Why pressure relieve?
Pressure on the skin from lying and sitting too long stops the blood being able to flow to the skin. This in turn restricts oxygen and nutrients from getting to the skin. This is how skin breakdown occurs. People with full (normal) sensation shift their weight naturally because being in one position for a long time starts to feel uncomfortable.
When you have impaired sensation, you must develop a daily habit of moving your weight as often as possible. Moving your weight is the only way to allow blood flow into an area that you have been sitting or lying on for a long time. Wheelchair cushions, specialised mattresses and overlays cannot perform full pressure relief for you.
While these will reduce your risk they won’t prevent skin breakdown.
The picture below shows all the bony parts of the body that can be at risk of pressure injury due to immobility. Young children may naturally move around a lot and this will reduce their risks. Unfortunately, as people get older and bigger they need to pay close attention to their skin and consciously pressure relieve.
Image from PVA Guidelines pressure ulcer prevention and treatment
How to pressure relieve in a wheelchair
- Lean forward on to a table, bed, chair, desk, or your knees.
- Lean to the side and then the other.
- Shift your legs one at a time to re-position.
Do a “lift” holding your armrests to lift your bottom off the seat.
Images from Modern Systems Knowledge Translation Center
NOTE: This technique will have a long term impact on your upper limbs, especially your shoulders. Where possible use the leaning techniques.
It is recommended that you pressure relieve every 20-30 minutes for 2 minutes or longer!
Tips to help prevent pressure problems:
- Set a watch timer or use your phone alarm. This will remind you to pressure relieve until you get into a habit.
- Always check your skin with a mirror morning and night. Especially your feet and bottom.
- Use your pressure relief equipment as prescribed. Don’t add sheep skins, continence sheets or any other items over your pressure relief cushion.
- Talk with your occupational therapist about your equipment needs for pressure relief.
- Remove all pressure if a pressure injury appears and seek medical help to manage the wound.
- Remember prevention is better than cure.