The hospital bed is a complex piece of equipment designed to maximize patient comfort and recovery. The knee gatch is a specialized feature—an adjustable joint in the bed frame that creates a bend beneath the patient’s knees. This articulation point is fundamental to patient care, influencing positioning, preventing skin injury, and aiding circulation. Understanding how this mechanism works and its proper application is important for both patients and caregivers.
Defining the Bed Frame Articulation
The term “gatch” historically refers to the mechanical hinge points that allow a hospital bed mattress platform to articulate. The knee gatch concerns the section of the bed supporting the patient’s lower body, creating a gentle elevation and bend at the knee joint. This mechanism slightly raises the patient’s knees, causing the lower leg and feet section of the bed to drop down. This creates a position similar to sitting in a recliner chair.
This articulation is distinct from raising the entire foot section of the bed, which keeps the leg straight and elevates the heels. The knee gatch introduces a flexion that mimics the body’s natural posture when seated. Modern hospital beds feature an electric knee-break function, allowing caregivers to adjust the angle with precision using a remote control. On advanced models, the knee gatch may only move within a small range, such as 0 to 15 degrees, to achieve postural correction.
The knee gatch often works in coordination with the head of the bed, which is frequently raised to Fowler’s position (a semi-sitting posture). Activating the knee gatch is the first step in adjusting the bed to this upright posture. This sequence is important because it stabilizes the patient’s body before the upper section moves, setting the stage for the feature’s primary benefits.
Essential Role in Patient Positioning and Comfort
A primary function of the knee gatch is preventing a dangerous movement known as shearing. When the head of the bed is raised, gravity pulls the patient’s body downward toward the foot of the bed. This sliding motion causes friction between the skin and the bed surface, which can lead to severe skin breakdown and the formation of pressure ulcers.
By elevating the knees first, the knee gatch acts as a brace, stabilizing the patient’s pelvis and torso and preventing migration toward the footboard when the head section is lifted. This anti-shear mechanism defends against skin injury, particularly over the sacrum and tailbone. The slight bend at the knees also helps offload pressure from the heels, which are a common site for pressure injuries when a patient is lying flat.
The gentle elevation of the legs offers a physiological advantage by supporting blood flow. Raising the legs slightly assists with venous return, helping prevent the pooling of blood in the lower extremities. Furthermore, the knee gatch allows the patient to assume a natural, semi-reclined posture, reducing strain on the lower back and hips. This position is also beneficial for patients with respiratory difficulties, as sitting upright reduces pressure on the chest and diaphragm, easing breathing.
Practical Guidelines for Safe Application
The proper application of the knee gatch requires careful attention to sequencing and angle to achieve benefits and avoid complications. To minimize shearing, the patient’s knees should be slightly flexed using the gatch before the head of the bed is raised. Clinical guidelines suggest raising the foot of the bed to a modest angle, such as 20 degrees, but never exceeding 30 degrees.
Caregivers must avoid excessive flexion of the knee joint, known as hyperflexion, which can compromise circulation in the lower legs. An overly sharp bend can impede blood flow to the lower legs and feet, potentially causing discomfort or injury. After any adjustment, monitor the patient’s lower extremities for signs of circulatory compromise.
Signs of inadequate circulation include feet feeling cool to the touch, numbness or tingling, or a change in skin color such as paleness or a bluish tint. The knee gatch should be checked and adjusted frequently, especially whenever the head of the bed is repositioned, to ensure the patient remains stable and comfortable. Following these guidelines ensures the knee gatch functions as a protective and therapeutic feature.