A pressure injury forms where bone presses against skin and the blood supply is cut off. It happens to people who sit or lie in one position for long periods, especially when they cannot feel or move easily. It can develop in hours and take months to heal.
Who is at risk
- People who use a wheelchair or spend most of the day in a chair.
- People who are bedbound or have limited mobility.
- People with reduced sensation, including after a stroke or spinal injury.
- People who are malnourished or dehydrated.
- People with incontinence, which damages the skin.
- People with dementia who cannot reposition themselves.
Where they form
Heels, base of the spine, tailbone, hips, shoulder blades, elbows, ears and the back of the head. Check these areas daily, especially after a bath or a change of clothes.
Early signs
- A red or purple patch that does not fade when pressed.
- Warmth, swelling or hardness over a bony area.
- Blistering or broken skin.
- Pain or tenderness in a spot that was not sore before.
A red patch that does not blanch is a warning. Act before the skin breaks.
Prevention
- Reposition. Change position regularly, following the plan from the nurse or OT.
- Check the skin. Daily, head to toe, especially in the areas above.
- Keep it dry. Change wet linen and continence aids promptly.
- Use the right equipment. A pressure-relieving mattress or cushion, and heels off the bed.
- Support nutrition and fluids. Ask for a dietitian review if intake is poor.
- Do not rub. Massaging a red area can cause more damage.
Ask for a skin assessment
A nurse or OT can assess risk and recommend a repositioning schedule and equipment. If you are funded, ask whether equipment can be covered.
If you find one
Cover it, keep pressure off it, and call the GP or a nurse the same day. Do not apply creams or dressings that were not recommended. Do not wait to see if it gets better.
Common questions
How often should someone be repositioned?
It depends on the risk and the equipment. A nurse or OT will set a schedule, often every two to four hours.
What does a pressure injury look like?
A red or purple patch that does not fade, or a blister or open wound over a bony area.
Can a carer help prevent them?
Yes. Repositioning, skin checks, keeping the person dry and reporting changes.
Should I massage the red area?
No. Massage can cause further damage.
Can equipment be funded?
Ask your plan manager, My Aged Care or the hospital. It depends on the program.
Sources and further reading
This guide is general information, not medical, legal or financial advice. If you are worried about your health, call your GP. In an emergency, call 000.