Abstract

GUERRERO MIRALLES, Mónica. Pressure ulcers: A potencial problem in collapsed emergency services. Gerokomos [online]. 2008, vol.19, n.2, pp.55-62. ISSN 1134-928X.

Pressure ulcers (PU) in the Hospital Units are a serious health issue where the nurse in its autonomous role becomes crucial as an estimated 51,6% of those ulcers take place within the hospital, 95% of them being avoidable. Emergency Departments (ED) could be the origin of a remarkable amount of PUs during the first few days of stay, arising from the fact that the average patient is becoming older and, as such, typically suffering multiple illnesses. Furthermore, the seriousness of the patient´s condition leads to a postponement of the PU prevention measures, if any, as a result of focusing attention on the life-threatening issue. The objective of this work is to ascertain the necessity of implementing PU prevention measures in at-risk patients from the very moment of their arrival at the Emergency Department. Data on 74 out of 102 adult patients treated at the Internal Medicine and ICU units of the Hospital Sant Jaume de Calella between February 26 and march 2, 2007. A prospective longitudinal analytic study with accidental probability sampling was performed that consisted in an evaluation of the patient´s skin integrity upon arrival at the ED, along with the assessment of the intrinsic and extrinsic risk factors, plus two further re-evaluations within 24 and 48 hours of the patients still staying at the hospital. One case of PU Stage III was recorded, along with 2 Stage II and 8 Stage I wounds, plus 7 further cases where early signs of PU development were observed, all within 48 hours from arrival. Results show that: - The hours of stay at the Emergency Department are key to the start of the PU process in at-risk patients in serious condition. - Identification of the group of risk through the Braden Scale and the installment of early preventive measures may reduce the incidence of PUs during the first two days of stay.

Keywords : Ulcer; emergency; wound; pressure; prevention.

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