bed rest

Bed rest is a technical term used in nursing and medicine . It describes maintaining a lying position in bed even outside of bedtime. Compared to sleep, bed rest lasts all day or several days.

The previously common equation of strict bed rest with rest and relief is now being critically questioned, because long bed rest without a clear reason, careful monitoring and care can even be life-threatening.

One distinguishes between:

Strict bed rest: Not allowed to get up, toilet on the bed bowl , washing in bed
Restricted bed rest: Getting up under supervision and for a limited time.

Indications

Even today, bed rest for as short a period of time as possible is sometimes medically sensible or even absolutely necessary. The seriously ill patient will often keep bed rest voluntarily, since he can no longer help himself. Here bed rest is the predominant problem.

Some medical reasons for bed rest are:

in the early stages of myocardial infarction ,
in shock
during ventilation
in pulmonary embolism
in severe heart failure
with extensive thrombosis with impending pulmonary embolism
if there is a pronounced risk of falling
if the femoral neck fracture is not treated
for unserved fractures of the lower extremities
during dialysis

Problems of bed rest

Bed rest brings some specific problems. Most of those affected find the toilet on the bed bowl very uncomfortable. Psychological reasons for the rejection play a role here. The real negative medical consequences of bed rest are more serious, especially if they have to be kept for several days. The main problems with bed rest are the risk of thrombosis and poor circulation when the bed rest is ended. Other negative phenomena are:

Risk of falling when mobilizing
Muscle atrophy and bone loss
Flatulence
Bedsores (bedsores)
Risk of pneumonia due to insufficient ventilation of the lungs

compensation

You can usually reduce the problems of bed rest considerably if you take special countermeasures. For those who are not too seriously ill, hydrotherapeutic measures, massages and brushing are recommended as compensation regulations. A bed bike can be helpful. Even with strict indications, bed rest should be loosened up if possible, e.g. B. through adjustable beds, occasional sitting in armchairs, going to the toilet on the bedside chair with assistance.

Contraindications

Even in the case of some serious illnesses, for which long bed rest was a standard treatment in the past, it is now believed that bed rest brings more problems than benefits. This is how a patient with pneumonia or a high fever will get up if he wants to. If he has poor circulation he will be given support. The benefits of strict bed rest are also not given or not proven for other diseases, which are listed below:

longer bed rest with myocarditis
longer bed rest in the event of a heart attack
strict bed rest with deep thrombosis

literature

C. Allen, P. Glasziou, C. Del Mar: Bed rest: a potentially harmful treatment needing more careful evaluation. In: The Lancet . 354 (9186), 9 Oct 1999, pp 1229-1233. PMID 10520630
Comments:
- KW Heaton: Dangers of bed rest. In: Lancet. 354 (9194), 4 Dec 1999, p. 2004. PMID 10622336
- KS Gebhardt, MR Bliss: Enforced bedrest. In: Lancet. 355 (9206), Mar 4, 2000, p. 844. PMID 10711950
MW Bleeker, PC De Groot, GA Rongen, J. Rittweger, D. Felsenberg, P. Smits, MT Hopman: Vascular adaptation to deconditioning and the effect of an exercise countermeasure: results of the Berlin Bed Rest study. In: J Appl Physiol . 99 (4), Oct 2005, pp. 1293-1300. PMID 15932956

Web links

Nicola Siegmund-Schultze: Immobilization: When bed rest makes you sick. In: Deutsches Ärzteblatt. 105 (4), 2008, pp. A-146 / B-131 / C-131.
Jörg Blech: Not because of bed rest. on: Abendblatt.de , November 3, 2007. (Slightly abbreviated from: Jörg Blech: Movement. The power that conquers diseases and extends life. Verlag S. Fischer, Frankfurt am Main 2007)