US 3397688 A
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Aug. 20, 1968 M. GOTTFRIED PNEUMATIC HEAD AND NECK IMMOBILIZEH 2 Sheets-Sheet 1 Filed Dec. 13, 1965 MA GOTTFRIED FIG.9
ATTORN EY S Aug. 20, 1968 M. GOTTFRIED PNEUMATIC HEAD AND NECK IMMOBILIZER 2 Sheets-Sheet 2 Filed Dec. 13, 1965 INVENTOR. MAX GOTTFRIED FIG] BY W
ATTORNEYS United States Patent O 3,397,688 PNEUMATIC HEAD AND NECK IMMOBILIZER Max Gottfried, Rossford, Ohio, assignor to Jobst Institute, Inc., Toledo, Ohio, a corporation of Ohio Filed Dec. 13, 1965, Ser. No. 513,249 Claims. (Cl. 128-76) ABSTRACT OF THE DISCLOSURE An immobilizer for the human head-neck zone which can be easily positioned to envelop a patients head and then inflated by mouth to strongly brace and support the injured zone. It consists of a helmet or hood enveloping a patients head and fabricated of sheet material having inflatable portions adapted to contact areas of the head together with means to hold the helmet in place during inflation. The device also has means for inflating the helmet to thereby engage the inner walls against side and rear head areas with a resilient compressive force. The means for holding the helmet during inflation consists of a harness passing around an armpit of the patient to a further releasable connection to the device.
The present invention relates to an improved pneumatic immobilizer for the head and neck of a person who has sustained injury in that zone. Typically, such an injury is to the cervical spine or is a cerebral concussion occasioned in an automobile collision, being known as a whiplash injury, which causes a forcible neck extension accompanying an abrupt and violent, backward, forward or backward and forward jerk of the head. However, the use of the improved immobilizer to :pre-treat or alleviate other sorts of injury, such as a dislocation, fracture, or the like in the head-neck zone, is of course contemplated.
It is an object of the invention to provide a pneumatic immobilizer device for these purposes, which, when placed in position to partially envelop the injury zone from above, rear and sides, can be quickly and easily inflated by mouth to an operative condition by a physician or surgeon (after having made any desired preliminary adjustment or treatment), by an ambulance attendant, policeman or the like, or even by an accompanying passenger in the event of an automobile collision. As thus conditioned, the improved device acts to strongly brace and immobilize the injured zone against possible dangerous or additionally traumatic movement, to stop or diminish bleeding, if present, and otherwise to benefit the patient until proper further treatment is available or in order. 5
More specifically, the invention affords a pneumatioally inflatable immobilizer structure in the nature of a roughly box-shaped, downwardly-and-forwardly opening helmet or hood. This structure or device is double-walled, being preferably fabricated of translucent or transparent plastic sheeting, appropriately sealed air-tight about cert-ain marginal zones thereof to constitute the same a specially contoured envelope; and a suitable valved inflating tube device on a panel area thereof is in sealed communication with the interior of the envelope to permit oral inflation into operative engagement with the patients head, primarily at the front, top, rear and side areas.
In further accordance with the invention, provision is made to restrain or limit the immobilizer, at certain internal portions thereof, against excessive ballooning, such as would detract from the most effective application of immobilizing forces. As herein shown, such restraining or balloon-limiting means takes the form of a plurality of internal spacer straps secured tightly to internal facing wall surfaces of the envelope, and acting under tension upon inflation of the latter to limit ballooning.
The location of these restraining spacers is such that the entire internal volume of the immobilizer is in open communication with the valved inflating means.
In another aspect, the improved pneumatic immobilizer has elongated and flexible, harness-like straps securely fastened thereto and adapted to be brought around and beneath the armpits, being crisscrossed about the patients back, or chest, or both, then securely fastened to forward parts of the helmet or hood structure, as by readily appliable and releasable snap fasteners or the like. The immobilizer is thus itself securely held in relation to the injured head and/or neck zone during and after the inflating procedure.
Furthermore, as thus secured the device affords a desired cushioning protection against post-injury impact of many kinds, and also keeps the head-neck zone warm while awaiting or during transportation.
Finally, it is an object of the invention to provide an immobilizer device of the character described which is capable of efficient and economical manufacture, preferably, as indicated above, of an inexpensive transparent or translucent synthetic sheet composition, and using simple and well known techniques for heat uniting and sealing the component parts.
The invention is also concerned with a method for making the improved pneumatic immobilizer device or unit.
The foregoing as well as other objects will become more apparent as this description proceeds, especially when considered in connection with the accompanying drawings illustrating the invention, wherein:
FIG. 1 is a perspective view showing the improved helmet as theoretically positioned in space prior to inflation, with the holding straps of the device applied in operative position;
FIG. 2 is a front elevational view of the immobilizer as actually applied to a patient, also prior to inflation;
FIG. 3 is a view similar to FIG. 2, but with the immobilizer in final inflated condition;
FIG. 4 is a view in front-to-rear vertical section along line 44 of FIG. 1, showing the relationship of certain of the inflation limiting members of the immobilizer in the inoperative, collapsed position thereof;
FIG. 5 is a view in vertical section similar to FIG. 4, but showing the immobilizer in fully inflated condition in operative relation to the head and neck of the patient, indicated in dot-dash line;
FIG. 6 is a view in horizontal section along line 66 of FIG. 1, which should be considered in conjunction with FIG. 4 as showing other of the internal inflation or ballooning-limiting means of the immobilizer in a collapsed inoperative position of such means;
FIG. 7 is a view in horizontal cross section on line 7--7 of FIG. 5, with the limiting means referred to above in extended, operative position;
FIG. 8 is a plan view of a layout of a superposed pair of flexible plastic blanks at the commencement of manipulations to complete the immobilizer, this view also indicating in dot-dash line the arrangement of certain heat sealed lines involved in subsequent operations, and being included for assistance it may afford in understanding more clearly the nature of the immobilizing unit and the manner of making it; and
FIG. 9 is a fragmentary view similar to FIG. 3, illustrating an alternative usage of the immobilizer with its holding straps passed across the front or chest area of the patient.
The improved helmet or hood-like immobilizer of the invention is generally designated by the reference numeral 10. It essentially comprises an envelope 12 wholly constituted by a pair of external and internal walls 13, 14,
respectively (FIGS. 4-7), which are preferably constituted in turn by sheets of a flexible, air-impervious plastic material, also by preference transparent or translucent. This affords a physician, surgeon or attendant a view at all times of the damaged member or members after the immobilizer is applied. An appropriate ma terial might be a polyvinyl chloride or polyethylene sheet of, say, twelve gauge thickness. That is, the envelope must be substantially non-stretchable itself, though sufliciently flexible (particularly as to its internal wall 14) to engage the patients head with considerable compressive force, conforming to a certain, though not major, extent to the outline of the head. Needless to say, the sheet material must retain air pressure at or above that to which it is subjected after oral inflation. Likewise, by strong preference, the material of the envelope 12 should be heat scalable, although the use of an appropriate strong adhesive in completing the same is possible.
The mode of constructing the helmet or hood envelope 12 of the immobilizer 10 is hereinafter detailed. However, for the present, it may be noted that it comprises a pair of upright parallel side panel areas 16, 17, a top panel area 18 bridging areas 16, 17 from above, the area 18 adjoining a relatively small, generally rectangular, front or forehead area 19, and a rear panel area as shown in FIGS. 4 and 6. As indicated above, the envelope 12, as constituted throughout by the sheets 13 and 14, is double-walled, and all portions of its interior, as partially separated by the inflation or balloon-limiting means referred to above (and to be further described), are in full air communication with one another, as at places at opposite ends of said limiting means.
Referring to FIG. 1, the outer wall 13 of the near panel area 16 of envelope 12 has an oral inflating device 22, including an appropriately elongated mouth inflation tube 23, attached thereto in sealed communication with the space between its walls 13 and 14. Device 22 is of a well known type, having an internal valve (not shown) which may be opened upon turning the device in one direction, and closed after inflation by moving it in the opposite rotative direction. No claim of invention is made as to the inflating device 22, save for its special adaptation to a special immobilizer unit 10 such as is the subject matter of the invention.
In general, the immobilizer is completed by a subarmpit sort of harness, generally designated by the reference numeral 25. It comprises a pair of elongated flexible straps 26, 27, which may be of the same plastic material as walls 13 and 14, and which are each strongly heat-adhered at 28 to a bottom marginal zone of each of the side wall panel areas 16, 17, adjacent the rear thereof. In the alternative, the securement of the straps might Well be to the rear panel section 20, preferably adjacent the lower side portions of the latter. Straps 26, 27, extending from these points of attachment, are adapted to be crisscrossed behind the patients back, then brought forwardly beneath the armpits (FIGS. 2 and 3), thence upwardly for releasable connection to marginal forward zones of panel areas 16, 17, i.e., at either side of the immobilizer 10 at which it opens forwardly of the patients face. The device also contemplates a front-wise crisscrossing of the holding straps pursuant to FIG. 9, or across both front and back.
For the purpose of the releasable strap securement, I prefer the use of snap fasteners 30, the female and male elements, respectively, of which are secured to the straps 26, 27, adjacent the free ends of the latter, and to the forward marginal zones of the wall panel areas 16, 17. By preference there will be a plurality of such fastener elements on both the strap and the panel zone, in order to permit a desirable range of adjustments as to the effective strap length for patients of different proportions.
As above indicated, the immobilizer device 10 is completed by a number of balloon or inflation-limiting spacers which act in tension for the indicated purpose. Thus, reference being had to FIGS. 4 through 7 in conjunction with FIG. 1, I contempalte a pair of parallel, horizontally and transversely extending spacers 32, 33 (FIGS. 4 and 5), and a pair of more elongated spacers 35, 36 (FIGS. 5, 6 and 7) which extend in parallel vertical relation to one another in the upright zones at which the rear wall panel area 20 adjoins the side panel areas 16 and 17.
In regard to the manufacture of the immobilizer device 10, reference should now be had to FIG. 8 of the drawings in conjunction with FIGS. 1 and 4 through 7. Its envelope 12 is fabricated of a pair of superposed blanks B and B of identical, generally T-shaped outline, which are in exact register with one another, as indicated in FIG. 8. While these blanks are not creased or scored, and are in perfectly flat condition as laid out, the 90 related dotted lines indicate how the blanks are hypothetically subdivided into the wall panel areas referred to above, i.e., the side wall panel parts 16, 17, the rear panel area 20 centrally therebetween, the top panel part or area 18, and the forehead extension part 19 of the latter. The sequence of operations in the heat sealing together of the transparent or translucent polyvinyl chloride or polyethylene wall sheets 13 of which the blanks B and B are formed, and the manner of heat sealed attachment of the various balloon-limiting spacers 32, 33, and 36 therebetween, may vary; however, the following procedure will serve the purpose of illustration.
Thus, the spacers 32, 33 may be cut from lengths of the same material, substantially shorter than the horizontally transverse dimension of the top and rear panel areas 18 and 20, then folded upon themselves along a longitudinal center line and adhered by heat sealing along marginal lines 38 to the respective envelope walls 13 and 14 adjacent the front and rear of top panel area 18. This operation will be performed with a suitable insulative shim or like protective separator interposed between the folded thicknesses of the respective spacers 32, 33, in order to prevent thermoplastic adherence thereof to one another.
Similarly, the more elongated upright spacers 35 and 36 are formed of elongated, medially folded lengths of the plastic material, then interposed between the envelope walls 13, 14 and sealed thereto along overlapped marginal lines at 39, with similar provision to prevent sticking of the spacer plies to one another. As indicated above, the two horizontal spacers 32, 33 will lie across approximate forehead and rear head zones; while the two upright spacers 35, 36 will lie approximately along rear and side head and neck zones (see in particular FIGS. 4, 5 and 6, 7). As also mentioned above, the ends of all spacers lie spaced in the direction of their respective lengths from any zone of heat sealing. Accordingly, the space throughout the immobilizer 10 between its outer and inner walls 13, 14 is uniformly inflatable orally through the inflating device 22. A greater number of spacers may be utilized, if found desirable.
The inflating device 22 is preferably applied to the outer wall 13, in one of the side areas 16, 17 of the unit prior to the assembly and securement of the spacers 32, 33, 35 and 36.
In the final assembly of the immobilizer 10, with the spacers 33 and 36 applied as described, the blanks B, B are united, and sealed but intercommunicating air cornpartrnents in the various panel areas 16-20, inclusive, are defined, by the production of a continuous heat sealed zone 40 located somewhat inwardly of and about the margins of the superposed blanks. Such margins are represented by the uper marginal edges a of the side panel areas 16, 17 (as viewed in FIG. 8), the lateral edge limits b of the top wall panel area 18, the corresponding lateral margins c of the forehead area 19, also the upper or outer edge at of the last named area, and the upper portions of the laterally outer edges e of panel areas 16, 17, as will be seen by a comparison of FIG. 8 with FIG. 1.
Thus, commencing in a line along and just above the transverse edge d of the forehead area 19, the heat seal zone 40 extends along that area and top area 18, in inwardly spaced relation to each side thereof, thence around the side and rear areas 16, 17 and 20, as shown in FIG. 8. This completes the heat seal 40, providing an anti-leak union of the immobilizer walls 13, 14 about the entire exposed marginal extent thereof, with air chambers of areas 16-20 in free communication with one another. Appropriate specific provisions, not germane to the invention, are made to resist the initiation of tear at all corners.
Thus prepared, the wall areas 16, 17 of blanks B, B are swung 90 to rear wall area 20; the top wall area 18 is also Swung 90 vertically relative to rear area 20, so as to bring its side margins into overlapped juxtaposition to the upper margins of wall areas or parts 16, 17; and the forehead area 19 is also swung 90 into the same relation to the upper portion of the forward marginal zones of the respective side wall panel areas 16, 17.
With the panel portions in question disposed as described, they are sealed together by heat to unite the side edges of forward portion 19 with the upper parts of forward edges e of panel elements 16, 17, and to unite the edges b of top area 18 with edges a of panel members 16, 17.
This brings the structure of immobilizer 10 into the general box-like outline represented in FIGS. 1, 4 and 6; and it is then trimmed closely along the outside of the united edges a-e in order to present an external appearance which is as smooth as possible, being practically undetectable from a simple crease. No particular care need be exercised in the trimming operation, inasmuch as the wall plies 13 and 14 are effectively sealed against air leakage within the panel margins referred to by heat seal zone 40.
The box forming of the helmet structure is preferably performed using an appropriate rectangular supporting and shaping mandrel or anvil (not shown) and coacting external sealing means (also not shown), one or both provided with means to thermally plasticize and unite the walls 13, 14 of the side areas 16, 17, and top and forehead areas 18, 19 and the rear area 20 to one another.
The unit 10 is now carried to completion as a whole by the application of the male elements of snap fasteners 30 to the upright forward marginal zones of the respective side wall .areas 16, 17, outwardly of the heat seal 40; and by the thermoplastic attachment of the harness straps 26 to the unit at 28. These straps will preferably have a number of the female elements of snap fasteners 30 preapplied thereto.
The manner of use of the immobilizer is believed to be obvious from an inspecton of FIGS. 1, 2, 3, and 7. As placed on the patients head, the harness straps 26 are drawn beneath the armpits and, with an appropriate degree of tautness, snap fastened to the envelope 12. The unit is then orally inflated through device 22, closing the latter when an appropriate pressure is reached.
Referring to FIGS. 3, 5 and 6, the inner wall 13 of the unit then takes a very stable compressive engagement with the top, rear and sides of the patients head, conforming to its outline. No great degree of pressure, if any, is exerted in the neck zone; however, the engagement mentioned above is ample to thoroughly immobilize both neck and head. Spacers 32, 33, 35 and 36 act effectively, .as shown in FIGS. 5 and 7, to limit ballooning of immobilizer 10, and thus make possible its effectiveness in gripping the head and stabilizing the injured or wounded part or parts as a whole.
FIG. 9 depicts an alternative usage of the harness 25, in which it has its straps 26, 27 crisscrossed about the front or chest area of the patient. Of course, harness provisions may be made to cross both the front and back. In
some cases, the front-crossed arrangement is to be preferred, as giving a greater pressure contact with the cheeks, while preventing the undesired ballooning. The immobiliz ing action is comparable, and in any embodiment the device gives protective cushioning action to protect against impact damage after application of the immobilizer, as well as to alford warmth to the patient while awaiting or during transportation.
As herein illustrated and described, the immobilizer unit presents two-walled inflatable portions at 16, 17, 18, 19 and 20 which are of substantial area and rectangular outline. However, it is contemplated that these areas might be further subdivided, if found desirable, and actually might not be inflatable throughout the entire longitudinal and lateral extent of each area, i.e., to some extent more locally applying the compressive effect to the head. Likewise, it is contemplated that in some instances the top and forehead areas might not necessarily be inflatable, but instead acting simply to grip against the forehead and top head areas of the patient.
Unit 10 is manufactured very inexpensively of inexpensive materials and by inexpensive procedures. It will be indispensable equipment for ambulances, emergency vehicles and wards, and the like. It is readily manipulated in use by a most unskilled person; indeed, it is contemplated that the unit may be purchased by vehicle owners as a class for time-saving availability in an emergency collision, for example, of the whiplash type.
What I claim as my invention is:
1. A pneumatically inflatable immobilizer for the human head-neck zone, comprising a helmetor hood-like unit to at least partially envelop a patients head at top, sides and rear, said unit being fabricated of flexible, airimpervious sheet material and having two-walled inflatable portions adapted to be placed adjacent at least the side and rear areas of the head, means to hold said'unit thus placed prior to and during inflation thereof, and means in communication with said portions to inflate the latter from the exterior, thus engaging inner walls of said portions against said side and rear head areas with substantial resilient compressive force to substantially immobilize said head-neck zone, said holding means comprising a harness having a fixed connection to said unit, said harness at least in part adapted for passing around an armpit of the patient to a further releasable connection to the unit.
2. The immobilizer of claim 1, in which at least one of said portions has internal means to limit the extent of ballooning thereof when inflated.
3. The immobilizer of claim 1, in which one or more of said inflatable portions has internal means to limit the extent of ballooning thereof when inflated.
4. A method of making a pneumatically inflatable immobilizer, comprising superposing a pair of substantially identical, approximately T-shaped blank portions of flexible, air-impervous sheet material in superposed register with one another, marginally sealing said portions to one another, and forming and marginally sealing areas of said portions together in a forwardly and downwardly opening, hood-like outline.
5. The method of claim 4, in which the immobilizer, in said hood-like outlline, has said blank portions sealed to one another around and within the margins thereof.
References Cited UNITED STATES PATENTS L. W. TRAPP, Primary Examiner.