Pressure injuries (also known as pressure sores or bed sores) develop on the skin and underlying tissue when there is continuous and constant pressure or friction. They can occur when a child has reduced mobility, such as being confined to a bed or a chair, or if they have a medical device attached to their skin. Pressure injuries can develop quickly especially when your child is unwell. Regular position changes, good hygiene and skin care, and a healthy diet can help prevent them forming.
Why do pressure injuries develop?
The constant pressure or rubbing slows the blood flow to the skin, preventing it from being healthy tissue. An injury is most likely to occur where the bones are closest to the skin, and the areas of skin in contact with a mattress, chair, cast or other medical attachment. This causes the skin to discolour, becoming red, blue or purple. They can look like a bruise or blister.
Where do they occur?
Pressure injuries can occur anywhere on a child’s body. They frequently appear on the heels, elbows, hips, buttocks, tail bone, nares, ears, and the back of the head when a child spends prolonged periods of time in a bed or wheelchair. They can also develop anywhere a medical device is attached to or comes into contact with your child’s skin, such as a tube, cast, splint, drip, drains or monitoring attachments.
What should I look for?
Check your child’s skin at least once a day for redness, signs of discolouration or blisters. You should also look for signs of infection, such as skin warmth, swelling, cracks, calluses, and wrinkles.
Things you can do to help prevent pressure injuries
- Inspect your child’s skin regularly (or ask your child’s care team if they have). If you find an area with redness or marking, relieve the pressure, and consult your child’s care team if the area does not improve.
- Change your child’s position regularly if they are unable to move themselves. Aim for every two hours during the day, and every four hours at night. If your child can move independently, encourage them to change position regularly if they are sitting or in bed for long periods.
- Rotate the position of lines and tubes, if they are in contact with your child’s skin.
- Make sure your child is getting food and fluids that are right for them.
- Use moisturising products to keep skin supple and prevent dryness.
- If your child is wearing nappies, change them as soon as they are soiled.
- Watch for foul-smelling odours under casts or splints.
- Avoid massaging reddened or bony areas, this may cause more damage to the skin.
- Avoid stretching or pulling on the skin
Tell your child’s care team immediately if:
- You notice anything abnormal about your child’s skin.
- Your child complains of pain or soreness, discomfort or pins and needles.
- Your child complains of pain around an attachment or device or under a splint or cast.
Lady Cilento Children’s Hospital
501 Stanley Street, South Brisbane
t: 07 3068 1111 (general enquiries)
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.