Prévention des escarres

Prévention des escarres

 Objectif

·        Activer la vascularisation au niveau des points d’appuis.

·        Eviter la nécrose d’une peau saine.

 Indications 

·        Alitement prolongé.

·        Personnes âgées.

·        Sujets inconscients, confus, désorienté.

·        Sujets à mobilité réduite ou en immobilisation totale

·        Paralysie.

·        Altération de l’état général : dénutrition, déshydratation.

 Actions. a)      évaluation des facteurs de risques en accord avec l’infirmier (ère).

·        Utilisation d’un support d’aide à la prévention d’escarre.

·        Utilisation des protections de coude  de talon, des coussins fluidisées, des coussins a eau. Des arceaux.

·        Etat de propreté corporelle, de la literie et vestimentaire.

b)      massage trophique (le matériel est toujours prévu quel que soit le soin ou la personne qui accomplit le soin infirmier (ère) ou aide soignant (e).

·        Le massage trophique ne sa fait que sur une peau propre et saine :

·        Se laver les mains.

·        Faire un soin de propreté sur la zone à masser.

·        Etaler le produit anti-escarre utilise par le service (sauf médicament) qui a été applique sur une compresse préambule  posé sur le chariot.

·        Effleurer jusqu’à ce que la pommade pénètre.

·        Faire ainsi sur toutes les zones à risque.

c)      changement de position.

·        Effectuer toutes les 3 heures.

·        Etablire une feuille de surveillance comprenant :

·        Heure.

·        Position.

·        Soins (type).

·        Observations.

·        Responsable.

·        Signature.

d)      surveillance stricte de l’alimentation.

·        Hydrate le patient.

·        Favoriser une alimentation en quantité et en qualité ( calories et protides).

·        Tout noter sur une feuille de surveillance.

 Transmissions.Transmission orale à l’infirmier ‘écrites sur le dossier de soins.

1.      Soin et heure.

2.      Etat cutané.

3.      Erythème (tache rouge).

4.      Phlyctène (ampoule séreuse ou thématique, noire).

5.      Nécrose (mort cellulaire définitive).

6.      Macération (atteinte des tissus superficiels et profonds).

7.      Escarres multiples.

8.      Produits utilisé.

9.      Heure d’exécution du prochain massage.

10.  Collaboration du patient, existence de douleurs.

11.  Hydratation et alimentation du patient.

 Important. 
    • Ne pas oublier les accessoires de massage dans le lit.
    • Laisser un tube de pommade pour la prévention en chambre ou déposer la pommade sur des compresses (attention aux infections croisées si le tube passe de chambre en chambre).
    • Veiller à ce que le lit ne présente aucun pli lors du coucher du patient. Bien tirer les draps.
    • Respecter les horaires, la feuille de surveillance et faire de bonnes transmissions.
      

42 votes. Moyenne 1.69 sur 5.

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Bonjour,

Parmi les supports permettant la prévention des escarres, je conseille vivement Echelle de Norton qui permet de définir efficacement le support des escarres le plus adapté aux besoins du patient.

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19. Brigitte (site web) 09/07/2008

Le massage trophique n'est plus autorisé car cela consiste en un pétrissage de la peau.
L'effleurage est de rigueur depuis quelques années => car cela facilite la vascularisation.

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