Pressure Sores
Tragically, too many nursing home residents suffer pressure sores which are also called bedsores, pressure ulcers, or decubitus ulcers. As the name suggests, pressure ulcers are caused by pressure. When the body is left in the same position pressure prevents the flow of blood which carries oxygen to the skin and tissues. Over time, the lack of oxygen causes the skin and tissues to die. Pressure sores are painful to the patient and dangerous. Patients with pressure sores are prone to life threatening infections.Most pressure sores are preventable with proper care. Federal nursing home regulations provide that in most cases a patient who is admitted to a nursing home without pressure sores should not develop them. For patients who are admitted to a nursing home with pressure sores the sores should not worsen.
The standard of care is for a bed bound patient to be turned and repositioned at least every two hours. The nursing home should have a written turning and repositioning program.
A patient at risk for pressure sores should have their skin checked at least daily so the nursing home can commence early treatment. Pressure sores are most likely to form on bony parts of the body especially the sacrum, hips, and feet. Pressure sores are easier to prevent than to treat. Once a patient has a pressure sore, the nursing home needs to keep pressure off of the sore. The sore needs to be kept clean and dry and the physician needs to be kept informed about the condition of the pressure sore. Nutritional support is critical for preventing and treating pressure sores. Nutritional status can be assessed by monitoring the resident's weight, food intake, and laboratory values.
Pressure sores are typically assessed by stages. A stage I pressure sore appears as a reddened area of the skin that remains red even after pressure is removed. A stage II pressure sore looks like a shallow crater or a blister. Stage III and stage IV pressure sores are far more dangerous. In both stage III and stage IV pressure sores the skin is broken leaving the body prone to infections. In a stage IV pressure sore, the underlying tissue or even bone may be exposed. A wound infection may occur when micro-organisms invade the wound and start multiplying.
The attorneys at Williamson & Lavecchia, L.C. represent patients who were injured or lost their lives due to pressure sores.
On this website we provide answers to frequently asked questions about pressure sores and link to other resources. For more information, read the article "Pressure Sores and the Law" in our cyberlibrary. Please feel free to contact us if we can provide further assistance.
Library for Pressure Sores:
- Photographs of Pressure Sores [PDF]
Description: Photographs and depictions of the four stages of pressure sores (bed sores) - Pressures Sores and the Law [PDF]
Description: This paper, co-authored by Tom Williamson and Josh Silverman, discusses the frequency of pressure sores, the legal liability of nurses and nursing homes, and notable verdicts and settlements awarded to victims of pressure sores. The paper was presented at the Mid-Atlantic Wound Care Symposium in Williamsburg, Va. on October 17, 1999.
Frequent Questions for Pressure Sores:
- What are pressure sores?
- How common are pressure sores in nursing homes?
- What are the stages of bed sores or pressure sores?
- Are pressure ulcers unpreventable?
Case Results for Pressure Sores:
- $710,000 Wrongful Death Settlement - $710,000 Wrongful Death Settlement
- $140,000 Settlement for Stage IV Bedsore - $140,000 Settlement for Stage IV Bed Sore
Web Resources for Pressure Sores:
- European Pressure Ulcer Advisory Panel
Description: The European Pressure Ulcer Advisory Panel was created to study effective measures to prevent and treat pressure sores. This website contains valuable information including photographs depicting the stages of pressure ulcers and prevention and treatment guidelines.
- American Academy of Wound Management
Description: The American Academy of Wound Management is a not for profit organization that credentials practitioners in the field of wound care.
- American Professional Wound Care Association
Description: The American Professional Wound Care Association is a membership organization that brings together professionals who treat complex wounds including pressure sores.
- Wound, Ostomy and Continence Nurses Society (WOCN)
Description: WOCN is widely considered to be amongst the leading certifying organizations for wound care specialists.
- National Pressure Ulcer Advisory Panel - Revised Staging
Description: The National Pressure Ulcer Advisory Panel has revised the staging system for pressure ulcers and has expanded the definition of pressure ulcers. In addition to the four stages of pressure ulcers, the Advisory Panel has added categories for deep tissue injuries and unstageable pressure ulcers. The Advisory Panel has also expanded the definition of pressure ulcers to include ulcers formed by friction or sheer.
- Encyclopedia of Surgery: Bedsores
Description: This link provides scholarly analysis of the prevalence of pressure sores, prevention, and treatment options.
- University of Virginia - Bed Sore Information
Description: The UVA Medical Center's Department of Dermatology provides a brief overview of bed sores (also known as pressure ulcers or decubitus ulcers). This site describes the causes of bed sores and discusses treatment options.
- National Decubitis Foundation
Description: The NDF website provides an immense amount of information pretaining to pressure sores.
- National Pressure Ulcer Advisory Panel
Description: Provides multidisciplinary leadership for improved patient outcomes in pressure ulcer prevention and management through Education, Public Policy, & Research.