Most people assume that having bed rails on a nursing home or hospital bed is a good thing. The assumption is that bed rails will prevent the patient from falling out of bed and suffering serious injury. This assumption is wrong – sometimes dead wrong!
Bed rails can increase danger in two ways. First, the patient may attempt to climb over the bed rail resulting in a fall from a higher position than would have occurred if the patient had just rolled off the edge of the bed. Second, and more dangerous, the patient can become entrapped between the bed rails and have their airway closed due to compression by the bed rails.
From 1985 to January 1, 2006, the U.S. Food and Drug Administration received 691 reports in which vulnerable patients (undergoing care and treatment in American health care facilities) became entrapped in bed rails. In these reports, 413 people died and 120 were injured. As of 2001, over 50% of these cases were in nursing homes. Out of those reported deaths, 84% involved strangulation, suffocation, or asphyxiation. Another study in California revealed that approximately 200 Americans die each year in restraints, and federal officials say they believe these are just a fraction of the actual numbers of injuries and deaths. Read the report here.
In response to the rising reports of entrapment, the FDA issued a Safety Alert in August of 1995 regarding the entrapment hazards and safety concerns which accompany the use of bed side rails. The Safety Alert was communicated to hospital administrators, hospital associations, nursing homes, risk managers, bio-medical/clinical engineers, and directors of nursing. The Alert was not specific to any one manufacturer or particular design of side rails but warned health care providers that the FDA had received 102 reports of head and body entrapment incidents involving side rails between 1990 and 1995. These unfortunate events occurred in hospitals, nursing homes, and private homes. The majority of the entrapments involved elderly patients. Read the FDA Safety Alert for yourself.
As an example of this continuing danger, it was reported that just two days ago police in Kansas City, Missouri were investigating the death of a resident in a local nursing home. The woman, in her 80’s, was found dead Thanksgiving morning lying in her bed with her neck pinned between a side rail and the head of the mattress. Read the report here.