Decub's starting in the ED

[Aneroo, LPN]

The other day when I came into work, it was an admission nightmare. There were people who had been waiting 26 hours for an open bed. We try and get people hospital beds when issues like that arise, but not much we can do but call and hound case mgrs and admission about the bed status. I don't know what ended up happening, just that the patients were finally moved to the floor.

Later in the night, we were venting about how insane it was for people to lay there that long. Someone mentioned "You lay on those stretcher for thirty minutes and your butt goes numb". I was thinking about it in my head, and made a joke about it, but now it's bothering me. I wonder how many decub's are starting down there in the ED. Our stretchers are usually just as wide as the patients butt- doesn't give us much room for turning. I honestly don't think I've ever went into a patients room and said "Ok, we need to turn you off your bottom to keep it from getting sore" unless I knew the patient had an existing decub. I'm really bothered by this now.

Do you turn your patients? Does anyone have any research on this?

I know it seems like there is always "They expect us to do so much!", just wondering how many actually do this.

-A

[suebird3]

we move either consiously,or unconsiously. it can take under two hours for a decube to start. you are thinking good! i wish more would think along those lines.

[color=#483d8b]

[color=#483d8b]suebird

[Nurseboy1]

Suebird is absolutely right about the time, decubs can start in as little as 2 hours of unrelieved pressure, regardless of patient age and health. Not only that, ER gurneys are not designed with pressure relieving surfaces like many hospital beds.

[NRSKarenRN, BSN, RN]

Recently spent 16 hours in local ER till hospital reopened closed floor. They now have regular beds that patents are transfered to if long wait anticipated. Something to discuss for your unit. espectially for elderly, those with limited mobility.

Turn, cough, deep breathe applys in the ER too. Sounds like a great PI project to me...

[Aneroo, LPN]

Recently spent 16 hours in local ER till hospital reopened closed floor. They now have regular beds that patents are transfered to if long wait anticipated. Something to discuss for your unit. espectially for elderly, those with limited mobility.

Turn, cough, deep breathe applys in the ER too. Sounds like a great PI project to me...

Luckily, we do get hospital beds sometimes, but not all of the time. I didn't have one of the long wait patients the other day, so I don't know what type of bed they were on. Regardless of bed, they're still not being turned. :uhoh21:

[analee23]

People naturally move to relieve pressure, thus preventing decubs.... I'd only worry about it with a sedated, diabetic, elderly, or parapalegic pt. But, still... 26 hours on a hard, narrow stretcher would be ROUGH!

[chadash]

I say if they aren't rolling themselves, roll 'em...

[Hellllllo Nurse, BSN, RN]

I say if they aren't rolling themselves, roll 'em...

Agree. Also try to keep bony areas seperated. When I worked in LTC we often got people back from ER with decubs.

One elderly man went to ER w/ cp unrelieved by Nitro x 3. We sent him with a towel folded between his contracted knees.

He came back with decubs on both inner knees, the towel had scrunched down to his crotch. It took over 6 mos, meticulous care, lots of taxpayer money and lots of suffering on the part of the pt to heal those decubs.