Using Gel Positioners To Prevent Pressure Ulcers

Preventing Pressure Ulcers In The Operating Room

Pressure sore, decubitus ulcer, and pressure ulcer are all terms used interchangeably to describe localized injuries to the skin and/or underlying tissue that usually occur over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction.

What Is A Pressure Ulcer?

The National Pressure Ulcer Advisory Panel (NPUAP) defines a pressure ulcer as an area of unrelieved pressure over a defined area, usually over a bony prominence, resulting in ischemia, cell death, and tissue necrosis.

According to a 2009 article, Prevention of Pressure Ulcers in the Surgical Patient, in the AORN Journal; “pressure ulcers (PUs) are a serious health care problem, and it is crucial to assess how patients acquire pressure ulcers after admission to a health care facility. In the OR, factors related to positioning, anesthesia, and the duration of the surgery, in addition to patient-related factors, all can affect PU development¹. . . All surgical patients should be considered at-risk for pressure ulcer development; therefore, preoperative departments should develop and implement strategic plans for pressure ulcer prevention.”

Quick Facts

Did you know?

Number of patients affected by pressure ulcers: 2.5 million per year


  • Pressure ulcers cost $9.1-$11.6 billion per year in the U.S.
  • Cost of individual patient care ranges from $20,900 to $151,700 per pressure ulcer.
  • Medicare estimated in 2007 that each pressure ulcer added $43,180 in costs to a hospital stay.

Pressure Ulcer Management

In 2008, The Centers for Medicare & Medicaid Services (CMS) included hospital acquired pressure ulcers (HAPU’s) as a “Never Event” which marked a turning point for most facilities. “Pressure ulcer management has become a standard part of every modern hospital’s protocol¹.”

Four Major Factors Contributing To Pressure Ulcers¹

  1. Uneven weight distribution
  2. Pressure
  3. Shear
  4. Heat and humidity build up

“Pressure ulcers are a costly, debilitating, and avoidable complication of surgery².”

The National Pressure Advisory Panel (NPUAP) and European Pressure Ulcer Advisory Panel (EPUAP) created the Pressure Ulcer Prevention: Quick Reference Guide outlining risk factors for patients in the operating room.

1. The following factors increase the risk the patient developing a pressure ulcer during a surgical procedure include:

a)Length of the operation
b)Increased hypotensive episodes intraoperatively
c)Low core temperature during surgery
d)Reduced mobility on day one of postoperatively
2. Use a pressure-redistributing mattress on the O.R. table for all individuals identified as being at risk of pressure ulcer development.

Action Products manufactures O.R. overlays that are cited by AORN best practices for Pressure Ulcer Prevention. The O.R. overlays, available in standard and custom sizes, provide pressure redistribution and reduce shear effects across the entire table surface. The low profile, simple design of the 1/2 inch Akton poymer O.R. overlay maximizes effectiveness and minimizes patient movement.

3. Position the patient in such a way as to reduce the risk of pressure ulcer development during surgery.

4. Elevate the heels completely (offload them) in such a way as to distribute the weight of the leg along the calf without putting all the pressure on the Achilles tendon.

The heel support gel positioner by Action is designed to secure and protect the heel area as well as cradle the patient’s Achilles tendon area.

5. Pay attention to pressure redistribution prior to and after surgery.

a) Place patient on pressure-distributing mattress prior to and after surgery.
b) Position the patient in a different posture preoperatively and postoperatively than the posture adopted during surgery.

Types of Gel Positioners

Head & Neck Gel Positioners help protect and cradle the patient’s head and neck by stabilizing the head movement and assists in the prevention of neck overextension.

  • Lateral Head Pad with Center Dish
  • Donut Head Pads
  • Prone Headrests
  • Horseshoe Head Pads
  • Contoured Head Pad
  • Ophthalmic Headrests
  • Ophthalmic Cradle Headrests

Extremity Gel Positioners protect the patient’s arms and legs during procedures.

  • Contoured Armboard Pads
  • Armboard Pads
  • Hand/Wrist Support
  • Foot Pad
  • Heel Support
  • Stirrup Pad Set

Torso & Hip Gel Positioners provide support for the torso and upper body by providing increased stability.

  • Flat-Bottomed Chest Rolls
  • Contoured Chest Rolls
  • Chest Gel Positioners
  • Trapezoid Gel Positioner
  • Dome-Shaped Gel Positioner

Proper patient positioning and cushioning of all pressure points is a priority and using the correct padding can protect the patient from pressure ulcers.

“Procedures longer than 2 1/2 hours to 3 hours significantly the risk of pressure ulcer formation. Positioning problems can result in significant injuries and successful lawsuits.” ~Patient Positioning In The Operating Room

AORN recommends “Classifying all surgical patients as “at risk” for PU development is an appropriate preoperative intervention to successfully reduce the incidence of possible PU development.” The uncontrollable length of surgeries and effects of anesthesia are two of the main contributing factors leading to the development of pressure ulcers. Although it is impossible to eliminate the risk of patients developing pressure ulcers during surgical procedures – some patients will develop pressure ulcers from skin breakdown regardless of preventative measures. It is important to be aware of the causes of pressure ulcers and what steps you can take to minimize the risk.

Additional Information:



Active Cooling Vest System For Surgeons In The OR

What is an active cooling vest? 

A cooling vest is a piece of equipment designed to cool a person down. Cooling vests are used by doctors, athletes, industrial workers, working dogs, individuals with Multiple Sclerosis or hypohidrotic ectodermal dysplasia, race care drivers, and military personnel.

Active cooling vests and systems require some form of power, electricity or battery, to operate. This type of cooling technology provides continuous cooling to lower the body’s core temperature by circulating cold water via a cooler through a tube to the vest.

CoolVest System 

Although cooling vests are used by a variety of people for a variety of uses, the CoolVest System has been designed specifically for surgeons working in the OR. Staying cool in the OR is an important consideration for surgeons, especially when performing pediatric surgeries, burn or trauma cases. The CoolVest System will keep you cool and focused – even when the OR has been warmed to AORN (recommended OR temperature 68-73 Fahrenheit) and Joint Commission Standards. When performing surgical procedures where the surgeon is exerting a great deal of physical effort, body temperatures can easily rise while covered with sterile gowns and lead aprons, not to mention the heat emitted from the OR lights.

CoolVest System Features

  • Lightweight vest made with hospital-grade ventilated nylon for maximum comfort.
  • Variable flow control and quick-dry disconnects for ease-of-use.
  • Choice of styles & sizes from small – XXXL
  • Variable hose lengths for freedom of motion.
  • Up to 70 feet of patented, thin wall, no-kink tubing for use under lead aprons.
  • Low-profile cooling unit for easy storage.
  • Wheeled cart with handle for convenient portability.
  • Single and dual vest capacity.
  • Heavy duty pump system.
  • Limited Lifetime Warranty with Free Loaner Program
  • UL Listing guarantees the highest quality standards for use in the OR.

Single-Surgeon System Includes

  • One premium CoolVest (Small-XXXL)
  • 8 foot insulated supply hose with quick disconnects
  • Protective hose cover
  • T-Drain kit
  • Maintenance additive (16 ounce bottle)
  • Stainless steel cart with hospital grade wheels
  • UL Listed cooler with variable flow 110V pump

A Dual-Surgeon System is also available and comes with two premium CoolVests. 

Remain Alert And Focused

The CoolVest System offers variable flow control, which allows you to regulate the fluid flow to your personal comfort level so that you won’t perspire, suffer fatigue or lose concentration. No matter how long or complex the surgery, you’ll remain alert an focused.

Stay Cool And Comfortable

The lightweight vest is made with hospital-grade ventilated nylon for maximum comfort. Available in sizes ranging from small to XXXL the CoolVest is lightweight, comfortable, and durable for OR conditions. Comfort is essential when working under intense pressure and performing hundreds of high-risk procedures each year. The CoolVest will help surgeons and medical staff stay cool and focused while working in the OR. Make sure to visit our Surgeon Cooling section on our main site for more CoolVest products.

3 Benefits Of The Basic Billy Life Support Simulator

Cardiac Failure, A Leading Cause Of Death

With cardiac failure as one of the leading causes of death, let “Basic Billy” show that it is not difficult to provide help and save lives through correct cardiac massage and ventilation techniques.

“About 5.1 million people in the United States have heart failure¹

Heart failure occurs when the weakened heart muscle cannot pump enough blood and oxygen to support other organs in your body. Unlike a healthy heart muscle that pumps blood into the aorta, the weakened heart muscle cannot pump enough blood into the aorta which results in heart failure. Although heart failure is a serious condition, the heart has not entirely stopped beating or is about to stop working². The heart simply cannot pump blood the way it should.

Designed Based Upon Extensive Results of Studies 

Basic Billy CPR manikin emerged by using the extensive results of studies focusing on the depth and force of compression during cardiopulmonary resuscitation or more commonly referred to as (CPR). The design of “Basic Billy” was based on guidelines set forth by the AHA (American Heart Association)  and ERC (European Resuscitation Council). “Basic Billy”, developed in Germany, was designed with optimal force and compression values in mind. Basic Billy is both anatomically correct and hygienic to use.

Two CPR Manikins In One

The “Basic Billy” basic life support simulator is quite versatile, as it can be used as either an adult or child  (approximate age 12). The interchangeable compression springs are located in the back of the trainer to give realistic depth feedback of either the adult or child. The head tilts easily to provide an open airway for mouth-to-mouth and mouth-to-nose resuscitation. As an added feature, the thorax raises as the lungs are ventilated.

3 Benefits Of The “Basic Billy” Life Support Simulator 

1. Easily exchangeable lung bag – The lung bag can be changed quickly and easily. Begin by removing the thorax skin and then remove the face skin. To detach the lung bag from the lung bag socket, you will need to remove the jaw insert. Replace the used lung bag with a new one and then reattach the lung bag socket to the jaw insert (make sure the lung bag lays flat once in place). Reattach the face skin and thorax skin to complete the complete the process.

2. Compression spring is quickly and easily converted from adult to child mode – Changing the compression spring allows for child mode. To exchange the adult compression spring (red spring) for the child compression spring (green spring), begin by removing the thorax skin, face skin and lung bag. Once that step has been completed, the thorax cover can be detached and removed (Tilting the head back will make it easier to remove the thorax cover).  The compression spring is located in the back of the trainer and can be easily replaced. Once the compression spring has been exchanged, follow the first step in reverse order.

3. Easily cleanable and hygienic – Basic Billy comes with disinfectant cleaning solution, 50 lung bags and 2 additional face masks for hygienic reasons. Cleaning is easy, simply spoon the contents of the package of cleaning solution into a large bowl of warm water and place the lung bag socket, jaw insert and face skin into the bowl of solution. The cleaning process will take approximately 30 minutes. Rinse all of the components with clean, warm water and dry with a soft cloth.

The robust construction, ease of use and realistic handling,  the “Basic Billy” life support simulator is suitable for both medical training and for teaching in schools, clubs and first aid courses. This simulator offers all the necessary features to learn about the life-saving algorithm, comprising cardiac massage and respiration for adults and children. For more information on the “Basic Billy” life support simulator, review the video below.


Please note this post/video is for product demonstration only and is not intended to train CPR. 



6 Anatomical Models For Setting Up Your Physical Therapy Anatomy Laboratory

In physical therapy, it’s important for medical staff to fully understand the human anatomy and how it works. Did you know the brain processes visual information 60,000 faster than text? For learning purposes, anatomical models are an excellent tool to use.

So what type of anatomical models will help set up your physical therapy anatomy laboratory? We’ve listed a few top anatomical models used for physical therapy training and applications.

  1. Lifting Demonstration Figure: Provide your clients with a graphic demonstration of the effects of correct and incorrect lifting techniques on the spine.
  2. Shoulder Joint with Rotator Cuff 5-Part: This model shows the musculature of the rotator cuff and the origin and insertion points of the shoulder muscles.
  3. Muscled Knee Joint Model: Included with this model is an educational card, this model is articulating the right knee with ligaments: meniscus, fibular collateral, tibial collateral, anterior and posterior cruciate and patellar ligament with patella.
  4. Functional Elbow Joint Model: This model provides an excellent graphic demonstration of the anatomy and mechanics of the joint, allowing better doctor-patient or teacher-student understanding.
  5. Hip Joint with Removable Muscles 7-Part: For educational purposes, the origin and insertion areas of the muscles have been raised and presented in color on the hip joint.
  6. Functional Model of the Knee Joint: In this model, the ligaments flexibility allows an excellent demonstration of the full range of motion, including flexion, extension, inner and outer rotation.

For a full list of joint anatomy models and other anatomical models for setting up your physical therapy laboratory, be sure to visit our anatomical model category on our website.

Why Medical Training Models Are Essential For Medical Students

Medical training models are common for teaching medical students certain medical applications and procedures. Anatomical models and simulators will help guide students in learning the process of a procedure, while increasing their comfort level with the application. Medical training models not only provide the student with hands-on practice, it gives the student a visual to apply real life situations instead of reading about it via books and slides.

We have a variety of models and simulators to choose from, such as CPR simulators, medical patient simulators, IV training models, real baby care dolls, and more! Our I.V. Injection Arm Model is unique in that it allows a realistic training to teach competence to medical staff. This model is also great for group instructors because of its high quality, stain resistance and easy to clean material. Many instructors use this model for the following training:

  • Intravenous injections
  • Correct puncture of peripheral veins for blood sampling. The following veins can be punctured: basilic vein, cephalic vein, median cubital vein, dorsal venous rete of hand
  • Positioning of a venous catheter

Another popular medical training model is our Basic Billy Basic Life Support Simulator. This simulator is used to teach students CPR techniques focusing on the depth and force of compression during cardiopulmonary resuscitation. Cardiac failure is one of the leading causes of death and with this medical training model, it shows how easy it is to provide help and save lives through correct CPR techniques.

Are you currently using any medical training models in your facility?

Featured Product: TruLife Oasis Elite Closed Head Ring

Our featured product for today is the TruLife Oasis Elite Closed Head Ring, an excellent gel positioner to provide pressure relief for your patients. This head positioner is designed with lightweight foam with silicone Trugel, the foam and gel work together to conform to the patient’s body shake and helps distribute weight evenly.


Product Features:

  • Unique gel & foam combination conforms comfortably to the patient’s head
  • Suitable for use in many surgical procedures
  • Dimensions:
  • Adolescent: 5.5″ Diameter x 1.3″ Thick
  • Adult: 7.8″ Diameter x 1.9″ Thick
  • MRI Safe
  • Latex Free
  • Non-Hazardous

Featured Product: Chemo Sharps Container

 A needlestick from a contaminated sharp has the possibility of leaving a worker infected with HIV, HBV, HCV and other dangerous pathogens. It’s important to appropriately discard sharps in your facility’s designated sharps containers. When selecting sharps containers it’s good to know the type of waste your facility has to discard, the storage area and space limitations and your facility’s state and federal regulations.

Chemo sharps containers are a safe way to dispose of trace chemotherapy, needles, administration sets and medication vials. The 1.5 gallon chemo sharps container is ideal for smaller volume treatment areas and home infusion usage and will help prevent percutaneous injuries and exposure to hazardous materials.


  • Dimensions: 8″ wide x 4.25″ deep x 11.75″ high
  • Has a liquid absorbent pouch and a gasketed locking screw cap to prevent leakage during disposal or transport
  • Bright yellow color for medical staff to easily identify
  • Unique locking top minimizes the risk of hazards resulting from mishandled, overturned or dropped containers
  • Container can be free standing on a table top or mounted with metal cabinets and stands
  • Puncture resistant walls


Have any questions or comments about our featured product? Let us know in the comment box below!

Weekly Wrap For November 18 – November 22, 2013

5 Benefits Of Disposable Patient Positioning Straps

Disposable patient positioning straps are used to assist in immobilizing patients and are great for infection control purposes. Proper patient positioning is critical to patient safety, a durable safety strap is often required for specific positioning techniques. 

Sharps Containers: Preventing Sharps Injuries With Proper Disposal

Sharps injuries are a very serious matter in healthcare facilities. According to the CDC, they estimate that about 385,000 sharps-related injuries occur yearly among medical workers in hospitals. Careful handling of contaminated sharps can reduce the risk of infection for hospital workers.

Whiteboard Wednesday: Types of PPE Supplies

This week's Whiteboard Wednesday, we discuss the different types of PPE supplies! Disposable gowns, face masks, infection control footwear, bouffants, lab coats, etc. are all important PPE supplies to keep in your medical setting.

World Wide Pressure Ulcer Prevention Day – November 21, 2013

We are proud to join the National Pressure Ulcer Advisory Panel (NPUAP) in the promotion of World Wide Pressure Ulcer Prevention Day!

“The National Pressure Ulcer Advisory Panel serves as the authoritative voice for improved patient outcomes in pressure ulcer prevention and treatment through public policy, education and research.”

World Wide Pressure Ulcer Prevention Day – November 21, 2013

We are proud to join the National Pressure Ulcer Advisory Panel (NPUAP) in the promotion of World Wide Pressure Ulcer Prevention Day!

“The National Pressure Ulcer Advisory Panel serves as the authoritative voice for improved patient outcomes in pressure ulcer prevention and treatment through public policy, education and research.”

The International NPUAP-EPUAP defines pressure ulcer as a “localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. A number of contributing or confounding factors are also associated with pressure ulcers; the significance of these factors is yet to be elucidated.”

Pressure ulcers or bedsores, are injuries to skin and underlying tissues that result from prolonged pressure on the skin. The development of pressure ulcers most commonly occur on bony areas of the body, such as the heel, ankles, hips, head or buttocks. Individuals who are confined to a bed for prolonged periods, required to use a wheelchair, or have a medical condition that limits them from easily changing positions are the most susceptible to developing pressure ulcers. According to the Mayo Clinic “bedsores can develop quickly and are often difficult to treat.” There are several strategies that can help prevent some bedsores and promote healing.

The NPUAP has categorized and defined (listed below) bedsores into four stages based on their severity. The severity of the pressure ulcer is ranked from stage I, the beginning stage, to stage IV, the most severe, where the ulcer exhibits large-scale tissue loss.

Category/Stage I: Non-Blanchable erythema 

Skin is intact with non-blanchable redness (lighter color skin) or darkly pigmented skin may not have visible blanching of a localized area usually over a bony prominence. “The area may be painful, firm, soft, warmer or cooler as compared to adjacent tissue.”

Category/Stage II: Partial thickness

Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough or bruising.

Category/Stage III: Full thickness skin loss

Full thickness tissue loss, bone, tendon and muscle are not exposed but subcutaneous (adipose tissue) fat may be visible. The depth of the ulcer can vary depending on the amount of subcutaneous tissue present in the region.

Category/Stage IV: Full thickness tissue loss  

The most severe stage, full thickness tissue loss with exposed bone, tendon or muscle has occurred.

Common sites of pressure ulcers for people who use a wheelchair develop on the tailbone, shoulder blade, spine, back of arms and legs where they rest against the chair. People confined to beds often develop pressure ulcers on the back or sides of head, rim of the ears, shoulders or shoulder blades, hip, lower back, tailbone, heels, ankles and the skin behind the knees.

Risk factors for developing pressure ulcers include anyone with limited mobility and is unable to easily change positions while seated or in a bed. Immobility may be due to:

  • Generally poor health or weakness
  •  Paralysis
  • Injury or illness that requires bed rest or wheelchair use
  • Recovery after surgery
  • Sedation (surgical procedure)
  • Coma

Relieving pressure from the pressure ulcer site is the first step in treatment. The use of support surfaces (special cushions or pads, mattresses and beds) and patient repositioning can help reduce the pressure on the sore. There are a whole host of treatment options that are available to people with bedsores or pressure ulcers that are out of the scope of this post, so please feel free to visit the NPUAP site for more resources.

The impact of pressure ulcers upon patients and families can be traumatic and life changing, so please help spread the word to help increase awareness of this global challenge that health care providers face on a daily basis. For further information about National Pressure Ulcer Advisory Panel and pressure ulcers please visit: NPUAP

5 Benefits Of Disposable Patient Positioning Straps

Disposable patient positioning straps are used to assist in immobilizing patients and are great for infection control purposes. Proper patient positioning is critical to patient safety, a durable safety strap is often required for specific positioning techniques. When selecting a patient positioning strap it is important to consider the safety and well-being of the patient during their procedure. By selecting disposable positioning straps like the Disposable Velcro Self Strap Restraint System you will reduce the risk of patient injury and maximize patient safety. Straps made from flexible materials provide a soft, injury reducing form of patient restraint that can be used during all phases of preoperative surgeries. Features of the disposable Velcro self strap restraint system include versatility, residue free adhesion, disposable for infection control, non-metal construction, and latex-free.


The disposable Velcro self strap restraint system comes in a 30′ roll and is easily trimmed to the desired length with ordinary scissors. The Velcro loop is laminated to the hook which makes an automatic self adjusting positioning strap/immobilizer that can be used during any O.R. procedure. This unique hook and loop combination is so versatile that it can be used with any table or surface that does not have side rails.

Residue Free 

The convenient Velcro strap acts like an ordinary roll of tape without the messy adhesive residue. The Velcro strap sticks to itself so you can quickly and easily trim to the desired length to accommodate patients of different sizes. The Velcro hook and loop strap quickly stabilizes the patient thereby minimizing trauma and bruising.

Infection Control

The World Health Organization states that the management of health-care waste is an integral part of hospital hygiene and infection control. “Health-care waste should be considered as a reservoir of pathogenic microorganisms, which can cause contamination and give rise to infection.” According to WHO, the most frequent route of infection transmission is indirect contact. For example, the infected patient touches an object, instrument or surface which then becomes contaminated. Subsequent contact between that item and another patient is likely to contaminate the second individual who then may then develop an infection. By using a disposable Velcro self strap restraint system the risk of indirect infection transmission is almost completely eliminated.

Non-Metallic Construction 

The Velcro self strap restraint system is latex and metal-free which reduces injury to the patient and the staff. Some reusable positioning straps have metal rings or buckles that can reduce the potential for skin cuts, abrasions and welts. The Velcro straps provide a soft and pliable surface which reduces skin irritation and pressure sores.

Latex Free 

Latex is used in a variety of medical products. Medical professionals are at risk since they are frequently exposed to latex products. Hospitals and health care facilities are beginning to create latex-safe treatment areas and surgical suites to accommodate people who are allergic to latex. Some facilities have also set up systems for identification of staff and patients with latex allergy. The disposable Velcro self strap restraint system is latex free and offers an excellent alternative to latex based products.

Proper patient positioning is critical to patient safety. By using a disposable patient positioning strap you add an additional layer of infection prevention. The disposable Velcro self strap restraint system will make a great addition to your medical facility.