5 Things Criminal Attorneys Should Know About…Pressure Ulcers

We’ve been republishing a series called “5 things criminal attorneys should know about …” where we highlight some areas of medicine that often cross into the criminal fields. The topic of Pressure ulcers was not originally in the series but it is definitely relevant. Cases in which Elder abuse and neglect is charged can be difficult due to the photographs of pressure ulcers that make the state of the victim seem horrific, and beyond what any “normal” person would allow. So we present to you 5 points to keep in mind when a case comes across your desk. This is not meant to be an in-depth review, but rather just bullet pointed facts. If you have any subject requests let me know!

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5 Facts about Pressure Ulcers

• All pressure ulcers result from pressure leading to impaired blood flow.
• Many risk factors contribute to the development of pressure ulcers including age, immobility, incontinence, inadequate nutrition, sensory deficiency, multiple comorbidities, circulatory abnormalities and dehydration;
• Tissues are capable to withstanding enormous pressures when brief in duration, but prolonged exposure initiates a downward spiral towards ulceration. Irreversible changes may occur after as little as 2 hours of uninterrupted pressure (Revis Jr., 2012).
• Experts disagree about the avoidability of pressure ulcers. Some experts believe that all pressure ulcers are preventable; others believe that stage III or IV ulcers always result from poor care.
• Those that believe that there are unavoidable pressure ulcers believe they develop in patients who are hemodynamically unstable, terminally ill, have certain medical devices in place and are noncompliant with artificial nutrition or repositioning. (Black, et al., 2011)

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