Pressure sores

Kiwis7 · 09-22-2003, 10:08 PM

My brother (T10/11) was injured six months ago. My mom turns him during the night to prevent pressure sores. My mom applied for some sort of special bed that would take away the need to manually turn my brother, however, she received notice that she was denied.

My question to all of you is what should my mom do? Is it true that my brother needs to be turned every two hours throughout the night to prevent pressure sores?

For six months my mom has been running on very little sleep. If anyone has any suggestions for my family, please reply to this message.

My mom is under the impression she must turn my brother every two hours when he is sleeping because he has lost a lot of weight over the past six months(he is 18 years old and approximately 130 pounds)and she fears he is more susceptible to pressure sores.

Please advise. Thank you in advance.

crazynurse · 09-22-2003, 11:22 PM

Hi Kiwis...sorry to hear about you're brother's injury.

In answer to your questions...

Yes, if a person is immobile, they must be repositioned every 2 hours to prevent pressure sores. However, w/ your brothers injury level being a low thoracic level, he will be able to turn independently eventually. It's hard to say more w/o knowing any other information...When was he injured? Are there any other injuries, fractures, broken bones etc. in his upper body that would prevent him from repositioning himself? Has he had surgery? Is he in a rehab center?

Also, you mentioned that he has lost alot of weight. Decubiti (or more commonly "bedsores") result from pressure on the skin impeding circulation to the tissue. The bony prominences are particularly prone to breakdown. It is essential to relieve the pressure on these areas frequently to prevent decubiti from developing.

Hope this helps.

SCI-Nurse · 09-23-2003, 07:59 AM

At this level of injury, your brother should be turning himself totally independently. He may need an alarm clock or kitchen timer to wake himself up to do this, but there is no reason he should need help. We would also not authorize a turning mattress for someone at this level for this reason. A pressure reducing static mattress or overlay should be sufficient at this level.

Many people at this level of injury also learn how to prone (sleep on their stomach) at night. As long as there is proper bridging done to prevent pressure on the tops of the feet, shins, pelvis and genitals, a person can prone for 8-10 hours at night.

(KLD)

marmalady · 09-23-2003, 08:13 AM

Did your brother go through rehab? It's possible he could some more outpatient therapy to teach him how to do the turns, if he hasn't learned yet. Talk with his SCI doc to see if this is a possibility.

If he does know how to turn himself, and is asking that your mom do it, it may be that he's just gotten 'comfortable' with the idea of mom coming to the rescue, and is reluctant to give that up. I'd pay attention to that, and have a chat with him if that's the case.

_____________
Tough times don't last - tough people do.

Kiwis7 · 09-23-2003, 12:42 PM

Thank you all for your replies.

My brother did have surgery a day or two after he arrived at the hospital.

He is currently in outpatient therapy, but I do not believe he has been working on repositioning himself while lying down. Good point, I will discuss this with him.

Also, I will point out to both my mom and my brother that he may sleep on his stomach, so long as he protects his pelvis, etc.

It's nice to know that the denial of the special bed is not necessarily something they need anyway. His level of injury is below the waist so I guess he just needs to work on repositioning himself during the night if he plans to sleep on his side. I imagine it will take some getting used to when you are used to sleeping on your side. I guess there are all sorts of adjustments to be made with SCI.

Thank you for caring.

09-22-2003, 10:08 PM	#1
Kiwis7 Junior Member Join Date: Sep 2003 Location: Chandler, AZ, USA Posts: 2	Pressure sores My brother (T10/11) was injured six months ago. My mom turns him during the night to prevent pressure sores. My mom applied for some sort of special bed that would take away the need to manually turn my brother, however, she received notice that she was denied. My question to all of you is what should my mom do? Is it true that my brother needs to be turned every two hours throughout the night to prevent pressure sores? For six months my mom has been running on very little sleep. If anyone has any suggestions for my family, please reply to this message. My mom is under the impression she must turn my brother every two hours when he is sleeping because he has lost a lot of weight over the past six months(he is 18 years old and approximately 130 pounds)and she fears he is more susceptible to pressure sores. Please advise. Thank you in advance.

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09-22-2003, 11:22 PM	#2
crazynurse Senior Member Join Date: Dec 2002 Posts: 136	Hi Kiwis...sorry to hear about you're brother's injury. In answer to your questions... Yes, if a person is immobile, they must be repositioned every 2 hours to prevent pressure sores. However, w/ your brothers injury level being a low thoracic level, he will be able to turn independently eventually. It's hard to say more w/o knowing any other information...When was he injured? Are there any other injuries, fractures, broken bones etc. in his upper body that would prevent him from repositioning himself? Has he had surgery? Is he in a rehab center? Also, you mentioned that he has lost alot of weight. Decubiti (or more commonly "bedsores") result from pressure on the skin impeding circulation to the tissue. The bony prominences are particularly prone to breakdown. It is essential to relieve the pressure on these areas frequently to prevent decubiti from developing. Hope this helps.

09-23-2003, 07:59 AM	#3
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,349	At this level of injury, your brother should be turning himself totally independently. He may need an alarm clock or kitchen timer to wake himself up to do this, but there is no reason he should need help. We would also not authorize a turning mattress for someone at this level for this reason. A pressure reducing static mattress or overlay should be sufficient at this level. Many people at this level of injury also learn how to prone (sleep on their stomach) at night. As long as there is proper bridging done to prevent pressure on the tops of the feet, shins, pelvis and genitals, a person can prone for 8-10 hours at night. (KLD)

09-23-2003, 08:13 AM	#4
marmalady Senior Member Join Date: Aug 2001 Posts: 3,988	Did your brother go through rehab? It's possible he could some more outpatient therapy to teach him how to do the turns, if he hasn't learned yet. Talk with his SCI doc to see if this is a possibility. If he does know how to turn himself, and is asking that your mom do it, it may be that he's just gotten 'comfortable' with the idea of mom coming to the rescue, and is reluctant to give that up. I'd pay attention to that, and have a chat with him if that's the case. _____________ Tough times don't last - tough people do.

09-23-2003, 12:42 PM	#5
Kiwis7 Junior Member Join Date: Sep 2003 Location: Chandler, AZ, USA Posts: 2	Thank you all for your replies. My brother did have surgery a day or two after he arrived at the hospital. He is currently in outpatient therapy, but I do not believe he has been working on repositioning himself while lying down. Good point, I will discuss this with him. Also, I will point out to both my mom and my brother that he may sleep on his stomach, so long as he protects his pelvis, etc. It's nice to know that the denial of the special bed is not necessarily something they need anyway. His level of injury is below the waist so I guess he just needs to work on repositioning himself during the night if he plans to sleep on his side. I imagine it will take some getting used to when you are used to sleeping on your side. I guess there are all sorts of adjustments to be made with SCI. Thank you for caring.