[Minimally conscious coma patients--patient positioning systems in general practice]

With a view to optimizing the positional management of patients with severe neurological damage, five positioning systems with different operating principles were submitted to suitability trials in a clinical neurological rehabilitation setting. The patients included were in the "Wachkoma", the minimally conscious state (i.e., in neurological early rehabilitation phase B). The experience collected by the various professions involved in positional management over a trial period of six months is summarized in the present report, indicating that none of the positioning systems used has been suitable for all patients alike. Hence, various items were compiled in a checklist to enable better estimation of each system's suitability in light of the individual patient, with muscle tone, body weight, skin condition, degree of mobilization and spontaneous movement the essential criteria in patient assessment. This checklist now permits identifying the positioning systems suitable for the individual patient in an economical manner, and lengthy positioning trials can be dispensed with to a large extent.