Group two

The second group is comprised of dynamic, powered systems that use alternating pressure air mattresses (APAMs). These incorporate alternately inflating and deflating air cells, which apply then remove pressure over the body’s interface contact points and aim to stimulate reactive hyperaemia on a programmed basis.


Some mattresses combine both dynamic systems in the form of a continous low pressure alternating system that can also function in continous low pressure mode without alternating the cells. These are APAMs that optionally can also function as a low air-loss system.

Different mattress types are useful in that they provide the clinician with a range of options to suit the individually assessed needs of the client and can be used to reduce pressure ulcer risk status following a holistic risk assessment (National Institute for Health and Clinical Excellence [NICE], 2005)

However, APAMs can have drawbacks, including:
>> Noisy pump units on some models
can be especially disturbing at night
(Beldon, 2002)
>> Patients can complain of discomfort (Nixon, 2006)

>> Motion sickness can be a problem for some patients (Beldon, 2002)

>> Amputees, especially bilateral amputees, cannot reposition themselves or may experience difficulty getting on and off

>> Some patients may experience movement down the bed, where they ‘migrate’ or are progressively drawn down the bed by the APAM cell cycle (Collins and Hampton, 2000)

>> Some patients can experience an exacerbation of wound pain when in contact with APAMs

>> Sleep disturbance in those patients with multiple sclerosis and

Alzheimer’s disease has also been reported (Chokroverty, 1996).

The Carital Optima mattress has been designed to address these problems.

The Carital Optima mattress

The Carital Optima mattress is a dynamic electrically powered mattress which although it has air cells is neither an APAM since it does not alternate, nor a low air-loss system, but functions by supporting the patient with the air-cells filled at lower pressures than that needed for an APAM. It
  

has been designed to overcome the disadvantages of APAMs and is intended for a wide range of dependent patients who are being nursed with or without existing pressure area damage. It is designed for use in a wide range of clinical areas, including acute, chronic or community settings, such as intensive care units, medical/surgical/elderly care wards, nursing homes or domiciliary settings.

The mattress comprises a base unit overlaid with a patented double cell structure, where each cell is located inside another (Figure 1). The mattress is made up of 21 of these double air cells, with the upper cells adapting to different body contours to provide the maximum contact area between the mattress’s surface and the patient’s body
surface area.

Each upper cell contains a series of interconnected adjustable inner cells that are connected to a controller (pump) unit, which inflates the inner cells. The cells are divided into three compartments – six cells each for the head and leg sections, plus a central block of nine cells for the torso.

None of these cells go through an alternating cycle so the mattress is not classed as an APAM.

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