Pressure Sores-Prevention And Care.
Pressure sores are liable to occur where any bony prominences press on the bed, a chair or against one another.
The tissues between may have their blood supply reduced, therefore devitalising the area. If this is allowed to continue, the superficial tissues will die and the skin will break down and ulcerate.
PRESSURE SORES MAY DEVELOP ON ANY PART OF THE BODY AND THEY ARE:
- Two moist surfaces that are in continual contact
- A bony part that just lies beneath the skin and is subject to pressure and friction.
THE AREAS MOST LIKELY TO BE AFFECTED ARE AS FOLLOWS:
- The lateral aspects of the hip joints.
- The medial and lateral aspects of the ankles.
- The heels.
- The medial, anterior and lateral aspects of the knees.
- The back of the head, particularly in elderly men and babies.
- The shoulder blades.
- The thoracic and sacral regions of the vertebral column especially in thin patients.
- The elbow.
CAUSES OF PRESSURE SORES
The following conditions can actually develop to pressure sores:
- Paralysed persons.
- Incontinent personss.
- Unconscious person and also helpless person.
- Obese and oedematous people.
- Emaciated people.
- Persons with poor circulation, may be having a respiratory disease or the other and heart failure.
- Person having tuberculosis, arthritis, rheumatism, fevers, toxaemia, malignant disease and malnutrition.
- People with injuries or disease in the central nervous system which causes interference with the nerve supply to skin and muscle.
- People with disease of metabolic origin. For instance, diabetis mellitus.
- People with fractures especially at the spine and also after operations if the patient has to remain in a particular position for a long period of time.
- People with convulsion, which also causes friction whenever it occurs.
PRESSURE CAN ALSO OCCUR DUE TO THE FOLLOWING REASONS
- Badly or too tightly bandages or splints.
- One limb pressing on the other in the case of a paralysed patient
- The patient left for a very long time on an unpadded bedpan
- Heavy objects pressing on the limbs, such as surgical appliances
FRICTION OCCURS AS A RESULT OF:
- The use of cracked bedpans
- Wrinkles and crumbs in the bed sheet and patches on linen
- Rough blankets and the weight of the bedclothes pressing on the limbs
MOISTURE OCCURS AS A RESULT OF:
- Accumulation of sweat in the folds of skin, for instance, under the breasts in overweight women, in the gluteal fold and also between the folds of fats on the abdomen.
- Not being comfortable with the toilet at the time of defaecation.
- Incontenence of urine and faeces.
PREVENTION OF PRESSURE SORES
Pressure sores can be prevented in so many ways from occurring. They are:
- By the use of bed appliances like the air rings, cushions, water beds and air beds, ripple beds.
- Make sure you clean and also a regular attention to all areas where two skin surfaces come together.
- Make sure that the patient’s position is changed frequently; which should be done in every 2 hours intervals. This will definitely help the pressure areas to be free from pressure.
- Make use of cradles to keep the weight of the bedclothes off the limbs and body.
- Make use of sheets that are not patched.
- Two or more nurses should lift heavy and helpless patient into the bedpan to avoid frequent falling.
- Do not allow a patient to lie on a wet bed; always make sure that you change the damp gown and linens.
- There should be frequent examination of all pressure areas and by changing the patient’s treatment if there is any change in the condition of the skin.
TAKING CARE OF THE INCONTINENT PATIENT
Incontinence means the inability of the patient to control the natural function of micturition ( that is passing of urine) and defaecation (that is passing of faeces). The patients suffering from incontinence may not know that either urine or faeces is been passed. Though the patient might not be aware of being incontinent, but can likely be conscious of when the bed is wet. This patient needs every possible nursing care and encouragement.
HOW TO TAKE CARE OF INCONTINENT PATIENT
- By encouraging the patient or person to not stay in bed but to get up and take gentle exercise whenever possible.
- By giving bedpans at regular intervals to patient who are unable to get up.
- Make sure that there is always an available beds which can be lowered so that the patient is able to get up whenever necessary without fear of falling.
- Make sure you encourage the patient to use a commode which must always be available at the bedside.
Incontinent patients should have on their beds a long waterproof and waterproof draw sheet. The draw sheet should not be a patched one. If the patient wets or soils the bed, a trolley is taken with the following materials:
- Bath towel.
- Talcum powder.
- Receptacle for soiled wool.
- Bowl containing water at a comfortable temperature.
- Clean sheets and clothes for the patient.
- Bowl with cotton wool.