Entrapment is defined as an event in which a patient is caught, trapped or entangled in the spaces in or about the bed rail, mattress, or hospital bed frame. Entrapment can lead to serious injury or death. Between January 1, 1985 and January 1, 2006, the FDA received 691 incidents in which patients were caught, trapped, tangled, or strangled in hospital beds. Of those reported incidents, 413 were deaths, 120 nonfatal injuries, and 158 cases where staff needed to intervene to prevent patient injuries.
Although that may not seem like a high number of cases of entrapment, it still is an issue in the medical community. The FDA first alerted the hospital and nursing home community to this problem in 1995. Since then the Hospital Bed Safety Work Group comprised of representatives from the FDA, hospital bed manufacturers, healthcare organizations such as the American Nurses Association and the American Healthcare Association, consumer groups such as the AARP, and other government agencies have worked together to investigate the problem, identify its causes, and find solutions. (“FDA Issues Guidance on Hospital Bed Design to Reduce Patient Entrapment 2”)
They discovered that the key body parts at risk of entrapment are the head, neck, and chest. They also found that 7 major zones of entrapment exist in a hospital bed, as shown in Figure 1, which include:
Under the rail Between the rail and the mattress Between rails, at the end of the rail Between split bed rails Between the end of the rail and the side edge of the head or foot board Between the head and footboard and the mattress
 Entrapment events have occurred in openings within the bed rails, between the bed rails and mattresses, under bed rails, between split rails, and between the bed rails and the head or foot boards. Elderly patients in hospitals and nursing homes, especially those who are frail, confused, restless, or who have uncontrollable body movement, are most vulnerable to entrapment.
Entrapments have occurred in a variety of patient care settings, including hospitals, nursing homes, and private homes. Long-term care facilities reported the majority of the entrapments mentioned above. (“FDA Issues Guidance on Hospital Bed Design to Reduce Patient Entrapment”) The risk of entrapment increases when the bed moves up and down and when a gap is present between the mattress and headboard or footboard. In addition, many facilities use older beds, called “legacy” beds, with new mattresses. This may present an entrapment hazard by increasing or creating spaces or gaps between various components of the bed system. (“Reducing Risk of Bed Entrapment”) Since this problem was discovered in 1985 many hospitals and healthcare providers have developed different cushions and covers to try to prevent entrapment in hospital beds. However, none of these devices block entrapment in all 7 zones. |
Works Cited
“FDA Issues Guidance on Hospital Bed Design to Reduce Patient Entrapment.” 9 March 2006. US Dept of Health and Human Services. http://www.fda.gov/bbs/topics/NEWS/2006/NEW01331.html 3 September 2007.
“FDA Issues Guidance on Hospital Bed Design to Reduce Patient Entrapment 2” 1 September 2004. MediLexicon International Ltd. http://www.medicalnewstoday.com/articles/12750.php 3 September 2007.
“Reducing the Risk of Bed Entrapment” 2007. Joint Commission Resources, Inc.
http://www.jcrinc.com/13613/ 3 September 2007.
Images Cited
Bed Rail Image. 9 March 2006. US Dept of Health and Human Services. http://www.fda.gov/bbs/topics/NEWS/2006/NEW01331.html 3 September 2007.