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Physical care Bathing The following general rules may be applied for bathing: • use ample water; • do not use excessively warm water; • preferably do not use soap; • cleanse skin by patting with a soft cloth; • pat skin to dry with a soft cloth; • dry skin alternatively with hairdryer on a low setting; • use clean flannels for every bathing. Most important in skin care is the prevention of blisters and/or wounds. When blisters and/or wounds have developed all the same, it is important to care for them as well as possible in order to prevent infections. It differs per patient whether blisters and wounds will develop easily or not. Baths A bath is good for the skin although it is not necessary daily. It is beneficial to soften the scabs of any wounds. This is why a bath is often advised. If the patient's dressing material is left on in the bath it might be easier to change it because the bandages can soak off from the skin and wounds. Thus, the removal of dressing material causes as little pain as possible and as little damage as possible to the wound bed. Bathing oil may be added to the bathing water of approximately 30° C (depending on the individual preference) to stop the dehydration of the skin. Another emollient is the addition of camomile tea to the bathing water (camomile tea: 6 tea bags in 3 litres of water, brew and cool for 10 minutes). For the cleansing of the damaged skin (with blisters and wounds) the advice is given to add a dash of chlorine (for example chlorhexidine 10% or Glorix®). For a child's bath approximately 5 millilitre is used for a large bath around 10 millilitre. This prevents infection of the wounds. The use of soap is discouraged because soap dehydrates the skin. Alternatively, a non-irritating soap with neutral pH (for example Sebamed®, Sporex®) or bathing oil (for example soya oleum emulgatum) may be used. The hair may be washed with a non-irritating neutral shampoo, for example, a mild baby shampoo. Soy oil may be used for the treatment of a dry scalp. Prudence is called for when the patient has infected wounds. The infection of non-infected wounds by the bathing water should be prevented. Consult the patient's doctor for per-mission to take a bath in the case of infected wounds. After the bath the skin is patted dry with a soft cloth. To prevent blistering, no rubbing, pressure or squeezing should be applied. In and out of the bath It may sometimes be difficult to get in and out of the bath (lifting in and out of the bath). Young children are lifted in and out of the bath by supporting the buttocks with one hand and the head with the other hand. Another option is for a second person to pat the child dry while the first person lifts the child. The child must never be lifted from underneath the arms. If adults find it difficult to get in and out of the bath, handrails can be attached to the wall. If it still presents serious problems, the use of a mechanical lift may be con-sidered. In this case, attention should be paid to prevent friction. Showering In the implementation of physical care, a shower may also be used with a fine shower head and tepid water of around 30° C depending on individual preference). Hard jets of water may damage the skin. If the patient finds it difficult to stand (continue standing) under the shower, a bathing chair may be used to prevent falling and bumping. |
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