GIVING A BACK MASSAGE
PREVENTION OF PRESSURE
ULCERwww.drjayeshpatidar.blogspot.comwww.drjayeshpatidar.blogspot.in
PRESSURE ULCERDEFINITION:- Any lesion caused by unrelieved
pressure that results in damage to underlying
tissuewww.drjayeshpatidar.blogspot.in
SYNONYMSDecubitus
ulcerBedsoreswww.drjayeshpatidar.blogspot.in
PATHOLOGY Pressure
Blood vessel collapse
Necrosis (tissue death)
www.drjayeshpatidar.blogspot.in
MECHANISMExternal pressure compress blood vesselsFriction and
shearing forces-tear and injure blood vessel
www.drjayeshpatidar.blogspot.in
EXTERNAL PRESSURE
www.drjayeshpatidar.blogspot.in
FRICTION AND SHEARING FORCESFriction-two surfaces rub against
each otherShearing-one layer of tissue slide over another
www.drjayeshpatidar.blogspot.in
FACTORS AFFECTING PRESSURE ULCER
DEVELOPEMENTAgingImmobility-paralysed,unconscious,lengthy
surgery,tranquilizersNutrition-malnourished,vit-c
deficiancywww.drjayeshpatidar.blogspot.in
FACTORS AFFECTING PRESSURE ULCER
DEVELOPEMENTHYDRATION-DEHYDRATION,OEDEMAMOISTURE-SWEATINGWARMTH-FEVERPOOR
HYGIENEINCONTINENCE
www.drjayeshpatidar.blogspot.in
PRESSURE ULCER STAGING STAGE I - Nonblanching Erythema With Skin
Intact.STAGE II - Partial Thickness Skin Loss(epidermis)- Blister /
Abrasion www.drjayeshpatidar.blogspot.in
PRESSURE ULCER STAGINGSTAGE III Fullthickness Skin Loss
-Necrosis Of Hypodermic TissueSTAGE IV - Fullthickness Skin Loss
-Extensive Damage To Muscle,boneor Supporting Structures
www.drjayeshpatidar.blogspot.in
STAGE I
www.drjayeshpatidar.blogspot.in
STAGE II
www.drjayeshpatidar.blogspot.in
STAGE III
www.drjayeshpatidar.blogspot.in
STAGE IV
www.drjayeshpatidar.blogspot.in
PREVENTING PRESSURE ULCERIdentify at risk patientsAssess their
skin dailyKeep skin clean & dry always keep pressure off skin
Avoid massage over bony
prominenceswww.drjayeshpatidar.blogspot.in
PREVENTING PRESSURE ULCERMinimize injury from
frictionNutritional interventionsImprove mobilityDocument measures
used
www.drjayeshpatidar.blogspot.in
GIVING A BACK MASSAGE/ BACK
RUBwww.drjayeshpatidar.blogspot.in
ACTIONExplain the procedure and offer back massage to the
patient.
www.drjayeshpatidar.blogspot.in
RATIONALEBack massage can facilitate circulation and promote
relaxation.www.drjayeshpatidar.blogspot.in
ACTION
WASH YOUR HANDS.Hand washing deters the spread of micro
organisms.www.drjayeshpatidar.blogspot.in
ACTIONCLOSE THE CURTAIN OR DOOR.Privacy increases
relaxation.www.drjayeshpatidar.blogspot.in
ACTIONAssist the patient to the prone position or side lying
position with the back exposed from the shoulders to the sacral
area. www.drjayeshpatidar.blogspot.in
RATIONALEThis position exposes an adequate area for massage with
privacy and warmth maintainedwww.drjayeshpatidar.blogspot.in
ACTIONUse the bath blanket to drape the patient. Raise the bed
to the high position and lower the side rail closest to you.
www.drjayeshpatidar.blogspot.in
RATIONALE. Having the bed in the high position reduces back
strain for the nurse.www.drjayeshpatidar.blogspot.in
ACTIONWarm the lubricant or lotion in the palm of your hand or
place the container in warm
water.www.drjayeshpatidar.blogspot.in
RATIONALECold lotion causes chilling and uncomfortable
sensation.www.drjayeshpatidar.blogspot.in
ACTIONUsing light gliding strokes (effleurage), apply lotion to
patients shoulders, back , and sacral
area.www.drjayeshpatidar.blogspot.in
SUGGESTED MOVEMENTS
www.drjayeshpatidar.blogspot.in
RATIONALEEffleurage relaxes the patient and lessens tension.
www.drjayeshpatidar.blogspot.in
ACTIONPlace your hands beside each other at the base of the
patients spine and stroke upward to the shoulders and back downward
to the buttocks in slow, continous strokes. Continue for several
minutes.www.drjayeshpatidar.blogspot.in
RATIONALEContinous contact is soothing and stimulates
circulation and muscle
relaxation.www.drjayeshpatidar.blogspot.in
ACTIONMassage the patients shoulders, entire back, areas over
iliac crests, and sacrum with circular stroking motion. Keep your
hands in contact with the patients skin. Continue for several
minutes, applying additional lotion as
necessary.www.drjayeshpatidar.blogspot.in
RATIONALEA firmer stroke with continous contact promotes
relaxation.www.drjayeshpatidar.blogspot.in
ACTIONKnead the patients skin by gently alternating grasping and
compression motions (petrissage).
www.drjayeshpatidar.blogspot.in
RATIONALEKneading increases blood circulation to
areas.www.drjayeshpatidar.blogspot.in
FRICTION
www.drjayeshpatidar.blogspot.in
ACTIONComplete the massage with additional long stroking
movements.www.drjayeshpatidar.blogspot.in
RATIONALELong stroking motion is soothing and promotes
relaxation.www.drjayeshpatidar.blogspot.in
ACTIONDuring massage, observe the patients skin for reddened or
open areas. Pay particular attention to the skin over bony
prominences.www.drjayeshpatidar.blogspot.in
RATIONALEPressure may interfere with circulation and lead to
development of decubitus ulcers. Back rub stimulates circulation to
these areas.www.drjayeshpatidar.blogspot.in
ACTIONUse the towel to pat the patient dry and to remove excess
lotion. Apply powder if the patient requests
it.www.drjayeshpatidar.blogspot.in
RATIONALEThis provides additional comfort for the
patient.www.drjayeshpatidar.blogspot.in
ACTIONWASH YOUR HANDS.www.drjayeshpatidar.blogspot.in
RATIONALEHand washing deters the spread of micro
organisms.www.drjayeshpatidar.blogspot.in
ACTIONAssess the patients response and record your observations
on the patients chart.www.drjayeshpatidar.blogspot.in
RATIONALEThis provides accurate documentation of the procedure
and condition of the patients
skin.www.drjayeshpatidar.blogspot.in
Thank youwww.drjayeshpatidar.blogspot.in
