Chapter 26: Acute oncology
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Post‐procedural considerations
Ongoing care
Reassessment by the medical team will be necessary in the event of an increase in pain or neurological symptoms.
Anticipated patient outcomes
Many patients can retain good levels of function and independence with the appropriate care. The successful rehabilitation of a patient is often dependent on the action taken by the healthcare professional during the acute presentation. It is therefore essential that an early and accurate diagnosis is made and, if appropriate, treatment given to optimize neurological functioning. Timely referral to rehabilitation services is imperative for assessment, appropriate intervention and thorough discharge planning to enable smooth transition back into the community (NICE [208]).
Active rehabilitation may be postponed until the medical team has confirmed that the patient's spine is stable. However, there is a significant role for members of the rehabilitation team in the acute management of these patients in terms of:
- assessment of motor recovery
- minimizing further complications such as chest infections which may arise as a result of prolonged bedrest
- effective, co‐ordinated discharge planning. The positioning and moving needs of these patients are often complex and so discharge planning may be lengthy and multifaceted, requiring ongoing support and rehabilitation in the community to optimize functional independence (Miller and Cooper [181]).
A referral to a physiotherapist is essential for patients with complex symptoms such as spinal instability, weakness and sensory impairment.
Documentation
Any changes in (neurological) presentation and/or function must be documented both prior to and following any procedure.
