Wednesday, February 10, 2010

Is Bed Rest An Effective Treatment Modality for Pressure Ulcers?

The following paper requires a thorough read:

Is Bed Rest An Effective Treatment Modality for Pressure Ulcers?
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Matching equipment to meets client needs.
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Linda Norton, OT Reg (ONT); and Dr. Gary Sibbald, BSc, MD, FRCPC (Med), FRCPC(Derm), MACP, DABD, MEd

Look at the patient lying long in bed.
What a pathetic picture he makes.
The blood clotting in his veins,
the lime draining from his bones,
the scybola stacking up in his colon,
the flesh rotting from his seat,
the urine leaking from his distended bladder,
and the spirit evaporating from his soul.
— Dr. Richard Asher, British Medical Journal, 1947

Practitioners often express concern that medical and scientific studies are difficult to interpret for clinical use; however, in terms of the complications of bed rest, agreement between all existing sources is remarkable. Although illness severity may leave no choice except bed rest, the rest itself is rarely what is of benefit. Practically every organ and body system promptly and progressively deteriorates when it is inactive (see Table 4).2
In this time of focusing on best practices and patient outcomes, examining the practice of bed rest is appropriate. If effort were directed at conducting a randomized control trial to reevaluate the practice of bed rest, assuming that bed rest could speed the healing of pressure sores, the complications of this treatment are so well documented that this practice cannot be considered “safe.”
Alternatives to bed rest include optimizing the nutritional status of the client and managing pressure and shear throughout the client’s daily activities. Managing pressure and shearing forces outside of the bed may be one way to improve client outcomes and quality of life. - OWM

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