Pressure sore prevention

Prevention is the single most important aspect in the management of pressure sores. Prevention is far easier and less costly than the intensive care necessary for the healing and eventual closure of pressure sores. Of primary importance, then, is the ability to identify patients who are at high risk so that preventive measures may be instituted. 

N Cullum, J Deeks, T A Sheldon, F Song, A W Fletchm-, Beds, mattresses and cushions for pressure sore prevention and treatment , CochratK Database Syst Rev, 2000 2 CD001735. 

Prevention is key in the management of pressure sores. Mild superficial pressure sore infections may be treated with topical antimicrobial agents. Systemic antibiotics are indicated for pressure sores associated with spreading cellulitis, osteomyelitis, or bacteremia. 

Careful monitoring and preventative care of high-risk patients can begin once these patients are identified. Intrinsic, or host-related, risk factors for the development of pressure sores include age greater than 75 years, limited mobility, loss of sensation, unconsciousness or altered sense of awareness, and malnutrition. Extrinsic, or environmental, risk factors include pressure, friction, shear stress, and moisture.37,42... 

Turning and repositioning the patient at least every 2 hours can reduce skin pressure and prevent pressure sores. However, because this level of care is unattainable in most hospital and nursing-home environments, multitudes of pressure-reducing mattresses have been manufactured. Although these can help to decrease pressure on susceptible areas, they do not negate the need for position changes.37,42... 

Integumentary System Assistance with turning and pressure shifts to prevent pressure sores, attention to avoiding extremes of heat and cold, especially for people with spinal cord injury Elimination System Urinary catheters and catheterization supplies, extra incontinence padding... 

Silicone sprays and occlusives, e.g. hydrocolloid dressings, may be effective in preventing and treating pressure sores. 

Severe cases of tetanus generally require admission to an intensive care unit for 3-5 weeks. Weight loss is universal in tetanus and these patients require enteral nutrition. Other important measures include close control of fluid balance, chest physiotherapy to prevent pneumonia, prophylaxis of thromboembolism and intensive nursing care to prevent pressure sores. 

Prevention is the single most important aspect in the management of pressure sores. After a sore develops, successful local care includes a comprehensive approach consisting of relief of pressure, proper cleaning (debridement), disinfection, and appropriate antimicrobial therapy if an infection is present. Good wound care is crucial to successful management. 

Goode PS, Allman RM. The prevention and management of pressure sores. Med Clin North Am 1989 73 1511-1524. 

Tertiary Active rehabilitation after stroke to improve speech and mobility and prevent pressure sores and other complications Treatment of asthma by reducing or eliminating exposure, with drug treatment if necessary, to prevent complications such as death... 

The current emphasis on the use of evidence to support clinical interventions has entered a new phase with the establishment of the National Institute for Clinical Excellence (NICE). One of the early issues that are being addressed by NICE is the prevention of pressure sores, vdiich will add considerably to the body of knowledge about tissue viability. One of the key problems for NICE and other review groups is how best to disseminate their findings and recommendations to practitioner . ... 

J B Reswick, J E Rogers, Experience at Rancho Los Amigos Hospital with devices and techniques to prevent pressure sores. In R M Kenedi, J M Cowden, J T Scales (Eds). Bedsore Biomechanics. Baltimore University Park Press, 1976,301-310. 

Patient care plans should include a number of daily evaluations to be performed by the patient, such as examination of the feet for any sores, cuts, or abrasions checking the skin for dryness to prevent cracking and chafing and monitoring blood glucose values as directed. Weekly appraisals of weight and blood pressure are also advised. 

Chlorine. Lacrimation. Rhinorrhea. Conjunctival irritation. Cough. Sore throat. Hoarseness Laryngeal edema. Dyspnea. Stridor. ARDS. Pulmonary edema Decontamination Copious water irrigation of the skin, eyes, and mucosal membranes to prevent continued irritation and injury Symptomatic care (no antidote) Warm/moist air, supplemental oxygen, positive pressure O2 for pulmonary edema Bronchospasm Beta-agonists (albuterol) Severe bronchospasm Corticosteroids (prednisone) (also used for PTS with H/0 asthma but use unproven) Analgesia and cough Nebulized lidocaine (4% topical solution) or nebulized sodium bicarbonate (use unproven)... 

Properties Colorless liq. sol. in most org. soivs. insol. in water m.w. 126.24 sp.gr. 0.802 (20 C) vapor pressure 9.9 mm Hg (37.7 C) m.p. -95 C b.p. 152-155 C flash pt. 35 C ref. index 1.441 Toxicology May be harmful by ing., inh., skin absorp. may cause mild skin irritation vapor may be irritating to eyes probably a CNS depressant si. nose/throat irritant high vapor cones, may cause headache, lightheadedness, nausea, drowsiness very high cones, may cause unconsciousness, death ing. may cause sore throat, nausea, diarrhea Environmental Prevent entry into drains Precaution Flamm. LEL 0.8% forms explosive mixts. in air vapor may flash back container explosion may occur underfire conditions ... 

Alphafit s technical textiles are made of sensory filaments. With this sensory filament, it is possible to measure surface pressure on three-dimensional variable surfaces. Textile three-dimensional pressure measurement is useful for all things foot related. The filament itself measures the pressure. The textile system works without the need of inserting any industrial sensors. This measurement system can be integrated into any textile. Production is stuimingly simple and can be done on a large variety of textile materials for many different applications. With the pressure-sensitive filament, special textiles can be produced for each and every part of the body, such as the hands, feet and knees. Possible areas of application also include numerous industrial uses. The original idea was to develop a measurement tool for orthopaedic shoemakers in order to prevent sore feet in patients suffering from diabetic foot syndrome. 

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