A hospital bed mattress is a specialized medical device designed to function with the articulation of a medical bed frame. Unlike a standard residential mattress, these products must accommodate frequent changes in position, such as raising the head or foot sections, while maintaining structural integrity. They are designed with specific considerations for infection control and patient comfort during extended periods of use.
Essential Requirements for Hospital Bed Mattresses
The primary requirement for any hospital bed mattress is its ability to flex and bend significantly without material breakdown. Medical beds articulate at multiple points, often requiring the mattress to bend at a 90-degree angle or more to accommodate patient positioning. Standard hospital bed frames typically require a mattress dimension of 36 inches wide by 80 inches long, often called a “twin XL” medical size.
Durability is important, as the mattress must withstand the constant mechanical stresses of articulation and the patient’s weight. Regulatory compliance is mandated, particularly concerning fire safety standards like the California Technical Bulletin 117-2013.
All medical mattresses must be covered in a fluid-resistant material, such as nylon or vinyl, to prevent the absorption of liquids. These covers feature welded or sealed seams, allowing for easy cleaning and disinfection to maintain hygiene standards and extend the life of the mattress core.
Static Support Mattresses
Static support mattresses rely on the inherent properties of their materials, such as density and firmness, to distribute pressure across a greater surface area.
High-Density Foam
High-density foam mattresses are the most common type, offering a cost-effective solution for patients who are generally mobile or require only short-term care. These foams use high indentation force deflection (IFD) ratings to prevent “bottoming out,” ensuring bony prominences do not make direct contact with the bed frame.
Gel-Infused Mattresses
Gel-infused or gel-overlay mattresses integrate viscoelastic gel components into the foam structure. The gel layers help redistribute localized pressure points and draw heat away from the patient’s skin, aiding temperature regulation. This cooling effect can also reduce shear forces by allowing the top layer to move minimally as the bed articulates.
Innerspring Replacement Mattresses
Specialized innerspring replacement mattresses are engineered for medical use, often in residential or sub-acute care. These mattresses contain flexible springs and reinforced perimeters designed to articulate smoothly with the bed frame without causing structural damage. They function well for patients who can independently reposition themselves and are generally comfortable for those at low risk for skin breakdown.
Static support systems are appropriate for individuals who spend less than 15 hours per day in bed and can shift their weight without assistance. They provide foundational comfort and support using material properties to manage pressure, but lack the mechanical intervention required for patients with significant mobility limitations.
Dynamic and Therapeutic Mattress Systems
Dynamic and therapeutic systems are advanced solutions for patients who are immobile or face a high risk of pressure-related injury. These mattresses utilize mechanical power, typically through an external pump unit, to actively change the pressure distribution or the patient’s position. These complex systems require a continuous power source.
Low Air Loss (LAL)
LAL mattresses employ connected air bladders that continuously circulate a small volume of air beneath a vapor-permeable cover. The primary function is to manage the skin’s microclimate by wicking away moisture and maintaining a consistent temperature. This constant airflow minimizes the heat and humidity that can make skin susceptible to friction and shear forces.
Alternating Pressure (AP)
AP systems utilize air cells that cyclically inflate and deflate on a programmed schedule, usually every 5 to 15 minutes. This action systematically shifts the points of contact, relieving pressure from specific anatomical areas over time. The continuous shifting of load helps promote blood flow to tissues that might otherwise be compressed.
Lateral Rotation
Lateral Rotation mattresses mechanically turn the patient up to 40 degrees side-to-side without requiring manual assistance. This turning helps prevent pulmonary complications, such as pneumonia, by facilitating the movement of respiratory secretions. This system is often reserved for critically ill patients who cannot be manually repositioned, offering both pressure relief and respiratory assistance.
Choosing a Mattress Based on Patient Needs
Selecting the appropriate mattress begins with assessing the patient’s mobility level and the anticipated duration of care. Patients who are ambulatory or temporarily confined to bed, such as during post-operative recovery, are well-suited for basic high-density foam mattresses. Conversely, individuals expecting long-term confinement need a more robust, therapeutic solution.
The patient’s risk for developing pressure injuries is a primary determinant, categorized as low, moderate, or high based on factors like sensation and blood flow. High-risk patients, such as those with paralysis, necessitate a dynamic system like alternating pressure or low air loss. Insurance coverage and budget also influence the final choice, as powered systems require a significantly higher investment than static options.