First, a scientific and reasonable diet
In the process of recovery, the wounded need to supplement enough nutrition. Scientific and reasonable diet can alleviate the pain of the wounded and promote the healing and functional recovery of the wound. Especially in the earthquake, a large part of the wounded are fracture victims, and the rehabilitation of fracture victims is a very important part of the physical rehabilitation of the wounded after the earthquake.
As the saying goes, "it hurts the bones for a hundred days." Compared with other diseases, fracture healing is a long process. At this time, in addition to rest, we should also make good dietary preparations to relieve pain and promote fracture healing. If the diet is not well regulated and the nutrition can't keep up, it will not only affect the patient's tolerance to fractures and soft tissue injuries, but also affect the healing of bones and wounds and the recovery of the sick body. Therefore, more efforts should be made in diet.
Fracture patients need to eat some digestible, nutritious and light food; It is advisable to adopt a diet with high calorie, high protein and high vitamins, eat more animal liver, abdomen, chicken, eggs, fish, shrimp, milk and bean products, and eat more vegetables rich in vitamins such as tomatoes, amaranth, vegetables and radishes, as well as various fresh fruits, so as to achieve comprehensive nutritional supplement and promote callus growth and wound healing.
Adhere to a reasonable diet after fracture, eat foods rich in calcium, protein and vitamins, and increase the absorption and utilization of calcium. Adequate protein and vitamins can meet the needs of the body, which is beneficial to bone repair and effectively shortens the process of fracture healing. Also pay attention to avoid blind calcium supplementation, eat more meat and drink more bone soup, partial eclipse, food is not easy to digest, drink less water and eat more sugar.
Second, careful nursing and psychological support.
After the earthquake, the wounded suffered serious physical and mental injuries and blows. The wounded are inconvenient to move, and even can't take care of themselves in serious cases. Therefore, oral hygiene care and skin care should be done for the wounded. Help the wounded to rinse their mouths frequently and apply glycerin to protect their chapped lips. For patients who stay in bed for a long time, especially paraplegic patients who are fixed with plaster, the skin should be kept clean and dry, and the sheets should be flat and wrinkle-free. Paraplegic patients should turn over every two hours and massage their compressed parts with 50% safflower alcohol or talcum powder to prevent bedsores.
We should do a good job in psychological treatment of the wounded, care for and comfort the wounded, alleviate their pain and enhance their confidence in overcoming the disease. Elderly patients, people with weak constitution or poor psychological endurance should strengthen psychological counseling.
Third, the rehabilitation of the wounded with upper limb fracture
The wounded should strengthen functional exercise, on the one hand, to prevent functional atrophy of the wound, on the other hand, to speed up recovery. Of course, all exercise activities should be carried out without affecting wound healing. Exercise gradually from small to large, don't be impatient.
For the wounded with upper limb fracture, many people lay down and rest after playing more than a dozen plaster splints, thinking that rest is a good way. In fact, rehabilitation training should be carried out on the second day after fixed treatment, especially for workers living in rural areas. Because they are used to regular work, stopping suddenly will lead to worse results. For the injured arm, the first rehabilitation exercise is aerobic exercise, such as jogging. If you can't run, go quickly or combine walking and running. This can effectively promote the blood circulation of the whole body, make the injured part get better nutrition, and at the same time, clean up the metabolic waste in time. In addition, effective strength exercises can be done in other parts of the body, such as sit-ups, waist turns, squats, etc., except that the injured limb needs to be temporarily fixed and strenuous activities cannot be done.
For the injured limb, under the premise of not affecting the fixation, appropriate activities can be carried out, such as clenching fists, bending wrists, flexing and stretching forearms, shrugging, etc. These actions will promote wound healing very well. Hands can also be placed at will, as long as the five fingers are opened as far as possible and forced backwards for 3-5 minutes each time, 5-6 times a day. Specifically, the rehabilitation process is as follows:
1. 0 ~ 4 weeks after operation: passive activities of healthy fingers, wrists, elbows and shoulders were carried out; Raise the affected limb to reduce edema, protect the fracture site (splint plaster fixation) and maintain joint function; Prevent contracture and stiffness of metacarpophalangeal joints and interphalangeal joints, prevent deformity and maintain the functional position of hands.
2. 4 ~ 6 weeks after operation: reduce the adhesion between tendon and surrounding tissues; Exercise flexor digitorum profundus tendon and flexor digitorum superficialis tendon respectively to improve the function of metacarpophalangeal joint and interphalangeal joint; Conduct active activity training to restore the flexibility and coordination of fingers; Physical therapy, microwave, hyperthermia, frequency spectrum and other treatment methods can be used.
3. 6~7 weeks after operation: the external fixator was removed; Early active exercise without affecting fracture healing and causing pain; Flexion of metacarpophalangeal joints and interphalangeal joints to obtain good grasping ability and improve finger extension ability; Increase the flexibility of fingers and improve the function of hands.
4. 7 ~ 12 weeks after operation: strengthen muscle strength, carry out progressive resistance exercise and increase tendon slippage; Coordinated training with both hands can correct joint contracture, and can also be combined with orthopedic braces for passive exercise.
5. Functional exercises with different grip methods and grip strength were performed 12 weeks after operation to help patients recover their dynamic working ability.
Fourth, the rehabilitation of the injured with thigh fracture.
The thigh fracture is a very big injury. Due to the special structure and position of the thigh, the treatment after the fracture will be relatively difficult. Because the strength of the thigh is relatively large, the fixation is very difficult, the fixation time will be relatively long, and the fixation strength is also large, which will have a serious impact on the activities of the whole lower limb. Therefore, rehabilitation after thigh fracture is more important. Premature exercise can easily lead to secondary fracture; If rehabilitation exercise is not carried out as soon as possible, the thigh muscles will shrink due to long-term fixation, which will cause other damage to health.
After the thigh fracture, you must first accept the doctor's fixation and treatment. In addition, it is necessary to start rehabilitation exercise as soon as possible to prevent muscle atrophy and functional degradation. In particular, functional degradation will cause more troublesome health problems.
During the fixation period, the lower limbs can perform ankle flexion, extension, rotation, circle and other activities to tighten and relax the lower limbs; With the healing of bones, it is necessary to gradually start the knee flexion and extension movement, hip flexion and extension movement and adduction and abduction movement without load. If only one leg is broken, then the other leg can carry out all-round activities, such as lying on your back to simulate riding on one leg, or holding both ends of the rubber band with both hands, putting it on the sole of your foot in the middle, and then doing kicking.
On the basis of good reduction and fixation, the earlier the functional exercise, the better. Functional exercise can promote blood circulation, reduce muscle atrophy, eliminate soft tissue swelling, prevent osteoporosis and accelerate fracture healing. Specifically, the functional exercise of bone injury can be divided into three periods: early, middle and late.
1. The main form of early exercise is rhythmic muscle contraction and relaxation. The upper limbs can clench fists, cantilever and lift shoulders, so that the muscles of the whole upper limbs contract and then relax. Lower limbs can make ankle flexion, quadriceps femoris contraction, make the whole lower limbs exert force, then relax and step by step. Don't do joint exercises in the early stage.
2. In the middle stage, the local swelling and pain disappeared, and the callus gradually increased due to the fibrous healing of the fracture end, which was relatively stable and not easy to shift under the splint package. In addition to continuing muscle contraction, you can also do some active joint flexion and extension activities, from one to more joints gradually increase, patients with lower limb fractures can walk in bed, and the injured limbs gradually bear the weight.
3. In the future, you can do some work that you can, so that all joints can get comprehensive exercise. Patients with lower limbs can gradually walk under the protection of crutches until the fracture is firmly healed. Attention should be paid to prevent activities that are not conducive to fracture healing, such as humeral abduction, adductor adduction, forearm fracture rotation, etc.
Verb (abbreviation of verb) Rehabilitation of traumatic brain injury
Patients with brain trauma are more prone to mental retardation sequelae, so attention should be paid to starting various functional training and rehabilitation nursing as soon as possible. It is necessary to strengthen basic nursing and training in daily life, personal hygiene, diet and sleep. Especially for people who can't take care of themselves, they should be trained in living habits to prevent their mental state from continuing to decline. As long as the patient is not seriously demented, he should be guided to defecate regularly and develop the habit of defecating regularly.
Limb massage should start from the distal joint, and according to the normal functional direction of the limb, passive movement should be carried out first. If the patient is unwilling to move because of pain, he should be comforted and encouraged at this time and strengthened slightly. Activities should start with a short amount of exercise and gradually increase, and encourage independent activities to resume as soon as possible.
For aphasia patients, adhere to the principle of easy first, then difficult, step by step, repeated practice and perseverance. Start with the speech function that the patient has the least damage, such as communicating with body language, eyes and gestures, and then train with specific items, words, words and short sentences. In speech training, we should start pronunciation practice as soon as possible, and also carry out intellectual training and homework training as soon as possible.