Symptoms

Stage I: A reddened area on the skin that, when pressed does not turn white. This indicates that a pressure ulcer is starting to develop.

• Stage II: The skin blisters or forms an open sore. The area around the sore may be red and irritated.
• Stage III: The skin breakdown now looks like a crater where there is damage to the tissue below the skin.
• Stage IV: The pressure ulcer has become so deep that there is damage to the muscle and bone, and sometimes tendons and joints.

First Aid Once a pressure ulcer is identified, certain basic steps must be taken immediately. These include:

• Relieving the pressure to that area. Use pillows, special foam cushions, and sheepskin to help reduce the pressure.
• Treating the sore. Treatment will be based on the stage of the ulcer. Your health care provider will give you specific treatment and care instructions.
• Avoiding further trauma or friction. Powdering the sheets lightly can help decrease friction in bed.
• Focusing on improving nutrition and other underlying problems that may affect the healing process.
• If the pressure ulcer is at Stage II or worse, your health care provider will give you specific instructions on how to clean and care for open ulcers, as it is very important to do this properly to prevent infection.
• Keep the area clean and free of dead tissue. Generally, pressure ulcers are rinsed with a salt-water rinse that removes the loose, dead tissue. The sore should be covered with special gauze dressing made for pressure ulcers.

Do Not

• Do NOT massage the area of the ulcer because massage can cause tissue damage under the skin.
• Ring-shaped cushions are NOT recommended because they can interfere with the blood flow to that area and cause complications.

Call immediately for emergency medical assistance if there are any signs that the pressure ulcer is getting infected. An infection can lead to serious problems because the infection can spread to the rest of the body. Some of the signs of an infected pressure ulcer include:

• A foul odor from the ulcer
• Redness and tenderness around the area of the ulcer
• The skin close to the ulcer is warm and swollen

If the patient starts running a fever or have other symptoms, such as weakness or confusion, he or she may be developing a systemic infection that can be very serious.