Help! I have a patient that is dear to my heart. I am a home health nurse, and have a pt that was on the wound vac, doing great, but according to medicare guidelines the wound was not closeing the 10% the two cycles...so it stalled. even thought the undermining, and the tunnels ended up closing. so the took the wound vac away from my patient. so now here I am with out a wound vac on a huge coccyx wound. it was like 4x2x1...now it is 5.5x3x1.5. and the wound was so pretty we had been doing Arglaes powder, ca alginate dressing changes for the last three weeks. it has actully been doing well...and little aspects of the wound is closing. But within the last three days the wound has went from wonderful pink tissue to dark red, one area of black and a small area of bone. the patient has a "healed" wound stage III on his right hip that just broke down within the last three days with no real reason to break down.
words of wisdom? Md's at least gave me antibiotics, pt caregive is not wanting patient to pass away in hospital, will not agree to hospice. I have tried everthing for this couple. anything else out there I could try? or suggest? I am open!!!!! pretty much what I suggest to the dr they let me do....
if things get bad my DON said we have to report to APS. so I am not sure. I know this caregiver does everything to protect her husband. but the doctors are not helping too much, but yet the caregive will not bring her husband to the doctors. so I am the one caught in the middle!!!! help!!!!!!!!!!!!!!!