BACK CARE.pptx

Its helps most important function in blood circulation and improving physical activities also

1. BACK CARE

2. Introduction Bedsores —  also called pressure ulcers and decubitus ulcers — are injuries to skin and underlying tissue resulting from prolonged pressure on the skin Bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips and tailbone.

3. DEFINITION  Back care  means cleaning and massaging back, paying special attention to pressure points. Especially back massage provides comfort and relaxes the client, thereby it facilitates the physical stimulation to the skin and the emotional relaxation .

4. Purposes To improve  circulation to the back To refresh the mode and feeling To relieve from fatigue, pain and stress To induce sleep To prevent bedsore To provide comfort

5. General principles Back  care can be inculcated with bed bath for the maintenance of personal hygiene Maintain proper privacy of the patient. Special care should be taken of pressure points along with two hourly positions changing . If the skin is moist or in summer season use powder and in case of dry skin or in winter season oil can be used to reduce friction.

6. The upward  strokes pressure should be more than downward strokes Choose the most appropriate massage strokes according to the patient condition. Do not do massage if skin turns red

7. Indications Unconscious patient.  Prolong bed ridden patient. Patient with restricted movement . Patient with B.M.I >30 kg/m2 Patient suffering from chronic back pain

8. Contraindications Any redness  or pressure sore in the back Surgeries in back, spine. Burn injury in the back. Trauma or fracture in rib cage . Spinal injury. Restricted movement after surgery. Patient suffering from clotting disorders.

9. Required positions Side lateral  position . Prone position. Sitting position

10. Articles required Basin with warm water (2 ) Bucket for waste water (1 ) Gauze pieces (2 ) Soap with soap dish (1 ) Face towel (1 ) Sponge cloth (2): 1 for with soap 1 for rinse Big Towel (2): 1 for covering a mackintosh 1 for covering the body

11. Mackintosh (1) Oil/ Lotion/ Powder (1): according to skin condition and favour Tray (1 ) Trolley (1) Screen (1)

12. Preparation of patient   Approach the patient safely Identify the correct patient Explain the procedure to the patient Oral consent Ask the patient to void or offer urinal

13. TECHNIQUES OF BACK CARE (STEPS)

14. EFFULURAGE PETRISSAGE TAPOTEMENT

15. FRICTION HACKING CLAPPING

16. 1 Perform hand hygiene To prevent spread of infection 2 Assemble all equipments required. Organization facilitates accurate skill performance 3 Check the client's identification and condition. To assess sufficient condition on the client 4 Explain to the client about the purpose and the procedure Providing information fosters cooperation 5 Close all windows and doors, and put the screen or / and utilize the curtain if there is. • To ensure that the room is warm. To maintain the privacy.

17. 6 Placing the appropriate position: 1) Move the client near towards you. • To make him/her more comfortable and provide the care easily. 7 Turn the client to her/ his side and put the mackintosh covered by big towel under the client's body. Mackintosh can avoid the sheet from wetting 8 Expose the client's back fully and observe it whether if there are any abnormalities. To find any abnormalities soon is important to that you prevent more complication and/ or provide proper medication and/or as soon as possible. • If you find out some redness, heat or sores, you cannot give any massage to that place. • If the client has already some red sore or broken down area, you need to report to the senior staff and /or doctor 9 Lather soap by sponge towel. Wipe with soap and rinse with plain warm water. To make clean the back before we give massage with oil/ lotion/ powder

18. 10. Put some lotion or oil into your palm. Apply the oil or the lotion and massage at least 3-5 minutes by placing the palms: from sacral region to neck 2) from upper shoulder to the lowest parts of buttocks Don’t apply oil or lotion directly to the back skin. • Too much apply may bring irritation and discomfort 11. Help for the client to put on the clothes and return the client to comfortable position. • To provide for warmth and comfort 12. Apply hand first to sacral area massaging in circular motion stroke upward from buttocks to shoulder Massage over scapula with smooth firm stroke.continue in one smooth stroke to upper arms and laterally along side of back down to iliac crests EFFLEURAGE STROKE Effulurage has a relaxing quality if done slowly and with light pressure It improves lymohatic & venous circulation 13. Use PETRISSAGE ( kneading skin by grasoing tissue between your thumb and finger )knead upward along one side of the spine from buttocks to shoulder and around the nape of the neck Downward towards the sacrum Repeat along other side of he back Petrissage causes stimulation to the skin if done quickly and with firm pressure It increase the circulation and promote relaxation

19. 14. Use FRICTION massage. Using one finger over another finger over the spine switch to effulurage A rhythmic manipulation of tissues stimulates circulation over the back 15. Use the TAPOTEMENT stroke to stimulate circulation over the back. lightly strike the back,using the fleshy sides of your hands in a rhythemical movement up and down back ( HACKING the muscular tissues with palm of hands CLAPPPING tisues with palm of hands ) Tapotement stroke stimulates the circulation over the back 16 . VIBRATION techniques can be an up and down movement or vibrating and shaking movement Its used to stimulate soft tissues

20. 17.Replace all equipments in properly •To prepare for the next procedure 18. Place Perform hand hygiene. To prevent the spread of infection 19.Document on the chart with your signature, including date, time and the skin condition. Documentation provides coordination of care Giving signature maintains professional accountability 20. Report any findings to senior staff information about patient for continuing care

21. Special Precautions Use  gloves if the patient is suffering from any communicable diseases or according to the hospital protocol . Never use too much oil or powder, it may create irritation . Provide massage using proper technique otherwise sometimes it may create subcutaneous tissue degeneration specifically in elderly. Direct pressure against pressure points in back should be avoided.

22. Rub your  hands before touching to avoid unnecessary chilling. Lotion or oil also can be preheated to avoid unnecessary chilling. Ideal duration of back care should be 5-20 minutes not more than thatand minimum 3-5 min for each step

23. Record and reporting .   After the procedure need documentation  Document if any abnormalities (i.e. redness) found during inspection.  Document the date & time of position changing and care given.  Put signature against documentation of back care given .  Document if pain or discomfort is present or not.