100% prevention of plantar flexion contractures - Sage products, Inc.

Strategies to Prevent Heel Ulcers and Plantar
Flexion Contractures In the Ventilated Patient
Tina Meyers, BSN, RN, CWOCN, ACHRN – Harris County Hospital District, Houston, TX; Rejeana Pezel, ICU/CCU; Jill Bennett, RN, MSN,
ICU/CCU; Vanessa Carroll, RN, ICU/CCU; Ann Russell, RN, BSN, ICU/CCU; Sharon Lagway, RN, ICU/CCU; Salvacion Ramos, RN,
ICU/CCU; Eloisa Asilo, RN, ICU/CCU; Marci Green, RN, ICU/CCU nurse – Conroe Regional Medical Center, Conroe, TX
Source: Research Institute for Human Engineering for Quality Life, “Measurement and
evaluation of the human dynamic characteristics,” Joint Passive Resistance Database a4,
2000. Available at: http://www.dh.aist.go.jp/bodyDB/a/HQL-00-04e.html
Study Inclusion Criteria:
Methods
� Sedated patient in the ICU for >5 days
� Intubated or not intubated
� Braden score of 16
6. Control patients also had ankle ROM measured, heel skin assessed,
and Ramsey sedation scale, and Braden scale administered at
admission and every other day.
7. Measurements performed by trained ICU nurses and physical
therapists
Capital Health's Best Practice Conference Wound Care: Champions for Change: October 6–8, 2008
21131
Reprints provided compliments of Sage Products, Inc.
800-323-2220 • www.sageproducts.com

Ramsey Score Averages
Score Entry Totals Exit Totals
1 7 7 8 8
2 22 44 20 40
3 3 9 9 27
4 11 44 11 44
5 7 35 4 20
6 0 0 0 0
Avg. 2.78 2.67
Modified Ramsey Sedation Scale:
1. Anxious, agitated, restless
2. Cooperative, oriented, tranquil;
accepts mechanical ventilation
3. Responds to commands only
4. Brisk response to light glabellar tap or loud noise
5. Sluggish response to light glabellar tap or loud noise
6. No response
� 100% prevention of hospital-acquired hPUs
� 100% prevention of plantar flexion contractures
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