Bed rails are safety or assistance devices attached to the side of a bed frame. They are used in various settings, including private homes, long-term care facilities, and hospitals. Bed rails are generally made of metal or plastic and can be either permanently affixed or temporarily installed. The purpose of a bed rail is to modify the sleeping environment to support the user’s needs or the requirements of their care plan.
Primary Functions and Applications
Bed rails primarily offer mobility assistance, acting as a sturdy hand-hold or grab bar. Individuals with limited mobility or those recovering from surgery often use these rails as a leverage point to help them reposition themselves in bed, sit up, or safely transfer in and out of the bed. This provides a reliable anchor point, helping users maintain a degree of independence.
Bed rails are also commonly used for fall prevention, creating a physical barrier to keep a person from rolling out of bed. This function is often sought for individuals who have poor balance, experience disorientation, or take medications that affect their awareness during the night.
In clinical settings, bed rails serve additional medical and positional purposes. They can assist staff with medical procedures, patient transport, or positioning a person for comfort or treatment. Full-length rails are sometimes used when moving a bed to ensure the patient does not fall off during transit.
Distinguishing Different Types of Bed Rails
Bed rails are categorized based on their design and installation method. Assist Rails, sometimes called bed handles or bed sticks, are typically short devices designed purely for grabbing and leverage. They secure to the bed by sliding a stabilizing base between the mattress and frame.
Home Safety Rails are longer, often adjustable, portable rails intended for standard residential beds. These rails can be half-length or full-length and are not permanently integrated into the bed structure. They are secured with straps or frames that run beneath the mattress, making them easily removable or adjustable for different bed sizes.
Hospital or Medical Rails are full-length or half-length barriers often integrated into the mechanism of a specialized medical bed. They are designed to be durable and compatible with the bed’s movements, such as raising and lowering the head or foot sections. These integrated rails are usually secured to the bed frame and are not meant to be removed by the user.
Significant Safety Concerns and Entrapment Risks
Despite their intended benefits, bed rails pose safety hazards, primarily the risk of entrapment, which can lead to asphyxiation or strangulation. Entrapment occurs when a person’s head, neck, chest, or limbs become caught in an opening in or around the bed rail system. The elderly, frail, and those with cognitive impairments like dementia are the most susceptible to these dangers.
Regulatory bodies, including the U.S. Food and Drug Administration (FDA) and the Consumer Product Safety Commission (CPSC), have issued warnings regarding these risks. CPSC data highlights that over 90% of fatalities associated with adult portable bed rails are caused by entrapment, typically of the head or neck. These incidents often occur when an individual attempts to climb over the rail or move through a gap.
Experts have identified seven distinct zones where entrapment can occur within a bed system. These dangerous zones include:
- Spaces within the rail itself.
- Gaps between the rail and the mattress.
- Spaces between split rails.
- Gaps between the end of the rail and the headboard or footboard.
To mitigate these hazards, the rail must fit snugly against the mattress and bed frame, eliminating any gaps that could trap a person. Only bed rails compatible with the specific bed and mattress should be used, and they should be installed according to the manufacturer’s directions to ensure a tight fit.