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Zone 3 — Between the Rail and the Mattress
This area is the space between the inside surface of the rail and the mattress
compressed by the weight of a patient's head. The space should be small
enough to prevent head entrapment when taking into account the mattress
compressibility, any lateral shift of the mattress or rail, and degree of play from
loosened rails. HBSW and IEC recommend a dimension of less than 120 mm
(4 ¾ inches) because the head is presumed to enter the space before the neck.
FDA is recommending a dimensional limit of less than 120 mm (4 ¾ inches) for
the area between the inside surface of the rail and the compressed mattress.
Zone 4 — Under the Rail at the Ends of the Rail
This space is the gap that forms between the mattress compressed by the
patient, and the lowermost portion of the rail, at the end of the rail. Factors
that may increase the gap size are: mattress compressibility, lateral shift of the
mattress or rail, and degree of play from loosened rails. The space poses a
risk for entrapment of a patient's neck. It may change with different rail height
positions and as the head or foot sections of the bed are raised and lowered.
The space may increase, decrease, become less accessible, or disappear
entirely. Thus, in some positions, the potential for entrapment in this zone may
still exist when the deck is articulated. At the time of this publication, the IEC
international standard recommends a dimensional limit of less than 60 mm
(2 3/8 inches) measured between the mattress support platform and the lowest
portion of the rail at the rail end to prevent neck entrapment. Based on the neck
diameter dimension described above, FDA recommends that the dimensional
limit for this space also be less than 60 mm (2 3/8 inches). To reduce the risk of
neck entrapment at Zone 4, FDA recommends consideration of the combination
of the gap size and the angle size (created between the mattress and the rail).
Thus, FDA recommends that the V-shaped opening under the rail at its end be
of an angle wide enough, i .e . greater than 60 degrees, to prevent wedging
entrapment.
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User Manual & Entrapment Guide
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