The Patient in the Respirator

Abstract

MR. S., AGED THIRTY-TWO, came to us after an attack of poliomyelitis which left the greater part of his body paralyzed. He has been in a respirator for nine months. We have learned much from our experience with him which might have value for other nurses who will be required to give nursing care to patients of this type. Baths may be given by placing a small bath basin inside the machine, usually between the patient's legs, one nurse working from either side. In this case, however, since the loss of pressure due to. four portholes being opened at once is too great a strain upon the patient, a more suitable method has been devised. The bath basin is filled with very warm water and placed on the bedside table which is drawn close to the respirator. The bath towel is placed inside the machine and left there throughout the bath. The rather small washcloth must be squeezed quite dry, to prevent the water dripping out as it is taken through the porthole. One half of the anterior surface of the body is bathed before the nurse proceeds to the other side, and there is a rest interval between the two halves of the bath. The back may be washed and rubbed with the aid of an orderly who draws the patient toward him as the nurse works from the opposite side. The nurse works very swiftly when four portholes are open. Small draw sheets, which fit across the mattress of the respirator without too much surplus to tuck in, have been made in the sewing room. These are changed every day or oftener if necessary. The large sheet is changed only every other day. Six people are needed to do this as quickly and efficiently as possible, since the patient is taken out of the respirator during this procedure. The nurse should have everything in readiness before the respirator is opened. All pillows and sandbags used for support should be removed through the bedpan porthole so that there will be no danger of their slipping out to block the runner when the carriage is being returned. A large sheet folded in half lengthwise fits the respirator mattress very well as the lower sheet. The upper end is folded in small pleats for approximately twentyfour inches, while the lower end is rolled up to meet the folds at the top. The clean draw sheet and small rubber sheet are folded together ready for use after the bottom sheet is changed. Three orderlies are needed to lift the patient, and two nurses to change the sheet. As soon as the carrier comes out, the nurses on one side of the patient and the orderlies on the other side loosen and remove the bottom sheet. The clean sheet is started at the top. Special care is taken to get it tucked in smoothly under the neck and shoulders. This is done by