Updated: May 6
Article May 3, 2022
What Are Bed Sores?
Bed Sores are pressure ulcers. Many patients cannot move to reposition their bodies due to an illness, injury, or disability. There are patients who suffer from permanent contractures. They cannot move because their bones and muscles are permanently fused in an unusual position. There are also stroke victims who are paralyzed from one side or both and cannot reposition without assistance. Patients who cannot readjust on their own are at the highest risk for further injuries such as bed sores.
Bed Sores - A skin injury that can become worse over time if not treated. These types of pressure ulcers commonly develop on the tailbone, heels, ankles, and hips. Bedsores are difficult to treat and develop quickly.
There are 4 stages of bedsores:
Stage 1: The affected area is red and feels warm when touched. No open wound present.
Stage 2: The affected area has an open sore, scrape, or blister. The wound has become an ulcer that digs deeper below the surface of the skin. The injury begins to feel tender and painful.
Stage 3: The affected area has a large open wound that is crater-like. The damage is below the surface of the skin. Fat is visible, but muscle, tendon, and bone is not visible yet.
Stage 4: The affected area is severely damaged, and the wound is deep and open. The sore extends past the subcutaneous fat, past muscle tissue, and deep down to reveal the bone. The muscle, bones, and tendons are visible.
It is common practice for Certified Nursing Assistants and Home Health Aids to provide repositioning assistance. When placing a patient back in bed, you may want to put a pillow under their feet. Most facilities put a policy in place where staff is required to put a pillow underneath the patient's feet to keep the heels floating.
Most patients are repositioned every two hours, during rounds. Other patients require more or less time, always check with the charge nurse and the care plan. Helpful Tip: It's good practice to try and make a specific effort to notice how the patient was resting before a brief change to make sure they are not accidentally repositioned on the same side.
Don't Forget Your Pillows
When the patient is in the lateral position, they will need at least 4 pillows. One to support their head, another pillow for their back, a pillow for the front, and another in between their legs. The pillows placed in front and back of them help keep them cradled and the pillow in front keeps their chest from compressing because of their arm falling forward. The pillow between their knees protects their knees and ankles from developing pressure sores. Depending on how the patient is resting, 4 pillows may not be necessary. Sometimes more or less is needed, and other times patients have special pillow wedges specifically designed for patients and their repositioning needs.
No matter how you position your patient, notice their tailbone, heels, ankles, and hips to protect them from developing a pressure ulcer. Use pillows, rolled-up blankets, rolled-up towels, or ask if the client already has something else they prefer to use.