Community paramedics help manage chronic wounds through several methods. First, community paramedics receive additional training to ensure they know how to assess a wound, recognize signs of infection, and properly manage tasks such as dressing changes and suture removal. All this leads to fewer wound-related infections, earlier recognition of sepsis, and faster recovery for the patient.
Wounds are one of those “small” pieces of a person’s health that can lead to big problems when mismanaged. Let’s look at how community paramedics manage wound care at home, closing the gap in healthcare and in skin health.
How Community Paramedics Work to Manage Chronic Wounds
A primary concern with wounds is infection. For this reason, physicians and nurses pay close attention to them when a patient is in the hospital. This means that, particularly for someone in post-surgery, they have regular dressing changes, wound irrigation (if needed), assessment for infection, and timely removal of staples or sutures when required.
If the doctor notices an infection beginning to develop, the patient is quickly placed on an antibiotic. In many cases, the patient is also placed on a preemptive antibiotic to prevent infection in the first place. All of this works relatively smoothly in the hospital – but what happens when the patient goes home?
If the patient has trouble following post-discharge instructions or if the wound is in a complex location, there’s a risk that a local or systemic (septic) infection could develop. In some cases, this could mean the loss of a limb. In others, the infection could be fatal. To reduce these negative outcomes, community paramedic wound care is playing an increasingly important role.
When a patient is discharged home after surgery (or specific in-hospital wound care), the community paramedic can make in-home wound care visits to ensure the wound is healing properly and to raise the alarm if any problems are found.
Let’s pull out the microscope and look closer at the mechanics of how a community paramedic works to manage wound care at home.
Here’s how community paramedics can make a difference for wound care at home:
- Environmental Monitoring and Education to Reduce Sores
- Trained Providers for Wound Care
- Reduction in Potential Infection Sources
- The Patient Does Not Need to Constantly Travel
Now let’s dive in.
MIH-CP and Wound Care: Environmental Monitoring and Education to Improve Wound Healing and Reduce Complications
It could be argued that the best care provider for a patient is the patient themselves. A careful patient is the only person constantly monitoring their own health, 24/7. Smart health systems looking to reduce hospital readmissions and improve patient outcomes do their best to leverage this inherent advantage of the patient. They do this through education.
When it comes to wounds, education is critical. Let’s look at an example. Consider someone with diabetes who develops a pressure ulcer on their back. This is typically due to extended periods of sitting or lying down. In the case of diabetes, associated nerve damage can sometimes make it difficult for the patient to feel pain, leading to a pressure wound that just gets worse and worse.
In a healthy person, the body naturally signals when a person has been in one position for too long, prompting a change in position to improve blood flow to a particular area. This doesn’t always happen in a diabetic patient (who may have trouble feeling) or a post-surgical patient (who might be severely restricted in their ability to move and heavily medicated for pain).
In both cases, the community paramedic can evaluate the patient’s home environment, ensuring that the patient has the tools needed to adjust their body to manage a wound. This could mean ensuring they have a walker or a pull-bar to adjust themselves in bed.
The community paramedic will also educate the patient on how often to reposition to avoid prolonged pressure on the wound. Education extends to other areas, such as how to maintain wound hygiene, what to watch for in the event of an infection, and how to perform basic functions (showering, using the bathroom) without disrupting the healing process.
Paramedics Are Trained to Evaluate and Care for Complicated Post-Surgical Wounds
While an individual is certainly vital to their own health, many wounds still require professional evaluation and care for proper healing. For example, if someone has minor cosmetic surgery on their arm, they will likely be able to manage dressing changes and cleaning for that area.
However, for a patient who has undergone major surgery, with multiple incision sites (or a number of traumatic injuries that required repair), self-management of wounds becomes almost impossible.
In the case of a complex wound, the community paramedic will be able to evaluate the incision site(s) for signs of infection, perform required dressing changes in a sterile manner, and notify the physician if any vital signs are abnormal.
Because contamination of wounds in the hospital can be high, there may be times when a physician chooses to manage a wound in the outpatient setting, specifically to reduce infection risk. Being able to implement home-based wound management will depend on having a strong health network and a team of well-trained community paramedics.
Community Paramedics Can Reduce the Potential for Infection by Treating the Patient in Their Home
We touched on this in the last section, but depending on the situation, a wound may be less likely to become infected if the patient is treated at home. This depends on many variables.
For example, if the hospital can provide a controlled, sterile environment with strict protocols and procedures for nurses and physicians to reduce contamination, some patients may remain in the hospital for management of a complex wound.
However, if the patient is in a hospital that is experiencing overcrowding, or the facility does not have the capability to maintain an exceptionally clean environment, then the patient may need to be treated at home.
Of course, the home presents many more variables. That’s where community paramedics will take the time to ensure that a person’s home is conducive to good wound care. If the home is especially dirty, it may need to be cleaned.
If there are many people and pets with access to the patient area, access may need to be restricted. Even small steps, such as testing the patient’s water supply to ensure there are no potentially contaminating microbes, can make a difference.
While not all of these interventions may be needed, the community paramedic can evaluate a patient’s environment and make a determination based on each individual’s needs.
The Patient Does Not Need to Constantly Travel for Wound Management (Yet Still Receives High-Quality Care)
Whenever a patient with a wound is forced to travel, they are exposed to additional potential infection sources. Even if the patient is taken by ambulance, there is no guarantee that the vehicle has been thoroughly cleaned to reduce contact with possible infection sources.
Also, even when safe and clean transport is possible, there are instances when a patient just can’t make it logistically. They might live incredibly far from the wound treatment facility, or they might have such severe immobility that they have to be constantly transported via ambulance – which can become incredibly expensive, depending on the setting.
That’s where the community paramedic can make a big difference. By reducing the need for the wound patient to travel, they can lower the risk of infection and reduce the overall cost of care.
Overall, the goal with community paramedics is to bring a specially trained professional into the patient’s home to promote rapid wound healing while also reducing the risk of infection and sepsis (which remains a major issue across the country).
Conclusion: How Community Paramedic Wound Care Improves Healing at Home
While a small wound might be easy to ignore, doing so can have disastrous consequences for a person’s life. Community paramedics can improve wound care for diabetic and post-surgical patients by bringing the professionalism and care found in the hospital directly to their homes.
Community paramedics are trained to manage complex wounds, perform dressing changes and suture removal, recognize signs of infection, and coordinate closely with fellow providers and manage data throughout the entire process.
That connectedness is what sets community paramedic wound care apart. If you’re interested in building an MIH-CP-based wound management team and need the software tools to make it happen, contact Julota to learn how their software can help your program succeed.
