Category 1 (FIG. 19)
When the blood is excluded from the pressure areas (as above) for a longer period of time, eventually, the tiny blood vessels begin to clot and this blocks the entrance, preventing the return of the blood when the pressure is relieved. At the same time, the pressure causes inflammation over the area causing a brighter redness.
A finger pressed in the centre does not turn the area white again. This is an indication that pressure damage over the tissues is occurring. It should be seen as an emergency.
Appropriate equipment and possibly increased repositioning is required in order to prevent the area from deteriorating. If possible the area should be kept free from any pressure.
If good care is provided at this point (Fig. 1) the area may recover. However, if the pressure has been sustained for many hours, then this may already be breaking down near to the bone. In that case, the injury will then work its way to the surface.
This process of break down from the bone can take many days and the carer may not see the first signs of serious damage for up to five days.
Category 1 pressure injury in the darker Skin (FIG. 2)
The area of pressure will be darker in colour, possibly hotter over the area and could be indurated (harder) over the area
. It takes greater skill and attention to diagnose pressure injury on the darker skin and the carer / nurse must be extremely vigilant in order to prevent pressure injury in the darker skin.