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Prevent Pressure Ulcers for Bedbound Patients
By Deb Bloom of Gimme One of Each
Preventing pressure ulcers can sometimes be a challenges, but there are simple ways to prevent them and keep your patient pain free and avoid more serious problems. These tips aren't just for caregivers in a nursing home or personal care home, anyone taking care of an elderly or bed bound person can benefit from these tips. What are Pressure Ulcers?
A pressure ulcer is an injury usually caused by unrelieved pressure that damages the skin and underlying tissue. Pressure ulcers are also called bed sores and range in severity from mild (minor skin reddening) to severe (deep craters down to muscle and bone). Where Do Pressure Ulcers Usually Form?
Pressure ulcers usually form where there is bone against skin, or against a mattress or chair. For people in bed, most common areas for pressure ulcers to form are on the lower back, (just above the tailbone), on the heels and on hip bones. If people are in chairs or wheel chairs, the location could vary. Pressure ulcers can also form on the knees, ankles, shoulder blades, back of the head and spine. Normally the nerves of your body tell you when to move to relieve pressure on the skin. People in bed who are unable to move may get pressure ulcers after just 1-2 hours. People in chairs can get pressure ulcers even quicker because the force on the skin is greater. What Puts People at More Risk?
If you're confined to a bed or a chair, being unable to move, loss of bowel or bladder control, poor nutrition and lowered mental awareness are risk factors that increase the chance of developing a pressure ulcer. Steps for Prevention
These steps can prevent ulcers from occurring and can also help them from getting worse. 1. Take care of the Skin - Inspect the skin at least once every day. Pay attention to any red areas that remain even after changing position. The inspection can be done by yourself or by a caregiver. Keep the skin clean and dry and when bathing use warm water, not hot. Apply lotion after bathing or frequent washing and avoid cold or dry air. If moisture cannot be controlled, such as in incontinent people, use pads or briefs that draw moisture away from the skin. You can also use a moisture barrier for people who are wet most of the time. 2. Protect the Skin from Injury - Avoid massaging the skin on bony parts of the body. Limit pressure on bony areas by changing positions frequently. If you're in a bed, preferably every 2 hours. If you're in a chair, change positions every 1 hour. There are also devices and other special products you can use (see pictures) to help prevent pressure points. Reduce friction by making sure when lifting a patient in bed that they are lifted, not dragged during repositioning. Friction can rub off the top layer of skin and damage blood vessels. Avoid using the donut shaped cushions for on a chair. These can actually increase the risk of pressure ulcers because there is still pressure from this cushion. In bed, use special air mattresses that contain foam, air, gel or water. The head of the bed should not be raised too high, unless for special medical conditions, and don't keep it raised for too long. This causes a pressure point on the coccyx (tailbone) area and can also cause sliding in the bed.
Use pillows or wedges between knees to keep knees from rubbing on each other. Avoid lying directly on hip bones by using pillows between legs. Spread the body over as much area on the bed as possible so there are less pressure points. Improve Your Ability to Move - A rehabilitation program can help some people to regain movement and independence. Even though it is more commonly thought that an elderly person will get a pressure ulcer more often, it can occur to anyone that is in bed or a chair most of the time. Age isn't the only factor, but also medical history and current problems.
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Contributor's Note
I use these tips every day in my line of work and they are very effective.
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Elderly are more prone
Heel or elbow protectors
Wheel chair cushion
Spread the patient over a larger area of the bed
This is a Stage 2 pressure ulcer
Mattress changes patient position automatically
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This intel was contributed by Morganna
Morganna
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May, 2012
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