bed sores/decubitus ulcers

[Guest guest]

The treatment of decubitus ulcers (i.e., bed sores) is a very worthwhile and important subject. However, from my experience in western hospital work (I was a nurse's aid at Laguna Honda in San Francisco among other places) an ounce of prevention is worth a pound of cure when it comes to bed sores.

 

When I first went to Laguna Honda (a large, state run convalescent hospital originally built to house the aging 'forty-niners/gold rush folks) , I was extremely challenged by the smell. The soiled sheets in the laundry shoots seemed to take over. I was prepared for the worst when entering the ward. All the patients in this particular ward were aphasic and contracted. I thought for sure that proper care was not being given to these patients. But only a week into my time there showed me otherwise. The CNA's were completely overworked, for sure, and there seemed to be little that could be done about the smell, but the patients received excellent care ... especially skin care. Not one case of bed sores among the 40 patients on my ward. These were adult patients that were as infants in their abilities ... in fact, even less so. They had to be turned regularly. Bathing and stimulating the skin while applying lotion was key.

 

I realize this may be a staffing issue in some places. This kind of care may not be readily accepted or enacted but it is important to note that at Laguna Honda, we had NO spare time. The work was hard and I went home everyday ready to drop. I felt torn about the little time we had to feed our patients properly given their limitations with motor skills among other things. We may not have had time for any extras but basic skin care and repositioning of patients was ingrained into the routine and procedures there ... Even though the patient/caregiver ratio was daunting.

 

I apologize if I belabor my point. But proper care can prevent bed sores. Keeping the patients clean, pressure points moisturized and rotating their body position regularly is vital.

 

In my time as a CNA, I saw too many bed sores (in other hospitals). Every time, it was apparent the patient wasn't being rotated or cleaned properly. Just something to think about.

 

That said, once a decubitus has formed, it is important to know how to treat it. MRSA infection is a serious danger (my grandmother lost a leg to just such a scenario). I am most interested to hear what others have to say about the treatment of bed sores and look forward to the posts.

 

be well,

Maya

[Guest guest]

I just reread my post and would like to add ................

 

I would be remiss if I didnt' acknowledge that there are times when it is impossible to rotate a patient due to their injury/post surgical condition. I apologize if I sound judgemental in my comments regarding bed sores, but it has been a point of frustration. Sometimes, the condition cannot be avoid easily ... but all too often, it can be with a little attention to some very basic things.

Maya

[Guest guest]

Hi Maya,

 

Re treatment of bedsores.

> ... there are times when it is impossible to rotate a patient due

> to their injury/post surgical condition... Sometimes, the condition

> cannot be avoid easily ... but all too often, it can be with a

> little attention to some very basic things. Maya

 

IMO, the following are the best ways to treat bedsores and

decubitus ulcers:

 

1. Remove the pressure frequently throughout the day by frequent

turning - often difficult, as Maya said

 

2. Ensure that high-risk patients have a vibrating air-mattress under

them - expensive but very useful.

 

3. Use of local laser (LLLT) or TENS daily around the edge of the

lesion. Kaada claims almost 100% success in 5-6 weeks with

TENS. Some acupuncture texts recommend circling the dragon " -

inserting several (4-6) needles in the healthy skin 5mm outside the

ulcer and running them under the ulcer base.

 

4. Apply Aloe-Vera Gel to the wound.

 

5. As a preventative in old debilitated patints, use frequent turning,

the vibrating air-mattress, emulsifying ointment and Sudocrem

routinely.

 

 

Best regards,

 

 

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