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Bed Rails That Kill

Bed Rails That Kill

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Published by mozzy72
For all the furniture that you need anywhere in your home or office visit http://www.welcominghomeinteriors.com & you will find just what you are looking for. http://www.welcominghomeinteriors.com
For all the furniture that you need anywhere in your home or office visit http://www.welcominghomeinteriors.com & you will find just what you are looking for. http://www.welcominghomeinteriors.com

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Published by: mozzy72 on Feb 26, 2012
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01/30/2015

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 ==== ====For all your Furniture requirements in all shapes & forms, gotohttp://www.welcominghomeinteriors.com ==== ====As attorneys, many of us have consulted with clients and their families as a result of a fall from ahospital or nursing home bed. These falls result in fractured arms, legs, and hips, and often evenmore serious injuries such as skull fractures. The patient’s (or family’s) immediatereaction to these unfortunate injuries is to blame the hospital, nursing home, nursing staff, orattending physicians for the failure to have bed side rails raised and in place to prevent such falls.This typical reaction is based upon the assumption that bed rails, when properly used, will preventthe patient/resident from falling out of the bed and suffering injury. However, bed rails are notbenign safety devices and this article will address the dangers created by their use. Bed side rails have been in existence for years and are manufactured by several differentcompanies with numerous configurations and designs. A quick search of the Internet discloses anumber of medical supply companies which manufacture and sell these products. The mostcommon bed rail designs include full-length rails, three-quarter-length rails, half-length rails,quarter-length rails, and split-rail configuration (often the most dangerous design). Bed rails are used extensively in hospitals and nursing homes. In hospitals, their use is typically anursing decision rather than based upon a physician’s order. However, in nursing homes,Federal regulations require a physician’s order if bed rails are to be used, as the regulationsrecognize side rails as a form of restraint. Notwithstanding the requirement for nursing homes,physician’s orders are often not obtained because of the belief that bed rails are simply asafety device. This is a misconception: bed rails often cause injury or death. There has been little study or publication about the risks and benefits of bed rails. However, thereports of adult deaths and injuries from bed rails on file with the U.S. Consumer Products SafetyCommission (CPSC) (incidents from 1993 to 1996) provide significant information for attorneysinvestigating a potential negligence claim. The CPSC information reflects that seventy-fourpatients died as a result of the use of bed rails. Moreover, it in not unrealistic to conclude that theactual number of patient deaths far exceeded the reported deaths. Regardless of the truefrequency of deaths, 70% of the reported patient deaths resulted from entrapment between themattress and the bed rail such that the patient’s face was pressed against the mattress.18% percent of the reported deaths were the result of entrapment and compression of the neckwithin the bed rails. Finally, 12% twelve percent of the reported deaths were caused by beingtrapped by the rails after sliding partially off the bed, resulting in neck flexion and chestcompression. The second source of significant information comes from the U.S. Food and Drug Administration.The FDA issued a Safety Alert in August of 1995 regarding the entrapment hazards and safetyconcerns which accompany the use of bed side rails. The Safety Alert was communicated tohospital administrators, hospital associations, nursing homes, risk managers, bio-medical/clinical
 
engineers, and directors of nursing. The Alert was not specific to any one manufacturer orparticular design of side rail but warned health care providers that the FDA had received 102reports of head and body entrapment incidents involving side rails between 1990 and 1995. The102 reports of entrapment resulted in 68 deaths, 22 injuries, and 12 entrapments without injury.These unfortunate events occurred in hospitals, nursing homes, and private homes. The majorityof the entrapments involved elderly patients. In part, the FDA’s Safety Alert recommended the following actions to prevent deaths andinjuries from entrapment in hospital bed side rails: Inspect all hospital bed frames, bed side rails, and mattresses as part of a regular maintenanceprogram to identify areas of possible entrapment. Regardless of mattress width, length, and/ordepth, alignment of the bed frame, bed side rail, and mattress should leave no gap wide enough toentrap a patient’s head or body. Be aware that gaps can be created by movement orcompression of the mattress which may be caused by patient weight, patient movement, or bedposition. Be alert to replacement mattresses and bed side rails with dimensions different than theoriginal equipment supplied or specified by the bed frame manufacturer. Not all bed side rails,mattresses, and bed frames are interchangeable.The entire FDA Safety Alert may be found at:[http://www.fda.gov/cdrh/bedrails.html]. In 1999 the FDA, in conjunction with representatives fromthe hospital bed industry, national healthcare organizations, and patient advocacy groups formedthe Hospital Bed Safety Workgroup. The Workgroup’s goal was to improve the safety ofhospital beds for patients in all healthcare settings who are most vulnerable to the risk ofentrapment. In April of 2003 the Workgroup published the results of its research in an articleentitled, “Clinical Guidance for the Assessment and Implementation of Bed Rails inHospitals, Long Term Care Facilities, and Home Care Settings.” The guidelines publishedby the Workgroup are too lengthy to discuss in detail in this short article but do set forth valuableconsiderations with regard to patient choice, nurse training and education, policy considerations,and specific bed rail safety guidelines. The bed rail safety guidelines recommend: 1. The bars within the bed rails should be closely spaced to prevent a patient’s head frompassing through the openings and becoming entrapped. 2. The mattress to bed rail interfaceshould prevent an individual from falling between the mattress and bed rails and possiblysmothering.3. Care should be taken that the mattress does not shrink over time or after cleaning.Such shrinkage increases the potential space between the rails and the mattress. 4. Check for compression of the mattress’ outside perimeter. Easily compressed perimeterscan increase the gaps between the mattress and the bed rail. 5. Ensure that the mattress is appropriately sized for the selected bed frame, as not all beds andmattresses are interchangeable. 6. The space between the bed rails and the mattress and the headboard and the mattress shouldbe filled either by an added firm inlay or a mattress that creates an interface with the bed rail thatprevents an individual from falling between the mattress and bed rails. 7. Latches securing bed rails should be stable so that the bed rails will not fall when shaken. 8. Older bed rail designs that have tapered or winged ends are not appropriate for use with

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