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Intensive Care


The multicare intensive care bed is not just a bed. On the contrary, it represents a system concept, which facilitates the monitoring of a patient's vital data, simplifies and speeds up procedures in critical moments and ensures comfort and convenience for both patients and nursing staff alike.

General purpose high quality bed with for the Intensive Care, with modern monitoring means.

This bed cannot be (perse) used to transport the patient to and fro to the surgery

The bed can be pre-sterilized before and after the patient use.

Two types of ICU beds are shown: The first type nominated as (I) being futuristic (competition) using three columns, but defining the general bed function areas; the second being a derivative of the actual hospital which has been tried out in practice.

General :

Type (ALRT) :

Lateral Rotational Therapy ALRT:

The ALRT tilt and turn frame ensures a patient can get periods of rotational bed rest, after spinal cord injury. The effect of lateral rotation promotes secretion clearance, the gravity helps chest drainage and reduces the incidence of respiratory complications.

Developed in conjunction with leading multi-disciplinary professionals, the frame can help reduce the incidence of back injury associated with manual handling.

Lateral Rotational Therapy Bed

This tilt and turn frame ensures a patient can get periods of rotational bed rest, after spinal cord injury. The effect of lateral rotation promotes secretion clearance, the gravity helps chest drainage and reduces the incidence of respiratory complications.

Key features at a glance:

* Programmable turning regime. Automated turning to selected angles at selected time intervals

* Auto cradle function provides optimum security whilst the patient is being turned as one third of the bed base simultaneously raises in opposition to the patient support surface during the full turn process.

* Angled side rails – can be positioned for use when the frame is in either standard position or the turning position

* Lateral rotation to a maximum of 45 degrees enables the carer to turn the patient to either side using a single control. A spirit level located on top of the Control Panel indicates degree of turn

* 3 section pressure redistributing mattress assists with weight pressure distribution

* Immobilising switches for electric movement functions ensures patient safety and peace of mind for carer,

Patient benefits / Patient Well-being ALRT:

* The automated rotation reduces the incidence of respiratory complications

* The automated lateral rotation helps in combating the effects of immobility in critically ill immobile patients

* Auto cradle function ensures patient safety is maintained during turns

* Electric / manual CPR ensures nursing staff are able access the patient quickly to perform CPR

* Two way stretch, vapour permeable Dartex cover reduces shear and friction ensuring patient comfort

* Safety features such as ‘manual crank’ and ‘manual backrest release’ ensure bed platform can be positioned in the event of mains power failure

* In order to assist patient safety the Atlas bed frame has an in-built safety system that prevents bed movements that are not safe for the patient

* Battery back-up facility ensures patient safety in case of power failure

Carer benefits / Improving nursing staff efficiency & safety ALRT:

* Eases and simplifies the considerable nursing demands of specialist patient management with its extensive range of programmable movements

* Alarm alerts carer to auto turn failures ensuring peace of mind for carer

* Electric height adjustment minimises manual handling when repositioning a patient

* Electric and manual CPR ensure that a carer is able to flatten the patient surface in case of cardiac arrest

* Fully electric the Atlas facilitates correct positioning of patient in line with nursing practice

* The automated rotation facility means maximum efficiency for otherwise labour intensive routines, whereby patients can be automatically turned to set angles over set time frame.

Technical Specifications ALRT:

Product Specification ALRT:

* Electric tilt and turn bed frame

* Electric variable height

* LED display indicates degrees of left and right turn, degrees per move and minutes between moves

* Programme button, which enables carer to scroll through pre-set turning programmes

* Alarm, which alerts carer to auto turn failures

* Trendelenberg and Reverse Trendelenberg

* Electrical and manual CPR in case of power failure

* Battery back-up in case of power failure

* Three section pressure redistributing mattress

* Two-way stretch, vapour permeable special mattress cover which reduces shear and friction forces on the skin

* Central locking brake system

* Angled side rails

* Immobilising switches for all electric movement functions

* Manual crank for turn in event of power failurem (battery or mains power)

* Auto cradle to support patient during turns

* Available with ‘Auto-Turn’ Module or just ‘Manual Turn’ module

Accessories ALRT:

* Arm rest

* Side rails

* Foot board

* Head board

* Skull traction

* IV pole double hook

* Lower limb traction

* Remote handset.

Use of rotational therapy in the treatment of early acute respiratory distress syndrome (ARDS): A retrospective case report

Goddard R (2005). The World of Critical Care Nursing; 3(3): 82-85

PUBLISHED SUMMARY:

• ‘Rotational therapy could have a significant effect on improving oxygenation’.

• ‘In this case report, oxygenation was vastly improved, weaning from ventilation was facilitated and no complications were noted’.

• ‘Existing research gives no clear guidelines for best practice in the use of rotational therapy’.

• ‘Further larger scale trials are indicated to demonstrate the effectiveness of this therapy’.

OVERVIEW:

Mechanically ventilated patients are commonly left in the supine position for long periods of time and this immobility can lead to numerous circulatory and respiratory complications.This retrospective case study demonstrates a vast improvement in oxygenation through the use of rotational therapy.

CASE REPORT:

• 52 year old woman admitted with abdominal pain and initially diagnosed with gall stone pancreatitis.

• Was transferred to HDU due to decreased oxygen saturation and urinary output.

• Despite the use of non-invasive ventilation, the patient deteriorated with extensive basal consolidation of both lungs and was admitted to ITU with early acute respiratory distress syndrome (ARDS).

• Due to increasing oxygen requirements, fatigue and secretion retention, the patient was intubated.

• The decision was taken to use rotational therapy rather than the standard practice of prone position ventilation, due to its benefits (improved oxygenation and postural drainage), following a significant fall in the patient’s oxygenation levels.

• Rotational therapy began on the second day in ICU and was used over a 91 hour period.

• The Acer mattress replacement system was used as it allowed selection of precise angles of turns, while providing the option to make adjustments at any stage according to the patient’s condition.

• The patient was rotated in an arc at 80°, with 30 minute rest periods in the central supine and extreme lateral rotation positions.

METHODS:

• Changes in oxygenation that took place while the patient was rotating or supine were measured.

• Oxygenation was calculated as a ratio of partial pressure oxygen and the fraction of inspired oxygen needed by the patient

(PaO2 x 7.5)/FiO2 – oxygenation index

FINDINGS:

• During the rotational periods (43.5 hours out of 91) there was a mean increase in the oxygen index calculated, improving from 54.84 to 208.12.

• While in the supine position oxygenation decreased.

• The longer the period of rotation, the greater the improvement.The longer the period in supine, the greater the reduction in oxygenation.

• PaO2 increased from 7.312 Kpa with 100% oxygen to 11.1 Kpa with 40% oxygen, and ventilation was successfully weaned.

• No changes in secretion clearance were highlighted during periods of rotation.

• The patient needed inotropic support to maintain adequate cardio-vascular function and no significant changes were seen during rotational therapy.

• No additional pressure area care was needed.The Acer system provides adjustable, zoned, low air loss pressure reduction during use.

CONCLUSION:

• Rotational therapy provided the following benefits;

– Improved oxygenation.

– Facilitated weaning from mechanical ventilation.

– Alternative to prone position ventilation.

• Clinically significant improvements in the patient’s oxygenation by using lateral rotational therapy have been reported.

• Two periods of uninterrupted rotation overnight gave the greatest improvement in oxygenation, when there are potentially fewer interventions needed for the patient.

• Results add to a growing body of evidence supporting the benefits of ACER rotational therapy (Bein 1998, Staudinger 2001 and Wang et al 2003).

LIMITATIONS OF THE STUDY:

• Focuses on a single patient only.

• Further large scale studies are needed in this clinical area to provide definite conclusions as to the benefits of lateral rotation for mechanically ventilated patients.

Clinically significant improvements have been reported in a patient’s oxygenation using the ACER system.

For more detailed information on the study, please refer to the full reference, which can be viewed at www.connectpublishing.com

References:

1. Bein T, Reber A, Metz C, Jauch K W and Hedenstierna G (1998) Acute effects of continuous rotational therapy on ventilation-perfusion inequality in lung injury. Intensive Care Medicine; 24(2): 132-137.

2. Staudinger T, Kofler J, Mullner M, Locker G J, Laczika K, Knapp S, Losert H and Frass M (2001) Comparison of prone positioning and continuous rotation of patients with ARDS: results of a pilot study. Critical Care Medicine; 29(1): 51-56.

3. Wang J Y, Chang P Y, Lin C J,Yu C j and Yang P C (2003) Continuous lateral rotation therapy in the medical intensive care unit. Journal of the Formosan Medical Association; 102(11), 788-792.

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