Paralysis Resource Guide - (Page 84) HEALTH MANAGEMENT RESPIRATORY HEALTH As we breathe, air is brought into the lungs and into close contact with tiny blood vessels that absorb the oxygen and carry it to all parts of the body. At the same time, the blood releases carbon dioxide, which is carried out of the lungs with exhaled air. Lungs themselves are not affected by paralysis, but the muscles of the chest, abdomen and diaphragm can be. As the various breathing muscles contract, they allow the lungs to expand, which changes the pressure inside the chest so that air rushes into the lungs. This is the process of inhaling – which requires muscle strength. As those muscles relax, the air flows back out of the lungs. If paralysis occurs in C-3 or higher, the phrenic nerve is no longer stimulated and therefore the diaphragm does not function. This means mechanical assistance – usually a ventilator – will be needed to breathe. People with paralysis at the mid-thoracic level and higher may have trouble taking a deep breath and exhaling forcefully. Because they don’t have use of abdominal or intercostal muscles, these people also lose the ability to force a strong cough. This can lead to lung congestion and respiratory infections. Moreover, mucous secretions are like glue, causing the sides of the leading cause of death “Pneumonia isspinal cord injury, regardlessfor all persons with of the level of injury or time since the injury. ” airways to stick together and not inflate properly. This is called atelectasis, or a collapse of part of the lung. Many people with paralysis are at risk for this. Some people have a harder time getting rid of colds or respiratory infections and have what feels like a constant chest cold. Pneumonia is a possibility if secretions become the breeding ground for various bacteria. Symptoms of pneumonia include shortness of breath, pale skin, fever and an increase in congestion. Be aggressive with pulmonary infections: Pneumonia is one of the 84
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