Patient discussions
Patients, families, and carers require full education on all aspects of spinal cord injury management.[149][150][151][152] A written management plan should be agreed with the patient, and shared with the patient and all carers. This should include full details of management of autonomic dysreflexia, starting thromboembolic prophylaxis (if immobilised for bed rest or admitted for medical illness or surgery), pressure ulcer prevention, nutritional requirements, bowel management, bladder management, physiotherapy, and stenting.
If opioid treatment is being considered for intractable chronic pain that has not responded to non-pharmacological and non-opioid pharmacological therapies, discuss with the patient the realistic benefits and known risks of opioid therapy, work with them to establish treatment goals for pain and function, and explain that opioid therapy will be discontinued if benefits do not outweigh risks.[94]
Patients with chronic spinal cord injury are often keen to try new treatments, and guidelines are available to patients who are considering participation in clinical trials for any emerging therapy. ICCP clinical trials information for patients Opens in new window
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