Reflections on recommendations for the prevention of pressure injuries during the COVID-19 pandemic

Abstract

Objective: To reflect on specific recommendations for the prevention of pressure injuries in patients affected by the new coronavirus (COVID-19) in intensive care. Method: theoretical reflection study based on the concept of pressure injury defined by the National Pressure Injury Advisory Panel. Results: the contents were categorized into three thematic axes: specific risk factors for the development of pressure injuries for patients with COVID-19; international recommendations on pressure injuries in patients with COVID-19 and challenges for implementing recommendations for preventing pressure injuries in the face of the COVID-19 pandemic in the Brazilian scenario. Conclusion: to promote the prevention of pressure injuries in intensive care patients with COVID-19 it is essential that health professionals are able to implement advanced interventions, in order to mitigate the intrinsic and extrinsic risks specific to that patient. However, it is essential to recognize potentially preventable lesions, differentiating them from possible inevitable ones, as well as making a differential diagnosis of lesions resulting from the pathogenesis of the virus itself.

Risk factors for pressure injury in patients with covid-19 in intensive care unit / Fatores de Risco para Lesão Por Pressão em Pacientes com COVID-19 em Unidade de Terapia Intensiva

“…It should be added that remaining in dorsal decubitus associated with clinical conditions, such as COVID-19, and hemodynamic instability may cause tissue hypoxia, however, repositioning should be performed respecting the patient's clinical status. 7,[24][25] According to the National Pressure Ulcer Advisory Panel -NPUAP, LP are classified into four stages, in addition to those considered unclassifiable, deep tissue injuries and injuries caused by medical devices. Stage 2 LP, the most identified in the study, involves the loss of partial thickness of the skin with exposure of the dermis.…”

An Interprofessional Approach to Preventing Tracheostomy-Related Pressure Injuries

“…20 In addition, emerging evidence suggests that COVID-19 has associated dermatologic manifestations related to the disease process that increase the risk for skin breakdown, making PI prevention in the context of COVID-19 even more challenging. 21,22 Implementing this work for all patients, including patients receiving a tracheostomy as an indirect result of COVID-19 infection, has helped to mitigate risk of MDPRI in an otherwise highly vulnerable population. The escalation pathways, standards, and tools to prevent TRPIs created by the interprofessional team have provided a sustainable structure to uphold best practice during an unprecedented time.…”

Diagnósticos de Enfermagem em Pacientes com Síndrome Respiratória Aguda Grave por SARS-CoV-2: relato de experiência

“…Atua na redução da permeabilidade dos vasos, na ansiedade, no uso de sedação e melhora a qualidade do sono, o que também pode ser benéfico com melhores resultados clínicos para pacientes com COVID-19 (15) . (16) .…”