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Patient Education - Sensing The Signs of Pressure Ulcers

Pressure ulcers are skin wounds that are caused by staying in one position for too long. Pressure ulcers are one of the most serious healthcare concerns for people needing assistance with their care.

Caregivers and family members have a very important role in preventing pressure ulcers by engaging their natural senses of vision, hearing, touching and smelling.

This reference summary will help you better understand what pressure ulcers are and how to use your senses to recognize the signs of pressure ulcers.

Pressure Ulcers

Pressure ulcers are a common type of sore that can happen quickly. Pressure ulcers happen when an area of skin dies because of periods of pressure put on it. Pressure ulcers are often called "bed sores". For example, if a person sits or lies for a long time in one position, the pressure on the skin could cut off the blood supply to the skin. If the pressure is not stopped, the area of skin starts to die.

Pressure ulcers can also happen when the skin is dragged over a surface. Make sure to lift yourself completely when moving. If you can't move yourself, ask your caregiver to use something to help with this, like a bed sheet.

Pressure ulcers are most likely to happen on areas where your skin and bone are close such as:

  • Elbows.
  • Back.
  • Ankles.
  • Hips.
  • Heels.
  • And any other area of skin under pressure for a long time.

Risk factors that make a person more likely to develop pressure ulcers include:

  • Obesity.
  • Being bedridden or living with paralysis.
  • Poor circulation.
  • Damage to nerves.
  • Loss of bladder or bowel control.

A pressure ulcer is not just a discomfort or annoyance. If left untreated, a pressure ulcer is a very serious health condition that can even cause death. However, if caught early pressure ulcers may be preventable or are at least far easier to treat.


You should always use your eyes to see pressure ulcer risks and examine the situation. If you notice the patient's skin has a new reddened area, this could be a sign of a pressure ulcer developing. Another factor that can play a role in pressure ulcer development is if the patient is less active. A patient that is not very active may have a pressure ulcer or other symptoms that they may not mention.

You should also use your eyes to notice:

  • If the patient should be turned or repositioned.
  • What the patient has eaten or if they have lost or gained weight.
  • If pressure relief devices, like heel protectors, are being used correctly.
  • If there is decreased activity.

Also use your eyes to notice:

  • If bed linens and clothing are dry and not soiled.
  • Any skin abnormalities, such as reddened, purple or maroon areas, blisters, spongy areas or swelling.
  • If the bed and mattress are placed correctly to avoid extra pressure on bony spots.


It is also very important to listen to the patient. Taking the time to stop and really listen to a patient's concerns can often give you useful information. Ask what a patient is feeling or if they have any discomfort or concerns. This is useful information that can be used to help provide better care to the patient. This information may also reveal signs of pressure ulcer risks.

You should use your ears to hear:

  • Complaints of not feeling well.
  • If the patient is not acting or sounding like they normally do.
  • Complaints of pain over bony areas or under a medical device.
  • Refusal of care.

Patients often share their concerns. However, it is important to also use other senses in case they do not feel comfortable letting their caregiver or family know about any discomfort they have.


You should also use your sense of smell to be aware of any odors in a patient's room. Unusual odors may be from a wound, urinary or bowel incontinence, or from their breath. Any unusual odors should be reported to a healthcare provider. They may be a clue to a hidden problem, such as a pressure ulcer.

You should use your nose to smell:

  • Wound odors.
  • Unusual odors.
  • Fruity breath odors.
  • Urine/bowel incontinence.


Another sense which should never be overlooked is touch. Something as simple as a light touch can reveal important information. Ask yourself if the patient's skin feels warmer than normal or if the patient is sweating more. Scratches or complaints of dry skin should also be noticed. These changes can affect pressure ulcer development. Use your hands to feel changes in the skin, such as:

  • Extreme dryness.
  • Abnormal sweating.
  • Moisture or wetness.
  • Warmer, reddened areas.


Remember, it is not enough to see the signs and symptoms of pressure ulcers. Any signs you notice need to be shared with a healthcare provider. Pressure ulcers are much easier to treat if they are found early. They may also be prevented.

You should also record any signs of pressure ulcers in case the healthcare provider has specific questions. Make sure to include when you noticed the signs.


Pressure ulcers occur when an area of skin dies because of the pressure exerted on it. They are one of the most serious healthcare concerns for people needing assistance with their care.

Caregivers and family members should use their four senses - look, listen, smell, and touch - to notice pressure ulcer warning signs, and then share these with a healthcare provider.

Pressure ulcers are much easier to treat if they are found early. They may also be prevented. This is why it is important to share any signs of pressure ulcers you notice with a healthcare provider.

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

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