Small pillows or thick pads of cotton should be placed under the patient's back and shoulders, between the knees and ankles when he lies on his side, and in other places where sores are likely to develop. Rubber rings are useful, but few patients like them for a long time. They should not be inflated more than necessary to raise the affected part from the bed; if much inflated, they are uncomfortable and may do harm. The ring may be covered with a muslin pillow case, or it may be wound smoothly with long strips of bandage or old muslin. Ordinary cotton batting wound with strips of muslin may be made into rings and used to remove pressure from heels, elbows, or other parts. These cotton rings are less heating than pads, and give better support.
The first sign of a bed sore is either redness of the skin or a dark discoloration like a bruise. Every point where a bed sore may form should be inspected daily. If the slightest symptom of a sore appears, the patient must not lie on the affected part, and every effort should be made to keep the skin from breaking; vigorous rubbing at this stage is dangerous, and will by no means make up for previous neglect. The condition should be reported to the doctor at once. If in spite of all efforts the skin does break, a peculiarly difficult kind of open wound results which must be treated and dressed according to the doctor's directions.
Devices to Give Support.
—The variety and number of pillows one patient can use is almost unlimited. A weak patient when lying on his side should have his back supported by a pillow. When he lies on his back a pillow should be placed under his knees to lessen muscular tension, and if he may be raised in bed, several pillows are needed to support him comfortably. A back rest is useful for a patient who can sit up in bed. Satisfactory back rests of several types can be purchased, or one may be improvised from a straight chair placed on the bed bottom side up, so that its legs lie against the head of the bed and its back forms an inclined plane. Back rest and chair alike should be covered by several pillows to make them
comfortable, and other pillows should be used to support the patient's arms.
A person who is sitting up in bed always tends to slip down toward the foot. This tendency may be corrected by using a foot rest, knee pad, or pillow. A hard pillow may be placed in the bed at the foot for the patient to brace his feet against; or a short board, well padded, may be arranged as follows for the feet to rest against: Fasten ropes to the board, as the ropes of a swing are fastened to the seat; set the padded board on edge at a convenient point below the patient's feet, and hold it in place by tying the ropes of the "swing" to the head of the bed. A pillow may be used in the same way, either at the feet or under the knees, by folding it over a long strip of muslin, the ends of which are then tied to the sides of the bed, brought up to the head, and there tied to prevent slipping. A cylindrical cushion six or eight inches in diameter and as long as an ordinary pillow, stuffed with firm material, may also be used for this purpose. It should be held in place by strips of strong muslin or ticking sewed to the ends of the cushion and tied to the head of the bed. The cushion should have a washable cover.
Fig. 18.—Showing Foot-sling for Supporting Patient in the Upright Position. (Sanders "Modern Methods in Nursing.")
Supports called bed cradles are used to keep the weight of the bed covers from sensitive parts of
the body, generally the feet or abdomen. They are semi-circular pieces of wood or iron fastened together so that they will stand up. A satisfactory cradle may be improvised as follows: Cut a barrel hoop in two, cross the halves at right angles and tie them together firmly; place the cradle over the affected part under the bed clothes. A smaller cradle may be made by taking sections that are less than half of the barrel hoop. If used for one foot only, the cradle should