ICU patients are in critical condition and need to stay in bed for a long time. Some patients may need to brake or turn over due to their condition, which poses difficulties for the prevention and care of ICU pressure ulcers. Below, I will share with you the prevention and care of ICU pressure ulcer patients.
Pressure ulcers, also known as pressure injuries, are a common nursing problem in clinical practice. Preventing pressure ulcers has always been a key focus of clinical nursing work. According to data, the high-risk population for pressure ulcers includes nerve damage, fractures, and the elderly. 70% of pressure ulcers occur in people over 65 years old, and most patients admitted to the ICU are within this range. The main clinical characteristics include critical illness, frequent catheterization, passive position, circulatory failure leading to skin dampness and coldness, poor microcirculation, and excessive use of antibiotics leading to dysbiosis of the microbiota. Subsequently, a series of skin problems can lead to the occurrence of pressure ulcers.
What causes pressure ulcers?
If a person stays in one position for a long time, such as lying in bed, it will reduce blood flow to various parts of the skin, leading to serious sores or blisters. If left untreated for a long time, pressure ulcers will continue to develop to the bone area. If dirty clothes or underwear are not changed for a long time, the occurrence rate of pressure ulcers may even be faster, as urine can further damage the skin.
Where do pressure ulcers occur?
The areas where there is no muscle wrapping or thin muscle layer, lack of fat tissue protection, and are frequently compressed at the bone prominence are prone to pressure ulcers.
What are the symptoms of pressure ulcers (bedsores)?
NPUAP divides pressure injuries into 6 stages, with varying degrees of injury in different stages. Pressure ulcers initially present as redness of the skin, and if they continue to worsen, the skin will be damaged, presenting a shallow volcanic crater appearance ranging from pale red to pink. Some pressure ulcers are blister like and can rupture, with severe cases even reaching deep into muscles or bones. Deep pressure ulcers can also form scabs.
Why are pressure ulcers (bedsores) difficult to heal?
1、 The patient's motor function and activity ability are limited, and if these factors are not effectively improved, even if we cure the pressure ulcer, it may recur. The sustained pressure or shear force during this treatment process may affect the healing of the wound, which is the most important factor.
2、 Generally, patients who lie in bed or sit in a wheelchair for a long time are often caused by systemic diseases, such as coma, paralysis, paraplegia, which are often combined with diabetes, neurological malnutrition, low immune function and other factors. These factors can all affect the healing of wounds.
3、 Many people do not receive effective attention in the early stages, and when we begin to discover wounds, various conditions such as infections may occur, which can affect the healing of the wound. Pressure sores in the sacrococcygeal region may also be close to the perianal area and may be contaminated by urine and feces. Also, the care of pressure ulcers is a very complex process, and without professional care and timely treatment, it is also a major reason why pressure ulcers are difficult to heal.
How to prevent the occurrence of pressure ulcers?
Preventing the occurrence of pressure ulcers is considered the most effective nursing method for pressure ulcers, and the cooperation of medical staff, patients, and family members is more conducive to reducing the risk of pressure ulcers.
1. Avoid long-term compression of local tissues
(1) Turn over every 2 hours, and if necessary, turn over every 1 hour;
(2) To protect the protruding areas of bones and support the gaps in the body, various decompression pads or new dressings can be used;
(3) Correctly use plaster, bandages, and splints for fixation.
2. Avoid frictional and shear forces
(1) When lying flat, the head of the bed should generally not be raised above 30 degrees;
(2) Reduce the time spent in a semi recumbent or sitting position to within 30 minutes each time and prevent the body from sliding down;
(3) When assisting patients with turning over or changing bed sheets, please lift the patient to avoid dragging, pushing, and other actions;
(4) When using a toilet, do not forcefully plug or pull it, and do not use a damaged toilet.
3. Protect the skin from irritation
(1) Check the patient's entire body skin once a day in the morning and once in the evening
(2) Keep the bed clean, dry, flat, and free of debris
(3) Clean the skin with warm water every day
(4) For patients with urinary and fecal incontinence, sweating, and excessive secretions, wipe them clean in a timely manner
(5) Do not let the patient lie directly on a rubber sheet or plastic cloth.
4. Strengthen nutrition
(1) Eat small meals frequently and provide high protein, high vitamin, and zinc rich foods;
(2) Correcting anemia and hypoalbuminemia;
(3) Control the risk factors of pressure sore such as diabetes.
Summary: Prevention of pressure ulcers is more significant than treatment. Only by preventing the occurrence of pressure ulcers is the most economical and effective measure. Through correct nursing, we can reduce the occurrence of pressure ulcer symptoms in bedridden patients and reduce the pain caused by the disease. Have you learned?