Page 9 of 17    Main Menu   <<Back   Next>>

 

Support Surface Considerations

The client indicates intensity of pain on a 10cm line marked from "no pain" at one end to "pain as bad as it could possibly be" at the other end.

Compiled by L. Norton (2006)

When choosing a support surface for a client, the clinician should consider not only its pressure management characteristics but also:

• The impact on the client (comfort, bed mobility, transfers, functional activities such as dressing in bed, etc.)
• The impact on the caregiver (skill required to properly set up and maintain the device, impact on caregiver burden)
• The environment (Where will the surface be used? Is it compatible with the bed or space within the room?)
• The product (fail safety, need for a power supply, need for specialized linens, etc.)

Category	Clinical considerations in addition to interface pressure
Standard (hospital bed or client’s regular bed at home)	Client does not have to accommodate to a new surface No additional costs incurred
Foam Overlay (4 inch egg-crate or convoluted foam)	May require frequent replacement (who will do this and when?) Deteriorates when exposed to moisture Can be warm
Foam Mattress (replaces the standard hospital mattress)	Can often be adapted with foam or gel in high risk areas May be less expensive than active support surfaces Generally do not impact transfers or bed mobility
Static Flotation (air cells, gel, fluid overlays/mattresses)	May be less expensive than active support surfaces May require less maintenance (gel, fluid) Air mattresses/overlays may require some maintenance
Alternating Air (large air bolsters alternately over-inflate and under-inflate in sequence)	Noise of the pump and movement of the mattress may be disturbing Can decrease bed mobility and make transfers more difficult
Low Air Loss (air constantly escapes through the bladders, reducing surface tension)	Noise of the pump and movement of the mattress may be disturbing Can decrease bed mobility and make transfers more difficult Low air loss mattresses may be better able to manage excessive moisture, but the client's fluid balance should be monitored
Turning/Rotation (assists the client to change position)	Motion of the bed can disrupt sleep Client may not be well positioned after the turn related to position on surface, contractures, etc. Noise, ease of transfers and bed mobility remain issues Client may find the gradual turning on the mattress more comfortable and less disruptive that being turned by caregivers
Air Fluidized (client is “floating” in silicone beads)	Client is unable to transfer/decreased independence with bed mobility Care is more difficult Usually requires a hospital admission

[back to top]

 

Page 9 of 17    Main Menu   <<Back   Next>>