Chest infections are not uncommon in tetraplegic patients. Most patients and their carers are well versed in active chest physiotherapy. In addition to treating chest infection with appropriate antibiotics, tetraplegic patients may need re-hydration, application of humidified oxygen and informed chest physiotherapy. Rapid fluid replacements can precipitate respiratory insufficiency in tetraplegic patients.
Estimation of arterial pH and PCO2 would assist the treating physician in establishing the need for respiratory assistance/ventilation. Clinical signs are often difficult to elicit in tetraplegic patients. A good quality x-ray is often necessary.