How do Bed Sores Happen?
Bed sores are caused by:
- Pressure: Prolonged pressure on a certain area of the body will decrease blood flow causing loss of oxygen and death to underlying tissue.
- Shearing: Shearing is when the body moves in an opposite direction as the bed or wheelchair. That force creates friction and breakdown of the skin leading to a skin ulcer.
- Friction: Friction occurs when a medical device, sheet, or tight clothing rubs against the skin causing a bed sore or ulcer.
Four Stages of Bedsores
Bedsores are “graded” or “staged” based on their severity:
| Stage 1 There is a persistent area of red skin that may itch, cause pain, and/or feel warm to the touch. Stage 1 wounds are superficial and go away shortly after the pressure is relieved. | Stage 2 There is skin loss at the outermost layer of skin or the skin’s deeper underlying tissue layer, or both. Stage 2 wounds are an open sore that looks like a blister surrounded by red or purple discoloration. | Stage 3 The pressure ulcer extends through all the skin layers down to the muscle, damaging or destroying the affected tissue and creating a deep, crater-like wound. | Stage 4 This is the most serious and advanced stage of pressure ulcers where large-scale loss of skin occurs, with damage to the underlying muscle, bone, and tissue. |
Stage 4 bedsores are extremely difficult to heal and can lead to lethal infections commonly identified as sepsis, even with aggressive treatment.
Stage 4 bedsores typically develop on:
- Tailbone, hips, or buttocks
- Shoulder blades and spine
- Heels
- Back of the head or ears
WHY DID THE BEDSORE HAPPEN?
- The facility did not conduct an initial assessment for skin breakdown.
- The facility did not devise a plan to detect, prevent, and treat the ulcer, bedsores, or wounds.
- The hospital did not follow its own plan of care.
- The patient developed the bedsores while at the facility or the sores got worse.
- The facility did not follow the doctor’s instructions or failed to coordinate with the proper medical personnel.
- The facility did not properly or frequently rotate the patient in order to prevent bedsores from emerging.