OSKA Aria Case Studies
To alternate or not to alternate. . .that is the question?
When it comes to pressure injury management, as clinicians responsible for providing the correct support surface for our clients, we often jump straight to the highest level of treatment or relief – alternating air. However, I would like to challenge our thinking and consider some cases where alternating air was not and is not always the go to or best option for our clients.
Gary had a recent Left MCA infarct and following a period of rehabilitation is living back home with his wife. His stroke has impacted movement on his right side and he has a dense hemiplegia with very limited independent movement in his right hand and arm. He currently transfers from bed using a bed rail onto his stronger left side and then requires assistance from his wife to stand using a standing aid.
During his time in hospital and due to his severe immobility prior to his rehabilitation Gary developed a stage 2 pressure injury on his sacrum. With a turning routine and treatment from the nursing staff in hospital this injury has now healed but Gary and his wife are concerned about this occurring once again.
His OT has set out to find him an appropriate mattress to meet his pressure care needs. He currently has intact skin and no redness on his sacrum, but his OT is aware that his previous injury puts him at higher risk of another injury developing.
The OT would like to trial an alternating air mattress due to Gary spending a lot of time in one position in bed. On trial of an alternating air mattress Gary had a lot of difficulty managing to get out of bed independently with his bed rail as he was previously able to do. This was a priority for Gary and he declined to trial any other alternating air mattresses as it took away his independence.
The OSKA ARIA Series 4 v3 was trialled as this is a hybrid – air & foam mattress. This means that through the system of a one-way valve and air displacement in the cells it allows for a high level of immersion and envelopment within the mattress. Gary found the mattress very comfortable and he was happy to find he could transfer himself from lying to sitting on the edge of the bed easily.
Used with a routine to frequently turn and reposition himself Gary found the OSKA ARIA was a great option for meeting his comfort preference and allowing him the independence to transfer himself in and around his bed – not to mention meeting his pressure care needs in managing his vulnerable pressure areas.
Dennis: Spinal Tumor
Dennis is a 27 year old gentleman who has recently been diagnosed with a c4-8 spinal tumour. The tumour was noticed after Dennis started experiencing a tingling sensation in his arms and legs. His symptoms progressed and more recently he has developed a severe sensitivity to light, sound, touch and movement.
This has impacted his quality of life greatly and he spends all day in his dark room, only tolerating whispering conversation for short periods and is further limited due to severe pain and weakness to stand up and mobilise. He has also lost a lot of weight and is only 55kg during his initial stages of therapy.
As a result, he started to develop pressure injuries on his bony prominence with a stage 3 injury on his scapula, stage 2 injury on his occipital bone and stage 2 on his heel.
Due to his severe movement impairment and reduce tolerance to repositioning himself in bed, Dennis was prescribed several different alternating air mattresses to offload his bony prominence in treating his wounds. This however exacerbated a lot of his symptoms. The noise, whilst relatively quiet was enough to severely disturb Dennis due to his auditory sensitivity, and the movement of the alternating air cells were also reducing his comfort on any mattress.
After trialling 9 other mattresses the OSKA ARIA Series 4 v3 was trialled with Dennis. Because this is a non powered option it worked wonders for Dennis as there was no additional movement or sound bothering him. This made a huge difference to his quality of life. He felt comfortable whilst also feeling supported by the individual air cells which provided him with sufficient pressure redistribution. Within a few weeks his pressure injuries were healing sufficiently and he is now pressure injury free.
Mary: Multiple Sclerosis
Mary is 47 years old and has been diagnosed with primary progressive MS. She requires assistance to mobilise short distances around her home and uses a scooter for getting around outdoors.
Mary currently sleeps on a queen size spring mattress with a memory foam topper however as her mobility and movement deteriorate she is finding it more difficult to move her self around in bed. Mary has also noticed that she gets hot when lying in bed and is concerned about heat retention and the impact this could have on her development of pressure injuries.
Mary is looking for a more appropriate mattress to meet her needs. Her priorities when finding a suitable mattress are:
- Provide her with a high level of comfort for potentially long periods resting in bed.
- Ability to move in and around bed and to transfer out of bed to maintain her independence for as long as possible.
- Management of her thermoregulation as due to her MS condition this impacts on her feeling very hot with difficulty to cool down.
Due to Mary only having a queen size bed this limited her options of pressure reliving mattress available. She was trialled with a number of different mattresses. For each she stayed in one position for 15-20 minutes to allow her to trial the comfort levels.
The OSKA ARIA Series 4 v3 Hybrid mattress with mattress surround was trialled. Mary was able to tolerate over 30 minutes lying on this mattress whilst maintaining her comfort and keeping her cool and dry. This was a lot longer than any other mattress she trialled which she struggled to tolerate for longer than 10 minutes of the trial.
The reason why the OSKA ARIA functioned this way was due to the combination of air and foam cells which work to displaced air when pressure is applied. So when Mary lied on the air cells, air left the cells, but as soon as Mary moved the air cells refilled, allowing the mattress to conform to the shape of her body. The ARIA gave her support and comfort whilst also encouraging her to move with the push back of the type of high specification foam. However most importantly, Mary did not immediately start perspiring and feeling hot on this type of surface and this was due to an aerolite foam – this microclimate management design allows for air to flow through the foam to keep the body cool and dry.
Mary was relieved and surprised to finally find a mattress that ticked all her boxes of priorities.