brain, spinal cord, and nerve disorders
Locked In Syndrome
Long term care
Like people in a coma, people in a locked-in syndrome require comprehensive care. Providing good nutrition ( Overview of Nutritional Support ) is important. People are fed through a tube inserted through the nose and into the stomach (called tube feeding). Sometimes they are fed through a tube inserted directly into the stomach or small intestine through an incision in the abdomen. Drugs may also be given through these tubes. Many Problems Due to Bed Rest result from being unable to move, and measures to prevent them are essential. For example, the following can happen: Pressures sores:Lying in one position can cut off the blood supply to some areas of the body, causing skin to break down and pressure sores to form. Weak muscles and nerve damage:When muscles are not used, they waste away (atrophy) and become weak. Lying in one position for a long time can put enough pressure on a nerve to damage it. Contractures:Lack of movement can also lead to permanent stiffening of muscles (contractures) causing joints to become permanently bent. Blood clots:Lack of movement makes blood clots more likely to form in leg veins. Pressure sores can be prevented by frequently repositioning the person and placing protective padding under parts of the body that are in contact with the bed, such as the heels, to protect them. To prevent muscle weakness, nerve damage, and contractures, physical therapists gently move the person’s joints in all directions (passive range-of-motion exercises) or splint joints in certain positions. Preventing blood clots includes use of drugs and compression or elevation of the person's legs. Moving the limbs, as occurs in passive-range-of-motion exercises, may also help prevent blood clots. Because people are incontinent, care should be taken to keep the skin clean and dry. If the bladder is not functioning and urine is being retained, a tube (catheter) may be placed in the bladder to drain urine. Catheters are carefully cleaned and regularly examined to prevent urinary tract infections from developing. 