Sally & Gareth

If you're using a mattress, such as an air mattress, specifically designed
to reduce pressure, and the patient has pressure sores on their heels, would
it be wrong to raise their heels using a pillow. Would the pressure
mattress be sufficient, and would the pillow negate any beneficial effects
of the mattress?

Any ideas folks?

Andrew Heenan

"Sally & Gareth" wrote...
> If you're using a mattress, such as an air mattress, specifically designed
> to reduce pressure, and the patient has pressure sores on their heels,
> would it be wrong to raise their heels using a pillow. Would the pressure
> mattress be sufficient, and would the pillow negate any beneficial effects
> of the mattress?

Certainly would not help, and may well negate the effects of the mattress.
Seems little point in spending all that cash on the special equipment, only
to put something between it and the patient ;o)

If foot/leg elevation is required, much better to either use the bed
controls - or chuck a pillow UNDER the mattress.
--

Andrew Heenan
http://www.realnurse.net/

hindmost

Andrew Heenan wrote:
> "Sally & Gareth" wrote...
>> If you're using a mattress, such as an air mattress, specifically designed
>> to reduce pressure, and the patient has pressure sores on their heels,
>> would it be wrong to raise their heels using a pillow. Would the pressure
>> mattress be sufficient, and would the pillow negate any beneficial effects
>> of the mattress?
>
> Certainly would not help, and may well negate the effects of the mattress.
> Seems little point in spending all that cash on the special equipment, only
> to put something between it and the patient ;o)
>
> If foot/leg elevation is required, much better to either use the bed
> controls - or chuck a pillow UNDER the mattress.
I'd add a couple of caveats to that. If the heel sores occur while the
patient is on the pressure releaving surface then you should review
whether that surface is appropriate. Heel pressures are complex because
they can be influenced by a lot of factors. muscle tone and contractures
of the lower limb in conditions like stroke and proprioceptive disorders
can result in greatly increased heel pressure, bilateraly and
monolateraly. In these cases the pressure relieving surface MAY be
appropriate for all other areas but not for that heel. If this was the
case then raising that point of of the bed MAY be appropriate. However
you then need to assess carefully the pressure effects on the point you
are using to raise the heel off of the bed. You are now in the twilight
zone between research, maufacturers specifications (AKA adverts) and
clinical judgement... (can anyone remember that music..)

Andrew Heenan

"hindmost" <" <?> wrote ...
> I'd add a couple of caveats to that. If the heel sores occur while the
> patient is on the pressure releaving surface then you should review
> whether that surface is appropriate. Heel pressures are complex because
> they can be influenced by a lot of factors. muscle tone and contractures
> of the lower limb in conditions like stroke and proprioceptive disorders
> can result in greatly increased heel pressure, bilateraly and
> monolateraly. In these cases the pressure relieving surface MAY be
> appropriate for all other areas but not for that heel. If this was the
> case then raising that point of of the bed MAY be appropriate. However you
> then need to assess carefully the pressure effects on the point you are
> using to raise the heel off of the bed. You are now in the twilight zone
> between research, maufacturers specifications (AKA adverts) and clinical
> judgement... (can anyone remember that music..)

thanks for that; fair comment.

but don't lose sight of the original question - it's almost NEVER going to
appropriate to pay thousands to hire a special mattress, then chuck a pillow
on top of it!

Cheers,
--

Andrew
http://www.realnurse.net/