Shift #3

1-      Assisted with a wound vac change. Learned that you don’t use wound vacs just to clean out a wound. We use them to enhance blood flow to the tissues. For a wound to heal we need a moist wound bed (not too wet or too dry), nutrients and oxygen.  Performed a dressing changed on a stage 2 pressure sore (toe), and learned that collegen can be used to aid as a scaffold and aid creation of granulation tissue (which is what happens when a wound is healing). 

Assisted my preceptor to clean a stage four sacral pressure ulcer. I learned that children with spina bifida, particularly those in wheelchairs, are at increased risk for pressure ulcers because they can’t feel sensation, and in adolescents they are often responsible for their own hygiene, and the pressure sore might not get caught until it’s extended into the entire tissue. I also learned that pressure sores are only stageable if you can see the wound base. A white wound base is covered in slough, and is thus unstageable. I also learned about the use of fluid airbeds for patients with pressure ulcers. The material inside the bed makes it so that the patient is basically floating, and there isn’t pressure on the bony prominences. It has it’s disadvantages however, in that it makes turning the patient difficult (if not impossible), but the patient still needs to be turned/repositioned every few hours.