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Different types of beds used in the clinical setting
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SPECIAL BEDS FOR POSITIONING SPECIAL BEDS FOR POSITIONING SPECIAL BEDS FOR POSITIONING SPECIAL BEDS FOR POSITIONING CLIENTCLIENTCLIENTCLIENT
Maria Carmela L. Domocmat, RN, MSN
Nurse Instructor
Northern Luzon Adventist College
SPECIAL BEDS FOR POSITIONING SPECIAL BEDS FOR POSITIONING SPECIAL BEDS FOR POSITIONING SPECIAL BEDS FOR POSITIONING CLIENTCLIENTCLIENTCLIENT
SPECIAL BEDS FOR POSITIONING SPECIAL BEDS FOR POSITIONING SPECIAL BEDS FOR POSITIONING SPECIAL BEDS FOR POSITIONING CLIENTCLIENTCLIENTCLIENT
� Beds and their purposes Beds and their purposes Beds and their purposes Beds and their purposes
� Beds to promote turning
� Beds to promote skin integrity
� Nursing care Nursing care Nursing care Nursing care � Nursing care Nursing care Nursing care Nursing care
� Care for a client on a turning frame
� Care for a client on a bed that promotes skin integrity
� Call company representative for regular servicing of bed
� Evaluate client’s response to procedure
2Maria Carmela L. Domocmat, RN, MSN
BEDS AND THEIR PURPOSES
� Beds to promote turning
� purpose
� examples
�Turning Frames�Turning Frames
� Stryker or Foster frames
� CirOlectric bed
�Oscillating Beds
� ex: Rotokinetic treatment table; Roto Rest bed
3Maria Carmela L. Domocmat, RN, MSN
BEDS AND THEIR PURPOSES
� Beds to promote skin integrity
� purpose
� examples
�air-fluidized beds or fluidized air bed�air-fluidized beds or fluidized air bed
�air mattresses (e.g., Flexicare bed)
� flotation bed
4Maria Carmela L. Domocmat, RN, MSN
NURSING CARE NURSING CARE NURSING CARE NURSING CARE
� Care for a client on a turning frame
� Care for a client on a bed that promotes skin
integrity
� Call company representative for regular � Call company representative for regular
servicing of bed
� Evaluate client’s response to procedure
5Maria Carmela L. Domocmat, RN, MSN
Turning Frames
Oscillating Beds
BEDS TO PROMOTE TURNINGBEDS TO PROMOTE TURNING
6Maria Carmela L. Domocmat, RN, MSN
BEDS TO PROMOTE TURNING
� purpose
� examples
�Turning FramesTurning FramesTurning FramesTurning Frames
� Stryker or Foster frames
CirOlectric bed� CirOlectric bed
�Oscillating BedsOscillating BedsOscillating BedsOscillating Beds
� Rotokinetic treatment table; Roto Rest bed
7Maria Carmela L. Domocmat, RN, MSN
PURPOSE
� immobilize the vertebral column
� facilitates turning
� promotes body functions (circulation,
respiration, elimination)respiration, elimination)
8Maria Carmela L. Domocmat, RN, MSN
TURNING FRAMES TURNING FRAMES
9Maria Carmela L. Domocmat, RN, MSN
TURNING TURNING TURNING TURNING FRAMESFRAMESFRAMESFRAMES
� Includes
� Stryker frames or Foster frames
� CircOlectirc bed
10Maria Carmela L. Domocmat, RN, MSN
STRYKER FRAMES OR FOSTER STRYKER FRAMES OR FOSTER STRYKER FRAMES OR FOSTER STRYKER FRAMES OR FOSTER FRAMESFRAMESFRAMESFRAMES
� an orthopedic bed that allows the patient to be
rotated as required to either the full supine or
the full prone position while maintaining proper
immobilization and alignment of injured body immobilization and alignment of injured body
structures
� allow for horizontal turning of client
11Maria Carmela L. Domocmat, RN, MSN
STRYKER FRAME
12Maria Carmela L. Domocmat, RN, MSN
STRYKER FRAME
13Maria Carmela L. Domocmat, RN, MSN
STRYKERSTRYKERSTRYKERSTRYKER FRAMEFRAMEFRAMEFRAME
� an apparatus specially designed for care of patients with
� injuries of the spinal column or cord
� used in the immobilization of patients with unstable spines, used in the immobilization of patients with unstable spines,
� postoperative management of multilevel spinal fusions
� management of severe burn patients
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health,
Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights
reserved.
14Maria Carmela L. Domocmat, RN, MSN
http://www.public.asu.edu/~gimpy/Stryker_8.jpg
15Maria Carmela L. Domocmat, RN, MSN
STRYKERSTRYKERSTRYKERSTRYKER FRAMEFRAMEFRAMEFRAME
� the frame on which the patient lies while in the
supine position is called the posterior frame;
the anterior frame is used when the patient is
turned on the abdomen. There are perineal turned on the abdomen. There are perineal
openings in both frames for use of a bedpan.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health,
Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights
reserved.
16Maria Carmela L. Domocmat, RN, MSN
http://www.public.asu.edu/~gimpy/Stryker_8.jpg
17Maria Carmela L. Domocmat, RN, MSN
http://2.bp.blogspot.com/_HZIO9Uu6NHY/TCzgnFtn2LI/AAAAAAAAAOo/jDXlGqb-
pk4/s1600/cama+stryker2.jpg
18Maria Carmela L. Domocmat, RN, MSN
FOSTER FRAME
19Maria Carmela L. Domocmat, RN, MSN
FOSTER FRAME
20Maria Carmela L. Domocmat, RN, MSN
FOSTER FOSTER FOSTER FOSTER FRAME/BED FRAME/BED FRAME/BED FRAME/BED
� also used for halo-femoral traction and
maintenance of continuous cervical traction in
flexion for patients with unstable cervical neck
problems
21Maria Carmela L. Domocmat, RN, MSN
http://farm4.static.flickr.com/3080/3118349162_d507a416d5.jpg
22Maria Carmela L. Domocmat, RN, MSN
CIRCOLECTRICCIRCOLECTRICCIRCOLECTRICCIRCOLECTRIC BEDBEDBEDBED
23Maria Carmela L. Domocmat, RN, MSN
CIRCOLECTRICCIRCOLECTRICCIRCOLECTRICCIRCOLECTRIC BEDBEDBEDBED
24Maria Carmela L. Domocmat, RN, MSN
CIRCOLECTRICCIRCOLECTRICCIRCOLECTRICCIRCOLECTRIC BEDBEDBEDBED
25Maria Carmela L. Domocmat, RN, MSN
CIROLECTRIC (COL) CIROLECTRIC (COL) CIROLECTRIC (COL) CIROLECTRIC (COL) BEDBEDBEDBED
� an electronically controlled bed that can be
vertically rotated 210 degrees, allowing a
patient to be placed in variety of positions
(Trendelenburg, prone, standing, supine)(Trendelenburg, prone, standing, supine)
� similar in principle to the stryker frame
� allows for vertical turning of client
26Maria Carmela L. Domocmat, RN, MSN
CIROLECTRIC (COL) CIROLECTRIC (COL) CIROLECTRIC (COL) CIROLECTRIC (COL) BEDBEDBEDBED
� indications
� used especially in orthopedics, those in some types
of traction
� severe burns and decubitus ulcers.� severe burns and decubitus ulcers.
� those with various types of spinal injuries
27Maria Carmela L. Domocmat, RN, MSN
CIROLECTRIC (COL) BEDCIROLECTRIC (COL) BEDCIROLECTRIC (COL) BEDCIROLECTRIC (COL) BED
� consists of a strong aluminum circular frame supporting an anterior and a posterior straight frame within the exterior aluminum circle. The patient is "sandwiched" and secured between the two straight frames during rotation. the two straight frames during rotation.
� one nurse can turn the client, with the electric motor providing the power
� attachments permit application of traction and other accessories
Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.
http://medical-dictionary.thefreedictionary.com/CircOlectric+bed
28Maria Carmela L. Domocmat, RN, MSN
THE CIRCO-LECTRIC BED
� During the 1950s Dr. Stryker
worked on what was arguably his
most famous invention – the
Circo-Lectric Hospital Bed.
� It resembled a small Ferris wheel.
� consisted of a bed suspended
between two wheels. An electric between two wheels. An electric
motor turned the bed to a vertical
or horizontal position, as well as
many positions in between.
� The device could be operated by
the patient or a nurse.
� Like the turning frame, this
reduced the amount of time and
effort used by staff to physically
move patients..http://www.kpl.gov/uploadedImages/Local_History/Essays_All_About_Kalamazoo_History/biographie
s/CircOlecrtric-Bed-294.jpg
29Maria Carmela L. Domocmat, RN, MSN
� CircOlectric
hospital bed for
trama / burn /
orthopedics
patient
http://img1.classistatic.com/cps/kj/101012/517r8/0645he4_20.jpeg
30Maria Carmela L. Domocmat, RN, MSN
http://www.public.asu.edu/~gimpy/Stryker_8.jpg
31Maria Carmela L. Domocmat, RN, MSN
http://www.public.asu.edu/~gimpy/Stryker_8.jpg
32Maria Carmela L. Domocmat, RN, MSN
OSCILLATING BEDSOSCILLATING BEDSOSCILLATING BEDSOSCILLATING BEDSOSCILLATING BEDSOSCILLATING BEDSOSCILLATING BEDSOSCILLATING BEDS
33Maria Carmela L. Domocmat, RN, MSN
OSCILLATING OSCILLATING OSCILLATING OSCILLATING BEDSBEDSBEDSBEDS
� uses a continual side-to-side rotation with the
client in constant motion
� ex:
� RotokineticRotokineticRotokineticRotokinetic treatment table; treatment table; treatment table; treatment table; � RotokineticRotokineticRotokineticRotokinetic treatment table; treatment table; treatment table; treatment table;
� RotoRotoRotoRoto Rest bedRest bedRest bedRest bed
34Maria Carmela L. Domocmat, RN, MSN
ROTO REST
� ROTO REST
kinetic treatment
table.
� ROTO REST is � ROTO REST is
Kinetic Concepts'
trademark for its
oscillating bed. Courtesy of Kinetic Concepts, San
Antonio, TX.
35Maria Carmela L. Domocmat, RN, MSN
ROTOROTOROTOROTO REST BEDREST BEDREST BEDREST BED
� used in the treatment of a variety of
neurological conditions in which the patient
must be kept still and in alignment.
� The bed can rock slowly back and forth, thereby � The bed can rock slowly back and forth, thereby
preventing some hazards of immobility.
� The patient is kept in place with a system of
belts and specially designed pillows and packs.http://medical-dictionary.thefreedictionary.com/CircOlectric+bed
36Maria Carmela L. Domocmat, RN, MSN
BEDS TO PROMOTE SKIN INTEGRITY BEDS TO PROMOTE SKIN INTEGRITY
37Maria Carmela L. Domocmat, RN, MSN
BEDS TO PROMOTE SKIN INTEGRITY
� Purpose
� relieve pressure by distributing body weight
� limits friction
� promotes circulation of air under client � promotes circulation of air under client
38Maria Carmela L. Domocmat, RN, MSN
BEDS TO PROMOTE SKIN INTEGRITY
� Examples
� Air-fluidized beds
� Air mattresses
� Flotation bed� Flotation bed
39Maria Carmela L. Domocmat, RN, MSN
AIR-FLUIDIZED BEDS
40Maria Carmela L. Domocmat, RN, MSN
AIRAIRAIRAIR----FLUIDIZED FLUIDIZED FLUIDIZED FLUIDIZED BEDSBEDSBEDSBEDS
� or Fluidized air bedFluidized air bedFluidized air bedFluidized air bed
� uses flow of temperature-controlled air through small
ceramic spheres to evenly distribute client’s weight
� Ex: Clinitron bed, Skytron Air Fluidized Therapy (AFT) � Ex: Clinitron bed, Skytron Air Fluidized Therapy (AFT)
Bed
http://medical-dictionary.thefreedictionary.com/CircOlectric+bed
41Maria Carmela L. Domocmat, RN, MSN
AIRAIRAIRAIR----FLUIDIZED FLUIDIZED FLUIDIZED FLUIDIZED BEDSBEDSBEDSBEDS
� minimizes pressure and distributes weight evenly over
the support surface. A gentle flow of temperature-
controlled air is projected upward through numerous
tiny openings called ceramic microspheres.
http://medical-dictionary.thefreedictionary.com/CircOlectric+bed
42Maria Carmela L. Domocmat, RN, MSN
AIR-FLUIDIZED BED: CLINITRON BED
43Maria Carmela L. Domocmat, RN, MSN
� Watch the following videos for more info about
Air-fluidized bed
� http://www.youtube.com/watch?v=BpjlMFR1mx4
� http://www.youtube.com/watch?v=3a7qNU9PRc8� http://www.youtube.com/watch?v=3a7qNU9PRc8
&feature=related
� http://www.youtube.com/user/HillRomVideo?blend
=3&ob=5
44Maria Carmela L. Domocmat, RN, MSN
AIR-FLUIDIZED BED: SKYTRON AIR FLUIDIZED
THERAPY (AFT) BED� preferred therapy for wound
care, burn care, oncology, orthopedics, critical care, neurology/neurosurgery, and plastic surgery.
� allows patients to heal faster, providing pressures well below capillary closing faster, providing pressures well below capillary closing to improve blood flow to the skin, reducing pain, and accelerating healing.
� Lowest Pressure, Friction, and Shear Forces Available
� Maximum Patient Weight: 250 lb.
http://www.stat-
med.net/content/p/9/pid/33/catid/31/Skytron_Air_Fluidized_Therapy_Bed
45Maria Carmela L. Domocmat, RN, MSN
AIR MATTRESSES
46Maria Carmela L. Domocmat, RN, MSN
AIR MATTRESSESAIR MATTRESSESAIR MATTRESSESAIR MATTRESSES
� Ex: Flexicare bed
� uses an automatic airbag system that adjusts
to individual’s weight and activity to evenly
distribute client’s weight distribute client’s weight
47Maria Carmela L. Domocmat, RN, MSN
FLEXICAIRFLEXICAIRFLEXICAIRFLEXICAIR ECLIPSE® LOW AIR LOSS MATTRESS ECLIPSE® LOW AIR LOSS MATTRESS ECLIPSE® LOW AIR LOSS MATTRESS ECLIPSE® LOW AIR LOSS MATTRESS
AND THERAPY AND THERAPY AND THERAPY AND THERAPY UNITUNITUNITUNIT
� provides pressure relief for patients up to 300 lbs.
� This five-zoned low air loss mattress enhances patient comfort and is appropriate for use with patients for use with patients experiencing a variety of conditions such as immobility, malnutrition, incontinence, contractures, fractures or amputations.
48Maria Carmela L. Domocmat, RN, MSN
FLOTATION BED
49Maria Carmela L. Domocmat, RN, MSN
FLOTATION BEDFLOTATION BEDFLOTATION BEDFLOTATION BED
� a waterbed or other fluid-filled mattress that
distributes body weight evenly to minimize
prolonged pressure in one area
� used for immobilized or burned patients to � used for immobilized or burned patients to
prevent pressure ulcers
http://medical-dictionary.thefreedictionary.com
50Maria Carmela L. Domocmat, RN, MSN
A conventional mattress creates
pressure points
on those areas of greatest weight
concentration.concentration.
A FloCore adjustable latex-flotation
mattress conforms to the body's
exact shape, providing total support,
correct spinal alignment and
eliminates uncomfortable pressure
points.http://www.flobeds.com/inav/deadbed.GIF
51Maria Carmela L. Domocmat, RN, MSN
NURSING CARE NURSING CARE NURSING CARE NURSING CARE NURSING CARE NURSING CARE NURSING CARE NURSING CARE
52Maria Carmela L. Domocmat, RN, MSN
CARE FOR A CLIENT ON A TURNING FRAME
� turn the client all in one piece (log roll)
� because frames are narrow, for safety purposes
do not permit the client to sit up, roll over, or
reach out to the side; do not place extremely reach out to the side; do not place extremely
obese clients on a frame
53Maria Carmela L. Domocmat, RN, MSN
CARE FOR A CLIENT ON A TURNING FRAME
� since only the prone and supine positions can
be used, strict attention must be paid to
prevention of decubiti
� before releasing pivot pins, secure all bolts and � before releasing pivot pins, secure all bolts and
straps to ensure client safety
54Maria Carmela L. Domocmat, RN, MSN
CARE FOR A CLIENT ON A TURNING FRAME
� when turning the CircOlecteric bed, do so slowly
so that the client’s cerebral circulation can
adjust to the new position; observe for signs of
hypotensionhypotension
55Maria Carmela L. Domocmat, RN, MSN
CARE FOR A CLIENT ON A BED THAT PROMOTES
SKIN INTEGRITY
� use only the incontinence pads recommended
by the manufacturer
� with oscillating beds assess for agitation and � with oscillating beds assess for agitation and
motion sickness
56Maria Carmela L. Domocmat, RN, MSN
CARE FOR A CLIENT ON A BED THAT PROMOTES
SKIN INTEGRITY
� with air-fluidized beds
� assess the client for signs of dehydrations because
air flow promotes evaporation
� use foam wedges when positioning the client � use foam wedges when positioning the client
57Maria Carmela L. Domocmat, RN, MSN
OTHER NRG CARE
� Call company representative for regular
servicing of bed
� Evaluate client’s response to procedure
58Maria Carmela L. Domocmat, RN, MSN
ETC. ETC.
59Maria Carmela L. Domocmat, RN, MSN
� FrameFrameFrameFrame : a rigid structure for giving support to or for immobilizing a part.� Balkan frameBalkan frameBalkan frameBalkan frame
� an apparatus for continuous extension in treatment of fractures of the femur, consisting of an overhead bar, with pulleys attached, by which the leg is supported in a sling.pulleys attached, by which the leg is supported in a sling.
� Bradford frameBradford frameBradford frameBradford frame� a canvas-covered, rectangular frame of pipe; used as a bed
frame in disease of the spine or thigh.
� Quadriplegic Quadriplegic Quadriplegic Quadriplegic standing framestanding framestanding framestanding frame� a device for supporting in the upright position a patient whose
four limbs are paralyzed.
Dorland's Medical Dictionary for Health Consumers. © 2007 by Saunders, an imprint of
Elsevier, Inc. All rights reserved. http://medical-
dictionary.thefreedictionary.com/Stryker+frame
60Maria Carmela L. Domocmat, RN, MSN
BALKAN FRAME
61Maria Carmela L. Domocmat, RN, MSN
� Balkan Frame Balkan Frame Balkan Frame Balkan Frame
AdjustmentAdjustmentAdjustmentAdjustment: For
flexion, raise
pulley (a). For
abduction, abduction,
swing foot-end
of balkan wide
of bed (b
http://www0.sun.ac.za/ortho/webct-ortho/general/trac/balkan.png
62Maria Carmela L. Domocmat, RN, MSN
BRADFORD FRAME
http://www.healthheritageresearch.com/images/BradfordFrameHSC-AR1937-
800.jpg
63Maria Carmela L. Domocmat, RN, MSN
BRADFORD FRAME
http://history.amedd.army.mil/booksdocs/wwii/orthoeuropn/ch04fig11.jpg
64Maria Carmela L. Domocmat, RN, MSN
65Maria Carmela L. Domocmat, RN, MSN
Quadriplegic standing frame
� Jenni Taylor, C1C2 quadriplegic
stands twice a week in her
EasyStand Evolv.
� Read more of her story in her
blog:blog:
� http://blog.easystand.com/2008/1
2/quadriplegic-standing-frame/
http://blog.easystand.com/wp-content/uploads/2008/12/jenni-taylor.jpg
66Maria Carmela L. Domocmat, RN, MSN