Pressure Relief: Please Take a Chair.

A product innovator takes pressure relief to the next level

Often when a resident develops a pressure ulcer, that unpleasant discovery is made while the resident is lying in bed. Aside from entertaining some, perhaps quiet, second thoughts about the quality of nursing care, facility management tends to blame the bed, or support surface, itself. As far as they're concerned, it "just doesn't work."

As far as Mark Hagopian is concerned, they're focusing on the wrong piece of furniture. "The problem happens when the resident is transferred to a wheelchair or gerichair. Fifteen minutes on one of those surfaces can produce a new wound or undo months of care for an old wound. The bed, if it was calibrated appropriately for height and weight, was fine."

Hagopian might be accused of defensiveness--after all, his engineering company, Biologics, Inc., of Clearwater, Florida, provided the technology for many of the low-air-loss bed overlays on the market today. He's stepping forward, though, with what he believes is the solution: a low-air-loss chair overlay that adjusts pressure as a sitting resident moves about. The key is a set of computerized algorithms he devised that enables an overlay the size of a wheelchair cushion to adjust to resident motion.

This hasn't been done before, he says, and for good reason. Although, as an engineer, Hagopian speaks in terms of "digital morphology" and "pressure gradients," he offers a "plain English" explanation: "You can't use alternating pressure relief in something this size because the pressures used are so high. And the typical low-air-loss bed-overlay computer doesn't know how to regulate a surface of this size without turning it into a basketball. What these new computerized algorithms have enabled us to do is to design a chair overlay that functions much like a hovercraft, making precise adjustments in a small space to make you feel like you're floating on air."

Every 11 seconds, transducers in the controller feed back to the computer new information on the resident's position in the chair. The air support is adjusted accordingly, always keeping the pressure exerted on any part of the body below that vital 32 mmHg cutoff for maintaining healthy skin over extended periods of time.

The idea occurred to him, he notes, when people kept sitting on a small test simulator he had devised for a low-air-loss bed overlay. "They kept saying how comfortable it was," he says, and, with a few modifications, the test simulator as chair overlay yielded pressures that Hagopian says were surprisingly low. A patented, 10-pound computerized air pressure controller for the bed mattress was then developed that could be removed from the bed and hung by brackets on a wheelchair or gerichair. Power for freely ambulating wheelchairs is provided by a rechargeable 12-volt DC battery that lasts up to four hours.

Hagopian predicts better wound prevention and more cost-efficient wound healing, now that the chair has been removed as a contributing factor to residents' pressure sores. As with any support surface, though--powered or unpowered--the key to successful pressure relief is a nursing staff that pays attention to residents' skin care needs and reacts promptly to the first signs of risk.