heel or her backside, for example, that body area would need additional
padding to make sure as little pressure as possible is put on to that
body part during the operation. When possible, the heels of a patient
should be lifted off the operating table. The simplest way to do that is to
use egg crate foam. It comes in a big brick. People tend to break it in
half, but you're better off leaving it as one piece and using it as a cush-
ion under the calf of the patient so that their heels float off the end of it.
Post-surgical heel injuries are very common because if you're oper-
ating on the leg, it's not moving, so the heel is just dug right into the
table. If the patient is draped across the legs, you don't see the heels.
You could dress the heel, especially for patients with significant arthri-
tis or who are having knee surgery, but in most cases foam achieves
the same result — getting the heels off the bed — and is a whole lot
cheaper.
Repositioning patients is straightforward: Make sure they get off the
position they were laying in while in the operating room. If they were
on their face all day, they simply lie on their back afterward. If they
were on their back all day, however, tell patients they need to give
their back a rest and that you need to get them on their side. That
usually convinces them to turn, even though it might hurt because
we're moving a body part that just had a surgery.
5. Watch for PACU injuries.
I've seen a lot of heel injuries
take place in post-op knee surgery patients when a physical thera-
pist or another professional tells the patient to bend her knee up,
push her heel into the bed and then slide her leg down into the bed.
This makes the heel literally run up and down the mattress and
leads to blistering. This is a standard exercise and a common occur-
rence in post-op outpatient settings, so your nurses need to make
sure the patients have a dressing on that heel or a sock on their foot
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