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

Cost

  • 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:

References:

 

7 Reasons To Pick These Carbon Fiber Armboards

Why Carbon Fiber? 

Carbon fiber is a popular material used in many industries including the medical device field, aerospace, and automotive engineering. The fiber-reinforced polymer which contains carbon fibers is extremely strong and lightweight. Although carbon fiber may be more expensive when compared to other materials, the impressive strength-to-weight ratio and rigidity of carbon fiber makes it an excellent candidate for various immobilization and medical support devices. This fiber-reinforced polymer also helps keep radiation doses to a minimum.

Medical Applications of Carbon Fiber

Carbon fiber provides one distinct advantage over other materials in the medical device field, that advantage is that carbon fiber is radiolucent, meaning that it is virtually transparent to x-rays and appears black on x-ray images. The radiolucent quality of carbon fiber makes it an excellent material to support limbs being x-rayed or treated with radiation. This is why you may have noticed more surgical table accessories like carbon fiber armboards appearing in hospitals and clinics.

Patient Positioning Challenges 

Medical imaging equipment (X-ray systems and CT scanners) will often present unique patient positioning challenges to medical personnel. Listed below are some of the attributes patient positioning systems will generally require for overall patient safety and image quality:

  • Lightweight
  • Durability and strength
  • Rigidity
  • Minimal impact to image quality (e.g. artifacts)

7 Reasons Why You Will Want To Choose Carbon Fiber Armboards

  1. Fully radiolucent
  2. High strength-to-weight ratio
  3. No mounting hardware is required for setup or breakdown
  4. 180° of lateral rotation
  5. Easy setup and removal
  6. Fold together for safe and compact storage
  7. Two armboard styles (rail mount carbon fiber armboard with quick release swivel and shoulder mount carbon fiber armboard with hexagonal base)

Rail Mount Carbon Fiber Armboard with Quick Release Swivel

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Strength And Durability

The rail mount carbon fiber armboard has been engineered to achieve a high degree of strength, durability, and radiolucency. Utilizing a quick release mounting mechanism, the carbon fiber armboard attaches quickly and easily to any surgical table that has a standard side rail.

Radiolucent 

This single, radiolucent armboard allows complete imaging of the arm and can be used in conjunction with other carbon fiber tabletops and extensions where ionizing radiation (x-ray) is used for imaging. Ideal for imaging in a variety of medical settings, including hospitals, clinics, and private practices. This armboard has been designed for use as an imaging platform and is not to be used as a surgical platform.

Rail Mount Carbon Fiber Armboard Specifications

Dimensions 

  • 26″ Length
  • 5.5″ Width

Maximum Capacity Tested Per ISO 6061

  • 25 pounds

Aluminum Equivalency 

  • AAE @ 100 kVp = 1.15mm

Accessories  

An optional armboard pad is available and has been specifically designed for the rail mount carbon fiber armboard with quick release swivel. Constructed of high-density comfort foam, the 2″ thick pad is covered with a conductive vinyl cover for easy cleaning and patient comfort.

Shoulder Mount Carbon Fiber Armboard With Hexagonal Base

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High Strength-To-Weight Ratio

The shoulder mount carbon fiber armboard has been engineered to provide the highest strength, durability, and radiolucency of any armboard on the market today.

Easy Setup and Breakdown 

Simply place the hexagonal base under the surgical table pad. By using the weight of the patient to hold the armboard in place, removal is quick and easy. A rubber brake disc is used to keep the board in position under the weight of the patient’s arm. The unique pivoting attachment allows for a full 180 degree of lateral adjustment, making patient positioning more efficient.

Radiolucent 

This shoulder mount radiolucent armboard allows for the complete imaging of the arm and can be used in conjunction with other carbon fiber tabletops and extensions where ionizing radiation (x-ray) is used for imaging. This armboard has been designed for use as an imaging platform and is not to be used as a surgical platform.

Shoulder Mount Carbon Fiber Armboard Specifications

Dimensions 

Swivel Base

  • 14″ Length
  • 18″ Width

Armboard

  • 27″ Length
  • 5.5″ Width

Maximum Capacity Tested Per ISO 6061

  • 25 pounds

Aluminum Equivalency 

  • AAE @ 100 kVp = 1.15mm

Accessories  

An optional armboard pad is available and has been specifically designed for the shoulder mount carbon fiber armboard with quick release swivel. Constructed of high density comfort foam, the 2″ thick pad is covered with a conductive vinyl cover for easy cleaning and patient comfort.

Material Of Choice

These two unique carbon fiber armboards are ideal for improving positioning accuracy for optimum imaging results. The physical properties and characteristics of carbon fiber make it an excellent material for use in the medical device field. The impressive strength-to-weight ratio, rigidity and radiolucency of the carbon fiber are attributes that make it the material of choice for supporting limbs being x-rayed or treated with radiation.

Share Your Experience

Have you used carbon fiber in your imaging department? Would you like to share your experience with us? We’d like to hear from you and learn more about your experiences. In an upcoming post, we will discuss how to properly clean and disinfect carbon fiber armboards and pads. Sign up for our blog and we will notify you when this post is available.

Why Are Head & Neck Positioners Important In The OR?

Why are neck and head positioners important for patients to use while in the operating room? The number one reason for positioning a patients head with a positioner in this situation is safety purposes. Many patients need support of their head and neck  to relieve pressure while going in to surgery.

Below are a few examples of a few different kinds of head and neck positioners we offer.

  1. Head & Neck Support is an ideal positioner for general skull work. Dimensions are 6.5″ high x 10″ wide x 12″ long
  2. 5.5″ D Ring is a reusable foam positioner that provides a safe area for minimizing pressure points and nerve damage during surgery. Dimensions are 5.5″ diameter x 1.5″ thick with a 2″ hole in the center.
  3. Slotted Adult Head Positioner has a soft flexible coating to provide comfort to patients, with 1″ deep slots for tubing. Dimensions are 8.5″ x 8″ x 4″ thick at the highest point, 3″thick at center.
  4. Waters Positioner was especially designed for laminographs of the orbits and facial bones. Dimensions are 7.4″ high x 12.4″ wide x 8″ long.
  5. Concave Disc are ideal for general skull work in general positioning, CT scan, MRI, nuclear medicine, and ultrasounds. Dimensions are 7″ in diameter and available in  1.5″ high, 2.5″ high and 3″ high discs.

Making sure patients are comfortable, safe and don’t develop pressure sores or pain. With our large selection of head and neck patient positioners, you’ll be able to find the support needed for your medical setting. Have any questions on this post? Let us know in the comment box below!

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.

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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: Padded Rubber Patient Restraint Strap with Buckles and Hooks

Today’s featured product is our Padded Rubber Patient Restraint Strap with Buckles and Hooks. This padded safety strap is ideal for safely and comfortably securing patients to an operating room table.

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Features

  • Strap Width: 2″ W
  • Padded Mid-Panel Dimensions: 18″ L x 5″ W
  • Available in 3 lengths: 96″, 108″, 120″
  • Strap Material: All Rubber, Conductive
  • Mid-Panel Pad Material: 3/4″ Thick Softcare Memory Foam with Deluxe Stretch Material Cover
  • Buckles: Two Airplane Style buckles to adjust strap length
  • Hooks: Ships complete with Two side rail Hooks to quickly anchor and remove the strap from the operating room table
  • Latex Free

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.

Versatile 

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.

 

 

Whiteboard Wednesday: Disposable vs. Reusable Products

Today on Whiteboard Wednesday, we compare disposable vs. reusable products for infection control. Watch our video below to see which infection control product is typically recommended!

Universal Medical Awarded GSA Contract

 We are excited to announce that we have been awarded GSA Contract #V797D-40002 effective Tuesday October 15, 2013, which will continue until Sunday October 14, 2018. There are 3770 of our products listed on the contract in the 65 II A Schedule  (Medical Equipment & Supplies). A schedule is a category of products that the government buys, within the schedule, products are further categorized into Special Item Numbers (SIN). Listed in the table below are the 21 Special Item Number categories eligible for purchase under our newly awarded GSA contract.

A25-C: Immobilizers/Soft Goods A-79: Exam, Treatment, OR Tables
A-25D: Positioners A-80: Medical Lighting
A-30: Restraints, Medical A-81: Chairs & Stools
A-32: Medical Hospitalware A-82: Medication Carts
A-39: Laser, Surgical A-83: Medical Supply Carts
A-64: IV Pumps A-84: Medical & Surgical Cabinets
A-69: Medical Beds and Mattresses A-85: Warming Cabinets
A-76: Patient Lifts A-87: Instrument Stands/Tables
A-77: Stretchers A-92: Supply Dispensing Equipment (PPE)
A-78: Scales A-94: Miscellaneous
A-96: Information Aids

The General Services Administration (GSA) was established in 1949 by President Harry Truman and is an independent agency of the United States government. The GSA was formed to help support and manage the administrative work of the federal government. The GSA facilitates the federal government’s purchase of high-quality, low-cost goods and services from quality commercial vendors. “The mission of the GSA is to deliver the best value in real estate, acquisition, and technology services to the government and the American People”. GSA has made it a priority to help expand opportunities for small businesses by working with the small business community to strengthen partnerships and support the success of their vendors.

Under delegated authority by GSA, the U.S Department of Veterans Affairs manages nine award contracts, one of which is Medical Equipment & Supplies (65 II A Schedule). The Veterans Affairs Federal Supply Schedule (VA FSS) supports the healthcare requirement of the VA and other federal government agencies by providing customers with access to high-quality goods and services.

Our hard work has paid off! We are excited to announce the GSA Contract Award and we look forward to this great opportunity to supply our government customers with high-quality products and service. As a newly awarded contractor we are pleased that the VA FSS has recognized that our company has satisfied all Schedule program requirements. If you have any questions regarding this announcement please contact us at info@universalmedicalinc.com for more information.