When can we sit the patient up? – Karen Barnard Interview

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Karen Barnard is the Advanced Trauma Nurse Practitioner at The Royal Berkshire Hospital and has been in this post for around 9 years.


We’ve discussed this with our Spinal Consultants and unless it is otherwise specified in the notes that they have a very unstable fracture, we now on admission are allowed to put our patients up to 30 degrees because that is also a very good position for the patient’s chest wise as well. We have that agreement that we can, unless otherwise stated, sit the patients up to 30 degrees on admission to the ward.

Certainly, from a patient’s chest point of view, if they are laying flat they tend not to breathe as well. They don’t breathe as deeply whereas if they are sat up to 30 degrees then they tend to be able to breathe better so that can help to prevent chest infections and you certainly don’t want chest infections in patients who have got spinal fractures because coughing can be painful and problematical for them. Also, if they are allowed to eat and drink then trying to eat or drink whilst lying flat is very difficult and very uncomfortable in the first instance but it also means they are at risk of aspirating and then this can lead to the patient developing aspiration pneumonia where they can end up in an intensive care unit on a ventilator and obviously you don’t want patients to do that.

Patients and nurses certainly don’t want this so if you can put them up to 30 degrees then it is better all round for the patient and also from the point of view that at 30 degrees the patient can see a little bit of what’s going on rather than just lying flat staring at the ceiling. Plus at this angle they can see their visitors better and their visitors can see them so it is better for them.