Posts Tagged ‘Wound Care Education Institute’

Sacral Wounds and Diarrhea Don’t Mix, Part 2

Monday, October 15th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

 

Frequent bouts of diarrhea make it difficult to care for wounds on the sacrum or coccyx, and healing often is impeded because of fecal contamination.

 

 

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Sacral Wounds and Diarrhea Don’t Mix, Part 1

Wednesday, September 12th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

 

Frequent bouts of diarrhea make it difficult to care for wounds on the sacrum or coccyx, and healing often is impeded because of fecal contamination.

 

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What Would You Do if Your Patient Chokes?

Wednesday, August 8th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

 

Every minute counts when a patient chokes, so you must react confidently and have a plan in place to handle this emergency situation.

 

 

 

 

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

John Quiñones stars in the ABC television show What Would You . The program features actors cast in scenes of conflict or illegal activity in public settings, while hidden cameras record the situation. The focus of the show is to see whether ordinary people intervene or just pass by and how they react. For example, a recent episode featured a young girl’s nanny berating her in public and calling her stupid. Several passersby asked the nanny to cool it, while others just squirmed and silently hurried by. The point of the show is that we never really know how we will react to a situation until we are actually in it, and then each of us has to make a choice.

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Help! My Wound Patient Is a Vegetarian

Thursday, July 12th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

 

Patients with wounds require increased amounts of dietary protein, typically meaning meats, poultry, dairy products, and eggs. Vegetarians will need alternate sources of protein and amino acids to meet their needs and heal their wounds.

 

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

 

If you have ever heard me talk about nutrition interventions for wound healing, you surely heard me emphasize the patients’ need for protein. In order to build new tissue to heal a wound, patients must consume enough protein each and every day to meet their increased needs. Typically, this means eating increased amounts of meat, poultry, fish/seafood, eggs, and dairy products. This seems simple enough, but what if you have a vegetarian patient?

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Wound Consulting Business: Do You Have What It Takes?

Friday, July 28th, 2017

Thinking about starting your own wound care business or becoming a wound consultant? Here’s what you need to know.

Wound Consulting Business: Do You Have What It Takes?

 

(Editor’s note: this is Part One of a two-part series on starting your own wound consulting business. Part Two will explore how to get started.)

Being a wound consultant is a dream for so many clinicians. It can be exciting and rewarding to start a wound care business, but it can also be overwhelming, confusing and risky. So before you take the plunge, here are some serious questions and factors to consider.

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Pressure Injury (Ulcer) Staging: More Real-World Answers

Friday, April 15th, 2016

More real-world wound care questions and answers relating to pressure injury staging, including slough, debridement and skin breakdown.

More Real-World Pressure Injuries

 

Can’t get enough of pressure injury staging? Neither can we. That’s why we’re excited to present even more questions and answers about this topic, based on what wound clinicians experience out in the field (versus what we might learn from textbooks or in a classroom).

In our first such post – packed with some awesome pressure injury staging questions from the field – we discussed slough, levels of destruction and debridement. Here, you’ll find out more about pressure injury staging as it relates to abrasions, surgical flaps, skin breakdown due to clothing, and more. So here they are – five more tips for staging pressure injuries, based on real questions from clinicians.

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What Stage Is It? Test Your Pressure Injury Staging Skills

Thursday, March 24th, 2016

(updated to reflect the 2016 NPUAP Staging Definitions)

How well do you know your guidelines for staging pressure injuries?  View the slideshow and test yourself!

Note: if you have any difficulties opening the slideshow, CLICK HERE to view it in SlideShare.

Test Your Pressure Injury Staging Skills from Wound Care Education Institute

 

 

Wound Care Education Institute® provides online and onsite courses in the fields of Skin, Wound, Diabetic and Ostomy Management. Health care professionals who meet the eligibility requirements may sit for the prestigious WCC®, DWC® and OMS national board certification examinations through the National Alliance of Wound Care and Ostomy® (NAWCO®). For more information see wcei.net.

Is it Really a Bruise? Get The Bigger Picture on Skin Lesions

Thursday, February 18th, 2016

In the world of wound care, clinicians define skin lesions precisely. So what might look like a bruise at first glance could really be a suspected deep tissue injury, purpura . . . or something else. Do you know the difference?

Bruise sDTI or Purpura?

If a picture is worth a thousand words, then in the world of wound care, the same can be said about the appearance of a lesion – where the blood has escaped the vessels and entered the skin. By paying close attention to the color and texture, you can determine if it is more than a simple bruise.

Knowing what to look for – and getting the bigger picture – helps us conduct better assessments. What appears at first glance to be a standard bruise could actually be anything from purpura or petechiae, to an ecchymosis or hematoma. Or wait . . . is it a suspected deep tissue injury (sDTI)?

These terms are often used interchangeably, but within wound care, clinicians define them more precisely.  Confused? Don’t worry, we’re here to help!

Bruise

A bruise (also known as a contusion), is a leakage of blood from the vessels into tissues, and is always the result of blunt force trauma.  Keep in mind that “blunt force” doesn’t necessarily mean your patient has been in a fist fight or hit with a baseball bat. The bruise can be the result of something as simple as bumping into furniture.

So is it a bruise? Here’s how to tell:

  • Bruises typically resolve within two weeks.
  • They are initially a dark maroon or reddish color (because the blood is oxygenated).
  • As the bruise ages, it progresses through the colors of a ripening banana – from green to yellow and then brown – before fading away. Note: these colors will be less obvious with darker skin, so as you make your assessment, compare the site with a symmetrical area, if possible.
  • The skin is always intact.
  • The damage can be superficial, it can be deep, or it can be a combination of the two.
  • The tissues may be painful and swollen, and there may be a localized temperature increase due to the inflammation.

Hematoma

A subdermal hematoma is a collection of blood in the skin, often clotted, bulging or mass-like.  It may be in just the epidermis and dermis, or down into the subcutaneous tissue.   A hematoma is not the same as a bruise, though you may find a hematoma within a bruise. The most common cause of a hematoma is injury or trauma to the blood vessels.

Purpura/Petechiae/Ecchymosis

Purpura consists of red or purple lesions that are similar to bruises, in that they are blood added to the skin tissues.  However, purpura spots are not the result of blunt force trauma. Instead, they are caused by either an inflammatory skin disease or a vascular problem. In addition:

  • Purpura spots don’t blanch when pressed.
  • There is usually no kind of pain associated with purpura.
  • Purpura may be palpable (that is, you can feel a rash-like texture with your fingers) or unpalpable.
  • Unpalpable purpura comes in different types, including petechiae, which are flat purpura spots under 3 mm. These pinpoint-sized spots may be quite difficult to identify in darker skin.
  • Flat purpura spots that are larger than 5 mm are called ecchymosis. These spots tend to be irregular in shape (ranging from a dark maroon to a purple), and can be seen on the skin or in the mucus membranes.

It’s important to note that ecchymosis and bruising are not the same thing, though you may hear some clinicians use these terms interchangeably. Again, ecchymosis is a kind of purpura, and is not caused by blunt force.

Suspected Deep Tissue Injury

Suspected Deep Tissue Injuries (sDTIs) also share some qualities with bruises in that they are non-blanchable, intact, and appear in similar colors – purple or maroon. Alternately, they may be a blood-filled blister.

But here’s the key difference: sDTIs are due to damage from pressure or shear, and not blunt force.  Therefore, you’re more likely to find them over a bony prominence and in patients with a history of immobility. The most common site for an sDTI is the heel.

When you touch the tissue of sDTIs with your fingertips, it could be painful, firm, mushy, boggy, and warmer or cooler compared to adjacent tissue.  It’s important to use palpation on all dark-skinned patients on high-risk areas, because visual assessment cannot be trusted. Swift identification of sDTIs is important because unlike bruises, which will resolve on their own, sDTIs can deteriorate rapidly, exposing additional layers of tissue despite treatment or offloading.

Do you know the difference?

Now that you’ve learned about the differences between bruises, sTDIs and other similar skin conditions, what do you think? Have you been able to distinguish the true identity of patient lesions in the past, or has it been difficult to properly assess them? Has your facility emphasized the need to distinguish between these types of lesions? And which type do you find the most difficult to identify? We’d love to hear more about your experiences – please leave your comments below.

Wound Care Education Institute® provides online and onsite courses in the fields of Skin, Wound, Diabetic and Ostomy Management. Health care professionals who meet the eligibility requirements may sit for the prestigious WCC®, DWC® and OMS national board certification examinations through the National Alliance of Wound Care and Ostomy® (NAWCO®). For more information see wcei.net.

Test Your Wound IQ

Tuesday, December 1st, 2015

Ready to Test Your Wound IQ? by ProProfs » Testing Software by ProProfs

You know you’re a wound care clinician when…

Friday, November 27th, 2015

Wound care clinicians are a unique group of professionals with special superpowers:  X-ray vision into the depths of the wound, the ability to smell every type of bacteria, and the drive to heal every wound, no matter what it takes.  Does this sound like you?

1.  You can eat pizza while viewing wound photos.

Eating pizza while reviewing wound photos

 

 

 

2.  You check your pet’s water dish for a slimy biofilm.

Drinking dog

 

 

 

3.  You start naming off anatomy while preparing turkey.

Turkey anatomy lesson

 

 

 

4.  You study the street maggots in the trash and think about how great medical maggots are at debriding wounds

Street maggots

 

 

 

5.  You look at a dressing and wish you could add bling.

Boo Boo Bling

photo courtesy of www.boobooblingshop.com.

 

 

 

6.  Your family can’t handle your workday stories at the dinner table.

Grossing our the family at dinner table

 

If you found yourself nodding, you’re clearly a “Wild on Wounds” superhero.  Keep on healing and have a WOUNDerful day!