AVOIDING BEDSORES
How to prevent tissue ulcers through proper body positioning
BY:KRISTIN SCHWEIZER, MPT
Pressure ulcers, commonly referred to as bedsores, are typically the result of pressure on small blood vessels that supply muscles, tissue and skin with essential nutrients. Often, this pressure occurs when a person is lying or sitting in one position for a prolonged period of time. The surface of the bed or chair presses against bones and compresses the blood vessels in the tissues in between. Deprived of nutrients, the tissues begin to die, resulting in ulceration.
Pressure ulcers can range in severity, but all must be attended to properly and promptly. People with pressure ulcers may experience pain and are at risk for infection. Those at greatest risk for developing ulcers have difficulty moving, impaired sensation and poor nutrition.
Areas of Concern
When the person is lying on his back, areas of concern include the back of the head, shoulder blades, spine, sacrum and coccyx, and the back of the heels. If on his side, the high-risk areas include the ear, shoulder, hip and outside of the ankle. The ideal position for lying in bed is slightly on the side, where the body forms a 30-degree angle to the mattress. Pillows can be placed behind the person’s torso to maintain this position. (A pillow between the legs will keep the inside of the ankles from touching.)
When sitting, the boney areas of the buttocks, as well as the sacrum and coccyx receive the most pressure. The ideal position for sitting is completely upright, with knees bent sharply and feet flat on the floor. This allows pressure to be distributed over the backs of the thighs instead of solely on the boney areas. A reclined position increases pressure across the sacrum and coccyx.
If a person cannot reposition herself, the caregiver should change her position at least every two hours; for example, after the person is on her right side for two hours, she should be turned to the left side.