Bedsores, also known as pressure ulcers, can cause extreme pain and discomfort for patients with injuries and medical conditions that keep them confined to bed or to a wheelchair or chair for the majority of the day. Bed-bound patients often rely on their caregivers, including nursing staff members and certified nursing assistants (“CNAs”), to help keep them comfortable, move around as needed and turn and position them at least every two (2) hours to help reduce the risk of bedsores.
When bedsores do occur, prompt treatment can help resolve bedsore symptoms and help patients make a full recovery. Failure to treat bedsores, on the other hand, can result in severe complications and worsening sores that can cause more pain for the patient. Bedsore can quickly become very expensive medical problems that patients and their families should not be forced to pay for if — as usually is the case — the negligence of a caregiver or health care provider caused the bedsores.
How to Treat a Pressure Sore
Treating a pressure sore starts by removing pressure from the affected area. Pressure sores or pressure ulcers typically start to develop from prolonged pressure over a specific area of the body, usually a bony area like the tailbone, spine, ankles, or heels. Continued pressure on a bony area can cause the skin to break down and cause more problems in that area of the body. By removing pressure from the affected area, you allow the body’s natural healing to kick in and help alleviate some of the immediate pain and prevent further deterioration.
1. Clean the Affected Area of the Skin and Pat Dry.
Sometimes, you will catch the development of a pressure sore early enough that the skin has not yet broken. You should request the treating health care staff clean the skin and affected area carefully with a gentle cleanser for sensitive skin. Make sure the health care staff member exercises reasonable care to avoid putting undue pressure on the skin or scraping across the skin, which could worsen the pressure sores.
If the skin has broken, request the treating health care staff cleanse the skin with warm saline solution.
Once the affected area is thoroughly cleansed, which can help reduce the risk of infection, treating health care staff should then pat the affected area dry with a soft, clean cloth. Make sure the treating health care worker does not scrape at the skin or rub hard to remove residue, since this could worsen the pressure sore.
2. Use a Dressing to Cover the Affected Area.
Covering the affected area of the skin can help reduce the risk of infection and aid in the healing process. The type of dressing needed to treat your pressure sore may depend on the sore’s stage, severity and where it occurs. Talk with the treating doctor — preferably a wound care doctor — about the specific pressure sore you have and best way to treat it. Your doctor may recommend using a simple bandage, gauze, a gel film or foam covering that will help protect the skin while it heals.
3. Avoid Further Pressure on the Skin Around the Affected Area.
If you, or the patient, have feeling in the area where the pressure sore developed, you may not want to put pressure on the wound as it likely will be painful and very uncomfortable. On the other hand, if the patient is unconscious or highly medicated and has no feeling in the affected area, they may not realize that they have shifted into a position that puts pressure on that area. This can quickly lead to the further deterioration of the pressure sore. In many cases, the use of special positioning devices, various cushions, pressure relieving boots and speciality mattresses which completely offload pressure or help the patient change position regularly can be effective solutions to eliminate pressure on the affected area.
4. Change Your Dressing Regularly.
A health care worker should not simply bandage a pressure sore and leave it indefinitely. Instead, they should change the dressing regularly while keeping the area affected both clean and dry. Observe the wound with each dressing change. If you notice that the wound does not heal or it seems to get worse, not better, photograph the wound regularly and consult your doctor. Nursing staff and health care workers may try to challenge or prevent you from photographing these wounds but as the patient or family member you have a right to photograph these avoidable wounds and a good quality picture of the pressure sore can play a critical role in evaluating the healing of these wounds for physicians and treating medical providers.
5. Take Steps to Prevent More Pressure Sores in the Future.
Clearing up one pressure sore, only to have another sore develop in the area of the body you shifted to keep pressure off the affected area, can become extremely frustrating, not to mention extremely painful. To prevent future pressure sores, take the necessary steps to prevent them.
- Keep your skin clean and dry. You may not want to bathe every day, since strong cleansers can add to the risk of developing pressure sores. Keeping your body clean and dry, however, can reduce the odds that you will develop a pressure sore and keep you safer and more comfortable. You should not, however, use talc or other powders to keep the skin clean and dry, since they can change the pressure on your skin and increase the risk that you will develop a pressure sore.
- Shift position regularly. If you can move on your own, you may want to make a habit of shifting in your bed or chair regularly. For patients who need assistance, ask their caregivers, nurse or certified nurse assistants to help turn and position the patient at least every two (2) hours so that they can stay comfortable and remove pressure from sore spots on their body. You may want to use pillows or cushions to help you change position in a bed or wheelchair. However, exercise care when positioning those cushions, since they could shift pressure to other areas of your body.
- Use a custom or foam pads or specialty mattresses to help protect parts of your body that rub together or press uncomfortably. In some cases, you may want to order custom pads that fit your body. Talk to your doctor if you feel discomfort in specific areas regularly. You may also want to request a speciality mattress or bed to reduce pressure under your tailbone or buttocks, especially if you spend a great deal of time sitting, if you are immobile or often confined to bed.
- Make sure that caregivers know the proper way to aid in moving you. Your caregiver should not drag you across the bed or across other surfaces, which could increase friction on the skin and raise the risk of developing a pressure sore. Instead, make sure your caregiver knows the proper technique for moving and positioning you, whether using a draw sheet or lifting you.
- If you use a wheelchair, make sure it fits you correctly. Wheelchair sizes vary based on the size and weight of the patient. If your wheelchair does not fit you correctly, it could raise the risk that you will end up with pressure sores, especially if you do not use proper padding. If you notice pressure sores developing due to wheelchair use, ask your doctor to check the fit of your wheelchair. You may need to order a wheelchair if your weight changes dramatically or if you regularly suffer pressure sores or other discomforts.
- Check the skin regularly — meaning every shift. Early signs of pressure sores may go unnoticed, especially if your treating health care staff members do not check your skin regularly and thoroughly. Make sure your caregivers, the assigned nursing staff and their aids check all areas of your skin each nursing shift and immediately document any signs of skin breakdown or irregularity.
- Get the right nutrition and hydration. When confined to bed, patients may be reluctant to eat and drink normally, especially if they are heavily medicated or are in significant pain or discomfort. Adequate nutrition and hydration, however, can make a big difference in the skin’s elasticity and the body’s ability to heal when a pressure sore develops. Make sure the patient is given adequate nutrition and plenty of water to drink. Consult the treating doctor about the patient’s diet, especially if they have recently been confined to bed.
When Should Family and Doctors Be Notified About Pressure Sores?
For patients admitted to a hospital, skilled nursing care home or assisted living facility, nurses and treating health care workers should immediately notify family members and all treating doctors and caregivers as soon as they notice any signs or symptoms of skin breakdown or the development of a pressure sores.
It is always better to be safe than sorry. So if you notice the following key symptoms, it is important you should contact a doctor as soon as possible.
- You notice pus or drainage coming out of the wound. Any time you notice pus, fluid or drainage coming from a wound, it could serve as a sign of an ongoing infection. Notify your doctor, as soon as possible, so that you can receive prompt, proper treatment for your injuries.
- The skin around the wound feels warmer than the rest of your skin. Like pus or drainage, temperature changes could indicate infection. You should also notify your doctor of any redness spreading away from the pressure sore on your skin, especially if that area seems to expand or venlarge over time.
- You have a fever. If you have a fever or increase in body temperature, it may indicate that your body is attempting to fight off an infection. Your doctor can determine where the infection originated, including whether the pressure sore has anything to do with it, and provide appropriate treatment. Notify your doctor immediately.
- You notice an odor coming from the sore. Your body may put off an odor as it fights the infection. Sometimes, others may notice an odor coming from the wound before you do, particularly when helping to change bandages. Clean and dry the area carefully to help determine whether the odor comes from the wound directly or from failure to properly clean the area and contact your treating physician immediately if the odor is coming from the pressure sore.
- You notice the sore worsening despite treatment. Pressure sores can develop within several hours and may deteriorate quickly if not treated properly. Once you notice the pressure sore and begin treatment, however, you should not notice it getting worse. If you notice symptoms worsening or the pressure sore deteriorating, especially if you have a fever, pus, an odor or other symptoms of an infection, contact your doctor as soon as possible.
- The sore does not start to heal within a few days. Healing times may vary depending on a patient’s health and the severity or stage of the pressure sore. However, if you do not notice healing within a few days, consult your doctor and a wound care specialist immediately to determine the reason for the delay and ask what treatment needs to be done to increase your odds of making a full recovery.
- You think something feels wrong or off. If you feel that your treating caregivers or nurses have not given the pressure sore adequate attention, consult with your treating doctor to make sure that you receive all necessary care and treatment.
Complications of Untreated Pressure Sores
You should not ignore pressure sores and hope they will simply go away, nor should you ignore worsening signs or symptoms of a pressure sore once you begin treatment.
- Cellulitis, or infection. Cellulitis can cause redness or pain in the affected area. This infection can spread rapidly, causing complications which can be very serious. These may include extensive tissue damage, tissue death and infection leading to amputations, shock and premature death.
- Joint or bone infections. As the infection related to a pressure sore spreads, it can enter your bones, muscles and joints, causing extreme pain and difficulty moving. In some cases, you may need aggressive treatment to treat this infection once it spreads to through your body. Some patients — especially those which are heavily medicated or unconscious — may not be aware of the significant pain as the infection progresses; but it can, nevertheless, cause extreme damage.
- Sepsis. In many instances, infected pressure sores lead to sepsis, a dangerous infection that spreads through the body. As your immune system triggers an extreme response to the infection in your body, inflammation can spread. Sepsis can lead to organ failure and even wrongful death.
Contact an Attorney if a Health Care Provider’s Negligence Caused You to Develop a Pressure Sores
With proper medical care and treatment most pressure sores, also known as bedsore and decubitus ulcers,
are completely avoidable. However, if health care providers do not evaluate their patient’s clinical condition and pressure ulcer risk factors, develop and implement a plan of care consistent with the patient’s health care needs and recognized practice standards — such as turning and repositioning their patient at least every two (2) hours — pressure sore can quickly develop in any medical facility. Severe pressure sores can cause significant pain and suffering, these sores can cause long-term complications and result in a patient’s wrongful death if not treated properly. If you or a loved one has developed a pressure sore while under the care of any health care provider, contact a medical malpractice attorney today to learn more about your legal rights and entitlement to compensation for your pain, injuries and resulting damages.