Page 13 - Mobility Management, November 2018

allow the ambient air to rush onto that surface and refresh it — to take out that hot, humid, stale air that’s been sitting between the patient and the surface, and bring in fresher, less humid air that’s more equal to the environment.”
Choosing seating that manages a client’s microclimate (see sidebar) can also help; so can self-care best practices such as cleaning up food spills or incontinence accidents as quickly as possible so the client’s skin isn’t exposed to those fluids for lengthy times.
“The faster a client is removed from a wet surface, the more beneficial,” Bowden said. “Problems just compound when you introduce moisture into the microclimate.”
6. MANAGING MICROCLIMATE IS A BALANCING ACT
Perhaps the biggest challenge to managing microclimate is
the balancing act between keeping the wheelchair user safe
and keeping that user mobile, functional and active. Sure, microclimates could be easier to manage if clients remained in climate-controlled, indoor settings at all times and never exerted themselves. But how functional or meaningful would that kind of existence be?
“It needs to be a balancing act,” Bowden said, while suggesting
that clinicians also factor in other risk factors as part of managing microclimate. “What is their skin like during the day, and how does it present itself? Is it at high risk, moderate or low risk? You have to think about that to evaluate how sweating will impact them. Someone at low risk who has high skin integrity is going
to be at low risk with sweating and moisture. With someone who has had multiple pressure injuries and is very bony, you’re going to worry about moisture a lot more, and you’re going to ask, ‘Do we need to take action?’
“If it gets to the point that the user is heavily sweating, and pressure reliefs are not working, that’s when you need to worry about their microclimate and say, ‘Shall we evaluate whether we should get them off the seating system and get their temperature down again?’ One of the clinician’s roles is to say, ‘How can I position someone in a way that they are safe and comfortable and will not further endanger themselves in the chair, while balancing the fact that this might be someone who has trouble regulating their temperature?’ These clients can swing from hot to cold very quickly. So the clinician’s struggle is to answer what that balance is, what kind of positioning they can [achieve], and when they should favor microclimate more. We do need to start factoring microclimate into the decisions that clinicians make for their patients.” m
THE SYSTEM WITH...MORE HEART
QLK is the only wheelchair docking system that gives everyone true peace-of-mind.
FEEL THE LOVE AT: QSTRAINT.COM/QLK-150
MobilityMgmt.com
MOBILITY MANAGEMENT | NOVEMBER 2018 13