What's the best way to do daily skin inspections?

To have a regular schedule of daily skin inspection.  In the morning, prior to getting dressed, is a good time; in the evening when you’re getting undressed is also a good time.  In between times, such as when you’re getting repositioned, if it’s convenient, you can do assessments at that point.  The visual inspection is essential. Either the patient does it with a long-handled mirror, if they can functionally do that, or a designated person such as family or caregiver.  What you’re looking for, initially, is a color change in the skin-pigmentation.  With a pale-complexioned individual, it’s going to look reddish or pinkish.  With a darker-skinned individual, the area of injury will be a darker tone than their normal tone, which is very important to recognize.  In addition, other signs and symptoms can be again, pain, there may be some blistering, there may be a bruise appearance—bluish, purplish, blackish, brownish—there may be a texture consistency difference.  For example, the heel should feel as firm as the palm of your hand.  In the case of a suspected pressure injury, or a beginning pressure sore, it can become soft or even mushy; you can depress it with your finger tips.  So these are the initially, beginning signs.

We do have long-handled mirrors that we use; you can buy them commercially, and you can teach yourself to use them, and we would teach you at rehab a lot of times, or a family member how to inspect daily.  I always tell people, “Do it while you’re dressing;” it’s the easiest time to do so.  You learn how to roll that way; you learn a little about what it looks like, what it should look like.  But if you have any skin sore, you should also look at that to see if it’s changing day to day.  If you notice redness, the next day it’s even more red, that something that you want to talk to a doctor or nurse about, because most often what we tell people is to stay off that area, and to limit the amount of time you’re in a wheelchair.