Hospital bed side rails pose a risk of trapping certain patients during use, FDA warned in a recent safety alert to health-care workers.

Since January 1990, FDA has received 102 reports of head and body entrapments involving hospital bed side rails. The 68 deaths, 22 injuries, and 12 entrapments without injury occurred in hospitals, long-term care facilities, and private homes. Although the number of reported incidents is small compared to the large number of patients who use hospital beds--well over a million, according to some estimates--appropriate precautions can further reduce accidents, the Aug. 23, 1995, alert stated.

All reported entrapments occurred in one of the following ways:

* through the bars of an individual side rail

* through the space between split side rails

* between the side rail and mattress

* between the headboard or footboard, side rail, and mattress.

All deaths involved entrapment of the head, neck or chest, while most injuries involved fractures, cuts and abrasions to the arms and legs. The majority of deaths and injuries involved elderly patients. Patients at high risk include those who are mentally unstable, restless, lack muscle control, or a combination of these factors. Risk also increases if the bed dimensions are inappropriate for the patient's size and body weight.

FDA recommends the following to people caring for patients in hospital beds:

* Inspect all hospital bed frames, side rails, and mattresses as part of a regular maintenance program to identify areas of possible entrapment. …