Patient Comfort and Safety: What is a Knee Gatch Used For?

Proper patient positioning is crucial, as immobile patients can develop pressure ulcers in as little as two hours. A key tool in preventing this is the knee gatch. So, what is a knee gatch used for? It's a feature on adjustable beds that elevates the knees.

Quick Summary

A knee gatch is an adjustable section of a hospital or home care bed that raises the user's knees. Its primary purpose is to prevent the patient from sliding down the bed, improve comfort, and aid in circulation.

Key Points

• Primary Function: The main purpose of a knee gatch is to prevent a patient from sliding down toward the foot of the bed, especially when the head is elevated.

• Pressure Ulcer Prevention: By stopping sliding, the knee gatch reduces shear and friction forces on the skin, which are major contributors to pressure ulcers (bedsores).

• Enhanced Comfort: Elevating the knees creates a more natural, contoured position that can relieve pressure on the lower back and sacrum.

• Improved Circulation: The feature can help improve venous return from the lower legs, which may assist in reducing edema or swelling.

• Safety Protocol: When using the feature, always raise the head of the bed first, then the knee gatch. To get a patient out of bed, the knee gatch should be lowered first.

Understanding the Fundamentals of Patient Positioning

In any care setting, whether it's a hospital, a long-term care facility, or a private home, the well-being of a patient with limited mobility is paramount. A significant component of this care revolves around proper positioning in bed. Without the ability to shift their weight regularly, patients are at a high risk for a variety of health complications, including pressure ulcers (bedsores), poor circulation, and respiratory issues. This is where the specific features of a medical bed become critically important. One of the most essential, yet often overlooked, features is the knee gatch. While the ability to raise the head of the bed is widely understood, the function of the knee gatch is just as vital for patient safety and comfort.

What is a Knee Gatch and How Does it Work?

The knee gatch, also known as a knee break, is a hinged section on the frame of an adjustable bed, typically located where a person's knees would rest. On semi-electric and full-electric hospital beds, this section can be raised and lowered, creating a bend at the knees. This simple mechanical adjustment serves several profound purposes that directly impact patient care.

When a patient is in a seated or semi-Fowler's position (with the head of the bed raised), gravity naturally pulls them towards the foot of the bed. The knee gatch acts as a crucial anchor. By raising the knees slightly, it creates a contour in the bed that cradles the patient, preventing them from sliding down. This single function has a cascade of positive effects.

The Primary Clinical Benefits of Using a Knee Gatch

The application of a knee gatch goes far beyond simple comfort. Its use is a deliberate clinical intervention designed to address specific health challenges.

1. Prevention of Patient Sliding and Shear Forces:

• Anchoring: As mentioned, the primary use is to stop the patient from sliding down when the head of the bed is elevated. This reduces the need for caregivers to constantly reposition the patient, saving them from physical strain and potential injury.
• Reducing Shear: Shear force occurs when layers of skin, muscle, and bone rub against each other as a result of gravity and friction. When a patient slides down in bed, the skin can stick to the sheets while the deeper tissues are pulled downward. This stretching and tearing of blood vessels and tissue at a microscopic level is a leading cause of pressure ulcer development. The knee gatch directly mitigates this risk by holding the patient securely in place.

2. Improving Circulation and Reducing Edema:

• Elevating the legs and knees can help promote venous return, improving blood flow from the lower extremities back to the heart.
• For patients prone to lower leg edema (swelling), using the knee gatch can help reduce fluid buildup by elevating the limbs above the level of the heart.

3. Enhancing Comfort and Support:

• A slightly bent-knee position is a more natural and relaxed posture for many people than lying completely flat or having legs extended straight out.
• It helps distribute the patient's weight more evenly across the bed surface, relieving pressure on the lower back and sacrum, which are high-risk areas for pressure sores.

Who Benefits Most from a Bed with a Knee Gatch?

While almost any patient using an adjustable bed can benefit, the knee gatch is particularly indispensable for certain individuals:

• Seniors with Frailty or Limited Mobility: Elderly individuals who spend significant time in bed are at high risk for sliding and skin breakdown. The knee gatch provides essential stability.
• Post-Surgery Patients: After many types of surgery, patients require specific positioning to aid recovery. The knee gatch helps maintain these positions comfortably and safely.
• Patients with Chronic Conditions: Individuals with congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD) often need to sleep with their head elevated to breathe more easily. The knee gatch is essential to keep them in this position throughout the night without sliding.
• Neurological Patients: Individuals recovering from a stroke or with conditions like Parkinson's disease may lack the core strength to reposition themselves, making the anti-sliding function of the knee gatch critical.

Comparison of Bed Positioning Features

To better understand the unique role of the knee gatch, it's helpful to compare it with other standard hospital bed functions.

Feature	Knee Gatch	Trendelenburg	Reverse Trendelenburg
Primary Action	Bends the bed frame at the knees.	Tilts the entire bed frame, head down/feet up.	Tilts the entire bed frame, head up/feet down.
Main Purpose	Prevents sliding, improves comfort, relieves lower back pressure.	Increases blood flow to the brain, used in specific medical procedures.	Reduces gastric reflux, improves breathing, lowers cranial pressure.
Common Use	General patient comfort and safety, pressure ulcer prevention.	Treating shock or low blood pressure, specific surgical procedures.	Feeding, reducing aspiration risk, managing GERD.

How to Use a Knee Gatch Safely and Effectively

Using a knee gatch is straightforward, but following the correct procedure ensures maximum benefit and safety.

1. Elevate the Head First: Always raise the head of the bed to the desired position before adjusting the knee gatch.
2. Raise the Knee Gatch: Slowly elevate the knee section until the patient is secure and comfortable. The goal is to create a gentle bend, not a sharp angle.
3. Check for Comfort: Ensure the patient's heels are not digging into the mattress. If needed, a pillow can be placed under the calves for additional support, but be cautious not to create a new pressure point.
4. Lowering the Bed: When preparing the patient to get out of bed, always lower the knee gatch completely first, followed by the head of the bed.

A crucial safety note: Never use the knee gatch as a restraint. Its purpose is for positioning and comfort. For more in-depth clinical guidelines on patient positioning, resources from the National Institutes of Health (NIH) provide evidence-based practices for caregivers.

Conclusion: An Essential Component of Quality Care

So, what is a knee gatch used for? It is far more than a simple hinge on a bed. It is a fundamental tool for ensuring patient safety, preventing painful and dangerous pressure ulcers, reducing caregiver strain, and providing a foundation for dignified and comfortable care. When selecting a hospital bed for home or facility use, the presence and proper functioning of a knee gatch should be considered a non-negotiable feature for anyone with limited mobility.

Frequently Asked Questions

Is a knee gatch the same as raising the foot of the bed?

No. A knee gatch creates a bend at the knees, while the foot elevation feature on some beds raises the entire lower section of the bed from the mattress frame. The knee gatch is more effective at preventing sliding.

Do all hospital beds have a knee gatch?

Most modern semi-electric and full-electric hospital beds have a knee gatch feature. Manual hospital beds may have a manually operated knee gatch, but it is less common on basic models.

Can using a knee gatch be bad for circulation?

When used correctly to create a gentle bend, it generally improves circulation. However, raising it too high for extended periods could potentially constrict blood flow behind the knee. Always aim for a comfortable, moderate angle.

What is the difference between a semi-electric and full-electric bed's knee gatch?

On a full-electric bed, the head, foot, and overall height are adjusted electronically via a remote. On a semi-electric bed, the head and knee gatch are electric, but the bed height is typically adjusted with a manual crank.

How does a knee gatch help with back pain?

By creating a bend in the knees, the knee gatch helps to flatten the lumbar spine against the mattress, which can alleviate pressure and reduce lower back pain for many individuals.

Is a knee gatch covered by Medicare?

Medicare Part B may cover the rental or purchase of a hospital bed, including one with a knee gatch, if it is prescribed by a doctor and deemed medically necessary for use in the home. Coverage specifics can vary.

Can I add a knee gatch to a regular bed?

No, a knee gatch is an integrated mechanical part of an adjustable bed frame. You cannot add it to a standard, non-adjustable bed. However, adjustable bed bases with similar features are available for purchase.