Key Considerations for Pressure Relief

Every year 180,000 new patients suffer from pressure ulcers or tissue injuries. Not only can these lead to hospitalisation and expensive treatment, but they can also cause death through sepsis. According to the Office for National Statistics, in England and Wales over an 11-year period, pressure sores were mentioned as an underlying cause or contribute factor on more than 11,500 death certificates.

That’s why pressure relief is vital. In this blog, I explore some common causes of pressure injuries and how occupational therapists can help prevent them.

What causes pressure injuries?

As the name suggests, the most common cause of a pressure injury is pressure – but it’s important to be aware of how different types of pressure can lead to injury.

For example, long periods (between one and six hours) of low pressure are just as capable of causing sores as short periods of high pressure. So whether clients are sitting on soft surfaces for long periods of time or hitting their elbow on a hard surface, they’re still susceptible.

How can you mitigate the risk of pressure injury?

Many factors contribute to pressure injuries – from intrinsic factors like age and continence to extrinsic factors like posture and moisture. When assessing clients, OTs have a range of solutions open to them. The Braden Scale, for instance, is an incredibly effective assessment tool that can help predict risk.

You should also seek advice from product experts. As an OTs, you understand strategies and your clients, but we know all the features, accessories and alternatives available. So use our expertise as part of your prescription process.

And remember – amidst all the tools and analysis, knowledge is key. Users and caregivers need to know how to prevent injuries, and this is just as important as prescribing the right seating.

How do you select the right chair?

Although it’s misguided to suggest that improper seating is the sole cause of pressure injury, it is true that inadequate chairs can exacerbate problems. It’s therefore essential that OTs prescribe the right one.

A simple way to reduce pressure is to ensure chairs tilt adequately. By prescribing chairs that have tilt-in-space with the ability to adjust to specific increments (such as a RAZ hygiene chair and the Legacy tilt-in-space seating solution), you allow for greater accuracy in position. This can help prevent poor posture and unnecessary pressure.

You should also take into account the differences between hydraulic and electric tilts. Although hydraulic tilts are often the default, in many cases electric versions provide greater benefits without big cost increases. Electric tilts are not only easier for caregivers, but they’re also easier for users to operate, allowing for a greater degree of independence.

Dimensions are also vital for pressure care. When prescribing chairs, OTs should fully take into account seat depth, seat width and the user’s requirement to have their feet supported. If the depth of a chair is too short, for instance, the user’s thighs aren’t properly supported, which leads to bad posture and a rotated pelvis. Conversely, if the depth is too long, the user won’t be able to sit all the way back, which causes the pelvis to tilt the other way. Both cases are bad for pressure.

Similarly, if a user is unable to get support under the feet, they will often slide down until they can feel a flat surface, which is not only bad for postural support but can also damage the tendons and muscles in the foot. Providing users with a footplate can therefore help relieve pressure and prevent injury.

Ultimately, the key to pressure relief is knowledge

OTs need to be fully aware of the factors that cause pressure injuries and the ways in which different seats can exacerbate or prevent injuries. Similarly, users and caregivers need to be aware of the mistakes they may be unknowingly making, so they can be proactive in preventing pressure sores.

 


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