Hospital Bed Safety, Gap Protection, Seizure Pads, Bed Bumpers

What Causes Bed Entrapment?

While rails on a hospital bed can often be utilized to help prevent a patient from trying to exit the bed
without assistance, sometimes rails can also be the cause of a patient becoming entrapped by getting body
parts caught in these rails. Unless they are specifically designed to reduce entrapment, bed rails should be
enhanced with pads or protectors to eliminate the risks involved with a patient potentially getting stuck in
them.

While any patient poses a risk for entrapment, this most often happens with the elderly or with individuals
who are experiencing physical weakness, delerium, confusion, agitation or pain. Gap protection is
medically necessary for both children and adults who have a medical condition or disease that places them
at higher risk of injury, or who are more susceptible to harm from exiting the bed without assistance. These
conditions may include cognitive impairment, the inability to communicate, dementia, seizure disorders,
traumatic brain injury, neurological disorders that cause vertigo or disorientation, cerebral palsy and
uncontrolled perpetual movement.

The 7 Zones of Bed Entrapment and Suggested Solutions

These are the 7 zones of bed entrapment provided by the FDA, along with their dimensional
recommendations for zones 1 through 4 as 80% of reported entrapment cases have occurred in these four
zones. We have also provided some suggestions for each zone to help reduce the risk for entrapment in
each of these areas of the bed.

Zone 1, Within the Rail
Any open space more than 4 3/4" between the perimeters of the rail can present a risk of head entrapment.
Vinyl bed rail pads and/or mesh side rail protectors can be employed to lessen the risk of potential
entrapment in this zone.

Zone 2, Under the Rail, Between the Rail Supports or Next to a Single Rail Support
If the gap under the rail between the mattress is more than 4 3/4" this can cause dangerous head
entrapment.
Bed rail pads and safety systems that include wedges and positioning devices to close gaps and provide
extra cushioning can be utilized to diminish entrapment risks in this zone.

Zone 3, Between the Rail and the Mattress
If the space between the inside surface of the bed rail and the mattress is larger than 4 3/4", this can pose a
risk of head entrapment.
Gap guards can help fill the gaps between the mattress and side rails, while roll control bolsters can be
positioned comfortably around patients to keep them from rolling near the sides of the bed.

Zone 4, Under the Rail at the Ends of the Rail
If the gap between the mattress and the lowermost portion of the rail is more than 2 3/8", this can pose a
risk of neck entrapment.
Side bolsters can be placed around patients to stop them from rolling near the bed sides, while bed rail
pads could be utilized to fit snugly over the rails to cover gaps.

Zone 5, Between Split Bed Rails
The space between the rails may present a risk of neck or chest entrapment when partial length head and
split rails are used on the same side of the bed.
Bed rail wedge pads and full-length bed rail bumpers add a padded layer between patients and the sides of
the bed, with both choices covering the bed rails.

Zone 6, Between the End of the Rail and the Side Edge of the Head or Foot Board
A gap between the end of the bed rail and the side edge of the headboard or footboard can present the risk
of resident entrapment.
Adding a padded layer between the patient and the sides of the bed with horseshoe wedges and bed rail
wedge pads will help reduce the risk of entrapment in this zone.

Zone 7, Between the Head or Foot Board and the End of the Mattress
When the space is too large between the inside surface of the headboard or footboard and the end of the
mattress, there is an increased risk of entrapment.
Mattress safety straps and mattress extenders can help fill the gaps with additional material and help to
keep the mattress firmly in place.

Rehabmart is pleased to offer a vast array of superior quality gap protection for hospital bed safety from 
such renowned manufacturers as Posey, DeRoyal, Independence Medical, Skil-Care, Drive Medical, 
McKesson Medical Surgical and many more.

Hulet Smith, OT
Rehabmart Team Leader & CEO

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