Some people are at a high-risk for entrapment, falls or other injury from portable bed rails. High-risk people include those with pre-existing conditions such as confusion, restlessness, lack of muscle control, or a combination of these factors. Additionally, people who are cognitively impaired from the use of medication or from a medical condition, such as Alzheimer’s or dementia, are at a higher risk of entrapment and injury.

• Consider other alternatives when bed rails are not appropriate. Alternatives include: roll guards, foam bumpers, lowering the bed and using concave mattresses that can help reduce rolling off the bed.
• Bed side rails should not be used as a substitute for proper monitoring, especially for people at high risk for entrapment and falls.
• If your loved one is in a long-term care facility make sure that a comprehensive assessment and care plan is in place before using bed rails (see information under Recommendations for Health Care Providers).

The FDA and CPSC recommend the following actions to prevent deaths and injuries from entrapment and/or falls from adult portable bed rails:

Before you install bed rails:

• Be aware that not all bed side rails, mattresses, and bed frames are interchangeable and not all bed rails fit all beds.
• Check with the manufacturer(s) to make sure the bed side rails, mattress, and bed frame are compatible, since most bed side rails and mattresses are purchased separately from the bed frame.
• Rails should be selected and placed to discourage climbing over rails to get in and out of bed, which could lead to falling over bed rails.

When installing and using bed rails:

• Confirm that the age, size and weight of the person using the bed rails are appropriate for the bed rails used.
• Install bed rails using the manufacturer's instructions to ensure a proper fit.
• Inspect and regularly check the mattress and bed rails for areas of possible entrapment. Regardless of mattress width, length, and/or depth, the bed frame, bed side rail and mattress should leave no gap wide enough to entrap a patient's head or body.
• Be aware that gaps can be created by movement or compression of the mattress which may be caused by patient weight, patient movement or bed position, or by using a specialty mattress, such as an air mattress, mattress pad or water bed.
• Check bed side rails regularly to make sure they are still installed correctly as rails may shift or loosen over time.
• When in doubt, call the manufacturer of the rails for assistance.