CARE OF PRESSURE POINTS (BACK CARE)

DEFINITION : Back care is a procedure of cleaning and massaging an individual's back as a therapeutic and
comfort measure.
PURPOSE :
(a) To prevent bed sore on back.
(b) To stimulate circulation.
(c) To detect early signs of bed sore.
(d) To relieve pressure from pressure points and to change positions.
(e) To keep the skin clean and dry.
(f) To refresh the patient and relieve fatigue.
(g) To enhance sleep.
(h) To improve sense of wellbeing.
GENERAL INSTRUCTIONS :
1. Explanation should be given to all patients who are susceptible to pressure sores.
2. Instructions may be given frequently to the needy patients, e.g.- paralyzed, unconscious or bed ridden
patients.
3. Back care should be followed by change of position.
4. Observation of skin during back care promotes early detection of pressure Sores.
5. Comfort devices to be used after back care.
ARTICLES REQUIRED

ARTICLES RATIONALE
1. Screen To provide privacy
2. Mackintosh with cover To protect bed linen
3. Fresh bed linen and the patient's clothes To change, if required
4. A tray containing
(i) A Small basin To take water
(ii) Sponge cloth To wash with soap and water
(iii)Soap dish with soap To clean the skin
(iv) Spirit/oil To apply after drying the skin
(v) Powder To prevent friction
(vi) A towel To dry the skin
(vii) A kidney dish To receive waste
PREPARATION OF THE PATIENT:
1. Assess the need for back care in the patient.
2. Explain the procedure to the patient.
3. Provide privacy by placing a screen.
STEPS OF PROCEDURE
1. Provide lateral/prone position to the client.
- For easy access to the back
2. Expose the patient's back shoulders upper arm and buttock cover the remainder of the body with a bath sheet.
Spread mackintosh and towel alongside the patient's back.
- To prevent unnecessary exposure of body parts. To maintain privacy or dignity of client.
3. Wash hands with warm water.
- To make the touch comfortable for the patients as cold causes muscle tension.
4. Wash back with mild soap thoroughly from cervical spine to the coccyx, wash off the soap and dry.
- To clean the back and to remove oil accumulation.
- To stimulate blood circulation and relieve muscle tension.
 5. Take spirit on the palm and apply it all over the back in a circular motion massage till the spirit/oil is
evaporated and skin is dry.
- Spirit keeps the skin dry. It hardens the skin and lessens the chances of bed sore development.
6. Apply talcum powder on the back.
7. Remove the mackintosh and towel, put the patient's clothes and make him comfortable.
- Keep the skin dry. It reduces friction.
- To leave the patient comfortable and dry.
- Promote a sense of well-being.
AFTER CARE:
1. Remove the screen.
2. Take the articles to the utility room, wash and replace in right place.
3. Wash hands.
4. Record the nursing intervention and client's response.
5. Report, if any observations are made.
STEPS FOR BACK MASSAGING
Give back massage using following steps:
1. Effleurage
2. Petrissage
3. Hand over hand
4. Friction
5. Brush stroke
6. Kneeding
7. Tapping
1. Effleurage: It is smooth long-long strokes moving the hands up and down to the back. The hands are moved
slightly down. The slights of back maintain in contact with skin but hands are moved firmly up the back. This rub
has relieving and sedative effect, if slow light pressure is used.
2. PETRISSAGE: Massage the back with both hands, with short, quick strokes.
3. HAND OVER HAND: Massage the back with short quick strokes with alternative hands.
4. FRICTION: Massage the back with your thumbs in circulatory motion and in upward manner. Starting from the
sacrum to supine till the shoulders. More outward each time, until the whole back is covered.

A. Effleurage B. Petrissage C. Friction

5.BRUSH STROKES: Lightly stroke the back with your fingertip to complete massage.
6. KNEADING: Lightly stroke the back like kneading with both hands together.
7. TAPPING: Slightly tap the back with both hands.

D. Tapping