When a patient comes into Emergency room or brought in by ambulance. And this patient has a wound or wounds.The right thing to do is for the Nurse to take a photograph of the wound (s) in Emergency department.If it is not done in Emergency Department, then it should be done upon admission to your unit or floor.
Photograph of the wound should also be done upon transfer to your unit and when your patient is discharged from the hospital.
If a new wound is discovered, photograph will be needed.
If there is a change in condition of the wound, picture should be taken to show the condition of the wound.Photograph of the wound should be taken weekly also . The photograph should be documented in patients charts and medical records. If a wound deteriorates from stage 11 to stage 111.It must be reported. That is mandatory to notify your Nurse manager for reporting.
The wound should be recorded as follows .
Progress of the wound healing.
Therapy and it’s effectiveness.
Evaluation and re-evaluation of therapy and changes made.
Photograph of skin alterations, pressure ulcers should be well documented.
Photo should be labeled as follows:
Patient name and medical record number.
Where is the wound location?.
The date and time of photograph.
Measurements: Length × Width ×Depth of the wound. (L ×W×D)
Measurements of the three dimensions of length, width and depth by multiply by one another is referred to as Stereophotogrammetry using the 3D digital.
Measurement tapes, or rulers are used and well labeled.
Okay are you ready to take the pictures?.
Remove the flash ,using low light.
Focus the camera close.
Steady the camera and take few pictures.
Review the pictures.
Label ,date and sign the pictures
Put pictures in the chart.
Put in the doctor orders regarding the wounds. Wound consult?.
Initiate a care plan for the wound.
Retake pictures every week.