Spinal injury rehabilitation is an important part of recovery after Spinal injury. It is expected that after obtaining Critical care at an acute care hospital, Spinal injury patients come to NIKISA Geriatric hospital for further recovery. NIKISA hospital will not admit the Spinal injury patients immediately after Spinal injury. The goal of Spinal injury rehabilitation is to help the Spinal injury affected patient to relearn skills which was lost with  the Spinal injury. Spinal injury rehabilitation will help to regain independence and improve the quality of life of the Spinal injury patient. The severity of Spinal injury complications and each person’s ability to recover vary widely.

NIKISA’s approach to Spinal injury rehabilitation

NIKISA spinal injury rehabilitation plan will depend on the part of the body or type of ability affected by the Spinal injury. Spinal injury recovering patients are divided into patients right at the time of admission to NIKISA Hospital.

1. Patients who require Critical care: These patients are the ones who require high degree of care. Following are the criteria used to recognise Spinal injury patients who require critical care;
   • Completely immobile and are in Supine position.
   • Discharged from acute care hospital with   cannula, Riels tube, and catheters.
   • The acute care hospital has done Tracheostomy.
   • Patients requiring Medical Oxygen, either continuous or on intermittent basis.
   • Spinal injury patients who require suctioning on account of Phlegm build-up
2. Spinal injury patients who are weak and completely bed ridden and therefore cannot communicate in an understandable manner with service providers.
3. Patients who do not require critical care.
   • Patients who do not come under the above criteria.
   • Patients who can be mobilised on wheel chair or on foot with or without support.
   • Patients who are normal except for Spinal injury related mobility of limbs and speech. They are able to eat normal food and do not require high degree of medical supervision.

Treatment of Spinal injury patients who require Critical care:

1. These patients are admitted to Critical care section till they attain a non-critical stage.
2. Critical care section is almost like an intensive care unit and has the following facilities.
   • Patients are provided with Fowlers bed.
   • Continues Medical oxygen supply facility is available in this section.
   • There are duty doctors at this section on 24 X 7 basis.
   • Patient monitors, suction facility is also available.
   • There is a minor OT in the Critical care section to do procedures on emergency basis.
   • Required activities like Chest physiotherapy, Suction etc are performed on bed side. 
   • Visitor entry is also restricted.
   • Emergency cart is readily available. Emergency medicines provided by the hospital are to be replenished by the patient’s caretakers.
   • Medicines and other consumables can be bought from the Hospital Pharmacy or from any other pharmacy and provided to the treating doctors and nurses.
   • The Nutritionist guides the patients and their families on dietary requirement of the patients. Patients can get their diet from their homes. External catering services are also available. 
3. Once, the patients recover from critical condition, they are shifted to wards, specially created for rehabilitation of Spinal injury patients.  In case the patient turns out to be more critical, the family members will be requested to shift the patient to an acute care hospital for further acute care. 

Treatment of Spinal injury patients who do not require Critical care

1. Spinal injury patients who do not require Critical Care in the judgement of NIKISA are moved to the wards created for Spinal injury recovering patients.
2. Physical facilities at the Spinal injury rehabilitation wards:
   • All the wards are provided on Single Occupancy basis.
   • These wards are fully equipped and have been designed keeping in mind the requirement of Spinal injury patients.
   • Corridors have been provided with rails for holding while walking.
   • Toilets are at ground level for easy mobilization of patients both on foot and also on wheel chairs.
   • Grab bars have been provided in bathroom and toilets.
   • Bed required for the convenience of patient will be provided. Option of utilising Fowler beds with air bed or luxury single bed or luxury double bed is provided to the patient.
   • Every ward is provided with attached bath rooms with hot and cold-water supply, western commode, Meals table, T V, Fridge, Nurse call facility, newspaper and Drinking water.
   • Services of Nurses and ward boys is available on 24 X & basis.
   • The wards are centrally air conditioned. (on account of Covid 19 restrictions AC is not being used for the present). Every ward is provided with pedestal fan.
   • Some rehabilitation equipment are provided at ward itself depending on the requirement of the recovering patient.
3. Medical and Diet care:
   • The patients are examined and treated by a team of doctors on a daily basis. In addition, whenever required our Specialists provide consultation to the patients.
   • Proper nutrition and taking medication as per the prescription of nutritionist and the treating doctor respectively is of paramount importance in Spinal injury recovery. Our Nutritionist will guide the patients and their families on dietary requirement of the patients. Patients can get their diet from their homes. External catering services are also available. 
   • Usually, Spinal injury patients suffer from disorders like diabetes and hypertension. We monitor the vital parameters.
   • Most Spinal injury patients get into a sedentary status, especially in-home settings and many develop secondary complications arising out of poor hygiene. Bed sores, urine and incontinence are very common in recovering Spinal injury patients; therefore, we monitor the patients for these secondary complications and take remedial actions.
   • Secondary Injuries arising out of unexpected fall is very common in Spinal injury patients. When untrained personnel handle Spinal injury patients some might suffer from limb and girdle fractures.   
   • Medicines and other consumables can be bought by patient’s caretakers from the Hospital Pharmacy or from any other pharmacy and provided to the treating doctors and nurses.
4. Physiotherapy:
   • A separate Physiotherapy section has been created to aid speedy recovery. To know more about Physiotherapy facilities available please click Physiotherapy section
   • Physiotherapy is provided by a team of Physiotherapists.
   • Progress in physiotherapy and rehabilitation is measured and recorded on a week to week basis.
5. Cognitive and emotional therapy:
   • Therapy for cognitive disorders. Cognitive therapy helps the patient to get back lost cognitive abilities, such as memory, processing, problem-solving, social skills, judgment and safety awareness. Our Psychologist provides these services.
   • Psychological evaluation and treatment. Emotional disturbance of Spinal injury patients will be addressed with proper counselling. Our Psychologist provides these services.

Non-Clinical Services:

1. Non clinical services towards the patients like bathing. dressing, spoon feeding. nasal feeding, toilet assistance, changing of diapers will be attended by the hospital staff.
   • Toiletries and towels will not be provided by the hospital. But, they, can be purchased at the pharmacy.
   • Care takers of patients can stay at the hospital at the ward assigned to the patients. Except providing a foam bed nothing else will be provided to the patient attendant.

Spinal injury rehabilitation takes time

Recovering from a Spinal injury can be a long and frustrating experience. It’s normal to face difficulties along the way. Dedication and willingness to work toward improvement will help you gain the most benefit.