US 3585386 A
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Description (OCR text may contain errors)
patient-suption with the shaft as the shaft rotates around its longitudinal axis. The chair can be rotated around a second axis that is Jerry L. Horton 3,072,788 1/1963 Oller 2925 Eugene St., Bossier City, La. 71010 3,449,569 6/1969 Oller p Primary Examiner-James W. Lawrence [:2] :iled d June ,5 1971 Assistant Examiner-C. E. Church 5] meme June Attorney-Browning, Hyer, Eickenroht & Thompson RADIOGRAPHIC CHAIR ROTATABLE ABOUT wo MUTUALLY PERPENDICULAR AXES ABSTRACT: The apparatus disclosed includes a 5 Chins 9 Drawing 518$ porting chair that is mounted on a shaft for rota Inventor United States Patent the longitudinal axis of the shaft. This allow oriented to rotate with the patient facin the direction of rotation to place the as head-up, head-down, brow-up or 86 1 sfinsu /0 Y 54 5 5 2 b/2 5,303 05 5 9 G 6 5 m 2 n mm m n m NW6 ""7 u ""3 n ""8 m NW un m mmmo m mm m mm5 "5 m m n m... 0 d s m U hr. 1 1 2 0 5 55 l. [l
g generally perpenchair for movement chair can be oriented with the patient facin dicular to the direction of rotation of the  References Cited UNITED STATES PATENTS 12/1937 Pohl PATENTED JUN] 5 I971 SHEET 3 0F 3 RADIOGRAPIIIC CHAIR ROTATABLE ABOUT TWO MUTUALLY PERPENDICULAR AXES This invention relates generally to patient supporting apparatus and in particular to such apparatus for moving the patient to a variety of positions.
The apparatus of this invention has utility whenever it is desirable to place a patient in a variety of positions. This is required, for example, when performing a pneumoencephalogram to determine the shape of the ventricles of the brain. For a pneumoencephalogram, air is injected into the patients spinal column usually with the patient in an upright sitting position. The air rises into the ventricles of the brain, displaces some of the spinal fluid, and forms an air pocket above the level of the spinal fluid. By changing the position of the patient, the air pocket can be moved to different parts of the ventricles. The air pocket is readily distinguishable on an X- ray plate. Therefore, by moving the patient to different positions, the air pocket can be moved from the top to the sides and bottom of the ventricles. From X-ray pictures taken at each such position, the neurosurgeon can detect abnormalities in the shape of the ventricles. This test is used primarily .to locate suspected brain tumors.
For a complete pneumoencephalographic procedure, the patient should be placed in five positions other than the initial or upright position. Movement into these positions and the taking of the X-ray pictures should be done as rapidly as possible because the air pocket dissipates with time. The patient cannot be depended upon to place himself in the desired positions because quite often he is unconscious or at least in a semiconscious condition. Therefore, if no other facilities are available, the patient has to be placed in these positions manually. To avoid this, a chair was developed that would position the patient in some, but not all of the required positions.
With the chair, the patient can be rotated from an upright position to a brow-down position, a brow-up position, and a head-hanging position. To complete the pneumoencephalogram, however, it is necessary to take X-rays with the patient laying on his right or left side in what is referred to as left and right decubitas positions. For these, even with the chair, the patient had to be removed and lifted bodily, if unconscious or semiconscious, to a table where X-rays were made from one side after which the patient was turned over so that X-rays could be made from the other side. Thus, as to at least the decubitas positions, the same problems existed with the chair as were present when the patient was manually placed in all of the desired positions.
It is an object of this invention to provide apparatus for moving patients to a variety of positions including the headdown, brow-up, and brow-down positions previously possible with the existing apparatus plus the decubitas positions.
It is a further object of this invention to provide patient-supporting apparatus that can position a patient as required for a complete pneumoencephalogram without removing the patient from the supporting apparatus.
It is a further object of this invention to provide patient-supporting apparatus that includes an improved head-holding device to securely hold the head of the patient from movementrelative to the support while the patient is moved by the support to a variety of positions.
It is a further object of this invention to provide patient-supporting apparatus that includes a unique holder for X-ray film cassettes that can. be quickly and easily positioned to locate X- ray cassettes in the desired position.
These and other objects, advantages and features of this invention will be apparent to those skilled in the art from a consideration of this specification, including the attached drawings and appended claims.
The preferred embodiment of the invention will now be described in detail by way of example in connection with the attached drawings in which,
FIG. 1 is an isometric view of the preferred embodiment of the apparatus of this invention;
FIG. 2 is a bottom isometric view of a portion of the apparatus of FIG. 1;
FIG. 3 is a fragmentary sectional view taken along line 2-2 of FIG. 2;
FIGS. 4, 5, 6, 7, 8, and 9 show six of the possible positions to which a patient can be moved with the apparatus of this invention.
The apparatus includes a support for the patient. In the embodiment shown in FIG. 1 such support is chair 10. The chair has seat 12, back 14, arms 15 and 16, and footrest l7. Straps 18 are used to hold the patient in the chair as the chair is moved to the various positions. I
To hold the patients head from movement relative to the chair, cup-shaped member 20 is supported above chair back 14 by rod 21. The rod slides in sleeve 22 and set screw 23 (FIG. 4) holds rod 21 against further movement when cupshaped member 20 has been located to receive the back of the patients head, as shown in FIG. 4. Straps 24 extend around the patients forehead and chin, also as shown in FIG. 4, to hold the patients head in member 20. Member 20 and straps 24 are made of a material that is pervious to X-rays so that these items will not interfere with the taking of X-ray pictures of the patients head.
Means are provided for supporting and rotating the patient support around a first axis. In the embodiment shown, the support for the chair includes base 26 which is made of U-shaped member 27 and column 28. Preferably, column 28 is extensible and retractable to move thechair up and down. As shown column 28 is a hydraulic cylinder. It includes cylinder 28a and rod 28b. Appropriate seals are provided to permit hydraulic fluid to be pumped into cylinder 28a and move the cylinder upwardly along the rod. The means for pumping the hydraulic fluid is not shown. Any convenient arrangement for this purpose can be used. U-shaped member 27 may be equipped with casters 27a so that the chair can be moved easily.
Supported directly on top of column 28 is power means housing 30. Extending laterally out the power means housing is shaft 32 upon which chair It) is mounted. Output shaft 32 is rotated around its longitudinal axis in any convenient manner. The power means for accomplishing this are located in housing 30 in the embodiment shown. Any desired power can be used. Hydraulic power or electrical power are two convenient systems appropriate for this application. Depending upon the speed of the motor employed, appropriate gear reductions can be placed between the motor and output shaft 32 so that the output shaft speed is within the desired range. Preferably, the shaft will be turned relatively slowly. With a relatively low output shaft speed, a worm and gear-type drive mechanism can be employed between the motor and the output shaft which will allow the chair to be locked in any desired position simply by stopping the rotation of the motor. In other words, the torque imposed on the shaft by the weight of the patient and the chair cannot cause rotation of the worm due to the high gear ratio between the worm and the gear. Brakes can also be used to do this.
In any event with the chair positioned as shown in FIG. 1, the patient is facing either toward or away from the direction of rotation of the chair depending on the direction of rotation of shaft 32. Rotation of output shaft 32 will rotate the patient from the upright position shown in FIG. 4 to any of the positions shown in FIGS. 5, 6, and 7. Generally, these positions are referred to as brow-down, head-hanging, and brow-up positions, respectively. In the head-hanging position of FIG. 6, column 28 has been extended to keep the patients head well above the floor. Also, in FIG. 7 chair 10 is shown rotated from what it is in FIGS. 4, 5, and 6. The patient could be placed in this brow-up position without rotating the seat by rotating shaft 32 clockwise as viewed in FIG. 4. It may be convenient, however, as for example to keep from moving the X- ray equipment, to rotate the chair to position the head of the patient on the same side for both the brow-up and the browdown positions. With the patient support of this invention this can be done as will be fully explained below.
In accordance with this invention, means are also provided that mount patient support on shaft 32 so that it can be rotated around a second axis to permit patient support 10 to be oriented so that the patient can be rotated around the first axis facing in a direction generally perpendicular to the direction of rotation of the chair. This is required to be able to move the patient to the left and right decubitas positions shown in FIGS. 8 and 9. In the embodiment shown, seat 12 is mounted on shaft 32 as shown in FIG. 3. PLate 36, which is welded to shaft 32, has central cylindrical stud portion 37 and annular flange 38. Bearing cap 39 is attached to the outer end of stud 37 by bolt 40. Bearing cap 39 holds bearings 41 and 42 in place around stud 37. Extending between bearings 41 and 42 is flange 43 of cylindrical member 44. This member also has outwardly extending flange 45 which is connected to seat 12 by a plurality of bolts 46. Recesses are provided in the upper surface of seat 12 to keep the heads of bolts 46 from extending into cushion 12a. When the seat is in the upright position, the weight of the patient is transferred from seat 12 through flange 43 of member 44 to bearing 42 and this bearing supports the seat for rotation around the axis ofstud 37. When the patient is turned upside down, as for example in FIG. 6, his weight is supported on bearing 41, which force is transmitted from this bearing to the shaft through bearing cap 39 and stud 37. In the in-between positions, the load is distributed between the bearings with the amount taken by each bearing depending upon the angle the seat makes with the horizontal.
With the patient support 10 so mounted on shaft 32, it can be rotated around a second axis relative to the longitudinal axis of shaft 32 so that the patient can be oriented to face in the direction of rotation or in a direction facing generally perpendicular to the direction of rotation of the support means. When patient support 10 is in the desired position, means are provided to lock it against further rotation around the second axis. In the embodiment shown in FIG. 3, L-shaped rod 48 extends through opening 49 in plate 36 and engages opening 50 in seat 12. When thus engaged with opening 50, the rod will hold the seat against rotation around the axis of stud 37. Coil spring 51 holds rod 48 in the locking position. To change the position of the seat on the shaft, the pin is pulled downwardly compressing spring 51 until its upper end clears opening 50, then the seat is rotated to the desired position and the rod is reengaged with one of the plurality of holes 50 provided in seat 12 for each position in which the chair is expected to be placed.
The patient support of this invention is particularly useful in certain X-ray techniques such as the pneumoencephalogram described above. It is another feature of this invention to provide a novel cassette holder that can be quickly and easily positioned in the desired position relative to the patients head for X-ray purposes.
In FIG. 1, cassette holder 60 is supported by two L-shaped members 61 and 62. One leg 61a of member 61 extends through sleeve 63, which is attached to cassette holder 60. Set screw 64 allows the cassette holder to be moved along leg 61a as desired. Leg 61b of member 61 extends into leg 62a of L- shaped member 62, which is tubular. Setscrew 65 can be released to allow leg 61b to be moved in or out as desired to change the position of cassette holder 60. Leg 62b of L-shaped member 62 extends through sleeve 66 attached to the side of back 14 of chair 12. Setserews 67 hold this leg of member 62 in the desired position. A similar sleeve to 66 is mounted on the other side of back 14 so that cassette holder 60 and its supporting members can be shifted from one side of the chair to the other, as required. For example, in the two positions shown in FIGS. 8 and 9, the cassette holder is located on opposite sides of the chair.
Back 14 of chair 12 is shown having opening 70. This opening, which extend both through the back and cushion 140, provides access to the patients back, as required in pneumoencephalographic procedures.
From the foregoing description of one embodiment of this invention b way of example, it will be seen that this invention is one wel adapted to attain all of the ends and ob ects hereinabove set forth, together with other advantages which are obvious and which are inherent to the apparatus and structure.
1. Patient-supporting apparatus for moving patients to a variety of positions comprising a base, a chair for supporting a patient including a seat and a back, and means on the base for supporting and rotating the chair, said means including power means having a cantilevered output shaft rotatable by the power means around its longitudinal axis and means mounting the chair on the cantilevered output shaft for rotation with the shaft around its longitudinal axis and for rotation around an axis generally perpendicular to the longitudinal axis of the output shaft whereby the chair can be positioned to orient the patient to face toward or away from the direction the chair is rotated by the output shaft or to face generally in the direction of the axis of rotation of the output shaft to permit the patient to be moved to a variety of positions while supported by the chair.
2. The apparatus of claim 1 further provided with means for holding the chair against rotation around the axis perpendicular to the longitudinal axis of the shaft when the chair is in the desired position relative to this axis, said means being releasable to permit the chair to be moved to another position relative to said axis when desired.
3. The apparatus of claim 1 further provided with adjustable cassette holder means including a cassette holder, a first member pivotally attached to the cassette holder, a second member pivotally and movably attached to the first member and to the back of the chair whereby the cassette holder can pivot relative to the first member, the first member can pivot and move axially relative to the second member, and the second member can pivot and move axially relative to the chair all as required to place the cassette holder in the desired position relative to a patients head when the patient is sitting in the chair and means for holding each member independently from such pivotal and sliding movement when the eassette holder is in the desired position.
4. A patient-supporting chair for moving patients to a variety of positions as required for example for a pneumoencephalogram comprising a chair having a seat and a back, means supporting the chair and for rotating the chair in a vertical plane around a horizontal axis, a base, and a column on the base for supporting the chair-supporting and rotating means, said supporting and rotating means including power means having a cantilevered horizontal output shaft and means mounting the seat of the chair on the cantilevered output shaft adjacent its unsupported end for rotation around a second axis perpendicular to the horizontal longitudinal axis of the output shaft to permit the patient to be placed in browup, brow-down, and head-hanging positions and by rotating the chair around said second axis to be placed in the left and right decubitas positions.
5. The chair of claim 4 in which the column is extendable and retractable to permit the height of the chair to be adjusted.