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Hill-Rom
TotalCare® Therapy System
30 Degree Head of Bed Alarm and Trending
At a glance
• Head of Bed Angle Alarm sounds when the head
of bed drops below 30 degrees
•The alarm records how many hours and minutes the
head of bed was elevated greater than 30 degrees within
a 24 hour period
•Eight additional days of statistics available on the Graphical
Caregiver Interface® (GCI) screen
• Line-of-Site® angle indicator provides a quick reference
point for checking head angle
•These features can monitor head angle and be incorporated
into your facility’s ventilator associated pneumonia
(VAP) protocols
Ventilator associated pneumonia is
a costly issue
Some ventilator associated pneumonia facts:
Clinical justification for 30 degrees or
greater head of bed positioning
• Ventilator associated pneumonia (VAP) is reported
to be the most common hospital-acquired infection
among patients requiring mechanical ventilation.1
How can you help reduce VAP? One thing you can do
is consistently position the head of the bed 30 degrees
or higher.
• VAP is the leading cause of death among hospitalacquired infections. The hospital mortality
2
of ventilated patients who develop VAP is 46%.
• C o m p a red to supine positioning, studies have shown
that simple positioning of the head of bed to 30 degrees
or higher significantly reduces gastric reflux and
ventilator associated pneumonia (8% versus 34%
respectively).4
• VAP adds an estimated cost of $20,000 to $40,000
per case as well as an increase in length of stay
3
in the ICU.
VAP is costly in both dollars and lives, but, with protocols
and practices, the incidence can be reduced.
• The CDC Recommends elevating at an angle of 30-45
degrees head of the bed for a patient at high risk for
aspiration (e.g., a person receiving mechanically assisted
ventilation and/or who has an enteral tube in place)
(Note: if not medically contraindicated for head angle
more than 30 degrees)5
30HOS SellSheet.qxd
5/16/06
11:38 AM
Page 2
Hill-Rom
TotalCare® Therapy System
30 Degree Head of Bed Alarm and Trending
TotalCare® features to help support your
VAP reduction protocols
With the Line-of-Site® angle indicator and the Head of
Bed Angle Alarm and Trending available on TotalCare®
bed systems, you now have an accurate way to monitor
head angle. These tools can be incorporated into your
VAP reduction protocols.
• The Head of Bed Angle Alarm can be easily set
to notify caregivers if the head of bed is lowered
less than 30 degrees.
When the alarm
is set, a pop-up
message immediately
notifies caregivers
when the head
angle is lowered
to less than
30 degrees.
View head angle statistics on TotalCare®
bed system Graphical Caregiver Interface®
(GCI) screen.
• Head angle statistics are visible and provide accurate
and up-to-the-minute head angle information
in hours and minutes.
• The conveniently-located
Line-of-Site angle indicator
provides a quick reference
for the angle of patient
head elevation.
References
1. Richards MJ, Edwards JH, Culver DH, et al. Nosocomial infections in medical
intensive care units in the United States: National Nosocomial Infections
S u rveillance System. Crit Care Med 1999;27:887-892
2. Ibrahim EH, Tracy L, Hill C, et al. The occurrence of ventilator-associated
pneumonia in a community hospital: risk factors and clinical outcomes.
Chest. 2001;20 (2):555-561
3. Chulay M. VAP prevention. The latest guidelines. RN 2005;68(3):52-57
Safdar N, Desfulian C, Collard Hr, Saint S. Clinical and economic
consequences of ventilator associated pneumonia: a systematic review.
Critical Care Med. 2005;33(10):2184-2193
4. Kollef M. Ventilator-associated pneumonia: A multivariateanalysis,
J American Medical Association 1993;270:1965-1970.
Ibanez J, Penafiel A, Raurich J, et al. Gastroesophageal reflux in intubated
patients receiving enteral nutrition: Effect of supine an semi recumbent
positions. J Parenteral Enteral Nutrition 1992;16419-422
Hill-Rom reserves the right to make changes without
notice in design, specifications and models. The only
warranty Hill-Rom makes is the express written warranty
extended on the sale or rental of its products.
© 2006 Hill-Rom Services, Inc.
ALL RIGHTS RESERVED.
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Orozco-Levi M, To rres A, Ferrer M, et al. Semi-recumbent position protects
from pulmonary aspiration but not completely from gastroesophageal
reflux in mechanically ventilated patients. American J Respiratory
Critical Care Medicine 1995;152;1387-1390
Drakulovic M, Torres A, Bauer T, et al. Supine body position as a risk factor
for nosocomial pneumonia in mechanically ventilated patients: A
randomized trial. Lancet 1999;354:1851-1854
Dotson R, Robinson R, Pingleton S. Gastroesophageal reflux with
nasogastric tubes: Effect of nasogastric tube size. Am J Respir Critical
C a reMed 1994;149:1659-1662
5. Drakulovic MB, Torres A, Bauer TT, Nicolas JM, Nogue S, Ferrer M. Supine
body position as a risk factor for nosocomial pneumonia in mechanically
ventilated patients: a randomized trial. Lancet 1999; 354(9193):1851--58.
Orozco-Levi M, To rres A, Ferrer M, et al. Semirecumbent position protects
from pulmonary aspiration but not completely from gastroesophageal
reflux in mechanically ventilated patients. Am J Respir Crit Care Med
1995;152:1387--90.
Torres A, Serra-Batlles J, Ros E, et al. Pulmonary aspiration of gastric
contents in patients receiving mechanical ventilation: the effect of body
position. Ann Intern Med 1992;116:540--3.