Geriatric Quick Consult      Pressure Ulcers      Do #2

Perform a pain assessment.

Patients have pain related to turning and positioning, dressing changes, and debridement. Sometimes the presence of the ulcer causes continuous pain, even when the patient is lying still1.

Knowledge Action
Systemic analgesia may well be needed.

This should be given before dressing changes, wound care, and turning.
  • Consider systemic analgesia especially before dressing changes.
The source of the patient's pain should be identified in order to relieve the discomfort.

Repositioning may help.

Covering a wound may relieve pain.

Padding a bony prominence may provide relief.

Removing a wound care product which is causing irritation may be very effective.
  • Identify source of pain.


  • Consider pain relief options.


  • Treat the pain!
If the patient is unable to speak, monitor physiologic parameters and nonverbal cues: increased heart rate and respirations, agitation, restlessness, groaning.

Improved pain control should lead to a decrease in the relevant parameter.
  • Monitor physiologic parameters that reflect pain.


  • Observe nonverbal cues.

References:

  1. Bergstrom, N, Bennett MA, Carlson CE, et al. Clinical Practice guideline number 15: Treatment of pressure ulcers.
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