Inside track
The obesity epidemic has put more people at risk for sleep disordered breathing (SDB), which means sleep professionals must be aware of the special needs of obese patients. Part of tending to these needs includes offering equipment suited for larger people, including bariatric beds. Sleep Review spoke with Steve Allee, director of marketing, Burke Inc, Kansas City, Kan, to get the lowdown on bariatric beds and the importance of this equipment in today’s sleep laboratory.

Q: Why should a sleep laboratory consider adding a bariatric bed?

A: We have learned that the majority of patients with morbid obesity suffer from sleep apnea, which can cause serious complications after bariatric surgery. Due to this, it is becoming standardized operating procedure to ensure successful treatment for sleep apnea before the patient has a weight-reduction operation, and, therefore, it just makes good sense to have at least one or two bariatric beds in place in the sleep lab.  

Q: When purchasing a bed for bariatric patients, what safety and comfort factors should a sleep clinician take into consideration?

A: Regarding safety, any institution should ensure that the entire bed has been certified as meeting the standards of the Underwriters Laboratories (UL) 60601-1 and the International Electro­technical Commission (IEC) 60601-2-38 by an independent Occupational Safety and Health Administration (OSHA)-recognized testing lab such as UL, Canadian Standards Association (CSA), or Electrical Testing Laboratory (ETL) before allowing it into the building. These two certifications are the Food and Drug Administration’s current recognized consensus standard for hospital beds and ensure the product has been tested to meet manufacturer claims of weight capacity, environmental hazard safety, and fire hazard safety. Beds now also must meet national safety standards regarding the interface of both patient and caregiver, with particular attention to side rail and entrapment issues. It is also important that the bed be capable of reducing its width in the event it is necessary to transport the patient through the doorway on the bed.

Regarding comfort, the bed must be wide enough. Usually a width of 48 inches will achieve this goal. This allows for comfort for the patient and room to work for the caregiver. Electrical functions such as hi-lo, Trendelenburg/reverse Trend­elenburg, and head and knee gatch functioning are usually standard, yet very important to the positioning of the patient for comfort and assisting the efforts of the caregiver. Also important is a very good pressure-reducing foam mattress rated for the proper weight capacity or a properly rated low-air-loss/alternating-pressure air mattress.

Q: When it comes to bariatric beds, what is the biggest misconception about these products?

A: That the equipment is too expensive. While, yes, the equipment manufactured to support bariatric patients who weigh up to 1,000 pounds, for example, does cost more, it is only because the cost of reinforcement is significantly higher. I daresay, if you could compare the margins of so-called regular equipment to bariatric equipment, you would find that not only are the percentages about the same, but in an ongoing effort to be as competitive as possible, it wouldn’t surprise me if the bariatric equipment actually came out a little less. The components required to provide safe support, such as steel and strength-enhanced actuators, are very expensive.

However, when you consider the peace of mind that renting or purchasing properly certified equipment affords, it is an excellent and prudent investment in proactively doing everything you can to provide safety for both patient and staff. It just takes one lawsuit due to injury because of inferior, uncertified equipment (or one workers’ compensation claim) to very quickly blow away the “resident wisdom” of procuring the cheaper, untested model.

Q: As the relationship between obesity and sleep disordered breathing becomes more evident, how do you envision sleep laboratories changing the way they do business?

A: Certainly, there will be more attention paid to budgeting for bariatric equipment, perhaps the establishing of an entire bariatric wing within the sleep lab. Beyond bariatric hospital beds and peripheral equipment, there will be planning for extra space in the bariatric patient’s room to accommodate this equipment as well as commodes that are attached to the floor vs the wall, extra space around the commode, and reinforced assist bars in the walls, as well as showers designed specifically to offer a more spacious and user-friendly environment.

Allee’s full interview is available online at www.sleepreviewmag.com.