Some people are at a high-risk for entrapment, falls or other injury from adult portable bed rails. High-risk people include those with pre-existing conditions such as confusion, restlessness, lack of muscle control, or a combination of these factors. Additionally, people who are cognitively impaired from the use of medication or from a medical condition, such as Alzheimer's or dementia, Parkinson's disease, Multiple Sclerosis (MS), balance disorders, stroke, or low blood pressure (hypotension), are at a higher risk of entrapment and injury.
- Consider other alternatives when bed rails are not appropriate. Alternatives include roll guards, foam bumpers, lowering the bed as near to the floor as possible, using concave mattresses that can help reduce rolling off the bed, or a bed trapeze to help reposition while in bed and to get in and out of bed.
- Adult portable bed rails should not be used as a substitute for proper monitoring, especially for people at high risk for entrapment and falls.
- If your loved one is in a long-term care facility, make sure that a comprehensive assessment and care plan is in place before using bed rails (see information under Recommendations for Health Care Providers).
The FDA recommends the following actions to prevent deaths and injuries from entrapment and falls from adult portable bed rails:
Before you install bed rails:
- Check whether the adult portable bed rails you are using comply with ASTM F3186-17: Standard Specification for Adult Portable Bed Rails and Related Products. This FDA-recognized international consensus standard establishes performance criteria for adult portable bed rails including resistance to entrapment.
- Be aware that not all bed rails, mattresses, and bed frames are interchangeable and not all bed rails fit all size beds.
- Check with the manufacturers to make sure the bed rails, mattress, and bed frame are compatible, since most bed rails and mattresses are purchased separately from the bed frame.
- Rails should be selected and placed to discourage climbing over rails to get in and out of bed, which could lead to falls.
When installing and using bed rails:
- Confirm that the age, size, and weight of the person using the bed rails are appropriate for the bed rails used.
- Install bed rails using the manufacturer's instructions to ensure a proper fit.
- Ensure that the safety strap or bed rail retention system is permanently attached to the rail and secured to the bed frame according to the manufacturer's instructions.
- Regularly inspect the mattress and bed rails for gaps and areas of possible entrapment. Regardless of mattress width, length, and depth, the bed frame, bed rail and mattress should leave no gap wide enough to entrap a patient's head or body.
- Use caution when using bed rails with a soft mattress as this may increase risk of entrapment between the mattress and bed rail.
- Be aware that gaps can be created by movement or compression of the mattress which may be caused by patient weight, patient movement or bed position, or by using a specialty mattress, such as an air mattress, mattress pad or waterbed.
- Check bed rails regularly to make sure they are still installed correctly as rails may shift or loosen over time.
- When in doubt, call the manufacturer of the bed rails for assistance.