THE DOCTORÕS GUIDE TO Pressure Ulcers - DM …

1 THE DOCTOR S GUIDE TOPrevention and TreatmentPressure Ulcerst Health workerst Caregiverst Home caret Patientst Nursingt EducatorsSIMPLE. PROVEN. SOLUTIONS s WWW HEELIFTGLIDE COM s 2013, DM Systems, Inc. All rights Pending. Suggested Code: E0191. To learn more about Heelift Glide or to request a free sample, visit Heelift Glide. It s about time. It s about time for a boot that saves you time by moving with the patient, not on the patient. It s about time for a heel offloading device that s comfortable, cool, and convenient. It s about time to take heel ulcer prevention seriously. IT S ABOUT TIMED esigned with input from wound care nurses, the Heelift Glide is the newest innovation from DM Systems. Thanks to a smooth fabric exterior and a new forefoot strap, the boot glides along the sheets and stays in place throughout your entire shift. The Heelift Glide is 40% lighter, measurably cooler, and less bulky than a pillow-style boot, improving patient DOCTOR S GUIDE TOPRESSURE Ulcers *Prevention *Treatment *Risk FactorsByKenneth Wrightin consultation withIn consultation with the WOCN (Wound Ostomy Continence Nurses) association, The AHCPR (Agency for Health Care Policy and Research), the NPUAP (National Pressure Advisory ulcer Advisory Panel).

2 Our special thanks for the editing and contributions from Dr. Shamil Kumar, Dr. W. Jensen, Sharlene Wiley BSN, CETN, Heather Orsted, , RN, BN, ET, Rick Fontaine and all the nurses that completed the editorial survey from the WOCN and CAWC. The content of this book adheres to the recognized best practice guidelines from the various authoritative North American associations and have been adapted for the lay # 1 55040 -830-5 Pressure Ulcers . Pressure sores. Self-help. Decubitus Ulcers . Skin Ulcers . Wound care. 2011 Mediscript Communications mail Tel 800 773 5088, fax 800 639 3186 All rights part of this publication may be reproduced, stored in a retrieval system or transmitted in any form by any means electronic, mechanical, photocopying, recording or otherwise, without prior permission of Mediscript Communications and Front Cover design by:Brian Adamson, HEALTHEDUCATION SERVICESM aking information work for youDoctor GUIDE Books Training workshops for health workersFor patient counseling & compliance CD slides, facilitator notes.

3 Delegate manual Easy to read like Readers Digest Ensure quality assurance standardSaves you time Economical cost effective Nothing controversial mainstream Retain & motivate staffGeneric information on treatments Increased performanceSelf help preventative tips Comply with accreditation guidelinesTITLES PROGRAMS Pressure Ulcers Alzheimer s DiseaseVenous Leg ulcer Type 2 DiabetesIncontinence care StrokeDiabetic Foot Ulcers Brain Injury Diabetes and Feet Multiple SclerosisUrostomies ArthritisIleostomies Pain in the older clientColostomies Nutrition & Aging How to Stop Smoking Preventing FallsCOPD prevention & treatment Elder abuseFor full listing go to or s &AX s EMAIL MEDICRIPT ROGERS COMThe ResponsibleEducation PromotionRELIABLE, TRUSTED&CERTIFIED EDUCATIONAL AIDSA pproved: HON (Health On Net). Accreditation & regulatory code brands with your CUSTOMIZED* editionMake These Books Your Own23 All About Pressure Ulcers & Positioning 2010 Mediscript Communications points because they bear the weight of thL body ^hen H persoU PZ sittinN or Sying Kown The most common SVcation for a Pressure \SJLY iU HK\S[Z is the coccyx or sacrum.]

4 The heeS is the seconK most common site. Pressure \SJers, however, can bL found in other parts of the body incSuding the LSIVws .seboS rae ro seot ,seSkna ,seenk ,spih ,sedaSb redSuohsPressure areas can aSso deveSop where two bon` surfaces, such as the knees and aURSes, rub together In obese persons a Pressure area can deveSop froT the friction of skin rubbing against skin ( under thL breasts) *65:0+,9 -69 ( 464,5; ;OPUR VM H JSPLU[ ^OV OHZ OHK H WrLZZ\rL \SJLr >OH[ ^LrL [OL Z`TW[VTZ [OH[ `V\ UV[PJLK& 2011 YOUR COMPANY NAME MEDIA CUSTOMIZATION FORMAT OPTIONSP rint book Format x 7 Website advertising and licensing on your websiteInstitution sponsorship for elearnE learn websites. YourWebsite addressKeyCustomizedContentYourCompany Logo&NameYourCompany NameAll About SeriesDr. GUIDE Series(With link to yourwebsite in ebook edition)PRINT x & EBOOK EDITIONSSECTION 1: UNDERSTANDINGINTRODUCTION: WHO SHOULDBE READING THIS book ?)]]]]]]]

5 6 PREVENTION IS BETTER THAN CURE ..8 EVERYBODY S DIFFERENT ..10 WHAT IS A Pressure ulcer ? ..10 WHAT CAUSES A Pressure ulcer ? ..13 WHO IS AT RISK? ..20 HOW TO RECOGNIZE A Pressure ulcer ..23IF YOU ARE A 2: TREATMENT BY PREVENTIONINTRODUCTION ..28 Pressure REDISTRIBUTION ..29 Pressure REDISTRIBUTION CARE ..38 HYGIENE ..40 NUTRITION ..41 COMFORT MEASURES ..43 GENERAL PREVENTIVE TIPS ..50 SECTION 3: Pressure ulcer TREATMENTFACTORS THAT INFLUENCE OPTIONS ..55 TYPES OF DRESSING ..60 CHANGING A DRESSING ..65 WOUND BED PREPARATION (DEBRIDEMENT) .. (Vacuum Assisted Closure ) Therapy ..68 WARMING (THERAPEUTIC HEAT) ..68 ELECTRICAL STIMULATION ..69 HYPERBARIC PHYSICAL TREATMENTS ..70 SKIN SUBSTITUTES ..71 GROWTH FACTORS ..71 MAGGOT DEBRIDEMENT THERAPY ..72A LITTLE CARE GOES A LONG WAY ..72 SECTION 4: APPENDIXPREVENTION AND TREATMENT CHECKLIST ..73 SKIN CARE RECORD ..74 TURNING SCHEDULE ..76 USEFUL WEBSITES ..77 WOUND CARE SPECIALISTS.

6 78 NUTRITION of ContentsIMPORTANT MESSAGE FROM THE PUBLISHERA note of cautionThis book provides generic information in harmony with the best practices guidelines documented by exper t organizations. See appendix for web sites. However treatment and advice on preventing and caring for Pressure Ulcers are wide ranging and depend upon the health care practitioner s diagnosis and assessment of the patient s condition. Consequently this book is not a substitute for the health care practitioner s advice and treatment. With this in mind the publisher and authors disclaim any responsibility for any adverse effects resulting directly or indirectly from suggestions, undetected errors or from misunderstanding on the par t of the readerThe book is appropriate for many health care workers known as the following (depending upon geographic region or type of work): Personal Suppor t Worker, Unlicensed Care Provider, Home Suppor t Worker, Home Care Aides, Nurse Aides, Nursing Assistants, Personal Care Attendants, Unlicensed Assistive Personnel, Community Health Workers.

7 The book is also appropriate for caregivers, family members of patients or patients. Ordering more copiesThanks to sponsorship, this book is available at discounted prices for as low as $ depending upon appropriate titles are available such as Venous Leg Ulcers , Incontinence Care, Diabetic Foot Ulcers , Urostomy etc. visit to review full range of titles. email: 8 IPITLSRI *E\ PU022001p6 Pressure Ulcers Mediscript Communications INTRODUCTIONIn order to understand what we re dealing with, let s take a look at the title of this book . Pressure Ulcers have been given many names bedsores, skin Ulcers , wounds, decubitus Ulcers but they all mean essentially the same thing. The important thing to understand is that the information in this book can help all these conditions. WHO SHOULD BE READING THIS book ? =SY EVI E LIEPXL GEVI [SVOIV GEVI TVSZMHIV SV WYTTSVX WXEJJ ERH you want a comprehensive, easy to understand reference GUIDE on all the issues.]

8 =SY EVI E LIEPXL GEVI TVSJIWWMSREP ERH ]SY [ERX XS LIPT ]SYV patients understand and prevent Pressure Ulcers , or help in the healing process of existing Pressure Ulcers . 7 SQISRI MR ]SYV JEQMP] LEW E TVIWWYVI YPGIV TVSFPIQ ERH ]SY want to help. =SY EVI EX VMWO SJ HIZIPSTMRK E TVIWWYVI YPGIV ERH ]SY [ERX XS prevent it from OF READING THIS book =SY [MPP YRHIVWXERH [L] E TIVWSR GER FI EX VMWO SJ HIZIPSTMRK Pressure Ulcers . =SY GER EGXYEPP] TVIZIRX E TVIWWYVI YPGIV JVSQ SGGYVVMRK =SY GER EZSMH GSWXP] XVIEXQIRXW F] XEOMRK TVIZIRXMZI EGXMSR [LIR XLI VWX WMKRW SJ E TVIWWYVI YPGIV FIGSQI IZMHIRX =SY GER WTIIH XLI LIEPMRK TVSGIWW SJ XLI TVIWWYVI YPGIV Section 1 Understanding7 Pressure Ulcers Mediscript Communications AND TREATMENT IS A TEAM EFFORTThe support worker or care - provider are the front line health workers, caring directly for patients, who are pivotal to the success of the prevention and treatment activities. There are also many other health professionals who are involved, such as, home care nurses, dietitians, family physicians and others.

9 It must be realized that this is a team effort and everybody should be working from the same page . Hopefully this book will provide the uniformity of information for the whole team, perhaps just basic information for the health care professionals but perhaps a little technical for the patient. With this in mind this book can be the catalyst for discussion and POWERHow a person copes with a Pressure ulcer or the threat of one HIZIPSTMRK GER GSRXVMFYXI WMKRM GERXP] XS E WYGGIWWJYP SYXGSQI The nurse, support worker, care provider and other members of the team all need the cooperation of the patient if the Pressure ulcer is to be prevented or healed. Consequently taking an holistic approach of treating the whole patient with their involvement in care practices is very NOTE7 SQI HMWIEWIW LEZI E TVIHMGXEFPI SYXGSQI SZIV XMQI ERH XLIVI is little you can do except to try to improve the patient s quality of life.

10 Pressure Ulcers , however, can be prevented and healing can be speeded up by following the instructions of the health GEVI TVSJIWWMSREP 7S [LIR MX GSQIW XS EZSMHMRK E TVIWWYVI YPGIV prevention is the order of the major contributing factor of Pressure Ulcers is unequalized Pressure creating an inadequate blood supply (known as ischemia) to the at risk skin area. However, there are many factors that, along with Pressure , contribute to the formation of an ulcer . It is important to recognize the individuality of each case and, because of this, we have provided opportunities throughout this book to [VMXI HS[R WTIGM G EHZMGI ERH XVIEXQIRX KYMHIPMRIW &I WYVI XS HS this, and refer to your notes Ulcers Mediscript Communications PREVENTION IS BETTER THAN CUREC urrent statistics show that each year in North America well over 1,000,000 people who are receiving care in hospitals, nursing homes or at home, develop Pressure Ulcers .]]]