Bed Rail Entrapment in Nursing Homes

Bed rail entrapment is a dangerous and potentially deadly hazard that can occur to most patients in nursing homes. It occurs when a patient becomes caught between the mattress and the bed rails, trapping them in a dangerous position.

Bed entrapment is most likely to happen among elderly or disabled patients because they are more likely to struggle to reposition themselves. To prevent entrapment, caregivers must inspect the bed regularly for any broken parts or protruding metal pieces and ensure all bed rails are adequately locked into place before allowing anyone to use them.

Was your loved one entrapped in the bed rails at their nursing home or assisted living facility? The personal injury attorneys at Rosenfeld Injury Lawyers, LLC legally advocate for all nursing home residents victimized by neglect and abuse.

Call our nursing home abuse lawyers at (888) 424-5757 or use the contact form to schedule a free consultation.

What Are Adult Bed Rails?

Adult bed safety rails are safety devices designed to help protect vulnerable patients and reduce the risks associated with falls from their beds. They offer added stability, support, and protection for adults suffering from a specific medical condition such as dementia or Parkinson’s disease.

Adult bed rails come in various sizes and styles, ranging from adjustable bars that fit across the length of the bed to half-rails that attach to just one side. Not all mattresses and bed frames are interchangeable, and not all bed rails fit all beds.

Adequately installing adult bed rails is essential to ensure patient safety and prevent injuries, so it's important to consult a healthcare professional before purchasing one.

What Are Adult Portable Bed Rails?

Adult portable bed rails are ideal for those who require additional stability and support while in bed but need the convenience of moving the rail when necessary.

Portable bed rails provide a comfortable, secure feeling for most patients unable to get up independently. Most adult portable bed rails can be easily adjusted and installed in minutes and are suitable for home and hospital use.

Caregivers should ensure that the rails fit securely before allowing a patient to use them, as some models have adjustable heights that cannot support heavier individuals.

Bed Entrapment Assessment Guidelines

Bedrail entrapment assessment guidelines are essential for patient safety in any care setting. These guidelines provide comprehensive information on assessing the risk of entrapment, identifying areas of concern, and selecting appropriate intervention strategies.

To start, it's essential to consider the person's expected movement and ensure that access points such as side rails do not create a hazardous gap between their body and the rails themselves.

Regardless of mattress width, length, and depth, the bed frame and bedside rail should leave no gap wide enough to entrap a patient's head or body.

The High Risk of Bed Frame and Rail Entrapment

Bed entrapment is a serious issue faced by nursing home patients. The problem has caused people to be uncertain about sending their loved ones to nursing homes, as being stuck in the bed rails for hours can lead to suffocation and immobility, resulting in bed rail injuries and even death.

Several cases of patients being severely locked in the bed rails in nursing homes have been reported, including a patient who died after becoming trapped and an eighty-year-old woman whose head was caught between the mattress and side rail.

An old man was entrapped between the side rail bars and sustained serious injuries on his head. Hundreds of bed entrapment accidents have occurred in nursing homes, risking their reputation.

The consequences of this problem are dire, and steps must be taken to prevent such incidents from occurring again.

Body Parts at Risk of Bed Rail Injuries

Hospital functional beds are essential medical equipment but can also be dangerous if the staff does not correctly install or fails to adequately maintain them. The head, neck, and chest are three essential body parts at risk for entrapment or falls.

Hospital bed system dimensional data references have been used to determine the relative sizes of these body parts for the population at most significant risk, and dimensional limits have been provided to reduce the odds of entrapment. Entrapment and side rail latch reliability is the primary focus of this guidance.

The US Food and Drug Administration (FDA) has reported several fires with electrically-operated beds; safety tips for preventing them are available on their website. Wheel locks, limb entrapment, side rail break, and mattress improperly sized are common hazards associated with these systems.

FDA Bed Entrapment Guidelines Overview

The FDA issued guidance on clinical resident assessments and assessment guidance to the healthcare industry in 2006 to reduce the risk of hospital bed entrapment. It includes clinical, dimensional, and mitigation concerns to help caregivers assess and modify existing bed systems.

Healthcare providers must familiarize themselves with ways to protect their residents and businesses from bed entrapment with existing hospital bed systems. Some developed mitigation guidelines chose to test without a mattress to ensure greater repeatability of testing and eliminate the risk of bed entrapment, resulting in more stringent requirements of rail supports.

Consumer Products Statistics of Bed Rail Entrapment Cases

Bed rail entrapment is a severe issue that has resulted in numerous deaths and nonfatal injuries. Data reveals 102 reported cases of bed entrapment since 2010, with 68 resulting in death and 22 serious injuries.

The Hospital Bed Safety Workshop (HBSW) reported 67 cases of bed entrapment over two years, with 36 resulting in death. These accidents demonstrate the need for healthcare facilities to take greater precautions regarding patient safety and provide adequate training on how to use bed rails safely.

The US Consumer Product Safety Commission and the Food and Drug Administration have both received reports of deaths and injuries related to bed rails, emphasizing the importance of considering the type of bed rail when creating a safe sleeping environment.

These systems should not be used as a restraint but rather as an assistive device for those needing help repositioning or preventing nighttime falls. Not all systems present a hazard, but many injured patients are transported to hospital emergency departments with entrapment injuries.

Entrapment Risks Compromising Resident Safety

The tragic episodes in healthcare settings are often due to negligence and lack of proper training. Healthcare doctors and nursing staff may not be adequately trained or guided, leading to inadequate patient care.

According to the National Electronic Injury Surveillance System (NEISS), 145 deaths and 36,900 injuries were attributed to entrapment between:

• The mattress/bed and the bed rail
• The bed rail bars
• A commode and rail
• The floor and rail
• The headboard and rail

Additionally, 11 deaths occurred due to falls off the bed rail, climbing over the bed rail, falling and hitting the bed rail, or falling due to an unraised bed rail. Most injuries occurred to the head, lower leg, and foot, including fractures, contusions, lacerations, and abrasions after the victim fell.

Food and Drug Administration Hospital Bed Rail and Portable Bed Rail Reports

The Food and Drug Administration (FDA) has received numerous reports of patients caught, trapped, entangled, or strangled in hospital beds between 1993 and 2019.

Several solutions are available to reduce the risk of injury or death due to entrapment in hospital beds:

• Adjustable-height low beds provide a restraint-free alternative for residents at risk of falling out of bed.
• Bolstered mattresses and bed alarms can help alert caregivers when at-risk residents attempt to exit the bed.
• Bedside mats can help protect against head trauma and reduce the impact of falls in the event one occurs.

Reduce Entrapment Risks to Prevent Injuries

There are also adjustable-height low beds with laminate panels that can help reduce entrapment risks on a spring, foam, or air mattress.

Entrapment is a severe issue that healthcare facilities need to address. The Hospital Bed Safety Workgroup (HBSW) has reported numerous deaths and injuries associated with hospital beds and portable bed rails.

According to the Hospital Bed System Dimensional and Assessment Guidance to Reduce Entrapment Reports, to reduce the risk of injury or death due to entrapment, healthcare facilities should ensure that all systems are adequately secured and regularly checked for any signs of wear or damage.

Additionally, adjustable-height low beds, bolstered mattresses, bed alarms, and bedside mats can help reduce the risk of entrapment.

Consumer Product Safety Commission (CPSC) Reports

The Consumer Product Safety Commission (CPSC) reported 155 deaths and five adult portable bed rails injuries from January 2003 to September 2012. Most fatalities occurred in individuals aged 60 and over, with half having a diagnosed medical condition, including:

• Cardiovascular disease
• Alzheimer's disease
• Dementia, memory loss, and other mental limitations
• Acute urinary retention with elevated fall risks or altered mental status

The majority of deaths and nonfatal injuries occurred at home (94), with the rest occurring at nursing homes (25), assisted living facilities (15), hospice facilities (3), other (5), or unspecified locations (13).

Bed rails should not be used as a restraint but as an assistive device to help those who need assistance getting in and out of bed or repositioning. Portable and hospital bed rails can present a hazard to certain individuals, particularly those with physical limitations or altered mental status.

Bed Rails as Physical Restraints

Bed rails often help individuals get in and out of bed or reposition themselves. However, they should not be used as restraints unless medically necessary.

The Health Care Services for the Elderly (HBSW) recommends avoiding bed rails and using less restrictive interventions. The US Consumer Product Safety Commission (CPSC) and the Food and Drug Administration (FDA) have received many death and injury reports related to adult portable bed rail products and hospital bed rails.

It is essential to consider the type of bed rail being used, as well as whether or not it is appropriate for the individual's medical needs, comfort level, and desire for freedom of movement when creating a safe sleeping environment.

Adult portable bed rails and hospital bed rails can present a hazard to specific individuals if they are not adequately designed, compatible with the mattress, or used appropriately, leading to entrapment or falls, which can result in serious injury or death.

Consult with a healthcare professional before using bed rails as restraints, and ensure that the bed rail is properly installed and used by the manufacturer's instructions.

Bed Rail Alternatives

Bed entrapment reduction alternatives are an essential consideration for caregivers of at-risk residents. Adjustable-height low beds provide a restraint-free alternative, while bolstered mattresses and bed alarms can help alert caregivers when a resident attempts to exit the bed.

Bedside mats can also help protect against trauma and reduce the impact of falls in the event one occurs. Caregivers should assess a resident's medical needs and ailments before determining if bed rails are necessary.

Low-risk residents may not need bed rails, while high-risk residents may benefit from an adjustable-height low bed with laminate panels and half rails, bolstered mattress with heel slope, a bed alert attendant deluxe alarm, and a foldable bedside mat.

An interdisciplinary team of staff members and conversations with family members can help to evaluate the resident's needs. Consider adding a quarter rail or transfer device to a fixed-height low bed for support and carefully evaluating entrapment zone dimensions when using bed rails.

Solutions to Aid Residents with Ingress and Egress

Trapezes can provide a great solution to help residents with ingress and egress for the appropriate candidate. Trapezes are designed to provide firm support, allowing residents to reposition themselves safely in bed. There are several assist devices available for current beds or legacy beds.

These trapezes offer a secure grip that allows residents to easily move in and out of bed without assistance from caregivers or family members.

Hire a Bed Rail Injury Lawyer to Resolve Your Compensation Claim

Entrapment is a severe safety risk that can lead to injury or death. To reduce the risk of entrapment, long-term care centers must perform routine resident assessments and take precautionary measures to ensure patient safety when using assistive devices.

Was your loved one harmed through abuse or neglect by their caregivers or others? Call our legal team at (888) 424-5757 to schedule a free consultation to discuss holding the nursing facility accountable.

At Rosenfeld Injury Lawyers, LLC, we accept all resident injury cases on a contingency fee basis, meaning you will pay our fees only after we obtain financial compensation on your behalf.

Resources:

• FDA: Bed Rail Safety
• CPSC: New Federal Bed Rail Standards