Dad looks uncomfortable in his wheelchair-Part 2

If you missed our last blog post about what pressure sores are and how to spot them, check it out here. Today we’re going to discuss important factors in preventing pressure sores.

Prevention is the most important factor in managing pressure ulcers Bedsores are easier to prevent than to treat, but that doesn't mean the process is easy or uncomplicated. And wounds may still develop with consistent, appropriate preventive care. Pressure sore prevention for wheelchair patients : Frequency. People using a wheelchair should change position on their own every 15 minutes and should have assistance with changes in position every hour.  Self-care. If you have enough strength in your upper body, you can do wheelchair push-ups — raising your body off the seat by pushing on the arms of the chair.  Specialized wheelchairs. Pressure-release wheelchairs, which tilt to redistribute pressure, provide some assistance in repositioning and pressure relief.  Cushions. Various cushions — including foam, gel, and water- or air-filled cushions — can relieve pressure and help ensure that the body is appropriately positioned in the chair. A physical therapist can advise on the appropriate placement of cushions and their role in regular repositioning. Repositioning for a person confined to a bed includes the following recommendations: Frequency. Repositioning should occur every two hours. Repositioning devices. People with enough upper body strength may be able to reposition themselves with the assistance of a device such as a trapeze bar. Using bed linens to help lift and reposition a person can reduce friction and shearing. Special mattresses and support surfaces. Special cushions, foam mattress pads, air-filled mattresses and water-filled mattresses can help a person lie in an appropriate position, relieve pressure and protect vulnerable areas from damage. Your doctor or other care team member can recommend an appropriate mattress or surface. Bed elevation. Hospital beds that can be elevated at the head should be raised no more than 30 degrees to prevent shearing. Protecting bony areas. Bony areas can be protected with proper positioning and cushioning. Rather than lying directly on a hip, it's best to lie at an angle with cushions supporting the back or front. Cushions should also be used to relieve pressure against and between the knees and ankles. Heels can be cushioned or "floated" with cushions below the calves. Skin care is essential in preventing pressure ulcers. Protecting and monitoring the condition of the skin is important for preventing pressure sores and identifying stage 1 sores before they worsen. Bathing. Skin should be cleaned with mild soap and warm water and gently patted dry. Or a no-rinse cleanser can be used. Protecting skin. Skin that is vulnerable to excess moisture can be protected with talcum powder. Dry skin should have lotion applied. Inspecting skin. Daily skin inspection is important for identifying vulnerable areas of skin or early signs of pressure sores. Care providers usually need to help with a thorough skin inspection, but people with more mobility may be able to inspect their skin with the use of a mirror. Managing incontinence. Urinary or bowel incontinence should be managed to prevent moisture and bacterial exposure to skin. Care may include frequently scheduled assistance with urinating, frequent diaper changes, protective lotions on healthy skin, urinary catheters or rectal tubes. Nutrition can aid and improve in the overall health of your skin. Your doctor, dietitian or other members of the care team can recommend dietary changes that can help improve the health of your skin. Diet. You may need to increase the amount of calories, protein, vitamins and minerals in your diet. Your doctor may also prescribe dietary supplements, such as vitamin C and zinc. Fluids. Adequate hydration is important for maintaining healthy skin. Your care team can advise on how much fluid to drink and signs of poor hydration, such as decreased urine output, darker urine, dry or sticky mouth, thirst, dry skin, or constipation. Feeding assistance. Some people with limited mobility or significant weakness may need assistance with eating in order to get adequate nutrition. Other strategies to prevent Other strategies that can help decrease the risk of pressures sores include the following: Quit smoking. If you smoke, quit. Talk to your doctor if you need assistance quitting. Stay active. Limited mobility is a key factor in causing pressure sores. However, daily exercise that is appropriately matched to a person's abilities is an important step in maintaining healthy skin. A physical therapist can recommend an appropriate exercise program that improves circulation, builds up vital muscle tissue, stimulates appetite and strengthens the body overall. Pressure ulcer prevention is everyone’s responsibility whether you are the primary caregiver, physician, nurse of medical equipment provider. We must all do our part to insure the ones that we care for are informed and educated on this condition. If you have any questions or comments about this information please comment below or give Burge Medical Supply a call 1 -888-650-7652.

Dad looks uncomfortable in his wheelchair

Today we will begin a two  part series on pressure sores. We will begin by discussing what pressure sores are and how to spot them. Our next blog will be about how to prevent pressure sores in the future. Burge Medical Supply Blog An unfortunate fact of life for many wheelchair users is the potential for acquiring pressure sores, also called pressure ulcers. These sores are the criminal element of the wheeled world. The development of these sores can rob a victim of their health, independence, and quality of life. The contributing factors and circumstances can be varied and complex. In most cases it is impossible to single out one element and pronounce it as the primary source. More times than not, it is a multi-dimensional problem. The solution may also be multi-dimensional and should be approached that way. Pressure ulcers result from long periods of uninterrupted pressure exerted on the skin, soft tissue, muscle and bone. They occur more frequently over a bony prominence such as the sacrum, the hip, or the heel. Two thirds of pressure ulcers occur in patients over the age of 70. Pressure ulcers can lead to pain, disfigurement, and slow recovery from comorbid conditions. They interfere with daily living and are strongly associated with longer hospital stays and higher mortality rates. Frailty and chronic illness, both common among older adults, predisposes to pressure ulcers. At Burge Medical Supply many of our patients spend at least 5 to 8 hours a day confined to their wheelchair or power wheelchair. The combination of skin breakdown and constant pressure on the buttocks, shoulders, lower legs, ankles and heels, from sitting in a wheelchair seating system, exposes the patient to pressure ulcers. Development Signs Pressure sores have a way of sneaking up on you so you don’t know there is a problem until the damage is done. If you have determined that your loved one is at risk for developing sores, it’s important to check their skin daily for any signs that an ulcer has begun. When checking the skin for signs of a developing pressure ulcer, always compare the bony areas that are most commonly affected to the surrounding skin. Signs that a pressure ulcer is beginning to form may include: Color changes – Skin over bony areas (lower back, hips, heels, elbows, etc.) may appear reddened and may or may not blanch white when pressed. Skin may also appear bruised, having a blue, purple, or black color.  Temperature changes – Compared to skin surrounding the affected area, the beginning stage of a pressure ulcer may feel warm to the touch or cool.  Changes in consistency of skin – The beginning stage of a pressure ulcer may make the affected skin feel firm to the touch or may make it feel boggy. Boggy skin can best be described as feeling as though it’s filled with fluid.  Changes in sensation – Your loved one may start complaining about pain, tingling, or itching in affected areas.  The Four Stages of Sores: Stage 1 sores are not open wounds. The skin may be painful, but it has no breaks or tears. The skin appears reddened and does not blanch (lose color briefly when you press your finger on it and then remove your finger). In a dark-skinned person, the area may appear to be a different color than the surrounding skin, but it may not look red. Skin temperature is often warmer. And the stage 1 sore can feel either firmer or softer than the area around it. At stage 2, the skin breaks open, wears away, or forms an ulcer, which is usually tender and painful. The sore expands into deeper layers of the skin. It can look like a scrape (abrasion), blister, or a shallow crater in the skin. Sometimes this stage looks like a blister filled with clear fluid. At this stage, some skin may be damaged beyond repair or may die. During stage 3, the sore gets worse and extends into the tissue beneath the skin, forming a small crater. Fat may show in the sore, but not muscle, tendon, or bone. At stage 4, the pressure sore is very deep, reaching into muscle and bone and causing extensive damage. Damage to deeper tissues, tendons, and joints may occur. If you notice any of these early warning signs, alert your healthcare provider immediately.