Therapeutic air surfaces are important tools for the prevention and treatment of pressure injuries. We get several questions about proper use and troubleshooting, and we would love to share those with you. There is no way that we could possibly cover all the possible issues related to these products in a single digestible article, so we chose the most common calls we receive. If you need help beyond this blog, call your DME partner.

 Q: Why does the patient fall out of the air bed?

A: There are some people that work hard to get out of bed regardless of what kind of surface you have them on. However, when used properly air surfaces are amazing aids to help keep a fidgety patient in place. Over the last two decades we have had several calls from concerned nurses describing an increase in the fall rate since “Mr. Smith” started on the air surface. Without exception we found that the caregivers have set the comfort pressure set too high. These surfaces are typically softer than the patient is used to. Mr. Smith asks a family member or caregiver to make the bed firmer, and of course they do. However, this action negates the therapeutic value of the surface and increases the fall risk. These beds are designed to cradle the patient. This helps redistribute the weight appropriately while creating an air bolster around the patient. When set properly the surface will discourage falls. If your patient or loved one is falling out of bed, start here. If they are particularly determined to fall out of bed, don’t blame the air surface. It might be time to look at other options like hi-low bed frames, safety bolster sheets, and fall mats. If you’re not sure call your DME partner. They should be able to help you find a good solution.

Q: How do I know if the air bed is set right?

A: This is a critical part of making sure the surface is delivering the appropriate therapy. If the surface is too firm, it loses the ability to distribute pressure properly and the patient is highly likely to fall out of bed. If the surface is too soft, the patient will “bottom out” causing comfort and pressure issues. As a rule, you want the patient cradled in the mattress with about 1/3 of the body mass from their heaviest area sinking into the mattress. You can unzip the top cover and check with your hand to make sure that they are not contacting the bed frame. There should be approximately four fingers distance between the bed frame and the patient at his or her heaviest point. At this setting the patient is getting the best therapeutic pressure reduction value from the surface. Additionally, the mattress is forming a bolster around the patient. Air pushes out around the patient and helps keep them contained to the center of the bed.

Q: My air surface won’t hold pressure, and I’m bottoming out. What’s wrong?

A: There are a few reasons this could be happening. We will start with the most common and work our way down:

• We get several calls about this and the first thing we check is power to the control unit. You might be surprised how often the problem ends up being an unplugged unit. If the unit is plugged into the wall, make sure that it is not plugged into an outlet controlled with a light switch. If the switch is off there will not be power to the control unit, and the mattress will not inflate. Try a different outlet that you’ve tested with something else. Also, if the power cord isn’t permanently attached to the control unit, make sure that the cord is firmly attached to the control unit. If you have plugged the unit into an outlet that you know works, and the cord is firmly plugged into the control unit and the unit is not getting power, something in the unit is faulty. Call your DME provider.
• The firmness setting on the control unit is not set properly to the patient’s weight. The actual pressure setting can vary from model to model, so we will use generalities here. On a non-bariatric control unit, the center value for the pressure setting is between 150-180 lbs. for the patient weight. With that as a reference adjust the firmness up incrementally and reassess the patient as described above. After adjusting make sure to give the mattress a little time to adjust. In smaller pump based units this could take 5-10 minutes.
• If you know that the firmness setting is higher than it should be we can move on. The next area that we suggest looking at is the CPR valve. Most air surfaces have a CPR valve of some sort. Look along the sides of the bed for a flag or valve system. If there are no CPR valves/plugs located on the actual mattress it may be the actual connection with the unit. Either way it will specifically be marked as a CPR valve or disconnect. If these are unplugged the mattress will not be able to maintain pressure. Make sure that the valve is closed, or the holes are plugged. If this was the issue correct the problem and give the mattress time to adjust. If this isn’t the case, read on.
• The air supply hose is another area that we occasionally see problems. This is especially true in older air surfaces. Check the simple first. Is the hose properly connected to the control unit? If not, this will cause a leak. Also check the tubing to make sure that the hoses are properly connected to the connection port. Over time the adhesives used to bond these will weaken and the tubing will come loose. Just give them a firm tug. If they pop off, re-glue them by applying a thin layer of Superglue to the inner diameter of the tube and slide it back onto the post. Let it set for the recommended time required by the adhesive, and you should be good. Sometimes the posts that connect the tubing to the connection port will break. If this happened, you should contact your DME partner. Finally, make sure that any posts on the connection port have the little o-rings and that they are in good condition. These o-rings provide a seal that keeps the air contained within the system. You can use a non-flammable silicone based lubrication to keep these is good working conditions. If they are damaged or missing, you can probably find a replacement at Harbor Freight.
• The air cells running throughout the mattress are connected to a baffle. Double check to make sure that all the air cells have a solid connection. Sometimes these come loose because of the patient sliding over them to transfer in and out of bed over long periods of time. Open the zippered top sheet and make sure that each one has a solid connection.
• Double check to make sure that all the “plumbing” inside the mattress is connected. As described above, sometimes the adhesives used to make these connections permanent will break down. While you’re in there make sure that all the tubing is in good condition, free of splits, cracks, or kinks. If you need new tubing contact your DME partner.

Q: Why won’t my control unit power on?

A: There are a few reasons this could happen, and we went over them in the “My air surface won’t hold pressure and I’m bottoming out” section. Just incase you skipped ahead, here are the primary reasons:

• We get several calls about this and the first thing we check is power to the control unit. You might be surprised how often the problem ends up being an unplugged unit. If the unit is plugged into the wall, make sure that it is not plugged into an outlet controlled with a light switch. If the switch is off there will not be power to the control unit, and the mattress will not inflate. Try a different outlet that you’ve tested with something else. Also, if the power cord isn’t permanently attached to the control unit, make sure that the cord is firmly attached to the control unit. If you have plugged the unit into an outlet that you know works, and the cord is firmly plugged into the control unit and the unit is not getting power, something in the unit is faulty. Call your DME provider.

Q: Can I put a sheet on my air surface?

A: This really depends on the patient’s skin integrity and what you are trying to accomplish for the patient. The simple answer is yes if the patient’s skin is not compromised, and you aren’t concerned with shear, tear, or friction. If the skin has good elasticity and you aren’t fighting shear it should be OK. However, check with your caregiver or wound nurse. The top sheet on these mattresses is made up of a low shear/low friction material. Putting a cotton sheet over the top will inhibit the therapeutic value for patients that need it.

Q: Can I put dryflow chucks on my air surface?

A: If the dryflow chuck is breathable it should be fine. However, if the dryflow chuck has a plastic backing or is too thick it will inhibit any low air loss therapy. The best bet is to use something thin, absorbent, and breathable.

These cover some general FAQs regarding therapeutic air surfaces. If your issue goes beyond the scope of this blog, you should contact your DME provider. These mattresses are amazing tools that integral to prevention and treatment of pressure injuries. However, they are often misused. We hope that this article helps you get more from your product.