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Thread: pressure sore stages

  1. #1

    pressure sore stages

    OK, I've spent the past half hour searching for the definitions of stages I-IV and can't find them. I know stage I is discolored, no skin break, and stage IV is to the bone, but the difference in II and III has me befuddled. Help please.
    A friend was a caregiver for a lil guy with multiple medical issues (microcephalia (sp?), a trach, G tube, etc). His dad had issues with the company she worked for, she'd signed a non compete clause, so she hasn't seen him since last Sept. The dad called her last night, his son is in the hospital with two stage three pressure sores (one on his tailbone, one his ear) due to poor care by AN RN! (My friend is a CNA.) He basically begged her to take care of his son, at least one day a week, so he'd know when to call the doc on stuff.
    The thing is, she's getting married next month, took this term off school to plan her wedding, is working full time as a pharmacy tech....... I'd like to tell her a stage three isn't life or limb (or ear) threatening. She has a friend who takes care of another medically fragile boy, who has agreed to take this lil guy on, but can only do it part time. If he were nearby, I could check on him, but he's about 35 miles from me, too far for me to be the good samaritan.
    Oh, and my friend is going to urge the dad to turn this woman in for negligence. A registered nurse who has only one patient, and lets his ear and butt get to stage III gives nurses a bad reputation. This is the first time the kid has had any skin breakdown, and he was disabled as a newborn. He's nine now.

  2. #2
    Senior Member lynnifer's Avatar
    Join Date
    Aug 2002
    Windsor ON Canada
    Stage III is not very good ... unfortunately. Stage II is a blistering of the skin .. redness but a definite break.

    Stage III is full thickness of the skin ... not yet to the bone. Doesn't take long though once that skin is completely gone.

    Picked this up from wikipedia:
    • Stage I is the most superficial, with only superficial irritation,
    • Stage II is blistering of the skin,
    • Stage III involves the full thickness of the skin, and is often complicated by infection,
    • Stage IV is the deepest, usually extending into the muscle, tendon or even bone.
    That poor kid. The good news (sorry) is that he is in hospital and hopefully receiving proper care. Hopefully he is on antibiotics as well! The IV kind ... that ear wound makes me nervous.

    It's too late for prevention so we think of it now .. what kind of mattress was he on? Pillow? How was the ear one caused? Unfortunately these are going to be weak spots from now on ... far too young for a 9yr old. The 'nurse' should have sought the help of a doctor when it progressed from Stage I to Stage II.

    I'm so sorry to hear of this. Kids should not have to go through things like this ... my heart goes out to him and I wish him a speedy recovery! Please keep us updated!
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  3. #3
    Senior Member
    Join Date
    May 2004
    Here yha go:

    Lynnifer and I probably know a fair amount about them........ I'm finally down to 2, from 4, major stage 3's and started IV for the starts of multilpe infections.

    Btw, the pic came from HERE

  4. #4
    Rollin had a stage 3 that ended up with successful flap surgery, but I couldn't remember (or find) the diff between 2 and 3. Thanks
    More about the lil guy- normal delivery, normal baby who got sick almost as soon as he got home. His parents' calls to the doc were dismissed as 'new parent' nervousness. When his fever hit 104, they took him to the ER, but his temp spiked 'over 106' before they could get things under control. It basically cooked his brain. He has a small pointy head, has the body control of a three month old, and the intellect to match. His brain isn't symmetrical, so his body isn't either. That's why his head has to be propped to keep him off his ear. Whether he's totally blind is debated- apparently he can track bright objects. He has seizures, a trach, G tube and is a sweetheart. My friend visited him today and says he's not acting like he's in pain. She rubbed his head and made him laugh, and turned his TV from the news channel to a music channel . The wound care dept locally is amazing. When he goes home they're gonna do home checks on him, instead of agency personnel doing it.

  5. #5
    Senior Member lynnifer's Avatar
    Join Date
    Aug 2002
    Windsor ON Canada
    That sounds much more encouraging already. Hope all goes well.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  6. #6
    There is a new staging system vs. the one above, which includes the following:

    Suspected Deep Tissue Injury (DTI)
    Stage I
    Stage II
    Stage III
    Stage IV
    Unable to stage (due to being mostly or all covered by eschar or slough)

    Also, the new terminology being rolled out has eliminated the terms "pressure ulcer", "pressure sore", "decubitus ulcer" or "bed sore" in favor of "pressure INJURY":


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