Practical Issues in Wound, Skin and Ostomy Management
In the pediatric world here at Cincinnati Childrens Hospital Medical Center we have been dealing with and preventing pressure ulcers from devices for years and have had great success with prevention.
One of the greatest challenges was with BIPAP. It is only recently that we have been able to get some masks that are made for pediatric pts but we still use many adult masks that do not fit properly. As a result we see PU’s. We developed a protocol which has tremendously decreased our numbers. This protocol consist of the following:
1. Wash face and mask once a day with
soap and water
2. Remove mask Q4H for mouth care and
give pressure relief
3. DO NOT PLACE ANYTHING UNDER THE
MASK UNTIL REDNESS BEGINS. IF
REDNESS DEVELOPS USE HYDROGEL
(SUCH AS CARADRES) THEN MEPILEX
LITE ON THE RED AREA ONLY.
REPLACE Q4H DUE TO DRYING OUT.
(this has actually shown to reverse the redness that develops and prevents PU development)
4. Alternate between two different mask (full
face vs shield) Q4H
We have also developed other protocols for trachs c collars pulse ox. if interested
I work in an ICU and am on the skin care committee. We are currently doing a quality improvement project to help improve our HAPU numbers. I am very interested in your other protocols that you use for other devices. Also, is it okay if I share your protocols with my unit. I am doing a power point presentation on prevention of MDRPUs and fined your face mask protocol to be very good.
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