Proper body positioning will help prevent pressure ulcers. Here's what to know - and do - for a person who is in bed or sitting a great deal.

Lying Down
When the person is lying on his back, areas of concern include the back of the head, shoulder blades, spine, sacrum and coccyx, and the back of the heels. If on his side, the high-risk areas include the ear, shoulder, hip and outside of the ankle.

The ideal position for lying in bed is slightly on the side, where the body forms a 30-degree angle to the mattress. Pillows can be placed behind the person's torso to maintain this position. (A pillow between the legs will keep the inside of the ankles from touching.)

If a person cannot reposition herself, the caregiver should change her position at least every two hours; for example, after the person is on her right side for two hours, she should be turned to the left side.

Sitting
When sitting, the boney areas of the buttocks, as well as the sacrum and coccyx receive the most pressure. The ideal position for sitting is completely upright, with knees bent sharply and feet flat on the floor. This allows pressure to be distributed over the backs of the thighs instead of solely on the boney areas. A reclined position increases pressure across the sacrum and coccyx.

You can do a great deal to assist with proper positioning. Whether the person is lying or sitting, you can use pillows to alleviate pressure from certain areas. The pillows must be placed above and/or below the boney area to bridge it; placing a pillow under a boney prominence does not reduce pressure. So, for example, to relieve pressure on the heels, place a pillow no lower than the ankle so that the heels remain elevated beyond the end of the pillow.

Extra Steps to Take
Paying meticulous attention to skin care is also key to preventing pressure ulcers. Be sure to:

• Keep skin clean and dry. This is especially important if the one in your care is incontinent; use a cream that acts as a moisture barrier. 
• Inspect skin daily. Pay special attention to boney prominences, areas where bones are closest to the skin. Areas of redness lasting longer than 20 minutes indicate pressure-related tissue damage. Seek medical attention if the skin remains reddened or an open sore develops.

Article provided by Caring Today magazine and www.caringtoday.com