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Information for patients and families
Our goal is to identify risks early and take all steps to minimise risk.
Table of Contents
Why are ICU patients at higher risk?
Lying face down (the prone position)
Common pressure injury risk areas
Warning signs of a pressure injury
What is the ICU team doing to prevent pressure injuries?
What is a pressure injury?
A pressure injury (sometimes called a pressure ulcer or bed sore) is damage to the skin and underlying tissues caused by pressure, friction, or reduced blood flow.
Patients in Intensive Care (ICU) are at increased risk of developing a pressure injury because critical illness affects circulation, mobility, nutrition and the body’s ability to heal.
Pressure injuries can develop quickly and may occur despite appropriate prevention measures.
A pressure injury, once developed, can cause pain and immobility, and can take a long time to heal – leading to a longer stay in ICU and in hospital.
Why are ICU patients at higher risk?
Critically ill patients are at increased risk of pressure injury due to immobility, reduced tissue perfusion, organ failure and the need for life support equipment.
Pressure injuries in ICU are not only caused by lying in bed. They can also occur from:
Oxygen masks, including non-invasive masks
Breathing tubes (endotracheal tubes)
Feeding tubes (nasogastric tubes)
ECG leads and monitoring equipment
Other devices, leads or cables attached to the patient
Our staff regularly assess both the skin and the medical device to reduce this risk.
Lying face down (the prone position)
Some patients in our ICU with severe respiratory failure may spend time lying face down, known as the prone position. Families often have concerns about facial swelling and skin marks.
Common pressure injury risk areas
Pressure injuries can occur in any position. These diagrams show common areas at risk.
Lying on your back (supine): back of the head, ears, shoulder blades, elbows, sacrum (tailbone), buttocks and heels.
Lying on your side (lateral): ear, shoulder, ribs, hip, knees and ankles.
Lying face down (prone): forehead, ears, cheeks, chin, chest, pelvis, knees and toes.
Everyone is at risk. Pressure injuries can develop quickly and may occur despite the best care. Regular repositioning, skin inspection and the use of pressure-relieving equipment can help reduce the risk.
Warning signs of a pressure injury
Redness or skin discolouration
Tenderness or pain in the affected area
Blistering
Broken skin
What is the ICU team doing to prevent pressure injuries?
The ICU team will:
Assess pressure injury risk every day
Reposition patients regularly
Use a pressure-relieving mattress
Inspect the skin routinely
Check and reposition medical devices
Provide nutrition and hydration support
Manage moisture from perspiration or incontinence
Escalate concerns to wound care specialists when required
What patients can do to help
Change your position regularly – ask staff to assist you if required.
Tell staff if you are uncomfortable – report pain, pressure, numbness or discomfort.
Let staff know if a mask or a tube feels tight or is rubbing.
Check your skin, looking for redness, marks, blisters or damaged skin.
Take part in mobilisation – sit out of bed, stand or walk when it is safe to do so. Our physiotherapists will help you with mobilisation.
How can families help?
Families are an important part of pressure injury prevention. You can:
Let staff know if you notice redness, marks, swelling or skin damage.
Tell staff if a mask, tube or device appears to be causing pressure.
Help encourage eating and drinking if appropriate (check with staff first).
Ask questions about pressure injury prevention.
Support repositioning plans with the patient.
Please don’t reposition the patient or medical devices without assistance from staff.
Important to know
Some pressure injuries may develop despite appropriate prevention due to the severity of the illness and the body’s ability to heal during critical illness.
Our goal is to identify risks early and take all steps to minimise risk.
Nepean Intensive Care Unit · Nepean Hospital · Nepean Blue Mountains Local Health District
More Information
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Patient Safety
Patient safety is an essential component of high-quality care provided in the ICU. Our team have worked hard to establish a number of tools and strategies that ensures the ICU provides safe care, in the context of evidence-based practice and the National Safety and Quality Health Service (NSQHS) requirements.
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Beyond Critical Care
Leaving critical care and going to the ward is an important step in your recovery process as your ICU stay only plays a small part in your journey in hospital. The following information will help you and your family learn more about the ward environment and provide information about your recovery process.
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