How Do You Treat Bed
Your doctor may suggest you start by making a few changes to your daily and nightly routines:
Try bladder retraining. Go to the bathroom at set times during the day and night. Slowly increase the amount of time between bathroom visits — for example, by 15 minutes at a time. This will train your bladder to hold more fluid.
Use an alarm clock. Set it to wake you up at regular times during the night so you can use the bathroom.
Try a bed-wetting alarm system. You attach it to your underwear or a pad on your bed. It will alert you as soon as you start to wet the bed.
Take medicines. Several can help with bed-wetting. Desmopressin reduces the amount of urine your kidneys make.
Other drugs calm overactive bladder muscles, such as:
If medicines and other treatments don’t work, your doctor might recommend one of these procedures:
Bladder augmentation. It’s an operation that makes your bladder larger, which raises the amount of urine it can hold.
Sacral nerve stimulation. It helps control an overactive bladder. Your doctor puts a small device into your body that sends signals to nerves in your lower back that help control the flow of urine.
Detrusor myectomy. It’s a major operation that treats an overactive bladder. Your surgeon removes part or all of the muscles around your bladder to stop them from contracting at the wrong times.
Dangers Of Pressure Ulcers Pressure Sores Or Decubitus Ulcers
What are pressure ulcers?
Pressure ulcers also referred to as bedsores or pressure sores, are skin and tissue injuries caused by prolonged pressure to the skin. Pressure ulcers are commonly found on the bony parts of your body including ankles, heels, hips and buttocks. 1 If left untreated, pressure sores can compromise your health and even lead to death.
What factors cause pressure ulcers?
How pressure ulcers are treated?
Pressure sores are categorized into four stages:
- Stage I ulcers are not actually open wounds. The skin may be very sensitive with a reddish appearance and could feel softer or firmer than the skin around it. When you press the ulcer it will not blanch or lose color when your finger is removed.2
Stage I pressure sores are often treated by incorporating pressure reduction products such as special cushions, mattress pads, and heel protectors. A person confined to a bed or wheelchair should change position frequently, every two hours if bed confined.1
J2 Pressure Reduction Cushion
Drive Pressure Reduction Mattress Pad with Pump
Iodoosorb/Iodoflex Wound Care
Stages Of Pressure Ulcer
This ulcer occurs in four stages:
Stage I – There is no broken skin but it will look discolored and red. The discoloration may vary from blue to purple. You will feel warm to the touch and may be itchy.
Stage II – There is a painful breakage in the skin with discolored skin around it.
Stage III – Due to the tissue damage below the skin surface, the ulcer is much deeper within the skin
Stage IV –Severe damage to the skin and tissue may lead to infection including your muscles and bones.
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What Is A Pressure Injury
A pressure injury is an area of injured skin. A pressure injury happens when force is applied on the surface of the skin. This force can be a constant pressure on an area of skin or a dragging force between the skin and another surface. These injuries usually happen over bony parts of the body . A pressure injury can become life-threatening if it advances to a deep wound or becomes infected.
The Reactive Hyperaemia Cycle
Unlike in water, all animals on land are unsupported by the medium they find themselves in. Therefore, all soft-bodied animals must develop mechanisms to ensure they do not suffer damage when their tissues are distorted by contact with whatever is supporting them. Despite this being an essential requirement of survival on dry land, little or no research seems to have been done to identify what physiological mechanisms exist to prevent pressure damage.
However, it is reasonable to assume that tissue distortion, when it occurs, causes ischaemia. This in turn stimulates protective movements to relieve distortion, and circulatory activity which aims to restore normal blood perfusion in the affected areas. The majority of protective movements are reflexes and the person is unaware of making them. However, if these prove insufficient to relieve ischaemia, the central nervous system is stimulated by discomfort and ultimately by severe pain. This generally ensures that pressure is relieved before permanent damage has been done.
Apart from restoring tissues to their resting state after an ischaemic episode, the circulatory system has a direct role in optimising perfusion of the tissues during distortion. Studies have shown that adaptive changes occur in the microcirculation in response to repeated loadings of tissue , although little is known about their triggers and mechanisms.
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Causes And Prevention Of Pressure Sores
Pressure sores are wounds that develop when constant pressure or friction on one area of the body damages the skin. Constant pressure on an area of skin stops blood flowing normally, so the cells die and the skin breaks down.
Other names for pressure sores are bedsores, pressure ulcers and decubitus ulcers.
What Are The Risk Factors For Bedsores
Being bedridden, unconscious, unable to sense pain, or immobile increases the risk that a bedsore will develop. The risk increases if the person is not turned, positioned correctly, or provided with proper nutrition and skin care. People with diabetes, circulation problems and malnutrition are at higher risk.
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Can Bedsores Be Prevented
Bedsores can be prevented by inspecting the skin for areas of redness every day with particular attention to bony areas. Other methods of preventing bedsores and preventing existing sores from getting worse include:
- Turning and repositioning every 2 hours
- Sitting upright and straight in a wheelchair, changing position every 15 minutes
- Providing soft padding in wheelchairs and beds to reduce pressure
- Providing good skin care by keeping the skin clean and dry
- Providing good nutrition because without enough calories, vitamins, minerals, fluids, and protein, bed sores cant heal, no matter how well you care for the sore
Other Tips For Preventing Pressure Ulcer
1. Check the skin daily for any signs or symptoms of pressure ulcers. The patients can take the help of Bedside Wound Care Services for this. 2. Maintain a healthy and balanced diet that contains sufficient and enough protein with good sources of vitamins and minerals.3. Quit smoking. People who smoke are more prone to develop pressure ulcers due to the damage caused to blood circulation. 4. For repositioning, wheelchair push-ups are good where the person can raise their body off the seat by pushing on the arms of the chair. The use of cushions or special mattresses is also prescribed to release pressure and ensure a well-positioned body. Avoid doughnut cushions as they can put pressure on surrounding tissues.5. Ensure regular pressure ulcer dressings to avoid any type of infection and effective wound healing.
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How Pressure Ulcers Develop
Pressure ulcers can develop when a large amount of pressure is applied to an area of skin over a short period of time. They can also occur when less pressure is applied over a longer period of time.
The extra pressure disrupts the flow of blood through the skin. Without a blood supply, the affected skin becomes starved of oxygen and nutrients, and begins to break down, leading to an ulcer forming.
Pressure ulcers tend to affect people with health conditions that make it difficult to move, especially those confined to lying in a bed or sitting for prolonged periods of time.
Conditions that affect the flow of blood through the body, such as type 2 diabetes, can also make a person more vulnerable to pressure ulcers.
Learn more about the causes of pressure ulcers.
How Can Pressure Ulcers Be Treated
It is important to watch out for early signs of pressure ulcers and to contact your doctor if you notice any changes to the skin. Ulcers are best managed early on, and your doctor will assess whether your pressure ulcer can be managed at home, if you need a referral to a wound specialist or if you require treatment at hospital.
Use healthdirects Service Finder tool to locate your nearest GP or nurse clinic.
Wound dressings can enhance healing. Your healthcare team will select the most appropriate treatment and dressing, depending on your specific pressure ulcer. There are 6 classes of dressings:
- alginate absorbent fibre dressings
Depending on the type of pressure ulcer, a bandage may also be applied to keep the dressing in place or support the injured area.
To promote healing and recovery, it is important to eat a balanced diet that includes protein, carbohydrates, fats and sufficient fluids.
Other treatments may include antibiotics if the ulcer becomes infected, or debridement a procedure used to clean the wound and remove any damaged tissue.
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Bed Sores Common Reasons And Home Remedies For Pressure Sores
Pressure ulcers are commonly known as pressure sores or deception. Injuries are caused by the constant pressure to any part of the human body. But usually occurs in those parts where there is an area of bone or cartilage. Pressure ulcers are treatable if detected early and are paid adequate medical care. If left untreated, without medical attention, can become life-threatening conditions.
Common Reasons for Bed Sores
Shear and friction: If a bedridden person is pulled or dragged from his bed that causes friction and stretches the muscles of the skin. The circulation of the skin is broken causing damage.
Moisture: Skin is very sensitive at this time. Perspiration, bed-wetting or feces also leads to the possibility of pressure ulcers.
The lack of movement: People who have been in bed for a prolonged period of time due to serious medical conditions, those most affected. Being in one position without any movement is one of the main reasons for pressure ulcers.
The lack of nutrition: A good diet can help fight this disease easily. Due to the lack of protein, vitamins and other substances needed in the body, the patient suffers from another party.
Age: An elderly person is affected primarily because young people are on their side. The thin skin and no bodily functions deteriorate the chances of recovery.
Home Remedies for Bed Sores
Topical calendula cream is very soothing and healing wounds. Used as directed on the label of the product.
What Are The Stages Of A Pressure Injury
There are four stages that describe the severity of the wound. These stages include:
- Stage 1: This stage is discolored skin. The skin appears red in those with lighter skin tones and blue/purple in those with darker skin tones. The skin does not blanch when pressed with a finger.
- Stage 2: This stage involves superficial damage of the skin. The top layer of skin is lost. It may also look like a blister. At this stage, the top layer of skin can repair itself.
- Stage 3: This stage is a deeper wound. The wound is open, extending to the fatty layer of the skin, though muscles and bone are not showing.
- Stage 4: This stage is the most severe. The wound extends down to the bone. The muscles and bone are prone to infection, which can be life-threatening.
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Symptoms Of Pressure Ulcers
The parts of the body most at risk of developing pressure ulcers are those that are not covered by a large amount of body fat and are in direct contact with a supporting surface, such as a bed or a wheelchair.
For example, if you are unable to get out of bed, you are at risk of developing pressure ulcers on your:
- shoulders or shoulder blades
- knees, ankles, heels or toes
If you are a wheelchair user, you are at risk of developing pressure ulcers on:
- the back of your arms and legs
- the back of your hip bone
Failure Of Reactive Hyperaemia
In patients with a failure of reactive hyperaemia, the tissues are no longer able to recover from ischaemic episodes, and pressure ulcer prevention is probably most difficult in this group. Failure of reactive hyperaemia can occur in very sick and dying patients in whom there is insufficient peripheral blood pressure to refill capillary beds emptied by compression. Clinically, this presents as white patches in pressure areas which do not change colour rapidly to the red of reactive hyperaemia, as they would in a healthy person. Rather, the white patches remain for many minutes before slowly returning directly to a more normal skin colour with little or no reactive hyperaemia being observable. Similar effects can be seen in critical care patients who are on high doses of inotropes, such as adrenaline.
Since individuals in the same diagnostic category can have either a normal or pathological circulatory response to repeated loading , this may well explain why some patients are more prone to pressure ulceration than others with the same diagnosis .
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Chronic And Acute Susceptibility
To formulate effective plans for the prevention and management of pressure ulcers it is important to understand that regardless of aetiology patients at risk of pressure damage fall into one of two groups – those who are acutely susceptible and those who are chronically susceptible.
Acute susceptibility arises due to sudden illness or trauma or due to an operative procedure. It is likely to be of relatively short duration and once the underlying causes are resolved, the patient will usually be susceptible no longer. For example, a patient admitted for surgery may only require high-dependency care for a short period on the day of the operation and overnight but will not be susceptible the following day when no longer ventilated and sedated. Following an acute episode, however, the patient may remain chronically susceptible if the acute episode causes permanent damage to the bodys defence mechanisms against pressure damage. For example, immediately following spinal injury there is an acute phase when there is very high susceptibility . This resolves after a period of time but the patient remains susceptible to some degree for the rest of their life.
Chronic susceptibility can be exacerbated by acute episodes. For example, an illness such as a chest or urinary tract infection may reduce tissue tolerance to pressure and increase susceptibility acutely for the duration of the illness.
Postoperative And Rehabilitation Care
Postoperative care of patients who have undergone reconstructive surgery is of utmost significance as these ulcers have high rates of recurrence. A study done on characteristics of recurrent pressure ulcers showed that patients who underwent reconstructive surgery and developed post-operative, had an 11% to 19% chance of recurrence. Those without any postoperative complications had recurrence as high as 61%.
When medical staff shift patients from the operating table to their air-fluid beds, they must avoid excessive shearing, and stretch on skin flaps. For the first four weeks, patients are positioned flat on their support surfaces, after which they can place themselves in a semi-sitting position. The patient starts to sit for 10 minutes only after six weeks of the surgical procedure. After these sitting periods, the flap should be examined for discoloration and wound edge separation. Over two weeks, the sitting periods will increase to 2 hours in 10-minute increments. Patients will also learn to lift for 10 seconds every 10 minutes to relieve pressure. Meticulous skin care is necessary.
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Treatments For Pressure Ulcers
Treatments for pressure ulcers depend on how severe they are.
For some people, they’re an inconvenience that needs basic nursing care. For others, they can be serious and lead to life-threatening complications, such as blood poisoning.
Ways to stop pressure ulcers getting worse and help them heal include:
- applying dressings that speed up the healing process and may help to relieve pressure
- moving and regularly changing your position
- using specially designed static foam mattresses or cushions, or dynamic mattresses and cushions that have a pump to provide a constant flow of air
- eating a healthy, balanced diet
- a procedure to clean the wound and remove damaged tissue
Surgery to remove damaged tissue and close the wound is sometimes used in the most serious cases.
Read more about the treatments for pressure ulcers.
Causes Of Pressure Ulcers
Pressure ulcers are caused by sustained pressure being placed on a particular part of the body.
This pressure interrupts the blood supply to the affected area of skin. Blood contains oxygen and other nutrients that are needed to help keep tissue healthy. Without a constant blood supply, tissue is damaged and will eventually die.
The lack of blood supply also means that the skin no longer receives infection-fighting white blood cells. Once an ulcer has developed, it can become infected by bacteria.
People with normal mobility do not develop pressure ulcers, as their body automatically makes hundreds of regular movements that prevent pressure building up on any part of their body.
For example, you may think that you are lying still when asleep, but you may shift position up to 20 times a night.
Pressure ulcers can be caused by:
- pressure from a hard surface such as a bed or wheelchair
- pressure that is placed on the skin through involuntary muscle movements such as muscle spasms
- moisture which can break down the outer layer of the skin
The time it takes for a pressure ulcer to form will depend on:
- the amount of pressure
- how vulnerable a person’s skin is to damage
Grade 3 or 4 pressure ulcers can develop quickly. For example, in susceptible people, a full-thickness pressure ulcer can sometimes develop in just 1 or 2 hours. However, in some cases, the damage will only become apparent a few days after the injury has occurred.
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