Pressure Management and Cushions
Pressure sores can occur at any point of contact between the rider and the wheelchair, including but not limited to backrest, seat or cushion surface, an edge of the seat, calf strap, and footrests. If riders do not have complete sensation, or if they cannot communicate effectively, riders should have a competent person evaluate the risk of pressure sores. Riders should monitor themselves carefully, and be monitored by an assistant, to minimize the risk of pressure sores. Whirlwind recommends professional fitting and rider training from a well-trained wheelchair user.
For more information about assessment and fitting, refer to the World Health Organizations's
Commercially Available Low-Cost Cushions for Pressure Management
Jarik Fluid Cushion by Rick Jay and Jarik Medical
CARVED FOAM PRESSURE RELIEF CUSHIONS
Whirlwind has developed instructions to make carved foam pressure relief cushions based on designs by Jamie Noon.
By UCP Wheels for Humanity/Noon Designs
Using the new cushion, adjust the foot supports so that there is equal pressure under the foot and under the thigh. Check with one hand to see if the pressure is safe. Check under the seat bones and hips (left and right sides).
- LEVEL 1 = SAFE: Fingertip can wriggle up and down. Usually, no change needed.
- LEVEL 2 = WARNING: Fingertips cannot wriggle, but can easily slide out. Change needed if the user and provider have concerns (i.e. history of skin problems)
- LEVEL 3 = UNSAFE: Fingertips are squeezed firmly. It is difficult to slide fingers out. Change is always needed.
If change is needed, try additional lifts, cut the foam or try a different cushion. Check pressure again.
Pressure Cushion Awareness
- No single cushion is appropriate for every rider.
- No piece of equipment takes the place of daily skin monitoring.
- Use a mirror to see changes in your skin color and texture. Reposition yourself in the chair frequently to relieve pressure on sensitive areas. Look for reddening and thickening (skin is firmer to the touch), which indicates skin damage, and seek medical attention if sores persist or become infected.