Airpulse PK Case Study at Shepherd Center – Catastrophic Care Hospital
March 21, 2005
Medical History and Level of Function:
Your client, G. Tomlin, was diagnosed with C5 complete quadriplegia in 1985, due to a diving accident. This condition has resulted in partial paralysis of the muscles of the upper extremities and complete paralysis of the stomach, back, and lower extremities. Your client has impaired ability to feel his body below the level of injury. He has a history of bilateral ischial decubitus ulcers, and has a decubitus ulcer under the right foot at the 5th metatarsal. Since the time of his injury, he has used a power wheelchair for his mobility and power tilt or recline seating systems for weight shifts.
Level of Function:
He is dependent for dressing, bathing, transfers, and sitting balance. His wife uses a patient lift for transfers. He is modified independent with power wheelchair mobility using a joystick. He is modified independent for weight shifts and uses a power tilt and recline seating system. He performs regular weight shifts but has been having problems with skin breakdown for the last 1.5years since receiving a new power w/c. He drives a van with a lift. He drives the van with specialty controls. He works full-time, but has been working from his bed, since his upright mobility has been restricted too. Before his skin breakdown, he could sit up to 14 hours a day. He also has bilateral planter flexion contractures. His left upper leg is shorter than the right, due to a femoral head resection in 1986. His upper body tends to lean to the left.
Mr. Tomlin has an Invacare Torque powered wheelchair with an Amy power tilt and recline seating system. He has used a variety of cushions to help prevent skin breakdown; however, none have helped prevent his problems until now. Cushions that have been ruled out include Jay gel cushions, ROHO High Profile, and the Ease alternating air cushion. When Mr. Tomlin was first seen at the Shepherd Center Seating and Mobility Clinic, he had open wounds under bilateral ischial uberosities and his sitting time was only a few hours a day. He was using the Ease alternating air cushion, but was still unable to heal his wounds. He needed to work from his bed. He was loaned an Airpulse alternating air cushion for one month and his skin is now healed. He is starting to sit for over 8 hours a day, which is allowing him to return to work. The Airpulse cushion is being recommended, since it allowed Mr. Tomlin’s skin to heal and allows him to sit closer to his accustomed time. Mr. Tomlin requires the following equipment repairs and modifications for safe and reliable wheelchair mobility.
Airpulse PK cushion with extra cover. This is the only cushion we have identified to allow your client to sit for 8 or more hours a day without skin breakdown. This cushion will help your client avoid costly surgery to correct pressure sores. Your immediate attention to these items, which are essential to your client’s good health, independence, and safety is appreciated.
Robert Miller, M.D.
Robert Meehan, P.T.
See the original report when you click here: Case Study: Shepherd Center