Pressure sores and long procedures...

[MereSanity]

More specifically Open Heart (when there is no circulation in lower extremities). We had a case go 11 hours and it wasn't good for the patient's skin. What does everyone else use (obviously you don't really know when a case will go this long). Gel under the bottom? Always use it or just when you know it will be more than a certain number of hours? Suggestions are appreciated!

[Rose_Queen, BSN, MSN, RN]

For our robotic and bariatric patients, we use tempurpedic pads on the bed. Some of our other beds with thinner pads also get covered with a full length gel pad. Other than that, we just make sure pressure areas are padded with eggcrates.

[canesdukegirl, BSN, RN]

I am in total joint surgeries quite a bit, and we use the tempurpedic beds as well. Our surgeon likes to use a peg board for positioning, so we have to cover it with 2 gel pads (full length) and smaller gel pads for the pegs themselves. I use the eggcrates too, as well as foam or gel donuts for the non-operative foot. Of course, ax roll and pillows.

Interestingly enough, a well respected surgeon that I work with HATES gel pads. He believes that instead of cushioning the bony prominences, we should pad the proximal and distal ends of the prominences. He says, "nothing is lighter than air", and believes that we are creating MORE pressure by padding. I can't say that I disagree with this logic. He has done many lectures on positioning and pressure sores, and his rate of dependent sores is very low.

[mercys]

All of our beds have gel pads or the bed itself is gelled. Use extra gels for certain procedures that require odd positioning.