is on bed all day (changing sides every 3 hours) in only exception of an hourly sitting position in the wheelchair and the time spent standing (30'-90', minimum 4 times/week).