Pressure measurement
The present disclosure provides methods and apparatus for evaluating tissue structure in damaged or healing tissue. The present disclosure also provides methods of identifying a patient at the onset of risk of pressure ulcer or at risk of the onset of pressure ulcer, and treating the patient with anatomy-specific clinical interventions selected, based on pressure measurements. The present disclosure also provides methods of stratifying groups of patients based on risk of wound development and methods of reducing incidence of tissue damage in a care facility. The present disclosure also provides methods to analyze trends of pressure values to detect tissue damage before it is visible, and methods to compare bisymmetric pressure values to identify damaged tissue.
1 . A method for identifying and providing an appropriate level of care to a patient in a care facility, the method comprising the steps of:
a) taking a plurality of pressure measurements of the patient at one or more body locations;
b) determining an average pressure value of the plurality of pressure measurements of the patient;
c) providing one or more anatomy-specific interventions based on the average pressure value;
d) increasing the level of anatomy-specific interventions based on an increase in the average pressure value; and
e) decreasing the level of anatomy-specific interventions based on a decrease in the average pressure value.
2 . A method of managing care of a patient, the method comprising the steps of:
a) taking a first set of pressure measurements at one or more body locations selected for monitoring upon admission to a care facility;
b) determining a first average pressure value of each of the first set of pressure measurements;
c) setting an intervention level to N=1 if one of the average pressure value of the first set of pressure measurements is above a first threshold;
d) implementing a level-N intervention for each of the one or more body locations having an average pressure value above a first threshold;
e) taking subsequent sets of pressure measurements at each of the one or more body locations at a level-N frequency; and
f) determining new average pressure values for each of the one or more body locations.
3 . The method of claim 2 , wherein the one or more body locations selected for monitoring are selected from the group consisting of a sternum, a sacrum, a heel, a scapula (os latum scapularum), an elbow, an ear, and other fleshy tissues over a bony prominence of a patient.
4 . The method of claim 2 , wherein one or more body locations selected for monitoring comprise one or more anatomical sites in long-term contact with a medical device, and are selected from the group consisting of a cheek, a nose, a chest, a stomach, and a lower abdomen area.
5 . A method of identifying and treating a patient at risk of tissue damage, the method comprising the steps of:
a) evaluating a patient for a risk of tissue damage upon admission to a care facility, wherein the evaluating step comprises:
i) taking a first plurality of pressure measurements in the patient;
ii) determining a first average pressure value of the first plurality of pressure measurements;
b) administering a first intervention of level-0 if the first average pressure value is below or equal to a first threshold; and
c) administering a first intervention of level-N if the first average pressure value is above the first threshold, where N is an integer and N has a value of 1 or greater.
6 . The method of claim 5 , further comprising the steps of:
a) taking a second plurality of pressure measurements in the patient at a first pre-determined frequency corresponding to the administered intervention level;
b) determining a second average pressure value of the second plurality of pressure measurements;
c) determining whether the second average pressure value exceeds a second threshold;
d) continuing to administer the first intervention if the second average pressure value does not exceed the second threshold;
e) continuing to take a plurality of pressure measurements at the first pre-determined frequency if the second average pressure value does not exceed the second threshold;
f) administering a second intervention of level-M if the second average pressure value exceeds the second threshold, where M is an integer and M is greater than N; and
g) taking a plurality of pressure measurements at a second pre-determined frequency corresponding to level-M if the second average pressure value exceeds the second threshold.
7 . The method of claim 6 , wherein the second intervention of level-M is selected from the group consisting of a heel boot, a barrier cream, neuromuscular stimulation, a topical cream, therapeutic ultrasound, shockwave therapy, a 30-degree wedge, a composite dressing, a hybrid mattress, a dynamic mattress, a support surface, a silicone pad, a low-friction sheet cover, and a low-friction padded mattress surface.
8 . The method of claim 6 , wherein the second average pressure value is determined from a subset of the second plurality of pressure measurements.
9 . The method of claim 6 , wherein the second threshold is equal to the first threshold.
10 . The method of claim 6 , further comprising the steps of:
a) determining whether the second average pressure value is less than a third threshold;
b) continuing to administer the first intervention if the second average pressure value is not less than the third threshold;
c) continuing to take a plurality of pressure measurements at the first pre-determined frequency if the second average pressure value is not less than the third threshold;
d) administering a third intervention of level-L if the second average pressure value is less than the third threshold and if the first intervention is not of level-0, where L is an integer and L is less than N; and
e) taking a plurality of pressure measurements at a pre-determined frequency corresponding to level-L if the second average pressure value is less than the third threshold.
11 . The method of claim 10 , wherein the third intervention of level-L is selected from the group consisting of a heel boot, a barrier cream, neuromuscular stimulation, a topical cream, therapeutic ultrasound, shockwave therapy, a 30-degree wedge, a composite dressing, a hybrid mattress, a dynamic mattress, a support surface, a silicone pad, a low-friction sheet cover, and a low-friction padded mattress surface.
12 . The method of claim 10 , wherein the third threshold is equal to the first threshold.
13 . The method of claim 5 , wherein the first intervention of level-Nis selected from the group consisting of a heel boot, a barrier cream, neuromuscular stimulation, a topical cream, therapeutic ultrasound, shockwave therapy, a 30-degree wedge, a composite dressing, a hybrid mattress, a dynamic mattress, a support surface, a silicone pad, a low-friction sheet cover, and a low-friction padded mattress surface.
14 . The method of claim 5 , wherein the first average pressure value is determined from a subset of the first plurality of pressure measurements.
15 . A method of identifying and treating a patient in need of an intervention for pressure ulcer, the method comprising the steps of:
a) taking a plurality of pressure measurements at an anatomic site of the patient;
b) determining an average pressure value of the plurality of pressure measurements;
c) determining whether the average pressure value exceeds a threshold corresponding to level N, where N is greater than or equal to 2;
d) administering the intervention for pressure ulcer to the anatomic site if the average pressure value exceeds the threshold; and
e) taking a plurality of pressure measurements every two hours if the average pressure value exceeds the threshold.
16 . The method of claim 15 , wherein the anatomical site is selected from the group consisting of a sternum, a sacrum, a heel, a scapula (os latum scapularum), an elbow, an ear, and other fleshy tissues over a bony prominence of a patient.
17 . The method of claim 15 , wherein the intervention for pressure ulcer is selected from the group consisting of a heel boot, a barrier cream, neuromuscular stimulation, a topical cream, therapeutic ultrasound, shockwave therapy, a 30-degree wedge, a composite dressing, a hybrid mattress, a dynamic mattress, a support surface, a silicone pad, a low-friction sheet cover, and a low-friction padded mattress surface.