Some Guidance, Advice and Tips for Pressure Care

The most important factor with Pressure Care is to try and prevent problems from occurring in the first place. Most Health care settings now have strict guidelines aimed at preventing pressure ulcers from developing.

If a pressure ulcer has developed special equipment (for example, an alternating pressure mattress or cushion) or wound dressing will be required. Don’t forget that lying in bed spreads the load (except for heels)

Do not rub the affected area as this may cause further tissue damage. Inflatable and material ring-shaped cushions should never be used as they may further restrict the supply of oxygen to the affected area.

If the sore has become infected, further treatment by a Nurse or Doctor may be required. This will be specific to the grade, type and location of the ulcer and may be accompanied by irrigation of the wound with a salt-water wash.

Pressure Care is Important

Pressure ulcers tend to develop on bony prominences and on areas of the body that have little body fat to cover them. This includes the hips, buttocks, heels, shoulder blades and the small of the back. Sitting in a chair or wheelchair for long periods of time, without pressure being relieved, is even more likely to cause pressure ulcer development.

Pressure ulceration occurs when the skin and underlying tissues are compressed for a period of time, between the bone and the surface, on which the patient is sitting or lying. Blood cannot circulate causing a lack of oxygen and nutrients to the tissue cells. Furthermore, the lymphatic system cannot function properly to remove waste products. If the pressure continues, the cells die and the area of dead tissue that results is called pressure damage. The amount of time this takes will vary, but may develop in as little as one hour in patients at greatest risk.

Aetiology of Pressure Sores

The factors causing pressure ulcers are divided into 2 Groups

INTRINSIC – Disease, medication, malnourishment, age, dehydration/fluid status, lack of mobility, incontinence, skin condition, weight.

EXTRINSIC – External influences which cause skin distortion – Pressure, Shearing Forces, Friction, Moisture.

Pressure

The blood pressure at the arterial end of the capillaries is approximately 32 mmHg, while at the venous end this drops to10 mmHg. The average mean capillary pressure equals about 17 mm Hg and any external pressures exceeding this will cause capillary obstruction. Tissues that are dependent on these capillaries are deprived of their blood supply. Eventually the ischemic tissues will die.

Shearing Forces

Shearing forces will only exist if pressure, usually caused by the persons own body weight, is also present. Shear forces occur when a part of the body tries to move but the surface of the skin remains fixed. (See Waterlow Manual for a better understanding of this phenomenon).

Friction

Friction forces occur when the shearing force increases sufficiently to overcome the bodies resistance to movement. The movement has an abrasive action.(See Waterlow Manual for a better understanding of this action).

Moisture

Skin should not be left wet as moist skin sticks to material (e.g. bathing, perspiration, incontinence (as urine and faeces are acidic), amniotic fluid) as it can become macerated making it more susceptible to shear and friction.

Certain areas of the body are more vulnerable to pressure ulcer formation than others.

Bony prominences in particular: heels, sacrum, buttocks, hips, elbows etc. Some groups of people are at greater risk from pressure ulcers than others.

Immobility for any reason contributes to the risk of pressure sore, therefore the elderly, wheelchair users and patients who are bed-ridden are most at risk. People living with incontinence especially women may also develop pressure ulcers, as prolonged exposure to moisture can cause breakdown of skin tissue. Many other conditions such as diabetes and arterial disease can also increase the risk of pressure ulcers as the supply of blood and oxygen to body tissue may be restricted.

In order to prevent pressure ulcers developing, it is important that those who are immobile have pressure relieved frequently either by manual turning or sophisticated bed systems. However even if a patient is lying on a bed system risk areas still require regular inspection.

This may need to be more frequent if sitting. A healthy balanced diet and plenty of fluids will also help the condition of the skin. Those at higher risk of pressure ulcers, such as the elderly and those with existing medical conditions should keep as active and mobile as possible, taking some form of exercise every day.  It is advisable to take part in exercise that uses a range of motions.

Also important is keeping the skin clean and dry, and checking that bed linen is free from wrinkles.

Choose Pavement Mobility Scooters to Zip Around Your Community

If an illness or injury has made it harder to do the things you love, especially if they require going outside the home, consider learning more about pavement mobility scooters to see if they might help you reclaim independence and dignity. These medium-sized options are very sturdy and specially designed to offer great traction on flat surfaces that are common in many communities.

Take them for a jaunt to your favourite shopping complex, or pop into a friend’s residence for a cup of tea and some memorable conversations. They’re ready to make your life simpler, and many online retailers offer delivery service so you don’t have to struggle with the hassle of picking up the product after you’ve purchased it.

 A Preventative Measure

Sometimes without even realising it, people who are managing physical challenges start to avoid spending time with others, seemingly content to remain solitary for days at a time. Ask yourself if there have been times when you’ve ultimately decided to stay at home rather than go out and do something nearby. If that’s the case, mobility scooters can help you break the cycle before it gets so severe it feels there’s no way out.

When you feel an impairment has adversely affected the manner in which you get around, that’s a strong signal it’s time to explore options. Many people choose a scooter over other aids like walkers and canes, because a motorised vehicle doesn’t require a user to stay balanced and rely on muscle strength to move forward. Pavement mobility scooters, for example, often have a pair of controls that are easy to manipulate with little more than a slight touch from a fingertip.

A Steadfast Shopping Companion

 Another reason that people often decide to use a scooter rather than another device is that motorised vehicles keep hands free to do other things like choosing items from store shelves, and paying for them at the till. Also, many scooter models come complete with a basket on the front, which provides a great space for storing shopping bags, coupons or catalogues. For some, shopping is the best medicine, because it offers the chance to experiment with new clothing styles or even try new foods. Depend on mobility scooters and get on the go again.

A shopping trip isn’t the only place to use a scooter. Rely upon it to attend community gatherings, doctor’s appointments and much more. Your freedom is waiting. Get it back now, and start to live a more fulfilling lifestyle.