US 3490443 A
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Description (OCR text may contain errors)
Jan. 20, 1970 JJJ. E. A. DECUPPER APPARATUS FOR TREATING BURNS Filed March 25, 1967 '7 Sheets-Sheet 1 1970 J. J. E. A. DECUPPER 3,490,443
APPARATUS FOR TREATING BURNS Filed March 23, 1967 '7 Sheets-Sheet 2 Jan. 20, 1970 J. J. E. A. DECUPPER 3,490,443
APIPARATUS FOR TREATING BURNS 7 Sheets-Sheet 5 Filed March 23, 1967 Jan. 20, 1970 J, 5 DECUPPER 3,490,443
APPARATUSFQR TREATING BURNS Filed March 23, 1967 I 7 Sheets-Sheet 5 Jan. 20, 1970 '7 Sheets-Sheet 6 Filed March 23, 1967 aw h m Q2 1 E u o: 2. Q m: m2 E 2 .vm we Jam 1970 J. J. E. A. DECUPPER 3,490,443
APPARATUS FOR TREATING BURNS Filed March 23, 1967 7 Sheets-Sheet 7 United States Patent 55,096 Int. Cl. A61h 1/00; A61g 7/10 US. Cl. 128-24 4 Claims ABSTRACT OF THE DISCLOSURE A tight casing for treating severe burns containing a removable cradle for supporting the patient, which is tiltable to modify its angular position.
As is known, the treatment of severe and extensive burns is subject to considerable difliculties because of, in particular, the danger of infection which is dangerous not only to the patient himself but also to other neighbouring patients in the same room, this being particularly true with modern methods for treating burns, notably with oxygen and possibly by spraying atomized antibiotics, as with such methods no dressing is used on extensive wounds, the patient lying naked on a suitable bed or other form of support. In order to reduce the risk of infection to other patients and to the nursing staff, it has been deemed desirable completely to isolate each patient suffering from burns in an individual room in which the atmosphere has been sterilized and in which the patient is often placed in an oxygen tent. Such complete isolation of the patient, who, sometimes for several weeks on end, can only see his visitors or members of his family through a glass partition and speak to them over an intercom, generally induces a mental condition and a morale which are detrimental to healing. Moreover, the construction of hospital centres provided with such individual isolation rooms is extremely costly. To overcome this drawback, it has been proposed to enclose patients suffering from severe burns in substantially airtight casings in which a conditioned atmosphere can be created and which are provided with openings giving access to the inside of the casings whereby the patients may be attended to without moving them from their beds. The casings that have been proposed for this purpose are somewhat rudimentary and merely consist of an elongated box which is mounted on legs and of which one end is hinged along its bottom edge to provide a head rest on the outside of the casing whereby the patient may see and speak to his visitors, read, watch a television set suitably located in the room, etc. Since, by isolating each patient in a casing, the danger of infection is greatly decreased, several such casings may be placed in one room. A plurality of longitudinally extending tubes on the removable cradle are connected to transversely extending arcuate members which rest on elastic, grooved rollers. The weight of the patient bearing on the elastic grooved rollers causes a braking action sufiicient to immobilize the cradle in selected angular positions.
The present invention is concerned with a casing of this kind for treating patients sufliering from severe burns which is designed so as to facilitate the handling and treatment of the patient and to make prolonged treatment more bearable for him. The casing is characterized in that it consists of a fixed foot panel and of three removable transparent panels, preferably made of plastic material such as Plexiglas, which form the sides and top of the casing, whereas its front wall, which is formed with an opening through which the patients head may be passed, consists of a sheet metal part capable of being secured to a support which is mounted inside the casing on a chassis carrying the latter and on which rests a removable cradle cum stretcher which is preferably tiltable to modify its angular position.
The cradle consists of two arcuate, preferably tubular, members forming the ends thereof, each resting on two grooved rollers mounted on the support, and of several longitudinally. extending connecting tubes, removable straps made of elastic material such as rubber being stretched between the two horizontal tubes connecting the corresponding ends of the arcuate members to provide the patient-supporting surface. Further, the grooved rollers supporting the cradle are made of a rubber which is suffliciently resilient to be deformed under the weight of the cradle and of the patient to act as a brake, the end faces of each roller being provided with metal cheeks carried by a pin mounted in the support.
It thus becomes extremely easy for the cradle to be tilted into any required angular position for nursing purposes, the cradle becoming automatically blocked in the angular position it has been moved to and the patient can himself alter the position of the cradle to increase his comfort. In addition, since the removable cradle can also be used as a stretcher, the wounded can already be placed thereon at the side of the accident thereby avoiding having to transfer the patient from one support on to another, such transfers being both painful and dangerous.
An embodiment of apparatus according to the invention will now be described by way of example with reference to the accompanying drawings in which:
FIGURE 1 is a perspective view of the casing as a whole;
FIGURE 2 is a perspective view of the casing without its removable panels, this view showing the transfer of the cradle together with its sliding support on to a patient- 7 conveying trolley;
FIG. 3 is a plan view of the chassis that supports the casing;
FIGURES 4 and 5 are respectively an end view and a partially cross-sectional view of the tiltable cradle FIGURES 6 and 7 show a variant in which the cradle supporting rollers are provided with brakes;
FIGURE 8 is a cross-sectional view of one of the stirrups used in assembling the removable panels with the foot panel and the head panel of the casing;
FIGURE 9 shows a variant of the casing illustrated in FIGURES 1 and 2;
FIGURE 10 shows an arrangement for carrying out inside the casing a control of the air that is present-in the latter;
FIGURE 11 is a partial view of the means for carrying out this control;
FIGURE 12 is a perspective view of a variant of the panel at the foot of the casing;
FIGURE 12A is a partially exploded view of FIG- URE 12;
FIGURE 13 is a further variant of the casing; and
FIGURE 14 is a perspective view of the panel at the foot of the FIGURE 13 casing.
The casing shown in FIGURES l and 2 for treating patients suffering from burns comprises a dished rectangular chassis I mounted on a trolley 2. Fixedly mounted on the base-frame 1 are an upstanding panel 3, provided with a rectangular window 4, and two cross-members 5 and 6 consisting of channel irons. These cross-members act as transverse slideways for a mobile support carrying a removable cradle which can be used as a stretcher and which will be described further on. The sides of the casing consist of two panels 7 and 7, made of transparent plastic material, such as Plexiglas, provided with metal frames 8 and 8', the top of the casing consisting of a similar panel 9, 9. The side panels and the top panel are provided with handles such as and 11 and 12 and 12'. At its front end, i.e. where the patients head is to be located, the casing comprises a wedge-shaped member 13 made of sheet-metal which is fixed to the laterally slidable support of the cradle. This wedge-shaped panel 13 is formed with a circular opening 14 through which is passed the patients head and has secured thereto, by means of a hinge 15, a padded support 16 forming a head rest. The opening 14 is provided with a neck-seal consisting, in known manner, of a sleeve 17 made of very thin and flexible plastic material, such as polyethylene, secured, on the one hand, to an annulus which is fixed to the edge of the opening 14 and, on the other hand, to an annulus 18 which is mounted so as to be capable of rotation on the fixed ring, such rotation of the movable ring causing a twisting of the sleeve 17 and a very gentle, but sufficiently airtight, tightening thereof around the patients neck in the manner of an iris diaphragm. The wedge-shaped head panel 13 may moreover comprise a rectangular glass window 20 and be provided with one or more mirrors 21 mounted above the patients head so as to enlarge his field of vision.
The side panels 7 and 7' are formed with openings 22, 22 and 22" which give access to the interior of the casing and which are provided with sealing devices 23, 23' and 23" similarly constructed to the diaphragm 17, 18 in opening 14.
The top panel 9 rests at its opposite ends, via its frame 9' which is provided on its under face with sealing strips not shown, on the top edge of the head panel 13 and on the top edge of the foot panel 3 and is secured to these two upstanding panels 3 and 13 by clamps 24, 24', 24" and 25, 25', 25" each consisting, as shown in FIG- URE 8, of a stirrup-piece or angle-iron 26 which is formed on its horizontal portion with an opening 27 through which extends an upstanding stud-bolt 28 anchored in the top edge of the metal panel 3 or 13 and having screwed thereon a tightening nut 29 formed with a head 30. A spring 31 is provided around the stud-bolt 28 to raise the angle-iron 26 and to release the panel 9 when the nut 29 is being untightened.
As previously indicated, a support is mounted inside the casing and is arranged to slide sideways along slideways 5 and 6. This support comprises two transversely extending slide members 32 and 33 which fit into the slideways 5 and 6 and which are connected by two longitudinally extending bars 34 and 35. As shown on a larger scale in FIGURE 5, the slideways 5 and 6 consist of channel irons in which are mounted rollers 36 supporting the slides 32 and 33.
A cradle forming the patients bed rests on the abovedescribed sliding support. This cradle consists of two arcuate tubular members 37 and 38 Whose ends are connected by longitudinally extending tubes 39 and 40 on which are stretched readily removable straps or bands 41 providing the bed surface. The cradle may be tilted to bring it to any desired angular position. To this end, each of the arcuate members 37 and 38 rests as shown in FIGURES 4 and 5 on two rollers 42 and 42' carried by pins mounted in stirrup-pieces 43 and 43' which are fixed on the longitudinally extending rods 34 and 35 of the support. These rollers comprise a grooved body portion 44 made of elastically deformable material, such as rubber, at the ends of which are provided metal cheeks 45 and 46 secured to the pin 47 extending through the roller. When a patient is lying on the cradle, the arcuate members 37 and 38 hearing on the grooved roller bodies 44 cause a deformation of the latter such as to cause a braking action sufiicient to immobilize the cradle in any selected angular position. However, in order to increase the safety of the arrangement, additional brakes may be resorted to, such brakes consisting, as shown in FIGURES 6 and 7, of stirrup-pieces 48 slidably mounted inside the roller-supporting stirrup-pieces 43. The upper edges of the stirrup-pieces 48 have concave surfaces 49 and 50 shaped to cooperate with the periphery of the metal cheeks 45 and 46 against which they are urged by a spring 51 mounted around a stud 52 projecting through an opening formed in the base portion of the stirruppiece 48 and secured in the base portion of the outer stirrup-piece 43. With such an arrangement, it is possible for the nursing staff, by inserting their hands through the openings 22 of the casing side panels, to tilt the cradle into a suitable position to attend to the patient, the cradle being automatically immobilized in the position to which it has been moved. It is also possible for the patient himself to tilt the cradle on which he is lying thereby enabling him it move himself into a more comfortable position.
As shown in FIGURE 2, there may further be provided, in order to wheel the patient into an operating theatre or other location, a trolley 53 which is provided with transversely extending slideways 54 and 55 that are identical as regards strength, spacing and height to the slideways 5 and 6 mounted on the casing chassis 3. It then suffices, once the panels 7, 8 and 9 have been removed, accurately to position the trolley 53 beside the casing chassis in order to transfer the patient-supporting cradle together with its support onto the trolley 53 without having to disturb the patient on his bed. This transfer operation is made safe by a spring-loaded hook 56 which is pivotally mounted on one of the longitudinal frame members of the trolley 53 and which, when the cradle support comes to be correctly located on the trolley, snaps into a catch 57 provided along one of the longitudinally extending rods of the sliding support.
As shown in FIGURE 3, two heating resistances '58 and 59 are mounted inside the box-chassis 1 to set up a suitable temperature in the casing, these resistances being connected to an external terminal box 60 (FIGURE 1) containing switches which may, if desired, be controlled by thermostats mounted inside the casing.
To prevent condensation from occurring on the inner surfaces of the casing panels, there is provided a cooling coil 61 Which is mounted on the bottom of the box-like chassis 1 and which is supplied with cold water through an inlet 62 fitted at one end of the chassis (FIGURE 2), a water outlet being fitted at the opposite end. Trays 63 and 64 and possibly a pan 65 are placed on top of the cooling coil 61 to collect condensates as well as the oozing and exudations caused by the burns, the introduction and removal of these trays being facilitated by flaps or doors 66, 67 and 68 provided in one of the side walls of the box-like chassis 1.
Piping 69 is also provided in the chassis 1 for introducing into the casing oxygen or any other gaseous or atomized fluid required for the treatment of the bums.
A hygrometer may also be placed in the casing to check the moisture content of the casing atmosphere.
It will be apparent from the preceding description that the apparatus according to the invention enables:
(l) The patient to be provided with practically all the care and attention that is required for his treatment without having to move him in any way, such as for instance washing, perfusions, oxygen therapy, spraying of atomized antibiotics, and ultra-violet ray sterilization, this being made possible by the access openings formed in the easing and by the fact that the bands 41 supporting burnt parts of the body can be unhooked.
(2) The maintenance within the casing of a conditioned and sterile atmosphere containing all that is required for disinfection and treatment.
(3) The patient to be placed already at the site of the accident on a removable cradle on which he will remain for his subsequent treatment, and for any X-ray examinations made necessary by possible fractures caused by the same accident as the burns.
(4) The patient to be wheeled into an operating theatre or other special treatment room without having to move him from his bed.
(5) Several patients to be treated in one room and yet keep each patient in isolation.
(6) The patients mental condition and morale to be improved by making it possible for him to receive visitors, to converse with them, to see his surroundings, to read with the help of a suitable support that can readlly be mounted on the front panel 13 above the opening 14 through which is passed the patients head.
Finally it is also possible to place within the casing measuring and diagnosing instruments, the data from such instruments being electrically transmitted outside the casing by means of circuits connected to the connection box 60.
The cradle support can finally be adapted to form scales whereby the patient may periodically be weighed.
In the variant that is diagrammatically illustrated in FIGURE 9, the tray 1 which consists of a fiuidtight parallelipipedic box is mounted on the chassis 2.
The cross-members 5 and 6 lie on two channel irons 70 and 71 which are disposed parallel to the longitudinal axis of the tray.
In these channel irons 70 and 71 are slidably fitted two rods 72 and 73 which are carried by the front wall 13 formed with the opening 14 for the patients head and provided with an actuation handle 74.
In this variant, the front wall 13 may be pulled away from the casing to enable only the stretcher 74 to be removed therefrom, the latter comprising, as shown, a head rest 75 which is secured to its arcuate member 38 and which can be adjusted both in height and as regards distance from the cradle.
The front wall 13 is adapted, when positioned against the casing, to be secured to the latter by locking means, not shown, consisting for instance of trapped bolts which are freely rotatable in the front wall 13 and which are screwed into threaded holes in the framework carried by the tray 1.
Beneath the fiuidtight tray 1 is mounted a box 74 in which are housed heating and possibly cooling means (not shown). This enables the tray 1 to be cleared of any operational means thereby enabling the tray to be used as a shower-bath basin.
For shower-bath purposes, a water inlet fitting 75 is provided on the foot panel 3 and the hose 76 of a showerhead 77 is connected to the portion of the fitting 75 which projects into the casing. To remove used water, a dis charge tap, not shown, is provided at a suitable location of the tray 1. It should further be noted that a supporting plate 78 is slidably mounted along the channel irons 70 and 71 whereby various pans may be placed beneath the cradle 74.
Inside the tray 1 and along one of its side walls is provided an elongated housing 79 (FIGURES and 11) whose top wall is formed with an opening 80 near the front casing wall 13. At its opposite end, the housing 79 carries an adjustable shutter device which is shown in greater detail in the cross-sectional view of FIGURE 11.
In the elongated housing 79 are provided an ultra-violet lamp 81 and a small fan 82 having a drive motor 83.
The device 80 has the appearance of a small box mounted on top of the elongated housing 79 and is provided in its top wall with an opening 85,1ocated inside the casing, and, beneath the opening 85, With a hinged shutter 86 which is controlled by a handle 87 located outside the tray.
The box-like device backs on to the foot panel 3 :and in the latter there is formed an opening 89 which is positioned beneath the hinge 90 of shutter 86.
If the shutter 86 is moved to a vertical position, the opening 80 communicates with the opening 85 so that when the fan 82 is working, the atmosphere of the casing can be made to circulate therein. If the shutter 86 is moved to its horizontal position and comes to bear against abutment 91, the casing freely communicates with the 6 atmosphere through opening 89 so that when fan 82 is working the atmosphere within the casing can be renewed.
The top wall of the elongated housing 79 comprises at least one removable plate so as to provide access to the ultra-violet lamp and to the fan and motor unit.
FIGURE 12 is a perspective view of the foot panel 3 near the bottom of which is to be seen the opening 89 referred to above.
At the base of the foot panel 3 is provided a desk 92 on which are mounted all of the controls for the various electrical devices and in particular the switches for operating the lamp 81 and the motor 83.
As the presence within the casing of these electrical devices could be the cause of an explosion when the casing is supplied with oxygen, the desk 92 is provided with a safety device which is constructed as follows: a break is made in the electrical circuit supplying the devices enclosed in the elongated housing 79 and the wire ends at the break are connected to two sockets 93 and 94 positioned on opposite sides of a mouthpiece 95 adapted to be connected to the oxygen source by a hose. To close the electrical circuit, there is provided a plug 96 having two pins 97 and 98 which are electrically connected to one another and which are adapted to be inserted into the sockets 93 and 94. This device is so designed that the pins can be inserted into the sockets only when the mouthpiece 95 is not connected by the hose to the oxygen source.
In the variant of FIGURE 13 is to be found again the fiuidtight tray 1 carrying channel irons 70 and 71 in which :are slidably mounted rods 72 and 73 secured to the bottom of the front wall 13 which is provided with actuation handles 98 and 99.
At the top corners of the front wall 13 are secured two rods 100 and 101 which are parallel to the rods 72 and 73 and which are slidably mounted in hollow members 102 and 103. These hollow members 102 and 103 preferably have a rectangular cross-section and they are secured in an appropriate manner, the details of which are not shown, for instance by welding, to the foot panel 3 visible in FIGURE 14.
The front wall 13 such as shown in FIGURE 13 is box-like with a trapezoidal configuration and is fitted in its lower portion with two trapped bolts 104 and 105 adapted, when the panel is moved into abutting relationship with the casing, to be screwed into threaded holes formed in two lugs 106 and 107 carried by the slideways 70 and 71. The box-like panel 13 is secured to the casing by the clamps such as those shown in FIGURE 1.
In the embodiment of FIGURES 13 and 14, the casing consists of three frames 108, 109 and 110 which are pivotally connected to one another, in the manner of a folding screen, by hinges 111 to 116.
In each frame is mounted a transparent panel consisting for instance of a pane made from a material such as Plexiglas.
The top frame 109 rests on the slideways 102 and 103 and is kept in position thereon by trapped bolts, such as that identified by reference numeral 117 and whose shank extends through a hole made in the top pane and is adapted to be screwed into a corresponding threaded hole made in slideway 102; in FIGURE 13, two trapped bolts have been shown, each cooperating with one of the slideways 102 and 103. The side wall 108 of the casing moreover comprises a door 118 and two actuation handles 119 and 120, and also a projection 121 (see FIGURE 14) which cooperates with a hook 122 pivotal ly mounted at 123 on the top of the foot panel 3.
The latter is provided with two actuation handles 124 and 125 which act as grips for manoeuvring the apparatus when the latter has to be moved, and, along the lower portion of the panel is secured a box 126 which is similar to the box 92 and which carries all of the electrical control means. The box 126 also houses the motor and fan unit and the ultra-violet lamp of FIG- 7 URE 10, this lamp being visible through a window 127. Finally, the panel 3 is fitted at 128 with a thermometer associated with a hygrometer.
What is claimed is:
1. Apparatus for treating severe and extensive burns, comprising a trolley, an elongated tray carried by said trolley, a front panel carried by said tray at one end thereof and provided with an opening for passing the head of a patient therethrough, a foot panel carried by said tray at the opposite end thereof and three movable transparent panels associated with said front panel and said foot panel to form a casing, a chassis mounted on said tray, a support mounted on said chassis, at least two grooved rollers carried by said support, a removable cradle cum stretcher resting on said support, two arcuate members carried by said support at the opposite ends thereof, a plurality of longitudinally extending tubes connecting said arcuate members and removable elastic straps stretched between said tubes, wherein said grooved rollers are made of elastic material having a resiliency such as to be crushed under the Weight of a patient lying on said cradle cum stretcher, the end faces of said rollers being provided with metal cheeks, said cheeks carrying a pin rotatably mounted in said support.
2. Apparatus according to claim 1 further comprising a stirrup-piece rotatably supporting each of said rollers, a further stirrup-piece having a concave upper edge, a spring urging said further stirrup-piece against the metal cheeks of an associated one of said rollers.
3. Apparatus according to claim 1, wherein said support is mounted for lateral sliding motion on said chassis and comprises two longitudinally extending frame members secured to cross-members carrying the cradlesupporting rollers and slidably mounted in two channel irons secured transversely to said chassis and wherein are rotatably mounted a plurality of rollers supporting the cross-members of said support.
4. Apparatus for treating severe and extensive burns, comprising a trolley, an elongated tray carried by said trolley, a foot panel carried by said trolley at one end thereof, a chassis mounted on said tray, a front panel carried by said chassis at its end remote from the foot panel and provided with an opening for passing the head of a patient therethrough, three movable transparent panels associated with said front and foot panel, a support mounted on said chassis, at least two grooved rollers carried by said support, a removable cradle cum stretcher resting on said support, two arcuate members carried by said support at the opposite ends thereof, a plurality of longitudinally extending tubes connecting said arcuate members and removable elastic straps stretched between said tubes, said grooved rollers being made of an elastic material having a resiliency such as to be crushed under the weight of a patient lying on said cradle cum stretcher and the end faces of said rollers being provided with metal cheeks, said cheeks carrying a pin rotatably mounted in said support.
References Cited UNITED STATES PATENTS 247,670 9/1881 Markham 128374 XR 653,259 7/1900 Otto 561 1,051,349 l/19l3 Neitro 128373 2,243,999 6/ 1941 Chapple 128-1 2,385,683 9/1945 Burton 128-373 XR 2,817,340 12/1957 Cuvier 128-373 2,980,106 4/1961 Carlson 1281 3,076,451 2/1963 Stoner 128-1 3,226,734 l/ 1966 Coventon 5-61 LAWRENCE w. TRAPP, Primary Examiner US. Cl. X.R. 5-61; 1281