Tuesday, 19 January 2010

ROTATION BEDS

Because of their constant motion, rotation beds—such as the Roto Rest—promote postural drainage and peristalsis and help prevent the complications of immobility. These beds rotate from side to side in a cradlelike motion, achieving a maximum elevation of 62 degrees and full side-to-side turning approximately every 4½ minutes.
Because the bed holds the patient motionless, it's especially helpful for patients with spinal cord injury, multiple trauma, stroke, multiple sclerosis, coma, severe burns, hypostatic pneumonia, atelectasis, or other unilateral lung involvement causing poor ventilation and perfusion.
Rotation beds such as the Roto Rest bed can accommodate cervical traction devices and tongs. One type of Roto Rest bed has an access hatch underneath for the perineal area; another type has access hatches for the perineal, cervical, and thoracic areas. Both have arm and leg hatches that fold down to allow range-of-motion (ROM) exercises. Other features include variable angles of rotation, a fan, access for X-rays, and supports and clips for chest tubes, catheters, and drains. Racks beneath the bed hold X-ray plates in place for chest and spinal films. (See Roto Rest bed.)
Rotation beds are contraindicated for the patient who has severe claustrophobia or who has an unstable cervical fracture without neurologic deficit and the complications of immobility. Patient transfer and positioning on the bed should be performed by at least two persons to ensure the patient's safety.
The instructions given below apply to the Roto Rest bed.
Equipment
Rotation bed with appropriate accessories • pillowcases or linen-saver pads • flat sheet or padding.
Preparation of equipment
When using the Roto Rest bed, carefully inspect the bed and run it through a complete cycle in both automatic and manual modes to ensure that it's working properly. If you're using the Mark I model, check the tightness of the set screws at the head of the bed.
To prepare the bed for the patient, remove the counterbalance weights from the keel and place them in the base frame's storage area. Release the connecting arm by pulling down on the cam handle and depressing the lower side of the footboard. Next, lock the table in the horizontal position, and place all side supports in the extreme lateral position by loosening the cam handles on the underside of the table. Slide the supports off the bed. Note that all supports and packs are labeled RIGHT or LEFT on the bottom to facilitate reassembly.
Remove the knee packs by depressing the snap button and rotating and pulling the packs from the tube. Then remove the abductor packs (the Mark III model has only one) by depressing and sliding them toward the head of the bed. Next, loosen the foot and knee assemblies by lifting the cam handle at its base, and slide them to the foot of the bed. Finally, loosen the shoulder clamp assembly and knobs; swing the shoulder clamps to the vertical position and retighten them.
If you're using the Mark I model, remove the cervical, thoracic, and perineal packs. Cover them with pillowcases or linen-saver pads, smooth all wrinkles, and replace the packs. If you're using the Mark III model, remove the perineal pack, cover, and replace. Cover the upper half of the bed, which is a solid unit, with padding or a sheet. Install new disposable foam cushions for the patient's head, shoulders, and feet.