Medical Mattresses

Pressure sores are areas of damage to the skin and the underlying tissue caused by constant pressure or friction. This type of skin damage can develop quickly to anyone with reduced mobility, such as older people or those confined to a bed or chair.

The skin over bony areas such as the heels, elbows, the back of the head and the tailbone (coccyx) is particularly at risk. The lack of enough blood flow can cause the affected tissue to die if left untreated. Pressure sores can be difficult to treat and can lead to serious complications.

Other names for this type of damage include pressure injuries, bed sores, pressure ulcers and decubitus (‘lying down’) ulcers.

Understanding pressure sore risks using the Waterlow assessment. This assessment was invented in 1985 by Judy Waterlow, and is used by health professionals as a simple method of assessing a patient’s risk of developing a pressure sore.

It’s also important to take into consideration is someone has a long-term diagnosis means their risk of developing pressure sores may increase, it is best to purchase a mattress suitable for a higher risk up front.

1. Build/Weight for Height: This risk factor takes into account the patient’s BMI (Body Mass Index), a widely recognised measure of a person’s height to weight ratio.
   • 0: Given to a BMI between 20 – 24
   • 1: Given to a BMI between 25 – 29.9
   • 2: Corresponds to a BMI over 30
   • 3: Given to a BMI below 20
     
2. Skin Type/Visual Risk Areas: This section deals with a nurse’s visual evaluation of their patient’s skin type or any skin deformities that may indicate an increased pressure sore risk.
   • 0: Represents a healthy evaluation
   • 1: Given to skin that is “tissue paper dry”, oedematous, or clammy
   • 2: Given if the skin meets the criteria to be considered “discoloured grade 1”
   • 3: Given to skin that is broken or shows spots at a grade of 2 – 4
     
3. Sex/Age: This section combines two separate scores: sex and age.
   • 1: Male patients receive a score of 1
   • 2: Female patients receive a score of 2
   • 1: Received by ages between 14 – 49
   • 2: Given to those between the ages of 50 – 64
   • 3: For those between 65 – 74
   • 4: For patients between 75 – 80
   • 5: For any patient above the age of 81
     
4. Continence: This section deals with continence, or a patient’s ability to control their bowels.
   • 0: Patients with full bowel control or those who are catheterised
   • 1: Given to those who suffer from urinal incontinence
   • 2: For patients with faecal incontinence
   • 3: For patients suffering from both urinary and faecal incontinence
     
5. Mobility: This section evaluates a patient’s level of mobility, as well as their tendency or ability to
   move around while in bed.
   • 0: Given to patients who are fully mobile with no restrictions
   • 1: For patients who are not fully mobile but are restless or fidgety in bed
   • 2: For patients who are apathetic with little motivation to move
   • 3: For patients with restricted mobility who are not fully bed bound
   • 4: Given to patients who are fully bed bound or in traction
   • 5: For patients who are fully chair bound, mainly those bound to a wheelchair
     
6. Malnutrition Score: This section takes into account whether the patient has been losing weight recently, and if so, how severely and for what reason.
   • 0: Given to patients who have not lost weight and have been eating well
   • 1: For patients who have recently lost 0.5 – 5kg, or those that have not lost weight but are eating poorly
   • 2: For patients who have recently lost 5 – 10kg, or if the carer is unsure of exact weight loss
   • 3: For patients who have recently lost 10 – 15kg
   • 4: For patients who have recently lost over 15kg
     
7. Special Risks: This final section assigns values based on specific conditions. For temporary conditions, scores can be discounted after 48 hours if the patient is recovering normally.
   • 1: For smokers
   • 2: For those with anaemia
   • 4 – 6: For patients with diabetes, MS, CVA, motor/sensory deficit or paraplegia
   • 5: Patients with single organ failure, peripheral vascular disease, orthopaedic/spinal surgery or trauma, or those who have been in operation for over 2 hours
   • 8: Patients with terminal cachexia, multiple organ failure, or those that have been on an operating table for more than 6 hours

What Your Score Means

Once all of these scores have been tallied up, medical professionals are left with a reasonably reliable assessment of the patient’s pressure sore risk, and can choose pressure relieving products accordingly. A score of 10+ indicates a patient is at risk, a score of 15+ represents a high risk level and a score of over 20+ means that the patient is at very high risk of pressure sore development