Pressure Relieving Devices and Their Effect on Bed Sores
PRESSURE RELIEVING DEVICES AND THEIR EFFECT ON BED SORES
Sixth in series
Over the past several days, Jonathan Rosenfeld and I have outlined several of the most common ways bed sores develop in nursing home residents and hospital patients. In this last entry of the series, we focus on pressure relieving devices. As we have seen, there are numerous ways caregivers can help alleviate or prevent bed sores. Proper hydration and nutrition are important as is preventing the development of contractures and keeping residents clean and dry. Patients at risk for developing bed sores or with existing bed sores, must also be turned and repositioned at least every two hours pursuant to federal regulations. When not being repositioned, it is still important to do everything possible to protect the patient from developing bed sores. That is where pressure relieving devices may be utilized.
USE A PRESSURE-REDUCING MATTRESS, BED, OR WHEELCHAIR. Use of a pressure-reducing mattress, bed, or wheelchair can help alleviate pressure to areas susceptible to the development of pressure sores.
MATTRESSES. There are many mattress options, such as foam, air, gel, or water. Frequently, physicians suggest the use of low-air-loss beds or air-fluidized beds. Low-air-loss beds use inflatable pillows to support the individual while air-fluidized beds uses thousands of silicone beads to suspend the individual. A physician will be able to direct you to the best option for your loved one.
Early stage bed sores are often treated by mattress overlays, such as eggcrate, Derma Tech, Silicore, Alternating Pressure System, and multi-zoned, or special mattresses designed to help heal or prevent bed sores.
The eggcrate overlay is a 4” foam bed pad is probably the cheapest option available. It is typically placed on top of the mattress for additional protection for pressure points. Foam overlays less than 4” do not provide enough protection from pressure to prevent pressure sores (provides comfort only). Keep in mind that foam products lose their effectiveness after only a few months and need frequent replacing.
A Derma Tech overlay is a foam mattress overlay. It is considered a higher quality product than an eggcrate overlay and may do a more effective job of preventing or treating existing bed sores. The Silicore overlay is a mattress overlay that is designed to prevent skin breakdown before it occurs. It is made of siliconized hollow core shafts that do not collapse when pressure is applied. Again, this is a higher technology than foam and may be more expensive.
An Alternating Pressure System mattress overlay is a mattress system overlay that may help nurses from having to turn and reposition the resident every two hours. However, it still requires supervision and should not be used as an excuse to ignore the resident. A physician should be consulted with respect to the turning schedule for those utilizing the Alternating Pressure System mattress. The APS mattress overlay employs changing air pressure to improve the patient’s circulation, which is critical for those at risk for bed sores. The pad consists of uniform air tubes that inflate and deflate approximately every four minutes.
A lateral turn/rotation mattress is useful for patients who require frequent repositioning. These mattresses automatically turn patients laterally to assist in changing their body position.
WHEELCHAIRS. Pressure-release wheelchairs are designed to tilt to redistribute pressure in wheelchair-bound people. If your loved one does not have a pressure-release wheelchair, a caregiver will need to manually change the individual’s body position every fifteen minutes. Pressure relief air chairs are mattress pads designed to fit into wheelchairs or onto a chair for pressure sore relief while seated. The air chair pad is especially useful for those patients who are not bed-bound but have difficulty ambulating on their own. If a nursing home resident is at risk for bed sores, but prefers to be mobile, an air chair pad may be just the thing.
PADDING: Mattresses, mattress overlays and wheelchair pads are all good things, but sometimes, they do not address some of the areas most at risk for developing bed sores. To that end, podus boots, posey comfort pads, and sheepskin wrist, elbow and heel pads are used to help alleviate pressure on bony projections, such as hipbones, elbows, wrists, and ankles.
What do pads, overlays and mattresses all have in common? They are designed to prevent the development of bed sores and or treat bed sores once they have occurred. Nursing homes often fail to do the necessary assessments on their residents to determine whether they are at risk for bed sores. Worse yet is when they do the assessments, but fail to implement the strategies necessary to prevent the development of bed sores. Sadly, the failure to implement is often the result of budgetary restrictions forced on the nursing home facilities by the corporate offices or the lack of proper training. Without utilizing the technologies, nursing home residents and hospital patients are substantially more likely to develop potentially life threatening bed sores.
Family member tips
If your loved one is at risk for developing bed sores or currently has bed sores you should:
• Talk to the nursing home and insist that your loved one receive all proper pressure relieving devices
• Visit the nursing home regularly and at different times. If the device is in use, insist that it be used
• Talk to the Director Of Nursing if you notice proper pressure relieving devices not being consistently used for your family member
