NIBBLES approach:
- Neurological Level: include AIS
- Immobilization: any spinal orthoses, extremity orthoses/splints/wraps? (to prevent contracture, facilitate stability, promote tenodesis, etc.) place nursing communication
- Bladder: appropriate UMN vs LMN orders
- Bowel: appropriate UMN vs LMN orders
- Blood Pressure: consider orthostatic hypotension
- Bone: vitamin D level, supplementation prn
- Lungs: include orders for nebulizers, ventilator settings, chest perccusion, post drainage and insufflator use if any needed
- Embolism / Extremities: DVT Prophylaxis
- Skin: wound care orders, turning schedule, also Lac-hydrin if dry skin
- Sexuality: include any sexual dysfunction
- Pain: neuropathic? nociceptive? visceral?
- MSK: include any pertinent MSK concerns. Assess for heterotopic ossification