Problem Solvers

Getting it Right the First Time

Pressure mapping is a key resource for wheelchair providers working to get patients the ideal cushion.

For wheelchair patients, having the right cushion is a critical need. Spending the majority of the time in their chairs exposes wheelchair users to a high risk of pressure sores and related conditions due to the constant interface with the cushion. Certainly how a cushion feels is important, but having the right cushion in place, the one that minimizes the most pressure, minimizes sheer and negates hot spots is the key. In the simplest terms, a cushion essentially has to be the perfect fit.

“There’s a lot more to it than making a cushion comfortable,” says Ron Resnick, president of Blue Chip Medical Products, a Suffern, N.Y.-based maker of support surfaces such as wheelchair cushions and therapeutic mattresses.

Fortunately, the situation is improving. While even just a few years ago, providers had only so many options to achieve that perfect fit, today’s range of cushion options is fare more varied. There are a variety of companies manufacturing a variety of wheelchair cushions that are both effective from a care perspective and a cost perspective, Resnick explains.

Moreover there are a variety of cushions to match lifestyle needs as well. For instance, there are cushions that offer increased durability for prolonged use, and even options stand up to outdoor use.

“Besides the fact that we’re getting good results in terms of significantly reducing interface pressure, I think the key is durability,” Resnick says. “Medicare is not paying for cushions like they used to.”

Pressure Mapping

All this means that providers have both the benefit of choice, and the challenge of choice. How do they find the right cushion for a patient amidst all those options? How do they ensure it will continue to be the right fit over time? It comes down to measurement, and that means pressuring mapping.

“You can identify very clearly the correct support surface or seating system for a particular patient,” Resnick says, who adds that results can Sometimes be surprising. Often the options that a provider or patient might initially gravitate to might not be the right option. “Even on my cushions, when I thought my cushion would be the prefect solution; it was not,” he adds.

And pressure mapping capability will mean that providers will increasingly map their patients more frequently to ensure that the patients are continuing to get the right benefit from their wheelchair cushions. More to the point, Resnick says that pressure mapping should be required far more often than it is.

“I think that for every facility that [regularly] orders wheelchairs and wheelchair cushions, that every patient should be mapped,” he says. “I think it should be incumbent upon the government. … If you need a CPAP, you have to do an oxygen test and you to go through a sleep study for the prescription. So if I’m ordering a cushion, why can’t I have a pressure map? It’s not invasive; it can be done right in the clinic.”

Pressure mapping not only gives a provider clinical insight in ensuring the right care for a patient, but it also gives them a business edge. Providers with pressure mapping capability can offer it as a service to local care facilities, or they can simply use it to differentiate themselves from their competition.

SensorEdge

That said, pressure mapping can be costly technology to implement. Systems in the past have been pricey and thus often left to specialized providers. To help more providers get access to pressure mapping, Blue Chip Medical Products recently partnered with a Parsippany, N.J.-based pressure mapping device maker to make a serviceable, U.S.-made pressure mapping solution that prevent costly pressure ulcers and increase patient comfort for both wheelchair and support surface applications.

At the heart of those solutions lies a technology called MeasureX, a proprietary software developed by SensorEdge that measures pressures in 2D and 3D pressure maps. The software also includes features for video recording, highlighting areas of interest, masking and data exporting.

In terms recording and using pressure mapping data, medical professionals using the software with a SensorEdge sensor pad, can record and save sessions; track center of gravity; view pressure in adjustable color gradients; generate average pressure graphs; use area masking to generate localized statistics; and customize how data is displayed. The data can be exported as .avi video files, and data is exportable to Excel Video recording capability.

The SensorEdge comes in two formats: a mattress-sized system for measuring therapeutic mattresses and support surfaces, and a wheelchair-sized unit. The wheelchair sensing pad for seating and positioning applications measures 18 inches by 18 inches, and again .02 inches thick. The sensing area is 16 inches by 16 inches with a resolution of 16 by 16 for standard and 32 by 32 for high definition. The total sensor is 256 standard or 1024 high definition, and the pressure range is 1 to 30 psi. That level of detail and software capability is what ensures the perfect fit, according to Resnick.

“Even within my own line of cushions, it’s not the most expensive cushion that works,” he says. “It’s the right cushion that works. And the only way to clinically and empirically find that, is to pressure map somebody.”

This article originally appeared in the May 2015 issue of HME Business.

About the Author

David Kopf is the Editor of HME Business.

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