Mrs. A.J. is considered a very high risk of developing pressure ulcers and would like to know what preventative treatments are available. 
Q4. What are the recommendations for preventing pressure ulcers in persons with SCI?
Lifelong prevention recommendations include:
1. Assess and manage all preventative strategies using an interprofessional approach with the patient being in charge.
2. Examining skin daily to allow for early detection of a pressure ulcer
3. Shifting body weight in bed and wheelchair on a regular basis independently or with assistance
4. Keeping moisture accumulation to a minimum and cleaning and drying skin promptly after soiling
5. Assess and manage pressure over a 24hr period in all surfaces including bed, chairs, and commodes. Anywhere the person lies or sits.
6. Having an individually prescribed wheelchair, pressure redistribution cushion and power tilt mechanism if manual pressure redistribution is not possible (See figure 5 for common areas for ulcer formation)
7. Manage friction and shear in all positions over 24 hrs including transfer.
8. Ensuring all equipment is maintained and functioning properly
9. Decreasing or stopping smoking
10. Limiting alcohol intake.
11. Optimize diet and hydration. Refer to a registered dietician.
Q5. List the different methods studied for preventing pressure ulcers in persons with SCI for which there is evidence.
1. Electrical Stimulation
2. Education on Pressure-Redistribution Techniques
3. Modifying Seating Parameters
4. Specialized Seating Clinics
5. Social Cognitive Approaches with Reward Systems
6. Telerehabilitation Approaches