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Giving a back massage


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Giving a back massage

  2. 2. PRESSURE ULCERDEFINITION:-Any lesion caused by unrelieved pressurethat results in damage to underlying
  3. 3. SYNONYMSDecubitus ulcer
  4. 4. PATHOLOGYPressureBlood vessel collapseNecrosis (tissue death)
  5. 5. MECHANISMExternal pressure –compress bloodvesselsFriction and shearing forces-tear andinjure blood
  6. 6. EXTERNAL
  7. 7. FRICTION AND SHEARING FORCES Friction-two surfacesrub against eachother Shearing-one layer oftissue slide
  8. 8. FACTORS AFFECTING PRESSURE ULCERDEVELOPEMENTAgingImmobility-paralysed,unconscious,lengthysurgery,tranquilizersNutrition-malnourished,vit-c
  10. 10. PRESSURE ULCER STAGING STAGE I - NonblanchingErythema With Skin Intact.STAGE II - Partial Thickness SkinLoss(epidermis)- Blister /
  11. 11. PRESSURE ULCER STAGINGSTAGE III – Fullthickness Skin Loss -Necrosis Of Hypodermic TissueSTAGE IV - Fullthickness Skin Loss -Extensive Damage To Muscle,boneorSupporting
  12. 12. STAGE
  13. 13. STAGE
  14. 14. STAGE
  15. 15. STAGE
  16. 16. PREVENTING PRESSURE ULCER1. Identify at risk patients2. Assess their skin daily3. Keep skin clean & dry always keeppressure off skin4. Avoid massage over bony
  17. 17. PREVENTING PRESSURE ULCER5. Minimize injury from friction6. Nutritional interventions7. Improve mobility8. Document measures
  19. 19. ACTION1. Explain the procedure and offer backmassage to the
  20. 20. RATIONALEBack massage can facilitatecirculation and
  21. 21. ACTIONWASH YOUR HANDS.Hand washing detersthe spread of micro –
  22. 22. ACTIONCLOSE THE CURTAIN ORDOOR.Privacy increases
  23. 23. ACTIONAssist the patient to the proneposition or side – lying position withthe back exposed from the shouldersto the sacral
  24. 24. RATIONALEThis position exposes anadequate area for massage withprivacy and warmth
  25. 25. ACTIONUse the bath blanket to drape thepatient. Raise the bed to the highposition and lower the side rail closestto
  26. 26. RATIONALE. Having the bed in the highposition reduces back strain forthe
  27. 27. ACTIONWarm the lubricant or lotion in thepalm of your hand or place thecontainer in warm
  28. 28. RATIONALECold lotion causes chilling anduncomfortable
  29. 29. ACTIONUsing light gliding strokes(effleurage), apply lotion topatient’s shoulders, back , andsacral
  30. 30. SUGGESTED
  31. 31. RATIONALEEffleuragerelaxes thepatient andlessens
  32. 32. ACTIONPlace your hands beside each otherat the base of the patient’s spine andstroke upward to the shoulders andback downward to the buttocks inslow, continous strokes. Continue forseveral
  33. 33. RATIONALEContinous contact is soothing andstimulates circulation and
  34. 34. ACTIONMassage the patient’s shoulders, entireback, areas over iliac crests, and sacrumwith circular stroking motion. Keep yourhands in contact with the patient’s skin.Continue for several minutes, applyingadditional lotion as
  35. 35. RATIONALEA firmer stroke with continouscontact promotes
  36. 36. ACTIONKnead thepatient’s skin bygently alternatinggrasping andcompressionmotions(petrissage)
  37. 37. RATIONALEKneading increases bloodcirculation to
  38. 38.
  39. 39. ACTIONComplete the massage withadditional long
  40. 40. RATIONALELong stroking motion is soothingand promotes
  41. 41. ACTIONDuring massage, observe thepatient’s skin for reddened oropen areas. Pay particularattention to the skin over
  42. 42. RATIONALEPressure may interfere withcirculation and lead todevelopment of decubitus ulcers.Back rub stimulates circulation tothese
  43. 43. ACTIONUse the towel to pat the patientdry and to remove excess lotion.Apply powder if the patientrequests
  44. 44. RATIONALEThis provides additional comfortfor the
  46. 46. RATIONALEHand washing deters the spreadof micro –
  47. 47. ACTIONAssess the patient’s responseand record your observations onthe patient’s
  48. 48. RATIONALEThis provides accuratedocumentation of the procedureand condition of the patient’s
  49. 49. Thank