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Lateral Rotation
Last Updated: 05/05/2007
A method of pressure management with support surfaces that can be programmed to rotate the patient up to 40° in either direction from flat supine. Lateral rotation (a.k.a. adjuvant therapy, rotation therapy) was originally developed in the late 1980's to attempt to prevent respiratory involvement in the ICU/CCC patient, or the patient on extended bedrest. Since its introduction into the market, lateral rotation has been used increasingly for the management of skin. Indications for this method of pressure management include prevention or healing of breakdown in patients at high risk due to their ability to maintain only one or two positions. Additionally, lateral rotation has been used for patients who cannot tolerate manual handling to be turned due to pain. These patients would include those with arthritis, hip fractures or replacements and skin conditions causing pain with contact.

Lateral rotation does NOT replace manual turning to reposition if the patient can tolerate it. Repositioning is meant to change the relationship of the body surface to the support surface, not to horizontal. If the mattress is rotated to 30°, then the patient should be positioned 20-30° from the surface of the mattress, not from horizontal. This gives the skin a chance to fully re-perfuse, to "breathe", to ventilate sweat and heat. Repositioning also shifts weightbearing points.

Span-America manufactures two mattresses that offer lateral rotation: The PressureGuard Turn Select, and the PressureGuard APM2 . The Turn Select is fully programmable to rotate the patient in any combination of 3 positions, at angles of 5°-30°, and for times of 1-120 minutes. The PressureGuard APMē can be changed from alternating pressure to lateral rotation with the flip of a switch, but cannot be programmed. Its rotation is fixed to 10-minute cycles.

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