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Use of Bed Rails Poses a Risk to Nursing Home Residents

Most of us would agree that bed rails are a necessary precaution to keep hospital and nursing home residents who may be sick or restless from falling out of their beds. But a post on The New Old Age blog on the New York Times online points out the risks involved with the use of bed rails.

“Rails decrease your risk of falling by 10 to 15 percent, but they increase the risk of injury by about 20 percent because they change the geometry of the fall,” explained Steven Miles, a geriatrician and bioethicist at the University of Minnesota who was quoted in the article. Patients can try to climb over the rails, falling farther than if they rolled off the lower level of the bed.

A greater risk with bed rails is entrapment. The article gives the example of an elderly man who died of asphyxiation in an assisted living facility in Wisconsin after his head became entrapped between the mattress and the rail.

Despite a warning issued by the Federal Drug Administration (FDA) in 1995 about the entrapment danger posed by bed rails, bed rails are still being used extensively in nursing homes and rehabilitation centers. In the article, Dr. Miles explained, “A person will roll into the slot next to the rail, and the mattress slides to the opposite side. That doubles the size of the gap. The patient drops into the gap, the mattress presses against his chest and he can’t breathe.”

In 2006, the FDA issued guidelines to reduce the hazards from use of bed rails. However, the best solution would be to establish manufacturing standards so that no bed has a dangerous gap between the mattress and rail.