Red Bottoms

ChristineN, BSN, RN · Apr 2, 2007

There should be some sort of OTC cream available in your clean supply room. You should also notify the nurse, as depending on the severity she may want to get a prescription product.

squeakykitty · Apr 2, 2007

I am a new cna, and I was wondering if it is normal for incontenent's to have red bottoms. I noticed in my training that quite a few of the residents both male and female do have "red bottoms". I was told that is is more from sitting than anything but to me it looked like "diaper rash".
When I am working with my clients, what would be the proper protocol at changing a pull up or brief, with a red bottom.
Do they get some kind of barrier cream???? Please let me know. I want to do my best and be my best.
Thanks

It's not from sitting, it's the beginning of skin breakdown. (diaper rash) It does need a barrier cream, after soap and water cleansing each time a resident is incontinent. I hope this helps.

aerorunner80, ADN, BSN, MSN, APRN · Apr 2, 2007

In clinicals we regularly used either A&D or this stuff called Butt Paste and put that on their bottoms before dressing them up again. It acts as a skin protectant to help prevent skin breakdown. Make sure you report this to the nurse though, even if they already know just to cover yourself. Especially report it if you notice it's getting worse.

chadash · Apr 3, 2007

Well, there are a few categories of red bottoms.

This can be from not changing diapers in a timely way. The urine can irritate the skin, and make it prone to breakdown and rash. Check diapered patients at least every two hours, and you should prevent this. A barrier cream is important as well, but nothing replaces frequent changes.

Pressure is a really serious problem. If the patient is red from pressure, they are headed for a decubitus ulcer. Bad stuff. Patients left sitting in wheel chairs are really prone. No one should be in a wheel chair more than two hours, and even then pressure releases are important in between. Lift the pt into a standing position at least every hour to reposition the cheeks....and let them lay down after two hours just to get off their bums. In bed, turn to opposite cheeks every two hours. Avoid the trochanters and sacral area.

Diligence pays! (adequate staffing required)

quisqueya · Apr 3, 2007

Thanks, I am a new cna and I just was noticing a "trend" however, I don't want to rock the boat, but when it is my shift I just want to do all that I can for my patients. Thanks for the advice.

chadash · Apr 4, 2007

Thanks, I am a new cna and I just was noticing a "trend" however, I don't want to rock the boat, but when it is my shift I just want to do all that I can for my patients. Thanks for the advice.

Good for you! all you can do is what you can do....guess I am stating the obvious here.. But, focus on the patient's real needs, and you will have a positive effect. It is ok to report red bottoms, and ask for suggestions and help, but you are right not to accuse. I always assume every one is doing their best unless I see blatant evidence to the contrary. I have a special sympathy for folks that work night shift, when the staffing is so slim and the people still need turned and changed. Even when they do the best they can, it is impossible to do it right. And even if they are able to turn and change in a timely way, elderly patients skin is just so vulnerable you can not prevent everything. LTC is a tough tough world.

So, be kind to your NA's. They are over worked.

some times I did want to slap management into next friday...