PRESSUREMAPPING@COOLLIST.COM LISTSERV

Jillian Swaine, B.Sc. (O.T.)
Consultant, Occupational Therapy Services
Calgary, Alberta, Canada

ABSTRACT

Clinical interpretation of interface pressure maps (IPM) is still a mystery to many clinicians. There is no reference book that clinicians can use to learn interpretation skills. We rely on a combination of expert opinion and research but how do we share that expert opinion information? To answer this dilemma, we started a listserv to commence the discussion about interpreting IPM. To date, there are 36 participants on the new listserv from 3 continents. Two major manufacturers of IPMs also participate.

BACKGROUND

There is a standard protocol for administering an IPM (1) but there is not a standard protocol for how to interpret the IPM. This is as critical as the process for administering. There has been much discussion about the domains or features of the IPM that are useful to interpret: pressure gradient, peak pressure, contact area. Do they all represent equal weight when it comes to interpreting an IPM for a client? Since there are numerous clinicians using this technology, we wanted to create a forum for clinical discussion.

STATEMENT OF THE PROBLEM

We began an informal survey of clinicians, clients and manufacturers while attending conferences and workshops. There was a consensus that a listserv would be helpful to share information and answer questions. The following questions arose:

How do I know if I am interpreting the IPM correctly?
How do others interpret the IPMs?
Is there a consensus or protocol for interpreting IPMs?

METHOD

We researched the listservs available on the internet that are hosted free of charge. We reviewed each of these listservs and chose www.coollist.com. We invited the manufacturers and key expert clinicians that we knew were using pressure mapping. We encouraged the IPM manufactures to invite those individuals who had recently purchased an IPM from their company to join our listserv.

Unfortunately, www.coollist.com does not yet support archives to the discussions. Therefore, we hired a programmer to create a web page that includes all the email messages. The messages can be searched with key words.

RESULTS

The topics and questions discussed include:

Protocols for doing an IPM and then a protocol for interpreting an IPM. Are they published? Is there a consensus on what needs to be included?
What domains do clinicians use to interpret? Do people use peak pressure for interpretation? If so, what is the recommended peak pressure limit?
What does "normal" look like in pressure mapping for the general public in with individuals with spinal cord injuries, cerebral palsy, spina bifida, etc.?
What is shear and friction and how can they be measured clinically? What does a shear wound look like vs. a pressure wound? Case studies were shared using photos and IPM.
How do clinicians use remote pressure mapping?
Types of cushions and their offloading capabilities including one individual with a spinal cord injury sharing his experience with maintaining wound closure and using dynamic seating surface.
Types of mattresses and overlays and their offloading capabilities.
Outcome measurement in seating and wound care. Sharing of references.
Risk assessments for the development of pressure wounds.
Mat assessments and their integration in a seating assessment which includes pressure mapping. The utility of pressure mapping a "worst case scenario" or flat surface.
Surgical surfaces and wound prevention.
Wound care integrated with IPM and seating services.
Dietary services integrated with IPM.

DISCUSSION

The listserv has been operating for 6 months. There has been sharing of information relevant to clinical discussion making. Several case studies have been shared and discussed. It has been a forum to ask questions, share interesting case studies along with the corresponding IPM data. In addition, the recent addition of archives for the listserv enables newcomers to search the listserv for past information.

REFERENCES

Levy, B. (1997). Which way is your tush leaning? National Seating and Mobility Symposium. www.fsaworld.com/products/which-way.pdf+interface+pressure+mapping+protocol&hl=en&ie=UTF-8
Lipka, DD, et al. The Pressure's On - Clinical Application of Pressure Mapping. In Proceedings of the 13th International Seating Symposium. Pittsburgh, PA, 1997: 103 112
Shelton F, Barnett R, Meyer E. (1997). Full body interface pressure testing as a method for performance evaluation of clinical support surfaces. Journal of Applied Ergonomics, May.
Von Zweck C. (1999). The promotion of evidence-based occupational therapy practice in Canada. Canadian Journal of Occupational Therapy, 66, 208-213.

ACKNOWLEDGMENTS

The author would like to thank Andy Woodcock from the ROHO Group and Dr. Ivan Sierralta, Calgary Technologies Inc.

Jillian Swaine
Consultant, Occupational Therapy Services
7103 Christie Briar Manor S.W.,
Calgary, Alberta, Canada T3H 2G5
Tel: 403-217-4887
Fax: 403-240-0004
Email: info@jillianswaineots.com
www.jillianswaineots.com
pressuremapping@coollist.com