CHAPTER VIII
APPLIANCES AND METHODS FOR THE SICK-ROOM
Patients who are confined to bed even for a few days often suffer acutely from muscular tension, from pressure, and from fatigue due to lack of exercise. Indeed, many a sick person is surprised to find that the bed which had seemed so infinitely desirable can change into a place of torment after a few short days of illness. "Bed-weariness" is hard to bear in any case of illness, but it is doubly hard for persons who are really helpless.
Unless the patient is an experienced sufferer he often has no idea what should be done to make him comfortable; while an equally inexperienced helper, though full of good will, is often discouraged to find that the arrangement she had thought perfect soon fails to satisfy her restless patient. But if she is willing to devote thought and ingenuity to removing small annoyances, she can do many things to alleviate his misery.
Bed sores
, or pressure sores, are caused by continued pressure upon the skin. The weight of the
body, or of a part of the body, if it comes for a long time upon one place finally interferes with the circulation in the tissues on which the part rests, and consequently interferes with the nutrition of the affected part. Any tissue to which the blood is not bringing all its necessary food supply tends to lose its tone, to become weak, and if the condition persists, to break down altogether.
The direct cause of bed sores then is pressure, and pressure is aggravated by moisture, wrinkles in the bed clothes, crumbs or other hard particles, lack of cleanliness, friction of any kind, or by rough, careless handling. Bed sores occur most often over bony prominences, such as the end of the spine, elbows, heels, shoulders, hips, ankles, and knees, but they may form anywhere, even on the ears or back of the head. They are more likely to appear on thin, aged, or depleted patients. These painful and serious sores can be prevented almost always by faithful care. When they occur, they result in the great majority of cases purely from negligence, and a person who knows the danger and yet through carelessness allows one to develop upon a patient may justly feel herself disgraced.
Prevention of bed sores depends upon keeping the skin dry and clean and upon relieving pressure by special devices and by turning the patient frequently. The parts where pressure comes
should be washed at least twice daily with warm water and soap, rubbed frequently with alcohol to improve the circulation and to keep up the tone of the skin, and powdered with a little good toilet powder. Much powder is likely to do harm by collecting in hard, irritating particles. The bed should be kept constantly dry and smooth, and free from crumbs, lumps, wrinkles, or other inequalities. Prolonged pressure should be relieved by turning the patient often,—once every waking hour is not too often if the body is emaciated,—and by pillows, pads, and rings.