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Bed and Rail Combinations Care should be taken when using hybrid mattress or mattress overlays, as these may raise the resting height of the patient in relation to the top rail. This distance should be checked to ensure it is in line with the BS EN 60601-2-25 or BS EN 50637 standards stated previously.
the rail is suitable for the bed and mattress. the mattress fits snugly between the rails. the rail is correctly fitted, secure, regularly inspected and maintained.
This means that when a mattress is placed on the bed platform the top of the mattress must be at least 220mm from the top of the side rails, as illustrated in the image below: The regulations also state that the gap between side rails must be smaller than 120mm.
Entrapment can happen between the end of the bed rail and the headboard if the gap is inappropriate. Avoid gaps over 60 mm which could be enough to cause neck entrapment.
If the space between the inside surface of the bed rail and the mattress is too big, it can cause a risk of head entrapment. The FDA recommended space is less than four and three quarters of an inch (4-3/4). Stander bed rails include a safety strap that holds the bed rail against the side of the mattress.
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A gap between the mattress and the lowermost portion of the rail poses a risk of neck entrapment. The FDA recommended space is less than two and three eights of an inch (2-38). Also, the bed rail such that the angle at the end of the bed rail relative to the top of a mattress is greater than 60 degrees.
Nursing staff should review decisions about bed rails whenever an in- patients condition or wishes change, but as a minimum review this every 24 hours and ensure regular cleaning and safety checks of rails/ bumpers.
It is vital to leave a proper gap between the mattress and the bed frame. This gap should not be too large to prevent the mattress from shifting, nor should it be too small to prevent ventilation and cleaning. Generally, this gap should be between 1 and 2 inches.

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