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Hospital Protocol: CRPS Patient: Handle With Care!
Complex Regional
Pain Syndrome (CRPS) is a chronic condition characterized
by severe burning pain, pathological changes in bone and skin,
excessive sweating, tissue swelling and extreme sensitivity
to touch. People afflicted with CRPS are extraordinarily
sensitive to certain stimuli, such as touch, movement, and
injections.
Patient Tips
1. Bring a written copy of your medication regime. It is important
to verify whether your medication regime can be taken care
of solely through use of the hospital's pharmacy. Some medications
may not be part of the hospital's formulary.
2. Avoid having ice applied to the CRPS-affected limb
3. Instruct all hospital staff to always ask before touching
you!
4. Request that the surgery protocols be adjusted so that
the pre-op shave be done after anesthesia (catheter is in
place for epidural or whatever). It feels like a lawnmower
has been run over your legs when they shave without anesthesia.
Patient Room
1. Whenever possible patient should be in a quiet part of
the hospital
2. In a semi-private room, patient should be in the second
bed to avoid inadvertent bumping
3. A Zone-Air bed should be used (adjust mattress pressure
to patient preference)
4. Heat and air conditioning should be well regulated
5. Standing orders should be issued for patients to have warm
blankets
6. Foot Cradle to hold bed linens off body area (will diminish
tactile stimuli)
7. Frequent linen changes may be necessary due to hyperhidrosis
(increased sweating).
8. Allow family members to bring in clean sheet and pillowcases
for patient. Hospital sheets are not soft and can irritate
the skin.
9. Place a sign above bed designating affected limb
Procedures
1. Perform a phlebotomy on unaffected limb only
2. Use Pediatric needles (any trauma can cause the spread
of CRPS to a new site)
3. Warm Alcohol or Betadine wipes with warm running water
on outside of package before opening package (these wipes
can be very cold to the patient)
4. If PICA site is available, see if blood can be obtained
from PIC instead of using vena puncture technique.
Blood Pressure and Pulse Rate
1. Use cuff on unaffected limb only
2. Use thigh cuff if both upper extremities are affected
Transport
1. Ask what kind of help the patient needs when transferring
to a stretcher or wheelchair (simply touching arms or legs
may cause hyperalgesia)
2. Use extreme care over bumps, such as elevator doorways
Feeding
1. Be careful not to touch patient extremities with bed-side
table
Patient Identification
1. Place red bracelet on unaffected limb
2. Place red dot sticker on patient chart
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