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A pressure injury (also known as pressure sore, pressure ulcer or bed sore) is an area of the skin that has been damaged as a result of constant pressure, poor blood flow or chafing and rubbing of the skin.
People of all ages, including babies and children, are at risk of developing pressure injuries. Children who are at increased risk of developing a pressure injury include those with spina bifida, a spinal cord injury, neurological impairment or other medical condition that restricts their
ability to move, or children who have an orthosis or prosthesis.
Many pressure injuries are preventable with careful management of your child, both in hospital and at home following discharge. A pressure injury is much easier to prevent than treat.
Common signs of a pressure injury include:
Pressure injuries can appear anywhere on the body, however, common areas on children are:
A number of factors may lead to your child developing a pressure injury, including:
Children with poor nutritional or fluid intake, a weakened immune system or those who are extremely unwell are at increased risk of developing pressure injuries.
While in hospital, nursing staff will assess and monitor your child for pressure injuries on a daily basis. If your child is at risk of developing a pressure injury, staff will discuss a management plan with you. This plan may include the following strategies:
Nursing staff may refer your child to other members of the healthcare team to contribute to their management plan, such as an occupational therapist, a physiotherapist or a dietitian. If your child has an existing pressure injury that requires dressings, a nurse specialising in wound
dressings (nurse practitioner or stomal therapist) may also be asked to assess your child.
Pressure injuries can be serious and may take months to heal. They can be painful and add to a child's existing health problems. Careful attention to the condition of your child's skin, prompt attention at any sign of damage, and maintaining a healthy diet is important for your
child. The more active your child is, the lower their risk of a pressure injury.
If your child requires long periods of bed rest and has reduced activity, an occupational therapist may recommend the use of specific equipment for your child at home to reduce the risk of pressure injuries.
These may include:
The occupational therapist will advise you where these products can be hired or purchased. If you have not seen an occupational therapist and would like to, your GP or nursing staff can organise a referral for you.
If you notice a pressure injury on your child at home, identify the cause and remove it where possible. Reposition your child so they are not directly on the pressure injury.
If the pressure injury does not heal within 24 hours or the skin is broken, contact your GP or treating healthcare provider.
Pressure injuries can be a sign of a deeper wound and need to be assessed as soon as possible.
Prevention is the key. But when pressure injuries do occur, they will be treated like a wound, with regular dressing changes and checks by nurses or doctors. When the area is showing signs of infection (red, warm, painful, swollen), antibiotics may be required to help treat the infection.
Should I set an alarm to wake in the night to go and change
my child's position?
This is usually not necessary, especially if your child
sleeps on a soft surface, like most mattresses. If your child is at increased
risk of pressure injuries, your child's doctor will advise whether regular
repositioning is required.
How long will it take for my child's pressure injury to
Most pressure injuries begin healing within 24
hours. Wound healing can be delayed for the following reasons: in children with
poor blood flow (perfusion); if your child is taking medication that weakens the
immune system; if the wound becomes infected; and by other medical conditions.
Have your child seen by a doctor if their pressure injury is not improving
within 24 hours.
Developed by The Royal Children's Hospital Nursing Services department. We acknowledge the input of RCH consumers and carers.
Reviewed July 2018.
This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.
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