Rotation Beds
Rotation beds—such as the Roto Rest—promote postural drainage and peristalsis and help prevent complications of immobility and ventilator—associated pneumonia.1,2,3 Because these beds hold the patient motionless, they’re especially helpful for patients with spinal cord injury, multiple trauma, stroke, multiple sclerosis, coma, severe burns, hypostatic pneumonia, atelectasis, or other unilateral lung involvement causing poor ventilation and perfusion.
Rotation beds turn in an arc up to 90 degrees and can be set to pause on either side for up to 30 minutes. They can accommodate cervical traction devices and tongs. Arm and leg hatches on the bed fold down to allow for range-of-motion (ROM) exercises. Other bed features include a fan, access for X-rays, and supports and clips for chest tubes, catheters, and drains. Racks beneath the bed hold X-ray plates in place for chest and spinal films. (See Understanding the Roto Rest bed.)
Rotation beds are contraindicated for pregnant patients and patients who have severe claustrophobia, an open chest, an unstable pelvis, or an unstable cervical fracture without neurologic deficit and the complications of immobility. Patient transfer and positioning on the bed should be performed by at least two people to ensure the patient’s safety.
The instructions given below apply to the Roto Rest bed.
Equipment
Rotation bed with appropriate accessories ▪ pillowcases or linen-saver pads ▪ flat sheet or padding ▪ gloves.
Preparation of Equipment
When using the Roto Rest bed, carefully inspect the bed and run it through a complete cycle in both automatic and manual modes to ensure that it’s working properly. Check the tightness of the set screws at the head of the bed if applicable for that model.
To prepare the bed for the patient, remove the counterbalance weights from the keel and place them in the base frame’s storage area. Release the connecting arm by pulling down on the cam handle and depressing the lower side of the footboard. Next, lock the table in the horizontal position, and place all side supports in the extreme lateral position by loosening the cam handles on the underside of the table. Slide the supports off the bed. Note that all supports and packs are labeled “right” or “left” on the bottom to facilitate reassembly.
Remove the knee packs by depressing the snap button and rotating and pulling the packs from the tube. Then remove the abductor packs by depressing and sliding them toward the head of the bed. Next, loosen the foot and knee assemblies by lifting the cam handle at its base, and slide them to the foot of the bed. Finally, loosen the shoulder clamp assembly and knobs; swing the shoulder clamps to the vertical position and retighten them.
If applicable for the bed model, remove the cervical, thoracic, and perineal packs. Cover them with pillowcases or linen-saver pads, smooth all wrinkles, and replace the packs. Cover the upper half of the bed, which is a solid unit, with padding or a sheet. Install new disposable foam cushions for the patient’s head, shoulders, and feet.
Implementation
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.7
If possible, show the patient the bed before use. Explain and demonstrate its operation and reassure the patient that the bed will hold him securely. Answer all questions to decrease anxiety and increase cooperation.
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