00:04
Hey guys, welcome to pressure injury care.
00:08
So what am I talking about here?
When you guys hear the word pressure
injury,what we're talking about
is a patient's bony prominences are
having a lot of pressure applied,
and this can result in injury.
00:21
So you may hear the terms 'pressure
injury' or 'pressure ulcer',
that's pretty interchangeable
and you may hear these terms.
00:29
So let's take a look at this.
00:32
So when we're talking about pressure
injury, there are several areas of risks.
00:36
So we're going to go through each different
position and some things to look for as a nurse.
00:41
So if you take a look at this image here, see all
these hot spots when the patient's in a prone position.
00:47
So take a look here, we see the
patient's toes, for example.
00:51
We see right here at the hips,
the bony prominences of the hips,
you see the patient's elbows,
even their collarbones here,
especially the patient's head over here as well.
01:04
If it's making contact with a mattress,
for example, this is going to cause
areas of risk for pressure injury.
01:11
And again, when you look at this
image, this may look a little odd here,
but imagine the patient's laying in bed, and
all these red hot spots are making contact
with consistent pressure on the mattress.
01:24
Now let's take a look at a different position here.
01:27
Let's take a look at the supine position.
01:29
So man, these hot spots again.
01:32
This is some of the really, really common pressure
injury points that you're going to see as a nurse.
01:38
So I want you to take special attention
down here at the feet of the patient.
01:43
So you see where there's a hot spot with the heels.
01:46
This is a huge, huge issue and one of the
first places we need to look as a nurse.
01:52
This is a really common place for
a patient to get a pressure injury.
01:57
Also, we don't really have a good
way to show the hot spot here,
but a patient's coccyx or sacrum in the back of
their tailbone is definitely a huge area of risk.
02:07
In a lot of times it goes
unnoticed unless the nurses assess.
02:13
Also notice again, the patient's elbows, even the
back of their shoulder blades we may not think about.
02:19
And the patient's back of their head in contact
with consistent pressure on that mattress.
02:26
Now here's another way we
could get pressure injuries.
02:30
Again, look at all these different hotspots.
02:33
The side of the foot, the hip bone and
constant pressure with the mattress,
side of the patient's head, their
shoulder blade, for example,
even knees to knees if the patients has
constant pressure applied to these points.
02:50
Now we talked about some areas to look and to
assess of where some pressure injuries may occur.
02:56
And again, you can imagine with
all those hotspots we just saw,
it's really important for a thorough, thorough
skin and head to toe assessment as a nurse.
03:08
Now who's going to be at risk?
This is a long list here but unfortunately, the
list is long for the areas of the people at risk.
03:16
So immobility is a huge one, right?
You can imagine, makes a lot of sense if
the patient's in the bed a long time,
they can't move, because of maybe an accident,
a motor vehicle accident, for example.
03:29
Here's a big population, if the
patient's in the intensive care unit,
a lot of the times they're on meds,
their consciousness is not there,
and we've got them sedated so they are laying flat
in that supine position for a long, long time.
03:44
So we want to make sure we assess these people.
03:47
Also, of course, if we have poor nutrition, poor
hydration, this is not supporting those nice,
that integumentary system to
help provide those defenses.
03:58
Our elderly patient again with their poor fragile skin,
that is definitely going to be a risk for friction,
shearing pressure injuries.
04:07
And again, as you can see
the list goes on here, right.
04:11
So one important point after all these
points and I want you to take a look at too
and we don't really think about a lot.
04:17
We have a lot of diabetic patients that
they have because of their disease process
can't feel very well.
04:25
So a lot of the times they
can develop pressure injury
when we're really not looking at these
patients as an at risk population.