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environment in the ward the main role is assigned to the middle and Junior
medical personnel.
The patient’s position in bed
can be active, passive and forced.
Active
position means that the patient is able to change it himself, to fast, to move.
The
passive
position the patient cannot change on his own due to the severity of his
condition, he lies in bed in the position in which he was laid. This happens in
unconscious or paralysis condition, in severe traumas.
Forced
position patient
takes himself to relieve his condition: a semi-sitting position of orthopnoe in
shortness of breath, a forced standing position in attack of angina pectoris, a
position lying on a healthy side with a fracture of the ribs, etc.
Skin care
The patient’s skin should always be kept clean for its normal functioning.
If it is not contraindicated, the patient he can take bath and shower once a week.
To the seriously ill in addition to daily washing, washing a patient intimately,
washing hands, wiping the body with warm boiled water should be performed
as necessary. The skin of the perineum requires daily washing. Recumbent
patients should be washed after each act of defecation and urination, as well
as in urinary and feces incontinence.
If these rules are not followed, with poor quality of care in patients that
have increased sweating, intertrigo (inflammation of the skin in the folds) can
appear in the inguinal, axillary, intergluteal areas, under the Breasts, between
the toes.
Bedsore (decubitus) it is necrosis of the skin with subcutaneous fat and
other soft tissues because of to dystrophic, ulcerative-necrotic changes due to
disturbance of local blood circulation and nerve trophism as a result of prolonged
compression, shear or friction. The cause of the formation of bedsores is poor
patient care.
In the development of bedsores there are 4 stages:
1. At first, an area of bluish-red color appears, without certain grains.
The integrity of the skin is not disturbed, when the pressure stops, the area does
not disappear.
2. With the persistent hyperemia of the skin, the epidermis (the surface layer
of the skin) is exfoliated, necrosis spreads to the subcutaneous tissue.
3.Tissue necrosis occurs deep into and sideways till the muscle layer with
penetration into the muscle.