This is a topic that fills us with great sadness. Unfortunately for our Dad, during his time in the hospital, he developed a pressure sore (bed sore). At that time we were never made aware of how bad it actually was. It was only in the week that he passed away or shortly before that we were made aware…
Please see Bedsores which includes:
- Our story
- What causes Bedsores and who is at risk
- Effects of Bedsores
- Illustrative YouTube video: New video aims to reduce risk of pressure ulcers
- Hospital stay and Bedsores
- Nursing home and Bedsores
- Stage 4 Bedsores
- Prevention of Bedsores/Neglect in treatment
- Treatment of Bedsores
- Pressure Ulcers
- Effects of Pressure Ulcers
- Treatment for Pressure Ulcers
- Prevention of Pressure Ulcers
- Osteomyelitis
- Additional links on Bed Sores
- Additional links on Pressure Sores
- Additional links on Osteomyelitis
- Our Final Thoughts
© Copyright 2019 Grief Probate Journey Blog *PLEASE NOTE THIS INFORMATION IS SOURCED FROM UK and AMERICAN WEBSITES* It is also based on our own experience. *We are not experts in this field, we are speaking purely on our own experience with information sought from the internet to give further examples.*
1. Our Story
This is a topic that fills us with great sadness. Unfortunately for our Dad, during his time in the hospital, he developed a pressure sore (bed sore). At that time we were never made aware of how bad it actually was. It was only in the week that he passed away or shortly before that we were made aware. Prior to this, we had no idea the grade of the pressure sore and how serious it was. This was despite from day one asking the hospital staff to be kept up to date on any changes in our Dad’s health status.
This again for us is a case of looking back in hindsight and realising just how much pain this alone would have caused for our Dad. This is not even considering other illnesses he contracted during his time in the hospital.
2. What causes Bedsores and who is at risk:
“Bedsores are areas of damaged skin and tissue caused by sustained pressure often from a bed or wheelchair — that reduces blood circulation to vulnerable areas of the body”. (9 Mar 2018).
2.2 What is the first sign of skin breakdown?
First signs. “One of the first signs of a possible skin sore is a reddened, discolored or darkened area (an African American’s skin may look purple, bluish or shiny). It may feel hard and warm to the touch.
2.3 What are the stages of bedsores?
“Pressure sores develop in four stages”.
- “The skin will look red and feel warm to the touch”.
- “There may be a painful open sore or a blister, with discolored skin around it”.
- “A crater-like appearance develops, due to tissue damage below the skin’s surface”.
- “Severe damage to skin and tissue, possibly with infection”. (22 Dec 2017).
2.4 Where do bed sores most commonly occur?
“Bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips and tailbone.” (9 Mar 2018).
2.5 What does a bed sore look like in the beginning?
“The skin will look red and feel warm to the touch. It may be itchy. There may be a painful open sore or a blister, with discolored skin around it. A crater-like appearance develops, due to tissue damage below the skin’s surface”. (22 Dec 2017).
2.6 How painful are bed sores?
“The simple answer is yes. Bedsores can be extremely painful. It is essentially an open wound, and usually develops in areas of the body that are hard to avoid putting pressure on. A bedsore is also known as a pressure sore or ulcer, or a decubitus ulcer”.
2.7 Why do elderly get bed sores?
“Age is the greatest risk factor for bedsores; the older the person, the more vulnerable their skin. In an immobilized older person, even a small skin tear, which could easily occur during routine activities such as transferring from bed to a wheelchair, might quickly develop into a bedsore”.
Unfortunately for our Dad, due to the lack of appropriate physiotherapy in the hospital, our Dad became bed-bound. This meant he had limited mobility and eventually became fully reliant on the hospital staff in order to make movements within the bed. (He was no longer able to sit in the chair as it was no longer suitable for him).
3. Effects of Bedsores:
“If not recognized and treated immediately, bedsores can quickly turn into serious infections — and can even be deadly. According to the Centers for Disease Control, one in ten nursing home patients suffers from bedsores or pressure sores (medically known as decubitus ulcers)”. (16 Dec 2015).
3.2 Are bed sores a sign of death?
“It is the negligence and delayed treatment of bed sores that lead to serious infections, which in turn cause the ultimate death of a patient. Bed sores can be treated if found early enough, and it is unfortunate that something as preventable and treatable as a bed sore can lead to fatal complications”.
3.3 Can bedsores cause sepsis?
“Is Sepsis Related to Bed Sores? If your loved one has a bed sore and is later diagnosed with sepsis then there is a strong likelihood that the sepsis is due to the bed sore or open wound. Sepsis is an illness caused by infection in the bloodstream by bacteria. If left undiagnosed and untreated, sepsis can be fatal”.
Our Dad developed sepsis during his time in the hospital. We were not made aware of this until seeing the certificate. We were saddened and shocked to find out our Dad had contracted this life-threatening infection and we were never made aware. (This is why we also have a topic on Sepsis).
4. Illustrative YouTube video: New video aims to reduce risk of pressure ulcers
5. Hospital stay and Bed Sores
5.1 Are hospitals responsible for bed sores?
“Bed sores hospital negligence cases can be brought against the hospital or care home if they do not provide the correct care or treatment and a patient or resident goes on to develop bed sores.
5.2 Are hospitals responsible for bed sores?
“They are most likely to occur on a patient’s buttocks, heels and sacrum. In fact, Medicare and many medical insurance companies will no longer reimburse hospitals or nursing homes for any costs associated with caring for pressure sores that a patient develops while being treated for another condition”.
5.3 Can you sue a hospital for bed sores?
“Yes, you can sue a hospital if the hospital’s negligence leads to a patient suffering harm from bedsores. However, it is possible that a patient develops bedsores during a lengthy hospital stay. In those cases, the hospital can indeed be the target of a lawsuit”.
6. Nursing Homes and Bed Sores:
6.1 What causes bedsores in nursing homes?
“Nursing homes are also responsible for feeding and hydrating their residents properly. One major risk factor for developing bedsores is improper nutrition or hydration. Dehydration and malnutrition are serious signs of neglect in a nursing home. Bedsores may be caused by these factors or a lack of attentiveness”.
6.2 Can you sue a nursing home for bed sores?
“Bedsores, Pressure Sores or Decubitis Ulcers are not the fault of the patient. At a hospital or nursing home there are federal laws in place to protect patients and assure they get the proper care. The sores can cause extreme pain and suffering and unfortunately even death. You can sue”. (17 Sep 2014).
7. Stage 4 Bedsore:
7.1 What does a Stage 4 bedsore look like?
“The elder patient’s joints, muscle fibers, tendons, ligaments, or bones in the affected area are visible and dying. The damage from the stage 4 bedsore will likely appear black and rotten, with crusty tissues that have died without being removed from the wound. A stage 4 bedsore is frightening in appearance”.
Unfortunately for our Dad, his pressure sore developed to stage 4. We were never made aware of this until the week before he passed away. We were beyond words to know that this had never been communicated to us sooner.
7.2 Can Stage 4 bed sores heal?
“Stage 4 bedsores need to be treated by a medical professional as soon as possible. Bedsores that reach stage 4 have become serious and can be life-threatening. This type of wound can be very deep in some cases. They can take anywhere from 3 months to 2 years to heal”. (20 Dec 2018).
8. Prevention of Bedsores/Neglect in treatment
“Bedsores have a reputation of being associated with the poor and unwanted. The toll bed sores take on patients and families crosses all backgrounds and ethnicities. Proper Medical Care Proven to Reduce Chances of Development. With proper nursing care, bed sores should be preventable”.
8.2 Are bed sores preventable?
“Moreover, bedsores are generally a sign of neglect and in almost all cases, bedsore medical complications are completely preventable, if appropriate care is being provided by the nursing home staff”.
8.3 How can you prevent bedsores on a bedridden patient?
“If you are currently on bed rest, there are several things you can do to prevent bed sores”.
- “Change positions frequently. When you change positions often, there will be less pressure on your skin, reducing your risk of developing pressure ulcers”.
- “Keep skin clean and dry”.
- “Use pillows”.
- “Exercise. (27 May 2015)”
8.4 Are bed sores a sign of neglect?
“In short, bedsores, which are also known as pressure ulcers, exhibit tissue damage beneath upper-epidermal layers in patients. This injury to the underlying tissue is a result of prolonged pressure on a particular area of the body, hence is often indicative of nursing home neglect”.
9. Treatment of Bedsores
9.1 What is the fastest way to get rid of bed sores at home?
“Clean open sores with water or a saltwater (saline) solution each time the dressing is changed. Putting on a bandage. A bandage speeds healing by keeping the wound moist. This creates a barrier against infection and keeps the surrounding skin dry”. (9 Mar 2018).
9.2 What is good for bedsores?
“Cleaning and dressing wounds”
- “Cleaning. If the affected skin is not broken, wash it with a gentle cleanser and pat dry. Clean open sores with water or a saltwater (saline) solution each time the dressing is changed”.
- “Putting on a bandage. A bandage speeds healing by keeping the wound moist”. (9 Mar 2018).
9.3 What is the best dressing for bed sores?
“Because hydrocolloid dressings form a moisture-proof barrier they frequently used with incontinent patients as they can keep urine and feces out of the healing wounds. Hydrocolloids should be used in un-infected bed sores”.
9.4 Should bedsores be covered?
“Keep the sore covered with a special dressing. This protects against infection and helps keep the sore moist so it can heal. Talk with your provider about what type of dressing to use. Depending on the size and stage of the sore, you may use a film, gauze, gel, foam, or other type of dressing”. (12 May 2018).
9.5 How often should you turn a patient to prevent bed sores?
“Many bedsore prevention protocols recommend moving an immobile patient every two hours. The thinking is that if the patient can’t shift position, then the nursing staff should do it for him or her. The few clinical trials that have examined repositioning don’t provide clear guidance on how often it should be done”. (1 Nov 2006).
10. Pressure Ulcers
10.1 Pressure Ulcers
“Pressure ulcers (also known as pressure sores or bedsores) are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin. They can happen to anyone, but usually affect people confined to bed or who sit in a chair or wheelchair for long periods of time”.
10.2 What causes pressure ulcers?
“Pressure ulcers can be caused by”:
- “pressure from a hard surface – such as a bed or wheelchair”.
- “pressure that is placed on the skin through involuntary muscle movements – such as muscle spasms”.
- “moisture – which can break down the outer layer of the skin (epidermis)”
10.3 Pressure injuries are described in four stages:
- “Stage 1 sores are not open wounds”.
- “At stage 2, the skin breaks open, wears away, or forms an ulcer, which is usually tender and painful”.
- “During stage 3, the sore gets worse and extends into the tissue beneath the skin, forming a small crater”.
10.4 How common are pressure ulcers?
“Pressure ulcers are one of the most common health conditions in the United States. The Agency for Healthcare Research & Quality (AHRQ) estimates more than 2.5 million individuals in the US develop pressure ulcers annually. (11 Nov 2016)”.
“An open wound is unlikely to heal rapidly. Even when healing does take place, it may be inconsistent, because of the damage to skin and other tissues. Less severe pressure ulcers often heal within a few weeks with proper treatment, but serious wounds may need surgery”. (22 Dec 2017).
10.6 What are at least 5 risk factors for pressure ulcer development?
“The intrinsic factors include immobilization, cognitive deficit, chronic illness (eg, diabetes mellitus), poor nutrition, use of steroids, and aging. There are 4 extrinsic factors that can cause these wounds—pressure, friction, humidity, and shear force”. (1 Jan 2007).
10.7 Who is most at risk of pressure sores?
“Risk factors”
“People are at risk of developing pressure sores if they have difficulty moving and are unable to easily change position while seated or in bed. Risk factors include: Immobility. This might be due to poor health, spinal cord injury and other causes”. (9 Mar 2018).
11. Effects of Pressure Ulcers:
11.1 How do pressure ulcers affect patients?
“Pressure ulcers affect a patient’s quality of life, morbidity, and mortality. Once a pressure ulcer develops, complications such as infection with the potential for sepsis and death may occur. Pressure ulcers are more likely to occur in individuals older than 65 years” (Russo, Steiner, & Spector, 2006).
11.2 Can pressure ulcers cause sepsis?
“The development of pressure ulcers can lead to several complications. Probably the most serious complication is sepsis. Additional complications of pressure ulcers include localized infection, cellulitis, and osteomyelitis. Quite often, a nonhealing pressure ulcer may indicate underlying osteomyelitis”.
11.3 Can you die from pressure ulcers?
“As a rule, these patients die of their primary disease process rather than of pressure ulceration, but the pressure injury may be a contributing factor in some instances. Each year, approximately 60,000 people die of complications of pressure injuries”. (11 Jun 2018).
11.4 Can pressure ulcers lead to death?
“Unless the patient has underlying medical conditions, stage three wounds will not lead to bedsore deaths. These cases can still be spotted and treated, but nursing homes that do not provide proper care may let the bedsores go untreated. By stage four, the ulcer develops large-scale tissue loss”.
“It may feel warm to the touch. It may burn, hurt, or itch. The pressure sore may look blue or purple in people who have dark skin”. (18 Jan 2019).
12. Treatment for Pressure Ulcers:
12.1 What is the best treatment for pressure sores?
“Caring for a Pressure Sore”
- “For a stage I sore, you can wash the area gently with mild soap and water”.
- “Stage II pressure sores should be cleaned with a salt water (saline) rinse to remove loose, dead tissue”.
- “DO NOT use hydrogen peroxide or iodine cleansers”.
- “Keep the sore covered with a special dressing”.
More items… (12 May 2018).
12.2 How are pressure ulcers treated?
“Treating pressure ulcers involves reducing pressure on the affected skin, caring for the wounds, controlling pain, preventing infection and maintaining good nutrition”.
“Other interventions include”:
- “Drugs to control pain”.
- “Drugs to fight infection”.
- “A healthy diet”.
- “Negative pressure therapy”.
12.3 What can nurses do to prevent pressure ulcers?
“A pressure-relief surface or special-care bed is recommended to help prevent pressure ulcers. Manage incontinence and moisture with a skin-care regimen, such as frequent cleansing and use of a moisture-barrier ointment”.
13. Prevention of Pressure Ulcers:
13.1 What actions should be taken to prevent pressure sores?
“7 Steps to Prevent Pressure Sores”
- “Get Seniors Moving”.
- “Check the Skin for Signs of Developing Pressure Sores Often”.
- “Use Specialty Bedding or Materials to Reduce Pressure”.
- “Keep the Skin Dry and Clean”.
- “Encourage Seniors to Maintain a Healthy Diet”.
- “Manage Chronic Health Conditions Effectively.”
- “Create an Incentive-Based Program for Senior Caregivers”. (11 Oct 2016).
13.2 Why pressure ulcer prevention is important?
“Nursing is also concerned with preventing further ulcer deterioration, keeping the ulcer clean and in moisture balance, preventing infections from developing, and keeping the patient free from pain. Many aspects of managing pressure ulcers are similar to prevention (mechanical loading, support surfaces, and nutrition)”.
14. Osteomyelitis
14.1 Osteomyelitis
“Osteomyelitis is an infection of the bone, a rare but serious condition. Bones can become infected in a number of ways: Infection in one part of the body may spread through the bloodstream into the bone, or an open fracture or surgery may expose the bone to infection”. (11 May 2019).
14.2 What causes osteomyelitis?
“Causes of osteomyelitis include bacteria in the bloodstream from infectious diseases that spread to the bone, an open wound from a trauma over a bone, and recent surgery or injection in or around a bone. The most common types of bacteria that cause osteomyelitis are Staphylococcus, Pseudomonas, and Enterobacteriaceae”. (13 Jul 2018).
14.3 Can osteomyelitis be cured?
“Most cases of osteomyelitis are treatable. Chronic infections of the bone, however, may take longer to treat and heal, especially if they require surgery. Treatment should be aggressive because an amputation can become necessary sometimes. The outlook for this condition is good if the infection is treated early”. (13 Jul 2017).
14.4 What bone is the most common site of osteomyelitis?
“In adults, the vertebrae are the most common site of hematogenous osteomyelitis, but infection may also occur in the long bones, pelvis, and clavicle. Primary hematogenous osteomyelitis is more common in infants and children, usually occurring in the long bone metaphysis”. (1 Mar 2018).
We do not know whether our Dad had contracted this infection. However, this is the area in which our Dad’s pressure sore was located and developed into stage 4.
14.5 Is osteomyelitis an emergency?
“Hematogenous osteomyelitis is an infection caused by bacterial seeding from the blood. Direct inoculation (contiguous-focus) osteomyelitis is an infection in the bone secondary to the inoculation of organisms from direct trauma, spread from a contiguous focus of infection, or sepsis after a surgical procedure”. (12 Apr 2019).
14.6 What are the long term effects of osteomyelitis?
“Symptoms of Osteomyelitis”
“The symptoms for acute and chronic osteomyelitis are very similar and include: Fever, irritability, fatigue. Nausea. Tenderness, redness, and warmth in the area of the infection”. (11 May 2019).
14.7 What happens if osteomyelitis goes untreated?
“Osteomyelitis is a bacterial, or fungal, infection of the bone. Osteomyelitis affects about 2 out of every 10,000 people. If left untreated, the infection can become chronic and cause a loss of blood supply to the affected bone. When this happens, it can lead to the eventual death of the bone tissue”.
14.8 What antibiotics are used to treat osteomyelitis?
“Oral therapy following IV treatment for patients with osteomyelitis from contiguous spread of infection”:
- “Amoxicillin-clavulanate 875 mg/125 mg PO q12h or”.
- “Ciprofloxacin 750 mg PO q12h plus clindamycin 300-450 mg PO q6h” or.
- “Levofloxacin 750 mg PO daily plus clindamycin 300-450 mg PO q6h” or.
- “Moxifloxacin 400 mg PO daily”. (8 Dec 2017).
15. Additional links on Bed Sores:
- Causes of Bed sores – Nursing Home Abuse Guide
- Bed sore Deaths – Wrongful Deaths in Nursing Homes
- Bed sores John Hopkins Medicine
- Bed sores or pressure sores – what you need to know
- A guide to Bed Sores/Pressure Sore Negligence Compensation claims – How to claim?. LegalExpert.co.uk
- Bed sores (Decubitus Ulcers): Causes and Treatments
16. Additional links on Pressure Sores:
- Pressure Ulcers: Revised definition and measurements
- Pressure ulcers: Advice for patients and carers
- Pressure ulcers: Prevention and management
- Causes and prevention of ulcers – Cancer Research UK
- Pressure ulcers – NHS Inform
- Medical Negligence -Pressure Sore- compensation. Claims.co.uk
- A strategy to reduce preventable ulcers – Nursing Times
17. Additional links on Osteomyelitis
- Osteomyelitis NHS
- Encyclopaedia – Osteomyelitis – NHS Direct Wales
- Osteomyelitis- Symptoms- Causes and Treatment – WebMD
- Bone Infection (Osteomyelitis): Symptoms and treatment
- Osteomyelitis – Bone, Joint and Muscle Disorders – MSD
- Osteomyelitis – Symptoms and Causes – Mayo Clinic
- Osteomyelitis (For Parents) KidsHealth
- Osteomyelitis. Bone Infection. Osteomyelitis Symptoms – Patient leaflet
18. Our Final Thoughts
In this topic unexpectedly we have learnt something new once again. We have learnt about Osteomyelitis. Until writing this topic it is a medical condition we hadn’t heard of. It really cannot be put into words how this makes us feel that we are continuously to this very date learning new things. It is a very surreal feeling, but at the same time, these are good things for us to know.
I guess our final thoughts would be in a situation as overwhelming as caring for a loved one, or even in fact if you yourself are the patient, as easier as it is said than done we would suggest:
- Try not to let the overwhelming feelings consume you
- Try your best to think and remain positive
- Do not lose faith or hope
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This again for us is a case of looking back in hindsight and realising just how much pain this alone would have caused for our Dad. This is not even considering other illnesses he contracted during his time in the hospital.
2. What causes Bedsores and who is at risk:
“Bedsores are areas of damaged skin and tissue caused by sustained pressure often from a bed or wheelchair — that reduces blood circulation to vulnerable areas of the body”. (9 Mar 2018).
2.2 What is the first sign of skin breakdown?
First signs. “One of the first signs of a possible skin sore is a reddened, discolored or darkened area (an African American’s skin may look purple, bluish or shiny). It may feel hard and warm to the touch.
2.3 What are the stages of bedsores?
“Pressure sores develop in four stages”.
- “The skin will look red and feel warm to the touch”.
- “There may be a painful open sore or a blister, with discolored skin around it”.
- “A crater-like appearance develops, due to tissue damage below the skin’s surface”.
- “Severe damage to skin and tissue, possibly with infection”. (22 Dec 2017).
2.4 Where do bed sores most commonly occur?
“Bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips and tailbone.” (9 Mar 2018).
2.5 What does a bed sore look like in the beginning?
“The skin will look red and feel warm to the touch. It may be itchy. There may be a painful open sore or a blister, with discolored skin around it. A crater-like appearance develops, due to tissue damage below the skin’s surface”. (22 Dec 2017).
2.6 How painful are bed sores?
“The simple answer is yes. Bedsores can be extremely painful. It is essentially an open wound, and usually develops in areas of the body that are hard to avoid putting pressure on. A bedsore is also known as a pressure sore or ulcer, or a decubitus ulcer”.
2.7 Why do elderly get bed sores?
“Age is the greatest risk factor for bedsores; the older the person, the more vulnerable their skin. In an immobilized older person, even a small skin tear, which could easily occur during routine activities such as transferring from bed to a wheelchair, might quickly develop into a bedsore”.
Unfortunately for our Dad, due to the lack of appropriate physiotherapy in the hospital, our Dad became bed-bound. This meant he had limited mobility and eventually became fully reliant on the hospital staff in order to make movements within the bed. (He was no longer able to sit in the chair as it was no longer suitable for him).
3. Effects of Bedsores:
“If not recognized and treated immediately, bedsores can quickly turn into serious infections — and can even be deadly. According to the Centers for Disease Control, one in ten nursing home patients suffers from bedsores or pressure sores (medically known as decubitus ulcers)”. (16 Dec 2015).
3.2 Are bed sores a sign of death?
“It is the negligence and delayed treatment of bed sores that lead to serious infections, which in turn cause the ultimate death of a patient. Bed sores can be treated if found early enough, and it is unfortunate that something as preventable and treatable as a bed sore can lead to fatal complications”.
3.3 Can bedsores cause sepsis?
“Is Sepsis Related to Bed Sores? If your loved one has a bed sore and is later diagnosed with sepsis then there is a strong likelihood that the sepsis is due to the bed sore or open wound. Sepsis is an illness caused by infection in the bloodstream by bacteria. If left undiagnosed and untreated, sepsis can be fatal”.
Our Dad developed sepsis during his time in the hospital. We were not made aware of this until seeing the certificate. We were saddened and shocked to find out our Dad had contracted this life-threatening infection and we were never made aware. (This is why we also have a topic on Sepsis).
4. Illustrative YouTube video: New video aims to reduce risk of pressure ulcers
5. Hospital stay and Bed Sores
5.1 Are hospitals responsible for bed sores?
“Bed sores hospital negligence cases can be brought against the hospital or care home if they do not provide the correct care or treatment and a patient or resident goes on to develop bed sores.
5.2 Are hospitals responsible for bed sores?
“They are most likely to occur on a patient’s buttocks, heels and sacrum. In fact, Medicare and many medical insurance companies will no longer reimburse hospitals or nursing homes for any costs associated with caring for pressure sores that a patient develops while being treated for another condition”.
5.3 Can you sue a hospital for bed sores?
“Yes, you can sue a hospital if the hospital’s negligence leads to a patient suffering harm from bedsores. However, it is possible that a patient develops bedsores during a lengthy hospital stay. In those cases, the hospital can indeed be the target of a lawsuit”.
6. Nursing Homes and Bed Sores:
6.1 What causes bedsores in nursing homes?
“Nursing homes are also responsible for feeding and hydrating their residents properly. One major risk factor for developing bedsores is improper nutrition or hydration. Dehydration and malnutrition are serious signs of neglect in a nursing home. Bedsores may be caused by these factors or a lack of attentiveness”.
6.2 Can you sue a nursing home for bed sores?
“Bedsores, Pressure Sores or Decubitis Ulcers are not the fault of the patient. At a hospital or nursing home there are federal laws in place to protect patients and assure they get the proper care. The sores can cause extreme pain and suffering and unfortunately even death. You can sue”. (17 Sep 2014).
7. Stage 4 Bedsore:
7.1 What does a Stage 4 bedsore look like?
“The elder patient’s joints, muscle fibers, tendons, ligaments, or bones in the affected area are visible and dying. The damage from the stage 4 bedsore will likely appear black and rotten, with crusty tissues that have died without being removed from the wound. A stage 4 bedsore is frightening in appearance”.
Unfortunately for our Dad, his pressure sore developed to stage 4. We were never made aware of this until the week before he passed away. We were beyond words to know that this had never been communicated to us sooner.
7.2 Can Stage 4 bed sores heal?
“Stage 4 bedsores need to be treated by a medical professional as soon as possible. Bedsores that reach stage 4 have become serious and can be life-threatening. This type of wound can be very deep in some cases. They can take anywhere from 3 months to 2 years to heal”. (20 Dec 2018).
8. Prevention of Bedsores/Neglect in treatment
“Bedsores have a reputation of being associated with the poor and unwanted. The toll bed sores take on patients and families crosses all backgrounds and ethnicities. Proper Medical Care Proven to Reduce Chances of Development. With proper nursing care, bed sores should be preventable”.
8.2 Are bed sores preventable?
“Moreover, bedsores are generally a sign of neglect and in almost all cases, bedsore medical complications are completely preventable, if appropriate care is being provided by the nursing home staff”.
8.3 How can you prevent bedsores on a bedridden patient?
“If you are currently on bed rest, there are several things you can do to prevent bed sores”.
- “Change positions frequently. When you change positions often, there will be less pressure on your skin, reducing your risk of developing pressure ulcers”.
- “Keep skin clean and dry”.
- “Use pillows”.
- “Exercise. (27 May 2015)”
8.4 Are bed sores a sign of neglect?
“In short, bedsores, which are also known as pressure ulcers, exhibit tissue damage beneath upper-epidermal layers in patients. This injury to the underlying tissue is a result of prolonged pressure on a particular area of the body, hence is often indicative of nursing home neglect”.
9. Treatment of Bedsores
9.1 What is the fastest way to get rid of bed sores at home?
“Clean open sores with water or a saltwater (saline) solution each time the dressing is changed. Putting on a bandage. A bandage speeds healing by keeping the wound moist. This creates a barrier against infection and keeps the surrounding skin dry”. (9 Mar 2018).
9.2 What is good for bedsores?
“Cleaning and dressing wounds”
- “Cleaning. If the affected skin is not broken, wash it with a gentle cleanser and pat dry. Clean open sores with water or a saltwater (saline) solution each time the dressing is changed”.
- “Putting on a bandage. A bandage speeds healing by keeping the wound moist”. (9 Mar 2018).
9.3 What is the best dressing for bed sores?
“Because hydrocolloid dressings form a moisture-proof barrier they frequently used with incontinent patients as they can keep urine and feces out of the healing wounds. Hydrocolloids should be used in un-infected bed sores”.
9.4 Should bedsores be covered?
“Keep the sore covered with a special dressing. This protects against infection and helps keep the sore moist so it can heal. Talk with your provider about what type of dressing to use. Depending on the size and stage of the sore, you may use a film, gauze, gel, foam, or other type of dressing”. (12 May 2018).
9.5 How often should you turn a patient to prevent bed sores?
“Many bedsore prevention protocols recommend moving an immobile patient every two hours. The thinking is that if the patient can’t shift position, then the nursing staff should do it for him or her. The few clinical trials that have examined repositioning don’t provide clear guidance on how often it should be done”. (1 Nov 2006).
10. Pressure Ulcers
10.1 Pressure Ulcers
“Pressure ulcers (also known as pressure sores or bedsores) are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin. They can happen to anyone, but usually affect people confined to bed or who sit in a chair or wheelchair for long periods of time”.
10.2 What causes pressure ulcers?
“Pressure ulcers can be caused by”:
- “pressure from a hard surface – such as a bed or wheelchair”.
- “pressure that is placed on the skin through involuntary muscle movements – such as muscle spasms”.
- “moisture – which can break down the outer layer of the skin (epidermis)”
10.3 Pressure injuries are described in four stages:
- “Stage 1 sores are not open wounds”.
- “At stage 2, the skin breaks open, wears away, or forms an ulcer, which is usually tender and painful”.
- “During stage 3, the sore gets worse and extends into the tissue beneath the skin, forming a small crater”.
10.4 How common are pressure ulcers?
“Pressure ulcers are one of the most common health conditions in the United States. The Agency for Healthcare Research & Quality (AHRQ) estimates more than 2.5 million individuals in the US develop pressure ulcers annually. (11 Nov 2016)”.
“An open wound is unlikely to heal rapidly. Even when healing does take place, it may be inconsistent, because of the damage to skin and other tissues. Less severe pressure ulcers often heal within a few weeks with proper treatment, but serious wounds may need surgery”. (22 Dec 2017).
10.6 What are at least 5 risk factors for pressure ulcer development?
“The intrinsic factors include immobilization, cognitive deficit, chronic illness (eg, diabetes mellitus), poor nutrition, use of steroids, and aging. There are 4 extrinsic factors that can cause these wounds—pressure, friction, humidity, and shear force”. (1 Jan 2007).
10.7 Who is most at risk of pressure sores?
“Risk factors”
“People are at risk of developing pressure sores if they have difficulty moving and are unable to easily change position while seated or in bed. Risk factors include: Immobility. This might be due to poor health, spinal cord injury and other causes”. (9 Mar 2018).
11. Effects of Pressure Ulcers:
11.1 How do pressure ulcers affect patients?
“Pressure ulcers affect a patient’s quality of life, morbidity, and mortality. Once a pressure ulcer develops, complications such as infection with the potential for sepsis and death may occur. Pressure ulcers are more likely to occur in individuals older than 65 years” (Russo, Steiner, & Spector, 2006).
11.2 Can pressure ulcers cause sepsis?
“The development of pressure ulcers can lead to several complications. Probably the most serious complication is sepsis. Additional complications of pressure ulcers include localized infection, cellulitis, and osteomyelitis. Quite often, a nonhealing pressure ulcer may indicate underlying osteomyelitis”.
11.3 Can you die from pressure ulcers?
“As a rule, these patients die of their primary disease process rather than of pressure ulceration, but the pressure injury may be a contributing factor in some instances. Each year, approximately 60,000 people die of complications of pressure injuries”. (11 Jun 2018).
11.4 Can pressure ulcers lead to death?
“Unless the patient has underlying medical conditions, stage three wounds will not lead to bedsore deaths. These cases can still be spotted and treated, but nursing homes that do not provide proper care may let the bedsores go untreated. By stage four, the ulcer develops large-scale tissue loss”.
“It may feel warm to the touch. It may burn, hurt, or itch. The pressure sore may look blue or purple in people who have dark skin”. (18 Jan 2019).
12. Treatment for Pressure Ulcers:
12.1 What is the best treatment for pressure sores?
“Caring for a Pressure Sore”
- “For a stage I sore, you can wash the area gently with mild soap and water”.
- “Stage II pressure sores should be cleaned with a salt water (saline) rinse to remove loose, dead tissue”.
- “DO NOT use hydrogen peroxide or iodine cleansers”.
- “Keep the sore covered with a special dressing”.
More items… (12 May 2018).
12.2 How are pressure ulcers treated?
“Treating pressure ulcers involves reducing pressure on the affected skin, caring for the wounds, controlling pain, preventing infection and maintaining good nutrition”.
“Other interventions include”:
- “Drugs to control pain”.
- “Drugs to fight infection”.
- “A healthy diet”.
- “Negative pressure therapy”.
12.3 What can nurses do to prevent pressure ulcers?
“A pressure-relief surface or special-care bed is recommended to help prevent pressure ulcers. Manage incontinence and moisture with a skin-care regimen, such as frequent cleansing and use of a moisture-barrier ointment”.
13. Prevention of Pressure Ulcers:
13.1 What actions should be taken to prevent pressure sores?
“7 Steps to Prevent Pressure Sores”
- “Get Seniors Moving”.
- “Check the Skin for Signs of Developing Pressure Sores Often”.
- “Use Specialty Bedding or Materials to Reduce Pressure”.
- “Keep the Skin Dry and Clean”.
- “Encourage Seniors to Maintain a Healthy Diet”.
- “Manage Chronic Health Conditions Effectively.”
- “Create an Incentive-Based Program for Senior Caregivers”. (11 Oct 2016).
13.2 Why pressure ulcer prevention is important?
“Nursing is also concerned with preventing further ulcer deterioration, keeping the ulcer clean and in moisture balance, preventing infections from developing, and keeping the patient free from pain. Many aspects of managing pressure ulcers are similar to prevention (mechanical loading, support surfaces, and nutrition)”.
14. Osteomyelitis
14.1 Osteomyelitis
“Osteomyelitis is an infection of the bone, a rare but serious condition. Bones can become infected in a number of ways: Infection in one part of the body may spread through the bloodstream into the bone, or an open fracture or surgery may expose the bone to infection”. (11 May 2019).
14.2 What causes osteomyelitis?
“Causes of osteomyelitis include bacteria in the bloodstream from infectious diseases that spread to the bone, an open wound from a trauma over a bone, and recent surgery or injection in or around a bone. The most common types of bacteria that cause osteomyelitis are Staphylococcus, Pseudomonas, and Enterobacteriaceae”. (13 Jul 2018).
14.3 Can osteomyelitis be cured?
“Most cases of osteomyelitis are treatable. Chronic infections of the bone, however, may take longer to treat and heal, especially if they require surgery. Treatment should be aggressive because an amputation can become necessary sometimes. The outlook for this condition is good if the infection is treated early”. (13 Jul 2017).
14.4 What bone is the most common site of osteomyelitis?
“In adults, the vertebrae are the most common site of hematogenous osteomyelitis, but infection may also occur in the long bones, pelvis, and clavicle. Primary hematogenous osteomyelitis is more common in infants and children, usually occurring in the long bone metaphysis”. (1 Mar 2018).
We do not know whether our Dad had contracted this infection. However, this is the area in which our Dad’s pressure sore was located and developed into stage 4.
14.5 Is osteomyelitis an emergency?
“Hematogenous osteomyelitis is an infection caused by bacterial seeding from the blood. Direct inoculation (contiguous-focus) osteomyelitis is an infection in the bone secondary to the inoculation of organisms from direct trauma, spread from a contiguous focus of infection, or sepsis after a surgical procedure”. (12 Apr 2019).
14.6 What are the long term effects of osteomyelitis?
“Symptoms of Osteomyelitis”
“The symptoms for acute and chronic osteomyelitis are very similar and include: Fever, irritability, fatigue. Nausea. Tenderness, redness, and warmth in the area of the infection”. (11 May 2019).
14.7 What happens if osteomyelitis goes untreated?
“Osteomyelitis is a bacterial, or fungal, infection of the bone. Osteomyelitis affects about 2 out of every 10,000 people. If left untreated, the infection can become chronic and cause a loss of blood supply to the affected bone. When this happens, it can lead to the eventual death of the bone tissue”.
14.8 What antibiotics are used to treat osteomyelitis?
“Oral therapy following IV treatment for patients with osteomyelitis from contiguous spread of infection”:
- “Amoxicillin-clavulanate 875 mg/125 mg PO q12h or”.
- “Ciprofloxacin 750 mg PO q12h plus clindamycin 300-450 mg PO q6h” or.
- “Levofloxacin 750 mg PO daily plus clindamycin 300-450 mg PO q6h” or.
- “Moxifloxacin 400 mg PO daily”. (8 Dec 2017).
15. Additional links on Bed Sores:
- Causes of Bed sores – Nursing Home Abuse Guide
- Bed sore Deaths – Wrongful Deaths in Nursing Homes
- Bed sores John Hopkins Medicine
- Bed sores or pressure sores – what you need to know
- A guide to Bed Sores/Pressure Sore Negligence Compensation claims – How to claim?. LegalExpert.co.uk
- Bed sores (Decubitus Ulcers): Causes and Treatments
16. Additional links on Pressure Sores:
- Pressure Ulcers: Revised definition and measurements
- Pressure ulcers: Advice for patients and carers
- Pressure ulcers: Prevention and management
- Causes and prevention of ulcers – Cancer Research UK
- Pressure ulcers – NHS Inform
- Medical Negligence -Pressure Sore- compensation. Claims.co.uk
- A strategy to reduce preventable ulcers – Nursing Times
17. Additional links on Osteomyelitis
- Osteomyelitis NHS
- Encyclopaedia – Osteomyelitis – NHS Direct Wales
- Osteomyelitis- Symptoms- Causes and Treatment – WebMD
- Bone Infection (Osteomyelitis): Symptoms and treatment
- Osteomyelitis – Bone, Joint and Muscle Disorders – MSD
- Osteomyelitis – Symptoms and Causes – Mayo Clinic
- Osteomyelitis (For Parents) KidsHealth
- Osteomyelitis. Bone Infection. Osteomyelitis Symptoms – Patient leaflet
18. Our Final Thoughts
In this topic unexpectedly we have learnt something new once again. We have learnt about Osteomyelitis. Until writing this topic it is a medical condition we hadn’t heard of. It really cannot be put into words how this makes us feel that we are continuously to this very date learning new things. It is a very surreal feeling, but at the same time, these are good things for us to know.
I guess our final thoughts would be in a situation as overwhelming as caring for a loved one, or even in fact if you yourself are the patient, as easier as it is said than done we would suggest:
- Try not to let the overwhelming feelings consume you
- Try your best to think and remain positive
- Do not lose faith or hope
Grief Probate Journey 