For patients with a pressure ulcer or at-risk for pressure ulcer, a pressure redistributing bed surface is recommended.   Many foam-based beds now offer some level of pressure redistribution.  However, it is recommended that you check with your individual bed vendor for specifics.

Pressure redistribution bed surfaces are an adjunct therapy.  Even when a specialty bed is in use, frequent repositioning is crucial to redistribute the patient’s weight away from high pressure areas.  Patients with a pressure ulcer or those who are at risk for pressure ulcer formation should be repositioned every 1-2 hours regardless of the surface they are on.

Low Air Loss Beds

Low air loss beds, also referred to as air mattresses, offer a higher level of pressure redistribution.  These beds can have either static air or dynamic (air that moves the patient).  CMS requires that patients meet specific criteria for a low air bed in the post-acute setting.

Consider a low air loss bed surface for the following patients:

  • The patient has a risk assessment (Braden) score of 12 or less, which signifies a high risk patient.
  • Repositioning is complicated by contractures, extensive skin breakdown, or excessive weight.
  • There are wounds on 2 or more turning surfaces of the TRUNK.
  • There are Stage 3, Stage 4, Deep Tissue Injury, or Unstageable wounds of the TRUNK.
  • The patient has contractures that complicate repositioning.
  • The patient has multiple Stage 2 wounds on bony prominences.
  • The patient is a paraplegic or quadriplegic and is not able to be repositioned.
  • The patient’s yeast rashes are severe enough to result in skin breakdown.
  • Patients is obese (Consider a bariatric bed surface).

For all low air loss or air fluidized beds it is imperative to manage microclimate under the patient. This aims to decrease moisture and heat on the skin and assists with maintaining skin integrity. The use of minimal linens is recommended on these surfaces because they hinder impede effective microclimate management

An appropriate, fluid-wicking, and breathable pad should be used on low air loss, air-fluidized, or other specialty support surfaces.  A flat sheet may be used when heavy soiling is expected.

Specialty Bed Resources