How to relieve/evenly distribute the pressure?
The position at an angle of 30°, with changes between the left and the right side, relieves the pressure on the sacral bone, ilium, hips and heels. Insert a pillow between the patient’s knees to ease the position. Make sure that there is no pressure on the inner and outer side of toes, ankles and feet. Changes of body positions always lead to an increased pressure on another body part.
Half-sitting position in bed increases the pressure on the sacral bone, and the risk of shearing increases as the patient slides downwards.
To relieve the pressure and position the patient comfortably, various pressure pillows may be used, depending on the requirements and the patient’s diagnosis.
Heels are a high risk area for the development of pressure ulcers. Microcirculation is low and the heel bone is close to skin surface. It is extremely important to relieve the overall pressure. For instance, a pillow may be placed along the calf, but you have to make sure it doesn’t increase the pressure on the Achilles tendon and that the heel is not covered. If necessary, bed base can be raised to 10° to increase venous circulation and reduce the risk of thrombosis in the lower legs.
In the sitting position, most of the body’s weight is carried by the buttocks and thighs. Pressure ulcers on the ischium are caused by insufficient pressure relief in the sitting position.
The time spent in the sitting position is a decisive factor for the development of pressure ulcers. Its duration for depends on the risk stage involved for every individual and it has to be adapted to the patient’s particular situation. The right position is the one in which gravity force goes down the back and straight through the ischium. The right height is the one at which knees rest at the same height as the hips. The patient’s feet always have to rest on the floor or on foot rest, otherwise the stability of the sitting position is lost, which increases the risk of the patient’s sliding forward.
An inappropriate sitting position increases the pressure on the ischium. Prevent shearing and friction by securing the patient against sliding in the chair. The most important goal for anyone who sits for a long time is to be seated comfortably, as comfort is an absolute requirement. The only person who can decide if the sitting position is good or bad is the very person who is sitting.
Lying and sitting positions have to be adjusted so that the pressure between the basis and the bony prominence is reduced to the lowest possible level.