- Decubitus Ulcers - Pressure Sores Stage 4 Four
are virtually always preventable and treatable. First
you must clean the skin. You must reposition at elast every 2 hours
or more frequently and you must keep weight off the wound: Never
sit on or lay on top of a pressure wound or it will not heal. Particular
care has to be taken for signs of infection such as a strong foul
odor and or large purulent (pus) drainage.
There are several stages
of Decubitus Ulcers with stage 4 being the most
serious/advanced. Pressure Sore Death
can occur if a stage 4 bed
sore decubitis ulcer is allowed to advance to infection
and aggressive treatment is not successful. Most pressure sores
are easily preventable. Our attorneys can review your nursing home
medical records to determine if the nursing home has acted negligently
in treating pressure sores.
The Federal Government has issued regulations that basically require
nursing homes NOT to allow a resident who enters a facility
to acquire pressure ulcers while under their care:
§483.25(c) Pressure Sores (also called Tag F314):
Based on the Comprehensive Assessment of a resident, the facility
must ensure that-
(1) A resident
who enters the facility without pressure sores does not develop
pressure sores unless the individuals clinical condition demonstrates
that they were
unavoidable; and (2) A resident having pressure sores receives necessary
treatment and services to promote healing, prevent infection and
prevent new sores from developing.
The National Pressure Ulcer Advisory Panel (NPUA)
has published their definitions of Pressure Ulcers (updated in 2007):
Pressure Ulcer Definition
A pressure ulcer is localized injury to the skin and/or underlying
tissue usually over a bony
prominence, as a result of pressure, or pressure in combination
with shear and/or friction.
Pressure Ulcer Stages
Intact skin with non-blanchable redness of a localized area usually
over a bony prominence.
Darkly pigmented skin may not have visible blanching; its color
may differ from the surrounding area.
Partial thickness loss of dermis presenting as a shallow open ulcer
with a red pink wound bed,
without slough. May also present as an intact or open/ruptured serum-filled
Full thickness tissue loss. Subcutaneous fat may be visible but
bone, tendon or muscle are not exposed. Slough may be present but
does not obscure the depth of tissue loss. May include undermining
Full thickness tissue loss with exposed bone, tendon or muscle.
Slough or eschar may be present on some parts of the wound bed.
Often include undermining and tunneling.
The Federal regulations and guidelines list the
classic risk factors for bed sores -
Impaired or decreased mobility and decreased functional
conditions such as end-stage renal disease, thyroid disease,
or diabetes mellitus
Exposure of skin to urinary and fecal incontinence
Under-nutrition, malnutrition, and hydration deficits
recurrence of prior ulcer
Assessment Tools: Both the Braden and Norton
scales help to measure Pressure sore risks.
Interventions such as frequent repositioning are critical
in preventing pressure ulcers as well as treating ulcers.
Our Boston area Law office represents victims of Nursing home Abuse
and Neglect. If your loved one has been injured or died as a result
of nursing home
abuse or neglect please call our Massachusetts attorneys
Clients win two more nursing home abuse verdicts
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