Pressure Ulcer Prevention

Pressure Ulcer Prevention for a Child with a Non-Invasive Respiratory Assistive Device

What is a non-invasive respiratory device?

A device that sits on, or just outside, the nose that helps your child to breathe easier and sometimes provide oxygen. These include nasal canulas, CPAP, and SiPap. If your child is has one of these devices, pressure ulcers can occur.

What causes pressure ulcers?

Prolonged constant pressure causes a loss of blood flow and oxygen to an area, which can causes the skin and tissue cells to become injured or die. Proper skin care and pressure relief can help prevent pressure ulcers.

What are the signs of pressure ulcers?

Your child may have one or more of the following:

• Skin discoloration, like redness or bruising, that does not go away
• Skin blisters or sores

Where do these pressure ulcers occur?

Pressure sores can occur in any area of the body, but boney areas are most common. For children on non-invasive respiratory support, high risk areas include the nasal bridge, septum, and upper lip.

What are doing to help reduce the risk for pressure sores for your child?

• Your child’s nurse and respiratory therapist will be frequently assessing for any skin changes. We will also be checking to ensure that the respiratory device is fitted and applied correctly.
• Your child’s nurse will also help to keep the skin clean and dry. The nurse will routinely apply barrier film to protect fragile skin from moisture and friction.

What can I do to help keep my child’s skin safe?

• Alert your child’s nurse or respiratory therapist of any skin concerns, such as rashes, sores, blisters, bruises
• Alert your child’s nurse or respiratory therapist if you have concerns about how your child's respiratory device is positioned
• When holding or helping to reposition your child, be mindful of the device and do not allow it to be pulled up or pressed against your child’s nose. Also, avoid any rubbing over fragile skin.

How do we identify proper placement of the nasal mask or prongs?

• The nares should be visible through the mask.
• The mask should sit on the face and not touching the nares.
• The nasal prongs should fill the nares and not touch the septum.
• The prong base should not touch the face.

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