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PubMedDate not supplied

Mechanical vibration in neonatal transport: a randomized study of different mattresses.

OBJECTIVE: To test the hypothesis that a gel mattress is most effective in attenuating mechanical vibration in neonatal transport, we performed a randomized block study of four mattress combinations (none, foam, gel, gel on foam) using mannequins and an ambulance traveling on fixed routes (city, highway). STUDY DESIGN: Mechanical vibration was assessed by measuring vertical accelerations at two locations: the forehead of a 2000-gm mannequin and the transport incubator base. From time histories of these accelerations, root mean square (RMS) values and power spectral density functions were calculated. The effect of the mattress on the transmission of vibration was determined from ratios of the RMS values at the two locations. An RMS ratio of < 1.0 indicates attenuation, whereas a ratio of > 1.0 indicates accentuation of vibration. From the power spectral density functions, the natural frequency of the system was determined for each mattress combination in relation to the natural frequencies of the ambulance. To determine the effect of the weight of the mannequin on vibration, additional measurements were performed using a 300-gm mannequin. RESULTS: All the observed RMS ratios were > 1. The highest ratios were observed on the city route in the absence of the gel mattress. The gel mattress, used alone or with the foam mattress, in contrast to foam or no mattress, shifted the natural frequency of the system away from the natural frequencies of the ambulance, avoiding a large amplification of vibration. A decrease in the weight of the mannequin caused the gel mattress to be less effective in attenuating vibration. CONCLUSION: A gel mattress, used alone or with a foam mattress, results in the least accentuation of vibration, but vibration in ambulance transport is not attenuated by any of the mattress combinations. The hazard of vibration may be particularly relevant when transporting extremely low birth weight neonates. These findings indicate a need for study and design of more effective devices that can reduce the vibratory stress.

Acceleration↗

PubMed2000

Preventing pressure ulcers: an evaluation of four operating-table mattresses.

Pressure is a major factor in the development of pressure ulcers. This research focused on assessing the pressure-reducing effects of operating-table mattresses. Five mattresses were tested: a standard operating-table mattress, a foam mattress, a gel mattress, a visco-elastic polyether mattress, and a visco-elastic polyurethane mattress. Four intraoperative postures were evaluated: supine, lateral, fossa, and the Miles-Pauchet position. Interface pressure measurements were performed on 36 healthy volunteers. The foam mattress and the gel mattress seem to have little or no pressure-reducing effect; the polyurethane mattress and the polyether mattress reduce interface pressure significantly better (p < .001); but none of the mattresses reduce pressure sufficiently to prevent the occurrence of pressure ulcers.

Adult↗

PubMed1994

Evaluating the long-term performance of a foam-core hospital replacement mattress.

Many hospitals have begun replacing their standard mattresses with pressure-reducing foam mattresses to eliminate the costly overlays that have been used for comfort and to protect patients at risk for development of pressure ulcers. Although researchers have tested the performance of new mattresses and have shown that many may be of use with patients at high risk, no information is available on the pressure-reducing capabilities of used mattresses. This study was designed to evaluate changes with use in the support characteristics of foam-core hospital replacement mattresses. In the first part of the study, interface pressure measurements were made at regular intervals over an extended period of use. Sixty mattresses were randomly selected from 750 mattresses currently in use at St. Luke's Episcopal Hospital, Texas Medical Center, Houston. The mattresses were labeled and marked at three selected points, and interface pressures under a standard load were measured at approximately 3-month intervals for 12 months. In the second part of the study, the stiffness of the foam, a measure of the foam's ability to support a weight, was measured at selected points on the mattresses. Patient reports of discomfort in the sacral area and of "sinking" into the middle of the mattress prompted this phase of the study. The stiffness profiles of 25 new mattresses were compared with those of 25 randomly selected mattresses that had been in regular use for at least 24 months. Data analyzed from part one showed trends that indicated that the interface pressures increased at each site during the course of the study; however, an analysis of variance indicated that the changes were not statistically significant during the time frame of the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Beds↗

PubMed1987

Transcutaneous oxygen tension measurement over the sacrum on various anti-decubitus mattresses.

Transcutaneous oxygen tension (tcPO2) was measured over the sacrum of 12 healthy, normal-weight volunteers positioned on five different mattresses. TcPO2 was lower (p less than 0.01) in those on a standard hospital mattress (median 0 mmHg), than in those on a sheep skin (median 22 mmHg), water mattress (median 33.5 mmHg), Spenco mattress (median 52.5 mmHg) or ripple air mattress (median 0/62 mmHg). The tcPO2 for the Spenco mattress was higher (p less than 0.01) than for sheep skin and for the water mattress. No significant difference was found in tcPO2 for the latter two named above. TcPO2 for the ripple air mattress alternated between 0, when inflated under the oxygen sensor, to about full oxygenation, when deflated. We believe that the ripple air mattress theoretically is the best mattress to prevent decubitus ulcers, but due to frequent mechanical failure of pump or mattress, the Spenco mattress is perhaps the best for practical use. Clinical comparative studies will be necessary to confirm that.

Adolescent↗

PubMed2004

Cot mattresses as reservoirs of potentially harmful bacteria and the sudden infant death syndrome.

Cot mattress materials were investigated as potential reservoirs of bacteria in relation to the sudden infant death syndrome (SIDS). The sleeping position of the infant significantly influenced bacterial population density of cot mattress polyurethane foams (p<0.0000001) and their covers (p<0.004). Staphylococcus aureus was isolated at significantly higher frequency (p<0.03) from the infant's head region of cot mattress materials. Significantly higher bacterial population densities (p<0.001) were associated with polyurethane foams from non-integral mattresses (exposed polyurethane foam), when compared to those from mattresses completely covered by polyvinyl chloride (integral type mattress). The frequency of isolation of S. aureus from polyurethane foams from non-integral mattresses was also significantly higher (p=0.03) than from foams from the integral type. The following factors were significantly associated with increased frequency of isolation of S. aureus: from the polyurethane foam, previous use of non-integral mattresses by another child (p=0.03 for all sample sites, p=0.01 for torso region); from the covers, sleeping in the prone position (p=0.003 head region, p=0.001 torso region). Prone sleeping was also significantly associated with increased bacterial population levels (p=0.01) and increased frequency of isolation of Escherichia coli (p=0.02) from the torso region of cot mattress covers. These findings could explain some recently identified risk factors for SIDS associated with type and previous use of cot mattresses. Clostridium perfringens was isolated at very low frequency and Streptococcus pyogenes was not isolated from any cot mattress materials tested.

Bedding and Linens↗

PubMedDate not supplied

Changes in sacral transcutaneous oxygen tension in the evaluation of different mattresses in the prevention of pressure ulcers.

Transcutaneous oxygen tension (TCPO2) is a recognized techniques for evaluating support surfaces as a pressure ulcer prevention method. Transcutaneous oxygen tension was measured over the sacral area of 20 volunteers positioned on five different mattresses, including a standard mattress. No specific change was noted on resting values (M = 68.2 mm Hg, SD = 9.4) before each of the five protocols were begun. Mean values were 17.9 mm Hg (SD = 27.9) for a nonspecific hospital mattress, 30.15 mm Hg (SD = 29.5) for the first foam mattress, 30.25 mm Hg (SD = 28.5) for the second foam mattress, 50.5 mm Hg (SD = 23.1) for the air mattress, and 50.95 mm Hg (SD = 21.6) for the water-filled mattress. Results showed statistical differences between the standard mattress and the four mattresses tested and between the foam mattresses and the two other mattresses. There was an inverse correlation between skinfold thickness and a decreased TCPO2 in contact area. Skinfold thickness could be an indicator of pressure ulcer risk. Further studies are needed to confirm the interest of this parameter.

Adult↗

PubMed2003

Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial.

BACKGROUND: A firm mattress is commonly believed to be beneficial for low-back pain, although evidence supporting this recommendation is lacking. We assessed the effect of different firmnesses of mattresses on the clinical course of patients with chronic non-specific low-back pain. METHODS: In a randomised, double-blind, controlled, multicentre trial, we assessed 313 adults who had chronic non-specific low-back pain, but no referred pain, who complained of backache while lying in bed and on rising. Mattress firmness is rated on a scale developed by the European Committee for Standardisation. The H(s) scale starts at 1.0 (firmest) and stops at 10.0 (softest). We randomly assigned participants firm mattresses (H(s)=2.3) or medium-firm mattresses (H(s)=5.6). We did clinical assessments at baseline and at 90 days. Primary endpoints were improvements in pain while lying in bed, pain on rising, and disability. FINDINGS: At 90 days, patients with medium-firm mattresses had better outcomes for pain in bed (odds ratio 2.36 [95% CI 1.13-4.93]), pain on rising (1.93 [0.97-3.86]), and disability (2.10 [1.24-3.56]) than did patients with firm mattresses. Throughout the study period, patients with medium-firm mattresses also had less daytime low-back pain (p=0.059), pain while lying in bed (p=0.064), and pain on rising (p=0.008) than did patients with firm mattresses. INTERPRETATION: A mattress of medium firmness improves pain and disability among patients with chronic non-specific low-back pain.

Adult↗

PubMed2000

An evaluation of mattresses and mats in two dairy units.

In order to investigate the relative merits of mats and mattresses in terms of cow comfort, production and performance, 29 cows were housed on ethylethene vinyl acetate (EVA) mats and 29 on mattresses of loose rubber crumb with a polypropylene cover, at each of two similar dairy units (SAC Auchincruive and Myerscough). Both mats and mattresses were newly installed at the start of the trial. The cows were housed in the autumn after calving. Milk yield was recorded daily. Cows were weighed and scored for body condition, locomotion, dirtiness and hock and knee injury at fortnightly intervals. Feed offered was recorded daily and refusals were weighed weekly. Monthly milk records of milk yield, milk composition and somatic cell count data were available for both herds. In addition, 24 h behavioural observations of 15 core cows in each group were made at weeks 0, 2, 4, 6, 8, 16, and 32 post-housing. There was no difference between cows on mats and mattresses in milk yield, composition or quality; in feed intake; in weight loss or body condition score; in severe hock or knee injury, or in the incidence of lameness. Cows on mattresses tended to have slightly higher total dirtiness scores than those on mats (7.06 vs. 6.95, P=0.074) and had dirtier udders (mattress, 7.50 vs. mat, 6.52, P<0.05). However, over the whole housing period, cows on mattresses spent longer feeding, ruminating and lying and a greater proportion of their lying time was spent ruminating. They spent less time standing doing nothing (idling) than cows on mats and less time idling in cubicles. Cows on mattresses appeared to adapt to housing more quickly than those on mats. Overall, neither mat nor mattress gave advantages in terms of production or performance, cows were slightly cleaner on mats but behavioural indices suggest that cow comfort was greater on mattresses.

Journal Article↗

PubMed2002

Deaths between bedrails and air pressure mattresses.

OBJECTIVES: To describe how patients die by becoming trapped between therapeutic air pressure mattresses and bed rails. DESIGN: A retrospective review of all voluntary reports deaths in beds with air mattresses that can be found in the Food and Drug Administration's on-line databases of adverse medical events that cover 1994 to 2001. SETTING: Death reports come from manufacturers, medical staff, and coroners and describe deaths in hospitals, nursing homes, and home care, although type of care site is often not given. MEASUREMENTS: Event descriptions were reviewed to determine how the person became entrapped in the rail and how responsibility for the event was allocated. RESULTS: There were 35 deaths involving many product lines. Twenty-one deaths involved overlay air mattresses placed on top of a regular mattress. Thirteen patients died in beds with built-in air mattresses. Compression of the mattress allowed an off-center person to slide against the rail where reexpansion of the mattress kept the person compressed against the rail. Two patterns were seen. In one, the mattress bunched up behind a person who was lying on the side of the bed, pushing the neck against a bedrail. In the second type, a patient died after sliding off the bed and having the neck or chest compressed between the rail and bed. Manufacturers attributed the deaths to poor clinical decision-making or inadequate monitoring. CONCLUSIONS: Lethal asphyxiation in beds with air pressure mattresses is a variant of bedrail-mattress entrapment that requires redesign by bed manufacturers and risk awareness by clinicians.

Asphyxia↗

PubMed1991

House dust mite allergens on different types of mattresses.

Beds and especially mattresses are important breeding grounds for house dust mites. We investigated whether supposed differences in the microclimate on water, spring and foam mattresses were reflected in the occurrence of house dust mite major allergens (Der fI, Der mI, and Der pI) in mattress dust. Fifty-one mattresses that had been in use for 8-25 months were sampled. Median concentration of total major allergens was 0.5 microgram/g dust (range 0-45) with little difference between the three major allergens and between the three types of mattresses. Occurrence of mattresses with concentrations above and below the proposed risk level (2 micrograms/g) was similar in the mattress groups. However, the allergen concentration was above risk level in 56%, if washable underblankets were not applied, compared with only 21% in the group with such underblankets. In conclusion, mattresses tend to accumulate allergen rather rapidly. Neither heated water mattresses, spring nor foam mattresses seem to be of any advantage for mite allergics, whereas underblankets made of synthetic fibres in a cotton or synthetic cover, commonly used in Denmark, might play a beneficial role in reducing allergen exposure.

Allergens↗

PubMed2006

Influence of mattress characteristics on house dust mite allergen concentration.

BACKGROUND: Exposure to a high level of house dust mite allergens (HDMAs) is considered as a risk factor for HDM sensitization and development of asthma in genetically disposed people. Mattresses are one of the most important sources of HDMA in people's living environment. OBJECTIVE: The aim of this study was to evaluate the association between mattress characteristics and HDMA concentrations on mattresses. METHODS: Dust samples of mattress surfaces were taken to evaluate the level of Der p 1 allergen. All participants filled in a questionnaire about the type of mattress, the type of covering (upper layer) of the mattress, dwelling characteristics and cleaning habits. Humidity and temperature of the bedroom were measured at the time of dust sampling. RESULTS: One hundred and sixty-eight questionnaires were filled in. Synthetic upper layer of the mattress was associated with a higher level of Der p 1 compared with cotton upper layer (2.6 vs. 0.8 microg/g Der p 1). Moreover, higher relative humidity (RH) was associated with significant higher concentrations and density of Der p 1. CONCLUSIONS: Two factors were associated with lower levels of Der p 1 found on mattresses, namely: a cotton upper layer of the mattress compared with a layer of synthetic material and lower RH at the time of sampling. As far as we know, the association between type of upper layer and concentration of Der p 1 has not been described before and could lead to the formulation of practical advices in order to reduce HDMA concentrations on mattresses.

Air Pollution, Indoor↗

PubMed2005

Aerial release of bacteria from cot mattress materials and the sudden infant death syndrome.

AIM: To investigate aerial release of bacteria from used cot mattresses and to assess factors that may influence this process. METHODS AND RESULTS: Movement on used mattresses, simulating that of an infant's head, significantly enhanced aerial release of naturally acquired bacteria from the polyurethane foams (total count data, P = 0.008; Staphylococcus aureus, P = 0.004) or from polyvinyl chloride covers (total count data, P = 0.001). Aerial release of naturally acquired bacteria from used cot mattresses showed high variability and was poorly correlated (R2 < or = 0.294) with bacterial cell density within the materials. In experiments involving inoculation of S. aureus and Escherichia coli onto the polyurethane of unused cot mattresses, aerial release of the species correlated well (R2 > or = 0.950) with inoculation density when simulated infant head movement was applied. Aerial release of these bacterial species from the material decreased with increase in width or aqueous content of the material, and was lower from polyurethane foam of a used cot mattress. CONCLUSIONS: Simulated infant movement and mattress related factors influence aerial release of bacteria from cot mattress materials. With simulated infant movement on cot mattress polyurethane foam, levels of airborne bacteria above the material are proportional to bacterial population levels inoculated onto the material. SIGNIFICANCE AND IMPACT OF THE STUDY: Cot mattresses harbouring relatively high levels of naturally acquired toxigenic bacteria, such as S. aureus, could pose a relatively high risk of infection to the infant's respiratory tract through increased aerial contamination. This has impact in the context of recent findings on cot mattress related risk factors for sudden infant death syndrome.

Air Pollution, Indoor↗

PubMed2000

The foam mattress-back syndrome.

BACKGROUND: Many medical residents used to sleeping on cotton mattresses at home complain of mild to moderate back pain after sleeping on foam mattresses provided in the hospital and hostel rooms. OBJECTIVE: To determine the relationship of sleeping on foam mattress with the appearance of back pain in a 500 bedded multispecialty tertiary care hospital. METHODS: One hundred medical residents were interviewed for the appearance of backache after sleeping on 10 cm thick foam mattress provided to them in the hostels. Pain was scored over a visual analog scale of 10 cm. Effect of sleeping on a regular cotton mattress was assessed. RESULTS: Sixty-three (5 female residents) developed back pain on the morning of a night of sleep over the foam mattress. The pain was mostly of lower back and was not associated with any objective neurodeficit. Four residents on account of the backache reported thirteen episodes of absenteeism. Sixty-one residents had a relief of the pain on going home where they would sleep on regular cotton mattresses, only to recur after sleeping again on the foam mattress in the hospital/hostel. CONCLUSION: Sleeping on foam mattress is associated with the appearance of backache in medical residents which is reproducible and gets relieved after using regular cotton mattresses.

Absenteeism↗

PubMed2003

Mattress encasings and mite allergen levels in the Prevention and Incidence of Asthma and Mite Allergy study.

BACKGROUND: Reduction of allergen exposure from birth may reduce sensitization and subsequent allergic disease. OBJECTIVE: To measure the influence of mite allergen-impermeable mattress encasings and cotton placebo encasings on the amount of dust and mite allergen in beds. METHODS: A total of 810 children with allergic mothers took part in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study. Allergen-impermeable and placebo mattress encasings were applied to the childrens' and the parents' beds before birth. Dust samples were taken from the beds of children and their parents before birth and 3 and 12 months after birth. Extracts of dust samples were analysed for mite allergens (Der p 1 and Der f 1). RESULTS: Active mattress encasings were significantly more effective in reducing dust and mite allergen levels than placebo encasings. Mite allergen levels were low in general and the treatment effect was modest. Twelve months after birth, mattresses with active mattress encasings had about half the amount of Der 1 (Der p 1 + Der f 1)/m2, compared to mattresses with placebo encasings, for the child's and the parental mattress. CONCLUSION: This study shows that mite-impermeable mattress encasings have a significant but modest effect on dust and mite allergen levels of mattresses with low initial mite allergen levels, compared to placebo.

Allergens↗

PubMed1997

Reduction of the mite-allergen reservoir within mattresses by vacuum-cleaning. A comparison of three vacuum-cleaning systems.

Mattresses are considered to be the main source of house-dust-mite (HDM) allergen. This study aimed to investigate different types of vacuum cleaners for their ability to reduce this allergen reservoir. Three types of vacuum cleaners were examined: a conventional vacuum cleaner, a water-trap cleaner, and a central vacuum cleaner. Cut out pieces of mattresses were analyzed for content of mite allergen after vacuum-cleaning. Three polyester mattresses from the homes of three children were selected for the study. These three mattresses had earlier been found to be contaminated by group 1 HDM allergen (8-15 micrograms/g of dust). Each mattress was divided into three main sections, separated by a safety zone, and each main section was subdivided into four parts. The three main sections were cleaned by each vacuum-cleaning system. Pieces 2-cm-thick of the surface of the mattresses were cut out, and extracts were made to assess the amount of mite allergen still present after different intensities of vacuum-cleaning. A considerable reduction in the level of mite allergen was found after using all three of the vacuum-cleaning systems. Only 22% of the original mite-allergen reservoir remained after intense vacuum-cleaning. Since the number of mattresses in the investigation was low, and niche formations of group 1 HDM allergen within the mattresses were observed, the results must be interpreted with caution. Furthermore, allergen-producing living dust mites were not affected by this method. However, intense vacuum-cleaning seems to reduce considerably the level of the mattress-bound mite-allergen reservoir, a fact which may be important in mite-allergic and mite-exposed families.

Allergens↗

PubMed2006

Critical dependence of acetate thermal mattress on gel activation temperature.

BACKGROUND: Sodium acetate gel mattresses provide an active method of warming patients through release of latent heat of crystallisation. They can be used as an adjunct to incubator care or as an exclusive heat source. OBJECTIVE: To determine activation temperatures of the Transwarmer mattress needed to achieve plateau temperatures of 38-42 degrees C. DESIGN AND SETTING: In vitro testing of mattress temperature. METHODS AND OUTCOME MEASURES: Transwarmer mattresses were activated at initial temperatures ranging from 5 to 40 degrees C. Mattress temperature was recorded up to 4 h to determine peak and plateau temperatures. Peak and plateau temperatures achieved by the mattress were related to the initial starting temperature. RESULTS: The starting temperature of the mattress was strongly correlated with peak and plateau temperature (r = 0.99, p<0.001). To achieve the target temperature of 38-42 degrees C, the Transwarmer mattress requires activation between 19.2 degrees C and 28.3 degrees C. A temperature of 37 degrees C could be generated by activation at 17 degrees C. CONCLUSIONS: Safe use of this device is critically dependent on gel temperature at the point of activation. To ensure warming of a hypothermic neonatal patient without running any risk of burns, the mattress should be activated with a gel temperature between 19 degrees C and 28 degrees C.

Beds↗

PubMed2000

Evaluation of cot mattress inner foam as a potential site for microbial generation of toxic gases.

Recent reports of biovolatilisation of phosphorus and antimony by anaerobic bacteria and of leaching of phosphorus and antimony fire-retardant additives from PVC cot mattress covers, indicate that the polyurethane inner-foam of cot mattresses could be a site for generation of toxic gases of group 15 elements. A toxic gas hypothesis for sudden infant death syndrome (SIDS) involving polyurethane foam of cot mattresses was proposed and tested experimentally. Levels of antimony, phosphorus, arsenic and bismuth were determined at four sites for 44 SIDS and 50 control (no death) cot mattress foams. There was no evidence to suggest that the levels of these elements in cot mattress foam have a causal relation to SIDS. Leaching of antimony trioxide from PVC mattress covers could account for detectable levels of this element in 52% of the cot mattress samples analysed. Volatile forms of antimony, phosphorus, arsenic and bismuth was not detected in the headspace of mixed or monoseptic cultures of anaerobic bacteria containing polyurethane foam. Past microbial activity had given rise to involatile methylated species of antimony in some of the cot mattress foams tested (61%, n = 24). Abiotic oxidation of biogenic trimethylantimony together with physical adsorption of methylantimony forms to the polyurethane foam matrix could account for the apparent absence of "escaped" volatile antimony species in culture headspaces of incubation vial. There was no evidence to suggest that levels of trimethylantimony or total methylantimony forms in cot mattress foams have a causal relation to SIDS.

Antimony↗

PubMedDate not supplied

Measurements of interface pressure between body sites and the surfaces of four specialised air mattresses.

Four specialised air mattresses had interface pressure measured under six body sites prone to pressure sores in 10 subjects, supine and sitting. The mattresses were the Clinirest (SSI) and FirstStep (KCI) continuous airflow mattress overlays, and Airwave (Pegasus) and Nimbus (Huntleigh) alternating pressure air mattresses. On the mattress overlays, average supine interface pressures were 2.33 kPa (scapula), 4.15 kPa (elbow), 1.94 kPa (sacrum) and 2.79 kPa (buttock), although they were higher at the occiput (7.97 kPa) and heel (11.7 kPa). The alternating pressure air mattresses had an average minimum interface pressure close to zero for three sites, rising to 4.28 kPa under the heel. Average maximum interface pressures were 8.61 kPa (occiput), 5.21 kPa (scapula), 4.90 (elbow), 4.85 kPa (sacrum), 4.61 kPa (buttock) and 13.2 kPa (heel). No accepted scientific method exists for comparing the two types of mattress. Our data suggest a clinical benefit at the occiput and heel (supine) in using an alternating pressure air mattress and a benefit in using a continuous airflow mattress overlay at other sites.

Air Pressure↗