(Introduction) Bed side rails have been utilized throughout the United States for decades. Intended to reduce falls, recent literature has shown them not to always be effective for this purpose. It is important for healthcare professionals to be aware of entrapment issues associated with the use of hospital bed side rails. The responsibility for specialty bed/therapeutic support surface selection is often that of the wound care professional. This review of the literature/poster aims to increase awareness of this subject.

(The Problem) During the past twenty years, adverse events of entrapments in hospital beds have been reported. “Between 1985 and 2004, the FDA received 606 entrapment reports of deaths, injuries or near misses” involving bed rails. Of those reports, “378 were of deaths, 116 were of injuries, and 112 were of near misses” (Draft Guide for Modifying Bed Systems and Using Accessories to Reduce the Risk of Entrapment April, 2005).

(Working Toward Solutions) In 1995, the FDA issued a safety alert: Entrapment Hazards with Hospital Bed Side Rails. The Hospital Bed Safety Workgroup was formed in 1999 to study this matter. In 2004, they published a draft guidance document entitled: Hospital Bed System Dimensional Guidance to Reduce Entrapment. The draft document details locations on the bed, where entrapments have and could potentially occur, and recommendations to reduce risk. The International Electrotechnical Commission's proposed anthropometrical measurements are also being considered for inclusion. Publication of the final guidance document is expected this year.

(Conclusion) Persons who are most at risk for hospital bed entrapment include those over the age of 65, those with impaired mental status, agitation, muscle control impairment, or a combination of these factors. Assessment and identification of this vulnerable population of persons at risk for entrapment is imperative. Equipment choices for those at risk must be carefully considered.