1-2
Contraindications for Percussion Therapy:
• Multiple rib fractures
• Persistent intracranial hypertension
• Bronchospasm
• Post-operative periods following cardiac surgery
Risks and Precautions
Side Rails / Patient Restraints -
Whether and how to use side rails or restraints is a decision that should
be based on each patient’s needs and should be made by the patient and the patient’s family, physician and
caregivers, with facility protocols in mind. Caregivers should assess risks and benefits of side rail / restraint
use (including entrapment and patient falls from bed) in conjunction with individual patient needs, and
should discuss use or non-use with patient and / or family. Consider not only the clinical and other needs of
the patient but also the risks of fatal or serious injury from falling out of bed and from patient entrapment
in or around the side rails, restraints or other accessories. In the US, for a description of entrapment hazards,
vulnerable patient profile and guidance to further reduce entrapment risks, refer to FDA’s Hospital Bed System
Dimensional and Assessment Guidance To Reduce Entrapment. Outside the US, consult the local Competent
Authority or Government Agency for Medical Device Safety for specific local guidance. Consult a caregiver
and carefully consider the use of bolsters, positioning aids or floor pads, especially with confused, restless or
agitated patients. It is recommended that side rails (if used) be locked in the full upright position when the
patient is unattended. Make sure a capable patient knows how to get out of bed safely (and, if necessary,
how to release the side rails) in case of fire or other emergency. Monitor patients frequently to guard against
patient entrapment.
It is recommended that electrically operated beds conform to IEC 60601-2-38. Medical Electrical Equipment
Part 2: particular requirements for the safety of electrically operated hospital beds.
When selecting a standard mattress, ensure the distance between top of side rails (if used) and top
of mattress (without compression) is at least 8.66 in (220 mm) to help prevent inadvertent bed exit or
falls. Consider individual patient size, position (relative to the top of the side rail) and patient condition
in assessing fall risk
.
Side rails must be in the full upright and locked position before bed rotation.
Patient Migration -
Specialty surfaces have different shear and support characteristics than conventional
surfaces and may increase the risk of patient movement, sinking and / or migration into hazardous
positions of entrapment and / or inadvertent bed exit. Monitor patients frequently to guard against patient
entrapment.
Percussion -
Chest physiotherapy should be used with precaution in patients without sputum production.
Adjust duration and intensity of percussion depending upon patient’s condition and response to therapy.
Skeletal Traction or Unstable Fracture (if not contraindicated) -
With skeletal traction, unstable pelvic
fracture or any other unstable fracture (to the extent not contraindicated), maintain physician directed angle
of articulation and guard against risks of patient migration or inadvertent deflation of surface.
Electromagnetic Interference -
Although this equipment conforms with the intent of the directive 89 /
336 / EEC in relation to electromagnetic compatibility, all electrical equipment may produce interference. If
interference is suspected, move equipment away from sensitive devices or contact the manufacturer.
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