Trouble with Sentry 1400 Low Air Loss/ Alternating Air Mattress

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Katalin

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Hi all, hoping someone can help with our problems with the alternating air mattress. Just had this delivered from the ALS closet on Thursday. First two nights, she finally slept till 5am, instead of 2am. That was good. Last night she slept badly. But the rest of it is a disaster. She is so miserable. One of the cells sits proud of the rest of the cells, right at the fold of her butt. I'm assuming it's proud because it's supposed to stop the patient from slipping down toward the foot of the bed. If we bring her higher in the bed, it's digging into the the area *below* the butt. Lower, and her mid-section is collapsing. Because she's generally always collapsing in the midsection, she's still having trouble passing gas (we're trying abdominal massage today), but she feels the gas-x is pushing gas toward her intestines and she can't pass it. And she's having passing urine in her brief since we got this mattress.

If we lower the pressure, she feels like she's bottoming out, and if we raise it, the dreaded ridge digs into her butt even more. We've got her on float, because if we use the alternating feature, the ridge really digs in when that zone is inflating. And the cherry on top is I have no real idea what she weighs. She's definitely flailing and miserable and uncomfortable. Any suggestions out there?
 

affected

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I wonder if you need to find out if this is how it should be or if there is a problem with the mattress?

We used an alternating air mattress and there was no proud cells at all - that seems like a feature that would totally defeat the purpose of the mattress. It must be so frustrating after those 2 great sleeps to start with!

Is she using a hospital bed?
 

Katalin

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Hi Tillie, thanks. Yes she has a hospital bed. So frustrated and upset on her behalf. There's a 36 page manual for this bed. Nothing explains this proud cell. No photos online seem to show it. It's like the ridge that runs the perimeter of the bed, which is to prevent the patient from rolling out...except we don't have the perimeter inflated, and even that's still somewhat raised. Can't find any reference online to other people having problems like this. I may try to temporarily lay some foam down on either end of the proud cell, which runs the width of the mattress. I'll be calling the closet first thing in the morning. Hoping others may have some advice.
 

Nikki J

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I was just reading through the product manual. Agree the answer isn’t there but I would try 2 things if you haven’t already. Change the weight setting since I gather only a guess? Maybe put it a little lighter first though not sure which way to go. Try fowler mode. Not sure either would help but worth a try since it is Sunday.
 

Katalin

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Thanks Nikki, I did try Fowler mode (good for sitting upright, puts more pressure under butt and back I'm assuming), and it didn't help, and have tried weight up and down, with breaks in between. Cell is still digging into Mum. I think Tillie may be right. It must be defective.
 

Katalin

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All right. So we just got back from putting some egg-crate shaped foam inside the mattress cover, from head to toe. It'll be okay for now...she's relatively comfortable. Argh! So what I can see is that there are two zones to that mattress, and the larger side to side cells are for the butt to toes area. Then the other zone is for butt to head area, and those cells are narrower. It occurs to me RIGHT NOW that my little mother is always asking to be hoiked high up in the bed. That means that her butt was always higher up the bed than it should be and that would be why she was sitting halfway onto where the transition point was, so she'd feel the difference between the two zone. So really, I assume that her butt should be FULLY on the big cells, and the upright section with the smaller cells should be going up the small of her back. Sometimes her head is within about 6" of the top of the bed. Really, her position on the bed should be dictated by her butt, not her head. But then her feet, because they flop forward, would be very close to the end of the mattress. She's about 5' 4" . My mother didn't come with an owner's manual. Am I out to lunch here?? If she knew I was discussing her butt *so frankly* with strangers, I think she'd be a little perturbed. :) My brain hurts.
 

Nikki J

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I think you are right. I did see a reference in searching for the manual about something at the level of the thorax. I can’t remember the description but wondered if it was what you noted.
 

Katalin

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Thorax??? Yikes. Thank goodness for google. I'm going to be boning up on my anatomy, no pun intended. I only know about the thorax in terms of insects. Grade 3. :)
 

Katalin

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Okay, Nikki, so the manual also says this. I thought Fowler's position was bolt upright, but it's just an incline, which is helping her with breathing at this point. So I need to set the Fowler Boost setting. Maybe that will help. Checked the manual again and don't find the word thorax. They never mention where the patient should be sitting! But I think getting her butt fully on the big cells will help. Will do that before we call in the ALS closet calvary.

FOWLER BOOST (All ST Systems)
This key activates or deactivates the FOWLER BOOST (FB) mode. When
activated, FB is shown on the display and the set pressure in the mattress
is automatically increased by a set percentage. It is not available when the
system is in Maximum Inflate mode. The percentage of increase may be
modified by going to ADVANCED SETTINGS.
This feature helps prevent a patient from “bottoming out” when he or she is
put into an inclined or “Fowler” position.


She complains she feels like she's bottoming out or "sitting in a hole".

Fowler's position
Description In medicine, Fowler's position is a standard patient position in which the patient is seated in a semi-upright sitting position and may have knees either bent or straight. It is an intervention used to promote oxygenation via maximum chest expansion and is implemented during events of respiratory distress. Wikipedia
 

Nikki J

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The reference wasn’t in the manual. I saw it elsewhere but sounds like you have a good plan!
 

affected

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Does your bed allow you to adjust so that you raise the area under her knees? This normally stops the PALS from sliding slowly down the bed when they are sitting up.
 

Katalin

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Thanks, Tillie, yes, it does rise under her knees. We always put the legs up before raising the head end to keep her from slipping down. I just think we've got the height of her head too high, and something wrong about the pressure. In which case she'll always be slipping down. I feel like I'm torturing the poor little mother, but we'll try to experiment tomorrow when she has a bit of energy again. We have to get to the bottom of this, so to speak.

Let you know tomorrow morning if the egg crate foam worked. I know it's the WRONG thing to do to this kind of mattress.
 

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Definitely get to the bottom of it and every pun can be a lifesaver in these situations! Fingers crossed for you and mum :lol:
 

Katalin

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Hi all, just an update: the nice OT sent a request this morning for a different mattress to the ALS equipment closet. This one has larger cells running the length of mattress, with a foam overlay. It is not alternating air, (a feature Mum couldn't tolerate in any case), but does have have air circulation coming up from below. Ironic, it's rather like what we cobbled together yesterday with the foam. It's a Pressure Guard CFT mattress, and I have high hopes for it. When I was a little girl, my favourite fairy tale was "The Princess and the Pea". I guess maybe I inherited that tendency from my Mum. Thanks all for suggestions. I'll check back and let you know how that works.
 

Katalin

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Another update, another question. In the Goldlilocks world of my mother's mattress, the new mattress with the longitudinal cells and the thicker foam overlay is working beautifully, and she's finally comfortable, tending not to slip down as often. We also know there are the alternating air mattress that sort of also blow air up through the top surface, but they're out of the question now she's comfortable---trying 5 mattresses was enough for her. Now the new trouble is she's building up a fair bit of moisture under her body as it lays on the mattress. Currently, just have a fitted sheet on top of the waterproof cover of the mattress. I don't want to unnecessarily layer up bedding to prevent chance of wrinkling and causing pressure ulcers. However, what do you all think of sheepskin overlays to absorb or prevent moisture build-up, and how do you deal with them if they get soiled? I don't want to start with the chuck pads again if I can help it. Currently we place a towel under her to catch any drips while changing briefs, and then remove it when we're done, and that is working. Any other suggestions, I'd appreciate it.

Kathy
 
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