Should all immobile patients have heel elevation, even if using high-level surfaces?

Elevating the heels of all immobile patients is an important practice in pressure injury prevention, regardless of the type of surfaces they are on. Immobile patients are at significant risk for the development of pressure ulcers due to prolonged pressure on specific areas of the body, particularly the heels, which are vulnerable due to their bony prominence.

Even when using high-level surfaces designed to reduce pressure, the elevation of the heels plays a dual role. It not only alleviates pressure directly from the heels but also enhances circulation, reduces shear forces, and promotes overall skin integrity. This preventative measure is vital because pressure injuries can develop rapidly, and the consequences can lead to complications that are difficult to manage.

Although existing injuries or low mobility may increase the need for heel elevation, the general guideline emphasizes that proactive prevention strategies, such as heel elevation, should be applied universally to all immobile patients to effectively guard against potential skin breakdown. Therefore, recognizing the importance of this practice in the care of all immobile patients underlines the essential role of prevention in healthcare settings.