When stirrups aren't available: Innovation of a low-cost pelvic lift cushion

Abstract

IntroductionGynecological exam beds with stirrups are considered by many the gold standard for patient positioning when performing a pelvic exam and suturing following a birth. However, there are many instances when a stirrup bed is not available due to the cost of the equipment, insufficient number of stirrup beds, or emergent procedures in centers that do not regularly stock such beds due to cost or lack of sufficient space. When a stirrup bed is not available, many clinicians resort to using work-arounds such as an upside-down bedpan or rolled towels to lift the patient's pelvis. While this may lift the patient's pelvis, this is uncomfortable for the patient and may even cause the patient to tense up during the medical procedure, making the exam or procedure harder to complete. Materials and MethodsIn 2018, a team at Stanford University developed a low-cost pelvic lift cushion as an alternative to upside-down bedpans that aimed improve patient comfort while maintaining satisfactory levels of visibility and physical access for clinicians. The Stanford team surveyed patient/clinician interactions in which the novel pelvic lift cushion, the stirrup bed, or an upside-down bedpan/rolled towels, were used. ResultsBased on 19 patient and clinician interactions, the pelvic lift cushion was found to provide patient comfort and appropriate access for clinicians during a pelvic exam. Clinicians scored it higher than the upside-down bedpan/rolled towels in every area. ConclusionThis inexpensive innovation can improve patient comfort by using an appropriately designed device while maintaining clinician satisfaction in settings where gynecological stirrup beds are not available or desired. Further research is needed to determine the device's effectiveness for different procedures and with a more diverse sample size.