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Skin Care and Pressure Ulcers
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- 2. - A pressureinjury is localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device. - The injury can present as intact skin or an open ulcer and may be painful. - The injury occurs as a result of intense and/or prolonged pressure or pressure in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion, co-morbidities and condition of the soft tissue. What is pressure injury?
- 3. - The climateof a very small or restricted area, that differs from the climate of the surrounding area - It usually occurs under the bony prominence where pressure is at its peak and heat build-up causes excessive sweat - it is created as a result of excessive heat and moisture usually from sweat, incontinence, discharges from wounds and when sitting on a seat surface that is not breathable Microclimate
- 4. What are thefactors that can cause pressure Injury
- 5. DECREASED MOVEMENT/IMMOBILITY - SEVEREARTHRITIS - STROKE - MULTIPLE SCLEROSIS - OBESITY
- 6. DECREASED SENSATION - Decreasedability to feel or verbally express pain and discomfort can affect persons feeling towards prolonged pressure on the skin.
- 7. CIRCULATORY PROBLEMS • Aterosclerosis •Localized Oedema • Diabetes
- 8. POOR NUTRITION -People whoare less in protein, Vit. C, Vit. E, calcium and Zinc
- 9. SHEER AND FRICTION -It causes the skin to stretch and blood vessels to kink which will impair blood circulation in the skin.
- 10. What is thecommon tool to assess Pressure Sore Risk? Braden Scale
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- 12. • flattening ofthe epidermal-dermal junction • decrease in the melanocytes and Langerhans cells • decrease in fibroblast function • decrease in blood flow • decrease in oil and sweat production • decrease in subcutaneous tissue, especially fat, • decline in the reproduction of the outermost layer of the epidermis Why elderly have higher risk?
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- 15. BED-BOUND • Use the30-degree tilted side-lying position. • Encourage individuals who can reposition themselves to sleep in a 30- to 40-degree side-lying position. • Avoid lying postures that increase pressure.
- 17. BED-BOUND • Limit head-of-bedelevation to 30 degrees for an individual on bedrest unless contraindicated. • If sitting in bed is necessary, avoid head-of-bed elevation or a slouched position.
- 18. IF A PATIENTHAS EXISTING PRESSURE ULCER • Do not position the patient directly on the ulcer or on areas of non-blanchable redness or deep tissue injury. • Continue to turn and reposition the patient regardless of the support surface in use. • Inspect the skin for additional damage each time the patient is turned or repositioned.
- 19. CHAIR-BOUND • Stand thepatient and reseat them in the chair frequently if possible. • Provide adequate seat tilt to prevent sliding forward in the chair • Elevate the legs or place the feet on a stool if the feet do not reach the floor • Elevate the feet and recline the chair by 30 degrees to reduce pressure.
- 21. • If thepatient can change his/her own position, encourage pressure relief every 15 minutes. This includes chair pushups, leaning forward, leaning side to side, or tilting backwards. Leaning forward is the most effective and might be easier than chair push-ups. • Acutely ill patients at risk for pressure ulcers should not sit for longer than two hours at a time and not return to sitting for at least an hour. • Patients who are incapable of changing their position while sitting should be repositioned at least every hour by a caregiver.
- 22. If a patienthas existing Pressure Ulcer • Minimize sitting time • Consider periods of bed rest to promote ischial and sacral ulcer healing. • Avoid sitting a patient with an ischial pressure ulcer in a fully erect posture. • Patients with existing pressure ulcers on the ischial areas should limit time sitting up in the chair to three times a day for 60 minutes or less, and they must use a cushion (gel or air cushions are best) that redistributes pressure.
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- 25. Difference of PressureInjury and IAD
- 26. MEDICAL DEVICE RELATEDPRESSURE INJURY
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