A: When choosing a pressure cushion there are a number of things to be considered:
INTRINSIC FACTORS
- Age and general health – any relevant ageing issues
- Body weight
- Sitting balance
- Level of physical function and independence – transfers, propulsion technique, ability to pressure relieve
- Pain and its impact in sitting
- Musculo-skeletal issues – postural deformities (fixed or flexible), contractures, range of movement, abnormal tone and spasticity, muscle wasting (atrophy)
- Skin integrity issues – circulation status, history of skin breakdown, scarring
- Continence – bowel and bladder management as moisture etc will impact on skin integrity
- Other psycho-social issues
EXTRINSIC FACTORS
- Pressure – vertical forces due to gravity exerted when sitting especially acting through bony prominences
- Shear forces – horizontal forces acting between a body and its supporting surface.
- Current equipment, e.g. Wheelchair and its setup
- Care situation
- Lifestyle – employment, study, recreation
- Financial issues and funding sources
- Care and maintenance of equipment – client reliability
Once these factors have been determined only then can a suitable cushion be prescribed.
Observed constantly to promote healthy skin condition and healing.