J. M. Walker, PhD, PT, C. McGowan &
School of Physiotherapy, Dalhousie University
Leaflet published by Nova Scotia Polio
Survivors Support Group, 1996
Lincolnshire Post-Polio Library version by kind permission of J. M. Walker
As a result of the polio epidemics in the 1940's to 1961 affected individuals underwent a variable period of rehabilitation and got on with their lives to the best of their abilities. While some exhibited obvious weakness as a result of the damage and loss of anterior horn cells, possibly wearing braces, or using ambulatory aids, many appeared to have a full recovery. The latter however was deceptive. Individuals with Grade 5 muscle strength (normal) may only have 60% of the normal complement of anterior horn cells. These individuals have been functioning for several decades at almost 100% of capacity; many are now wearing out and showing new health problems related to their prior poliomyelitis infection.
Late effects of poliomyelitis may include:
Polio survivors and particularly those showing post polio sequelae, possibly diagnosed with post polio syndrome (PPS) may be more susceptible to adverse drug reactions. As polio survivors are often operating at or near their maximum level of function when performing even the simplest of daily routines, certain medications can seriously impair their functioning. Common medications may have this effect.
Emergency / Surgery medications which should be used with greater caution are:
Medications administered in the emergency setting to be taken for long term use should be only given to the patient in partial allotment. The patient should be advised to consult their family physician (? Neurologist) to determine if that medication will pose any potential risk, considering their polio history. Lower than usual doses may be adequate.
|Use of anaesthetic should be carefully monitored because its
effects are heightened & prolonged in the patient with PPS or respiratory
Swallowing & coughing difficulties: Pharyngeal & laryngeal muscle weakness (patient may not be aware of) may cause a decreased cough reflex & increased risk of aspiration.
|When intubating these patients, take the diminished cough reflex
Weakness & fatigue:
|If casting is required, patients will benefit from the use of
A wheelchair or other ambulatory aids may be needed
The patient who just managed to be independent may not be able to with a cast
May require an extended stay
|Extra blankets may be required to ensure adequate
|Interaction between pain relief and person's fatigue levels and
muscle weakness must be considered
Energy conservation is important. May need to use wheelchair rather than walk, sit not stand, lie down not sit, need regular rest periods & not be woken during rest periods.
Important questions to ask of patients in the Emergency Care setting
IF a polio survivor
|Polio survivors may carry an Injury Control Checklist which
provides a list of contacts for additional information in the case of an
For further information contact:
Nova Scotia Polio Survivors Support Group
c/o Abilities Foundation of Nova Scotia
3670 Kempt Rd., Halifax, N.S. B3K 4X8
J.M.Walker Ph.D., PT, C. McGowan & G. Vardy
School of Physiotherapy
4th Floor, Forrest Building,
5869 University Ave.,
Halifax, NS Canada B3H 3J5
Registered Charity No. 1064177
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Original Think-tank, Cornwall,
Document Reference: <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/library/walker/guide_surgery_emergencycare.html>
Created: 20th August 1998
Last modification: 31st January 2010.