S - SKIN INTEGRITY
Prescribe wheelchairs and seating systems specific to the individual with SCI that allow the individual to redistribute pressure sufficiently to prevent the development of pressure injuries. Obtain specific body measurements for optimal selection of seating system dimensions (postural alignment, weight distribution, balance, stability, and pressure redistribution capabilities). Prescribe a power weight-shifting wheelchair system for individuals who are unable to independently perform effective pressure relief. Use wheelchair tilt-in-space and/or recline devices effective enough to offload tissue pressure. Use standing wheelchairs to remobilize individuals with an existing pelvic pressure injury. Full-time wheelchair users with pressure injuries located on a sitting surface should limit sitting time and use a gel or air surface that provides pressure redistribution. (Adapted from PU-PVA 2014, p.58; Level A)
Prescribe wheelchair seating systems for each individual with an SCI individualized to anthropometric fit that:
- provide optimal ergonomics
- provide maximal function
- redistribute pressure
- minimize shear
- provide comfort and stability
- reduce heat and moisture
- enhance functional activity
- inspect and maintain all wheelchair cushions at regularly scheduled intervals
- replace wheelchair seating systems that are no longer effective.