Numerous reports of death caused by strangulation or suffocation involve hospital beds, and many of these deaths go unreported.
Some side rails extend the full length of the bed; others, called half rails, are about 2-1/2 feet long. Most can be raised or lowered and may be metal or plastic. Because side rails are divided vertically or horizontally with slats spaced about six or more inches apart, an elderly person’s head can get trapped, causing him or her to strangle. Particularly thin, frail people may even squeeze between the rails and fall to the floor. A resident may be suffocated if a mattress fits too loosely within the frame and leaves a gap large enough to trap his or her head between the mattress and side rail.
Pressure ulcers (Bed Sores)
Pressure ulcers are also referred to as pressure sores, bedsores or decubitus ulcers. A pressure sore is caused by unrelieved skin pressure that damages the underlying tissue. A pressure sore can also result from friction caused by rubbing against something such as a bed sheet. The resulting injury may range from very mild, pink discoloration of the skin that disappears a few hours after the pressure is relieved to deep wound damage extending to bone. Pressure ulcers are typically on the tailbone, hips, heels, shoulders and inside/outside of the knees or ankles. They can also develop on the legs, arms and ears. Without proper attention to nutrition, hydration, turning and re-positioning, physician-ordered care, treatments, and possible surgical intervention, pressure ulcers will not heal.
The levels of pressure ulcer severity are graded from Stage I to Stage IV:
- Stage I: An intact, reddened area of the skin that stays red for more than 30 minutes after the pressure has been relieved. The area may be hard and warm to the touch.
- Stage II: A partial loss of skin layers involving the upper layer but not the deeper layers of skin. This damage may appear as an abrasion, blister or shallow hole.
- Stage III: Deeper tissue damage to the muscle that may include necrotic tissue (blackened, dead tissue), drainage or infection.
- Stage IV: Deep tissue destruction that may go through muscle to the bone and can look like a deep crater. Stage IV may also include necrotic tissue (blackened, dead tissue), drainage or infection.
Pressure ulcers may indicate nursing home neglect. While small wounds may develop even in the most reputable nursing homes, these wounds will heal and should not develop into severe wounds if given immediate attention. According to federal law, in most situations, there is no medically valid reason for a pressure ulcer to progress to Stage IV.