Restorative CareQuestion 123 of 200

When positioning a bedbound resident, which technique BEST protects the heels from pressure injury?

a.Place a thin pillow directly under the Achilles tendon
b.Float the heels off the mattress by placing a pillow lengthwise under the calves
c.Apply tight elastic stockings up to mid-thigh
d.Massage the heels vigorously with lotion every shift

Explanation

Heels have minimal subcutaneous tissue and high pressure injury risk. The standard of care is to FLOAT the heels by placing a pillow lengthwise under the lower legs from below the knee to above the ankle, with heels completely off the surface. A pillow under the Achilles (a) still allows heel contact. Tight stockings (c) may impair circulation and require a physician order. Vigorous massage (d) is contraindicated — it can shear fragile capillaries and worsen tissue damage. 42 CFR §483.25(b) requires prevention of pressure ulcers when avoidable.

Law Reference: 42 CFR §483.25(b)

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