Flashcards in Wounds & Bleeding Deck (38)
Pressure ulcers - Pressure - pressure points
Back of head
Lower back and buttocks
Pressure ulcers - Shear - definition
Shear occurs when the skeleton moves, but the skin remains fixed to an external surface. Blood vessels are kinked or twisted. (i.e. pulling a patient up in bed, sliding a patient from a bed to a stretcher).
Pressure ulcers - Friction ulcers - definition
Friction ulcers are generally superficial and easily reversed unless the cause is not removed.
Common in bed ridden patients who use heels and elbows to aid movement.
Pressure ulcers - Moisture - definition
Moisture is a chemical cause of promoting pressure ulcers. It weakens the cell wall of the skin cells. It can change the pH of the skin.
Pressure ulcers - Moisture - causes
Faecal & urinary incontinence
Pressure ulcers - Who is vulnerable?
All patients with spinal cord injury, the chronically unwell and the elderly are at high risk of developing pressure damage due to:
Lack of sensation
Lack of movement
Pressure ulcers - Intervention
Minimize pressure for all patients.
Encourage weight shifting every 15 minutes.
Handover to staff with pressure sore information.
Use transfer devices.
Position with pillows to elevate pressure points.
Use 2 people minimum & draw sheet to pull patient up bed.
don't drag a patient.
Keep head of bed <=30degrees incline
Pas skin surfaces - elbows, heels, etc.