How can heels be offloaded during bed repositioning to protect skin, and how can it be achieved?

• A. Heels are at risk; offload using heel boots, pillows, or foam under the calves.
• B. Heels have no risk; offloading is unnecessary.
• C. Only use traction devices.
• D. Move heels first to speed transfer.

Answer: (A)

Heels are at high risk for pressure injuries during bed repositioning because the calcaneus sits against the bed with limited cushioning, making sustained pressure and shear easy to create. Offloading the heels keeps them from bearing weight on the bed, protecting the skin. This is best achieved by using heel-protection devices or supports (such as heel boots) and by placing a pillow or foam under the calves so the heels hover clear of the surface. This setup redistributes pressure away from the heels and reduces friction and shear during movement. Ensure the devices fit properly—snug but not constricting—and keep the feet in a neutral position. Regularly inspect the skin under the devices for redness or breakdown and adjust as needed. When repositioning, perform smooth, coordinated movements to minimize drag; relying on traction devices or moving the heels first does not provide the same protective effect and can increase risk.