TotalCare sport beds.

Nurses General Nursing

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Specializes in ICU/Critical Care.

I work in ICU and we sometimes have these Totalsport beds that do rotation therapy and also percussion and vibration for patients who need pulmonary toileting. I'm doing this online education for work and it says when patients are on rotation, we are not suppose to use pillows. My question is, even though the patient is using rotation, isn't the rotation just for the lungs and not for relieving pressure off of the patient's bottom.

Specializes in Neuro ICU and Med Surg.

It does automatically reduce pressure. The pt is on right side for a set time center for a set time and left for a set time so the pt is constantly rotating.

Specializes in ICU/Critical Care.

Ok, I wasn't sure. We were talking about it the other day and I thought we still had to use a pillow to relieve the pressure on the patient's bottom.

Specializes in Critical care.

I was also under the impression that a pillow was still needed with q2h turns. A Hill-Rom rep said no, but then our hospital wound care nurses still recommend manually turning q2h even while in rotation mode. The rep said that the air shifts underneath the pt while on rotation so the pressure is relieved. It's confusing. I've seen people still get breakdown while on rotation and no pillows, and people still breakdown using pillows and rotation. I think there are a lot of other factors that go into preventing breakdown, such as nutrition, skin moisture/incontinence care, etc.

Specializes in ICU/Critical Care.

I agree.

I use those beds too. We all still turn our patients every 2 hours. The rotation and percussion modules are underutilized sometimes.

Specializes in ICU.

I will agree with the above posters. They only rotate the upper torso, and I ALWAYS still turn my patients off of their bottoms Q 2 hours even if they're on rotation.

Specializes in Critical care.

Another benefit of going in q2h to turn is you can make sure the patient isn't lying on top of a device. Sometimes patients wriggle around and end up with the Foley tubing or monitor lines underneath them, once I found a syringe cap buried under a patient's back.

There will always be that 90 lb lady on 20 mcgs of norepi who will get a breakdown that just can't be prevented but someone who gets a pressure ulcer from a device is not really excusable. Once I cared for a patient on IABP post OHS who hadn't been turned in over 16 hours. They had the EKG leads for the balloon pump on her back, so she laid on top of them all night. She had Stage I pressure ulcers in the shape of the lead wires all across her back. Of course she was happy she lived through the ordeal, but that breakdown could've been prevented.

I have done extensive study on the total care Sport bed and we use them in our ICU. They are UNDERUTILIZED, but can be very beneficial in preventing and treating pneumonia. THEY DO NOT prevent pressure ulcers. In fact, if rotation is being used aggressively (which is the most beneficial) it causes friction and sheer. There IS however, a pressure relief surface.

I love the Total Care Sport and if you are interested, I will send you my literature reivew on the topic.l

Specializes in ICU/Critical Care.

Yeah, that would be great. I usually just manually turn my patients and put the bed on Opt-rest.

When we started using these beds, we were initially told that they would prevent pressure ulcers if we used the rotation mode. However, we still experienced problems and went back to the rep. Then we were told they do not prevent the ulcers, and that any rotation less than something like 80 degrees was not beneficial..and that the timing needed to be almost constant. (not on one side for more than a minute or something ridiculous) Then to top it off, that we should have been using pillows.

If you stand at the foot of the bed and watch the turn rotation you can tell if it is turning adequately. Most times the pillows are necessary at least for the coccyx area. Good beds for pulmonary therapy, not so great on the skin issues.

Specializes in ICU/Critical Care.

Thats what I thought. How about the Opti-rest option. I put that on when I place my patient on their back. Does the opti-rest make the bed more of an air mattress?

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