Bed rails are supposed to protect nursing-home patients from a fall, but a CBC I-Team investigation has turned up dozens of incidents involving bed rails at Winnipeg homes — most resulting in injury, but some linked to deaths.

Eileen Stratton, 84, suffocated in 2004 after becoming trapped between her mattress and bed rails. (Family photo)In examining four years of records from Winnipeg nursing homes as part of its Questionable Care investigation, the I-Team found more than 200 incidents involving bed rails.

Three deaths were linked to their use, including the death of Nina Logan's mother's, Eileen Stratton, in 2004. Stratton, 84, suffocated after becoming trapped between her mattress and a bed rail at Golden West Centennial Lodge.

"They said she was found face-down, lying on her left side between the mattress and the side rails of the bed. Her face was against a pillow, and her legs were protruding from the bottom side of the rail," Logan said.

"It makes me sick, because I've seen some of the pictures of how people can get themselves caught in those bed rails and, you know, you hate to think of someone you love struggling like that and going through that. It's horrible.

"It's something that can be prevented, and it should be prevented, and they should be looking at that a lot more closely," she added.

Two other deaths in Winnipeg over the past five years have also been connected to bed rails:

• In 2003, a 77-year-old man suffocated at West Park Manor after his head became wedged between rails.
• In a case in March 2008, a woman died two weeks after she had been caught in a bed rail at the Misericordia's interim care unit. That case is still under investigation.

Rails blamed for suffocation, falls

Stephen Miles at the University of Minnesota has extensively studied the use of bed rails. As many as 500 deaths related to the use of rails have been reported in the United States, he told CBC News.

Stephen Miles at the University of Minnesota says as many as 500 deaths related to the use of bed rails have been reported in the United States. (CBC)"What happen is there's a space between the mattress and the rail, and a person slides into that space, and … the mattress then moves to the other side, and the chest gets caught — usually right between the mattress and the other rail — and then they're squeezed in the chest so that they can't inhale," he said.

"When they're squeezed in the chest like this, they can't scream, either, and so … it usually takes a couple of minutes and they suffocate from not being able to breathe."

During his research, Miles put himself in some of the positions patients were found in to see how their deaths might have happened.

"There's a great deal of physical pain," he said. "And then of course, the inability to breathe is one of the most frightening experiences that a person can have."

Risk of falling from bed 'vastly overrated'

People have also caught their heads between the bars, Miles said, or they've been seriously injured climbing over the top of the rails, falling further than they would have if the rails weren't in place.

Between 1980 and April 2008, Health Canada received 67 reports of life-threatening entrapments related to bed rails, 36 of which led to deaths. (WRHA)The risk is greatest for smaller people who don't have good use of their limbs, and people who are confused and unable to recognize the danger, Miles said.

To prevent suffocation injuries and deaths, Miles recommends people ensure their loved one's beds allow not more than 2.5 centimetres of space between the mattress and bed rails when the mattress is pushed to the other side.

"More than that, they should ask the nursing home, 'Who says this rail is really needed?'" he said.

"It turns out that the idea that older people fall out of bed is actually vastly overstated. You can use some handgrips along the bed if a person likes to use that to stand up. You can have a low bed. You can have a concave mattress on the bed that's got kind of a little valley in it, and often that's all that it takes."

WRHA raising awareness of risks

Health Canada has warned about the potential dangers of bed rails since as early as 1995.

Between 1980 and April 2008, Health Canada received 67 reports of life-threatening entrapments related to bed rails, 36 of which led to deaths. There have been at least 17 coroners’ inquests or investigations into deaths related to beds and side rails.

Real Cloutier, director of long-term care for the Winnipeg Regional Health Authority, said officials are aware of the potential for problems with the rails.

"We've been working really hard with staff within personal care homes and the public to educate that bed rails aren't necessarily the right thing to use to protect somebody in a personal care home," said Real Cloutier, director of long-term care for the WRHA.

The WRHA is in the process of replacing many old beds, and is now asking all patients to sign release forms before the rails are used.