Zero falls. Against a historical rate of 4 falls every 1000 days per patient. Thus, the smart socks to be worn during hospitalization in those at risk may in the future limit the risk of trauma for people affected by stroke, suffering from other neurological diseases or undergoing orthopedic and neurosurgical interventions. To rattle off these figures is a research that has seen the nurses of the Wexner Medical Center of the University of Ohio as protagonists, conducted on almost 570 patients at high risk of falling, admitted to the Ohio State’s Brain and Spine Hospital.
The smart socks adopted in the experiment, coordinated by the head nurse Tammy Moore and described online at Journal of Nursing Care Qualitythey are called Pup (Patient is Up) by Palarum. Patients were selected on the basis of the possibility of experiencing traumatic events of this type: all subjects at greater risk were offered stockings until discharge or at the end of the period in which they were most at risk. No other alarm system was adopted to alert those who assisted these people.
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How the control works
The socks that are worn by patients (in the future they could be used not only inside the hospital but also in people at risk who live alone at home) are equipped with pressure sensors perfectly integrated into the fabric. These are able to understand if and when the person gets up, leaving the bed, and transmit the information over a closed, wireless system. As soon as the patient moves, the signal passes on a tablet in the room but above all reaches the typical “nurse’s room” on the floor, in addition to directly alerting those in the ward through the electronic badge.
This apparatus of imperceptible signals immediately warns the three paramedics closest to the room where the patient is moving, with a “cascade” reaction that after only one minute in case of no reaction passes to other nurses and, in the absence of a response to the whole department. Obviously, as happens in any hospital, as soon as the paramedic enters the patient’s room the signal goes off.
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False alarms almost absent
In the period of observation of the patients (the enrollment of about 2500 people was expected then the research was suspended due to Covid-19), the system detected about 5000 noteworthy events: 99.8% of these were actually associated to movements potentially at risk and therefore with the need for support. In short: socks with sensors, in addition to being useful and easy to wear, hardly deceive the real need for support for these extremely fragile patients, who could have a substantial deterioration in their health by falling. Smart socks could be added to bed or chair pressure sensors in the future, which can be of great help if sufferers suddenly get up to go to the bathroom. But their use appears to be characterized by numerous meaningless calls, perhaps linked to simple movements of the body on the bed itself. The risk is that a “wolf, wolf” effect is created because the carer does not consider the call to be reliable, delaying the actual reaction of the staff. By limiting the “false positives”, one could perhaps move with greater certainty on the reasons for the “call”. In the study with socks, the median response time of the paramedics after the signal path was 24 seconds.
Attention at home
While waiting for further data to confirm the actual usefulness of these socks, it should always be remembered that even at home (and not only in the hospital) falls can occur with consequent trauma and fractures. In general terms, in addition to eliminating carpets, moving to the bathroom of the elderly as well as to the hospital can be a risky moment. The elderly go in the toilet especially at night and on the street they must not find tables, stools or anything else. In the tub and shower, as well as obviously on the floor that surrounds them, “protective” rugs are needed. Surfaces in contact with water show those with rubber suction cups at the bottom. Access to the bathroom must be simple, perhaps with an opening door. But a shower is preferable, preferably with a child seat to avoid slips. The grab bars for quick grip are fundamental for the elderly person, especially if they have movement or strength problems.
Watch out for the light
Finally, let’s not forget two aspects: good ambient lighting is essential. Therefore, switching on the light must be immediate and simple, precisely because the risks increase at night. The switches must be within reach and avoid wires running on the floor. And it is better to pay attention to the shoes. At home it is always necessary to wear shoes that prevent slips: better not to rely on the classic slippers that can “slip”, it is better to use closed ones.
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