turning in a hospital bed

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mich5

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is there any way a pals can sleep on their side in a hospital bed and have their cals turn them onto their other side two or three times per night?
 

GregK

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Yep.
They make a fancy wedge system for that.

or you can simply use pillows.
 

mich5

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how does your cals turn you over to the other side?
 

GregK

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The wedge system uses a sliding cloth.

Others just grab and pull. Not especially good for the back.
 

lgelb

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Yes, but as a former CALS, sleep was scarce so I would look for other options first.

Depending on your physical capabilities these days, those might include a trapeze or handle(s) attached to the bed frame or side rail, or a more comfortable setup so you could stay on your back or the same side (the right pillow, bed angle and overlay or bolsters all play a role here).

If you opt to try the on-the-back position, the best chance of success is to have a good bed angle for the knees, and to have the hips and feet supported with foam blocks/belt and pressure boots if needed to keep them stable and relieve pressure-causing contact with the bed.

Best,
Laurie
 

GregK

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Do a Google search for Prevalon Turning and Positioning System.
 

lgelb

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Prevalon also makes a commonly-used pressure boot, though floppy legs will need something splint-like added for extra stability.
 

GregK

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... floppy legs will need something splint-like added for extra stability.
My floppy feet are wedged into a pillow
 

wishmobbing

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I'm still not very good at turning my PALS let alone write what the OT tried to teach me. There's good video tutorials on care. Anything with the word "turning in bed" and "kinestetic" could be interesting when doing a YouTube search. Kinesthetic principles have the focus on being comfortable for patient and caregiver, paying attention to how a body and its movement work. All easy in theory, but at 3 a.m. I won't pass as a spokesperson.

Luckily since my PALS got an anti-decubitus mattress (foam) and a dozen positioning pillows (a load of blankets and towels would work just as well) he doesn't need to be turned every 1-4 hours. Sleep deprivation would make for cranky CALS and you'll be better rested, too, if you tweak all the different aspects others already mentioned.

Sweet dreams!
 

KimT

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If you have lots of money you can check out the Freedom Bed by Pro Bed.
 

GregK

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Or for a bit less, the HillRom Progressa bed system with a pulmonary mattress
 

lgelb

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Continuous lateral rotation mattresses are pretty different than changing sides with one push; the steps between positions are much incrementally smaller.

Besides being really expensive, there is no evidence overall that they are superior to other pressure relief surfaces (which can be as low-tech as foam with the right powered bed frame). And most PALS aren't at high pressure injury risk just by being in bed at night. For PALS who are in bed 24/7, of course, the situation would be different, but most aren't, for long lengths of time.

Powered rotation can also be intrusive and disturbing as muscles weaken, atrophy ensues, balance/center of gravity changes and joints weaken. Think of being out in the ocean and continually being buffeted by small waves. All night.

For keeping a PALS comfortable at night, I would look to another solution first, and we have mentioned several. The bottom line is that "hard and soft support" like foam shapes, pillows, bed angles, etc. positioning can be customized and changed as you progress, and updated during the night if/as needed, but a powered mattress doesn't permit that level of fine-tuning.

As for optimizing circulation and reducing pressure ulcer risk, circulation is improved with passive/active range of motion exercises and massage. Moisture management and hygiene also go a long way toward reducing pressure ulcer risk.

I am not saying the CLRT beds don't benefit anyone, but I wouldn't spend a lot of time and money trying to get one as a first-line bed.
 

lgelb

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Greg, I wouldn't keep wedging your feet together into a pillow, a cauldron of heat and moisture, long-term. One alternative to consider is the Prevalon boots tied together through the loops, with a sash or something (to keep the feet at the right distance from each other), with a plastic block or strip attached wherever it needs to be to keep the sole from flopping.
 
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