The hospital at CRP-Savar is the only hospital in Bangladesh that specialises in the treatment of spinal cord injuries. The 100-bed hospital receives over 350 admissions as in-patients each year. Admissions are normally due to traumatic paraplegia, traumatic tetraplegia and conditions caused by disease, but exclusively for the treatment of spinal injuries or illness affecting the spine. Some patients are managed conservatively, whilst others require surgical intervention. The majority of patients arrive a long time after their accident or illness, when complications are difficult to manage.
Specialized nursing care is a vital part of the treatment of paralyzed patients. CRP has a highly skilled nursing staff complemented by input from foreign volunteers. The nurses are engaged to look after the patients' physical condition. This includes bladder neuropathy, bowel and pressure sore management. Pressure sores are the main complication for paralyzed patients. Special dressing techniques are required to aid wound healing as well as treatment for infection and blood transfusions if necessary. Pack beds are used, which are designed to relieve pressure from the wound area. Improved diet is offered with additional nutritious foods and vitamin supplements. Where necessary, reconstructive surgery is performed to manage the unhealed sore.
Measures are taken in order to prevent pressure sores developing. Two hourly position changes are necessary. Special pressure relieving mattresses are used when available and ensuring a high standard of hygiene is also important. Specific staffs have responsibility for giving health education and advice to patients on pressure sore prevention as well as bladder and bowel management.
Another common complication is urinary incontinence. Many patients are admitted with an indwelling catheter or condom device. The best management for these complications is self administered, clean intermittent catheterization. The paraplegic patient is taught how to introduce the clean catheter themselves and carers of the tetraplegic patient are taught the same technique. The aim is to control incontinence by emptying the bladder at regular intervals and by using medication which works on the bladder muscle.
An out-patient service is provided by CRP six days a week, where patients can be referred to other services provided by CRP, such as pathological tests, x-ray, physiotherapy, occupational therapy, for mobility aids and health education. Some patients with spinal injuries are admitted to the in-patient department for treatment or surgical interventions. Surgery is performed in the operating theatre at CRP two days a week. Several different surgical procedures are carried out at CRP including spinal fixation, surgery on spinal tumour and club foot.
The pathology laboratory is equipped with the some modern items of equipment such as a biochemistry analyser and ELISA reader for HIV testing, Hepatitis B and C and other sexually transmitted diseases. A radiology unit carries out over x-rays for in-patients and out-patients and is staffed by a team of experienced staff members.