Frequently requested information on:
- Mattresses - Dynamic Mattress, Premier Active MattressRepose Mattress
- Palliative Patients and Mattresses
- Chairs, Riser Recliner Chair & Cushions
- Cushions
- Mattresses
Dynamic Mattress
Braden score –high (10-12) to sever (<9)
High risk up to category 4 pressure damage
There are many different dynamic mattresses available and all work on the same principle. The mattresses are made up of a number of cells that make up the whole length of the mattress. Dependent on the manufacturer there may be slight variations in the number of cells that inflate/deflate at any one time. E.g. Nimbus 3 mattress is a 1 in 2 cell system i.e. A/B/A/B – all A cells are inflated while the B cells are deflated then they change over and all the B cells inflate and the A cell deflate.Cycle time can also vary between manufacturers.
The dynamic mattress in the catalogue is the Talley Quattro PlusTheTalley Quattro plus is a 1 in 4 cell system i.e. A/B/C/D/A/B/C/D- all A cells are deflated while B/C/D are inflated, and so forth. As 3 cells are inflated at any one time it gives the patient more support than a 2 cell alternating mattress.
Premier Active Mattress
Braden score Moderate (13-14) to high (10-12)
High risk up to category 2 pressure damage
The Premier Active is a Hybrid mattress. The same foam is used as our base mattress the Premier Glide. Inside the foam is a dynamic core of air cells that work at a higher pressure than dynamic mattresses i.e. the Talley Quattro etc. The patient will lie directly on top of castellated foam that is the top part of mattress. Some patients may find that they are able to move themselves more easily on this mattress than on a Reposeor dynamic mattress as it provides a firmer surface, particularlythose that need to be able to self transfer with a transfer board.
In case of power cuts or with the pump turned off this mattress is the same as a Premier Glide i.e. for high risk and no pressure damage
Repose Mattress
Braden score moderate (13-14) to high risk (10-12)
High risk up to category 2 pressure damage
The Repose mattress is for high risk and up to category 2 pressure damage. It is a single cell unit.The patient is slightly submerged into the mattress. It is this slight submergenceby increasing the surface area that the body is in contact with, that reduces the pressures exerted on the body.By wriggling the patient essentially knocks the air around in the mattress and so any movement a patient can do themselves will help with pressure area care.However, Frontier advises that movement on the Repose mattress isn’t vital.
- Palliative Patients and Mattresses
Palliative patients with significant weight loss or with cachexia may find mattresses like the Nimbus or Talley Quattro Plus uncomfortable as they are lying directly onto the air cells.Although the dynamic mattresses have comfort settings the movement of the mattress may also be a bit disconcerting. When making your clinical decision it is important to note that an alternating dynamic mattress takes between 15 and 20 minutes to inflate which logistically may be difficult.
Considerations;
- Can you move this person?
- How will we move this person onto the mattress?
The Premier Active has had positive feedback for palliative patient’s now receiving care primarily for comfort purposes. The premier active improves comfort by ensuring that the patient lies on the castellated foam that is the top part of mattress.
The Premier active is for high risk and up to category 2 pressure damage. It may not always prevent pressure damage developing for the dying patient as the skin is an organ and it too will begin to fail in End of Life - see SCALE doc.
It is important to reflect the care provided in the patient’s care plan to acknowledge the complexities of End of Life care and the options explored to reduce the likelihood of pressure damage occurring.
- Chairs, Riser recliner chairs and cushions
The issue with any chair and particularly riser recliner chairs when cushions are added to them is that they change the ergonomics of the chair. A chair that fitteda person well before the cushion was supplied may now potentially be too high. This will increase the risk of shearing sacral pressure damage and also pressure damage on the heels as the person braces themselves into the chair trying not to slip out.
The height of the cushion takesaway from the height of the arm rests. Decreasing this height (from seating base to arm rest) may in turn affect how the person is able to transfer making them more dependent on others. This may also decrease the person’s stability when sitting.
The additional risk to the patient with a riser recliner chair is primarily the rise function. At the point when the patient is moving to leave the chair there is a risk that the cushion will slip, potentially causing the patient tofall. It is imperative that the clinician completes a comprehensive risk assessment and documents this clearly in the patient’s notes as to the use of a pressure relieving cushion in a riser recliner chair.
- Cushions
Essentials cushion
Braden score mild risk (15-18)
No pressure damage
Weight limit 17stone/ 108Kg
Dimensions 17”x17”x3”
The Essentials cushion is suitable for those at risk of developing pressure damage but who have no current pressure damage. This is a foam cushion made from the same high density foam as the premier glide mattress.
Repose cushion
Braden score moderate to high risk (10-14)
Up to category2 pressure damage
Weight limit 20st/127kg
Dimensions 450mm x 450mm x Depth: 51mm (17.75” x17.75” x 2")
The repose cushion is a single cell static air cushion. The person submerges slightly into the cushion increasing surface area thereby reducing pressure.
By wriggling the patient essentially knocks the air around and any movement a patient can do themselves will help with pressure area care. However Frontier advise that movement on the Repose cushion isn’t vital.
Some patients have reported feeling unstable when using the repose cushion however it is the lowest height cushion at 5cm and the only cushion with an integral strap to secure the cushion to an arm chair.
FlowForm Ultra 90
Braden score moderate to high risk (10-14).
Up to category 2 pressure damage
Weight limit 20st/ 127Kg
Dimensions (431mm x 431mm x 88mm) 17” x 17“x 3.5”
The FlowForm Ultra 90 is a foam and gel cushion. The cushion provides a more stable sitting surface than the repose cushion.A gel sac is contained within the high density foam cushion. The patient submerges slightly into the cushion increasing surface area thereby reducing pressure.
Roho Cushion
Braden score high to severe risk (<9 to 12)
Up to category 4 pressure damage
Weight limit – no weight limit
Dimensions: 460mm x 460mm (18” x 18” x 4”), 4” is the depth of the air cells.
Other sizes possible but need ordering as special request.
The Roho cushion is a static air cushion.Within the cushion air moves throughout the cells. The air cells move in all directions with the patient’s movements, by being submerged into the cushion point pressure is reduced.The amount of air required for pressure relief in the cushion is dependent on the individual patients’ weight.
This cushion can look to be very flat when the patient is not sitting on the cushion, carers and or family members need to be made aware of this and educated accordingly.
The clinician will need to set this cushion up as NRS are unable to do so.
The air pressure in the cushion needs checking every 6-8 week.
Additional support for set up can be arranged if needed once the request has been approved by Tissue Viability team.
Starlock cushion
Braden score high to severe risk (<9 to 12)
Up to category 4 pressure damage
Weight limit – no weight limit
Dimensions450 x 450mm (18" x 18"x4”) 4” indicates the depth of the air cells; other sizes need ordering as special request.
The Starlock cushion differs from the Roho cushion, each air cell on the Starlock cushion is locked when setting up this cushion. This locking system creates a copy of where the person has sat.This encourages the person to sit back in the same place on the cushion.
The locking system means when setting up the cushion the air cells under a particular area of pressure damage can be turned off so that there is no pressure on the area of pressure damage. The locking system of the Starlock cushion also enables postural issues such as pelvis obliquities to be corrected or contained.
The clinician will need to set this cushion up as NRS are unable to do so.
The air pressure in the cushion needs checking every 6-8 weeks.
Additional support for set up can be arranged if needed once the request has been approved by Tissue Viability team.
Baros dynamic cushion
Braden score high risk (10-12) to severe risk (<9)
Up to category 4 pressure damage
Weight limit = 19ST/ 121KG
Dimensions = 17”x17” x 4” (44cmx44cmx10cm)
This is an alternating dynamic cushion. With a dynamic cushion the patient needs to have core stability (the ability to maintain their sitting balance).The patient sits on top of the air cells which alternate underneath them. The cells alternate between being inflated and deflated (1 in 2). There are 6 air cells in the cushion. At the front of the cushion there is a bar of foam which helps with the stability of the seated person when the first air cell is deflated. Without being able to maintain their sitting position the person is at risk of “Being walked off” the cushion.
The other issue with the dynamic cushion is the height of the cushion which is 10cm/4”. This height is added to the height of the chair, which in turn is taken away from the height of the armrest which will alter the ergonomics of the chair. This cushion is suitable for armchairs as a replacement cushion in the same way a dynamic mattress is a replacement mattress.
This cushion needs requesting from Tissue Viability Team.
G drive/ equipment/ equipment information/portal equipment information (V1)
(November 2014)