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Discuss management & nursing implication in care of EC Fistula.
Demonstrate appropriate turning & offloading practices.
Identify appropriate use of Skin IQ devices.
Abnormal tract communicating between the gut and skin surface.
Foreign Body
Radiation
IBS / Iatrogenic / Infection
F
R
I
E
N
D
S
Epithelialization of tract
Neoplasm
Distal Obstruction / Diverticula
Sepsis
Recognize
Intervene
Monitor
Pressure & shearing force creates iatrogenic wounds and adds to patient suffering and healthcare workload.
Monitor patient for safety risks:
- Bed: HOB, wheel lock, height
- Pressure: turning / offloading, devices
- Therapeutics: IV, feeding, NPWT, brace/splints.
- Environment: lighting, personal belongings, clutter, fall mats
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Misc:
- Line management
- Turning
- Biatain
- Early mobility
- Specialty beds
- Citadel
- Bariatric
- Envella
Offloading:
- Wedge
- Cushion
- Boots
Reduce pressure:
- Ear Pillow
- Duoderm
- Pillows
Shearing = Pressure + Friction
Reduce pressure.
Reduce friction.
- Skin IQ
- Sheets
- Air cushion movers
Maintain HOB at minimum required to prevent aspiration.
Arjo Skin IQ
How do you turn it on?
How many times can you reuse it?