US 3585660 A
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Description (OCR text may contain errors)
June 22, 1971 GQTTFRED ETAL 3,585,660
BODY SUPPORT CUSHIONING SYSTEM Filed March 26, 1969 2 Sheets-Sheet 1 G DENNIS G. MOSINIAK ANSIS V. TENTERIS L BY ATTORNEYS June 22, 1971 V M GQTTFR|ED ETAL 3,585,660
BODY SUPPORT CUSHIONING SYSTEM 2 sheets-sheet z Filed March 26, 1969 B M I 2 0 m. 4 2 w l 3 2 .0 G & F u .ZP. B O
MAX GOTTFRI D DENNIS G. MOSINIAK BY ANSIS V. TENTERIS ATTORNEYS United States Patent W US. Cl. 5-348 14 Claims ABSTRACT OF THE DISCLOSURE A cushion for uniformly distributing support of an invalid comprising a liquid container of flexible sheet material which is impervious to the fluid, and means to elevate side portions of the container to form a loose upper surface which can conform to the supported body portions of the invalid and support those portions as infiotation. A support structure for the liquid container is arranged to control the position of the side portions of the container and, for a constant volume of liquid therein, adjust the depth and enable bodies of varying weight to be floated free of the underlying support surface. Restraining means are provided for the container to maintain its orientation on the support surface during manipulations of the container and invalid. A cushioning pad accommodates the container restraining means and container positioning means while minimizing discomfort to the user.
SUMMARY OF THE INVENTION This invention relates to body support systems and particularly to cushioning means for supporting invalids and a support structure for the cushioning means.
Bedsores or decubitus ulcers are usually attributed to the occlusion of the blood supply to areas of support of an invalid where high pressures are developed as in the region of bony protuberances upon which body weight is concentrated. In these regions when the surface pressure exceeds the pressure distributing the lymph fluid, a starvation of the cells occurs. As taught in the copending patent application entitled Body Support Cushioning System by Max Gottfried, Dennis G. Mosiniak and Ansis V. Tenteris, Ser. No. 756,074 filed Aug. 28, 1968, deleterious concentrations of supporting force can be avoided by utilizing principles of flotation to support an invalid by effectively floating the invalid in a pool of liquid such as water and isolating the liquid from the invalid by a flexible material such as neoprene impregnated nylon which presents a loose interface between the supporting liquid pool and the invalid conforming essentially to the invalids body in a manner approaching that which would be experienced if the invalid were immersed in the liquid. In such an arrangement the preponderant supporting force is that provided by the displacement of liquid as the invalid sinks into the pool.
While the above described structure functioned effectively in relieving the invalid of damaging pressure concentrations, manipulation of the apparatus was found to be difiieult particularly where one attendant of limited strength was required to remove the invalid from the pool for periods of treatment. In the aforenoted application one technique of removing the patient from the pool was to lower the side portions of the liquid impervious envelope whereby the fluid supporting the invalid flowed into those lower side portions thereby lowering the patient to the underlying and relatively rigid support and permitting the liquid to flow away from the invalid to expose those portions of his body which were formerly effectively immersed in the pool.
3,585,660 Patented June 22., 1971 The fluid state of the aforenoted cushioning system tends to create difficulties in the manipulation of the fluid filled envelope and the invalid, particularly when one side of the cushioning system is lowered while the other side is maintained elevated, inasmuch as the fluid tends to concentrate in the low side and the resultant unbalanced tends to pull the envelope from its underlying support surface and transversely shift the invalids position. Manipulation of the side portions of the cushion is enhanced and facilitated by a pivotal support structure to which the envelope is secured and which takes advantage of leverage around the pivotal mounting to position the side regions at any of a range of heights whereby the widths and depths of the pool supporting the invalid can be adjusted to assure that the invalid is floated completely free of the underlying support surface.
An object of the invention is to improve body support cushions for invalids.
A second object is to simplify the construction of body support cushions and the supporting structures therefor.
A third object is to facilitate the manipulation of a body support cushion utilizing liquid for the supporting medium and therefore involving a substantial weight of liquid.
A fourth object is to enable adjustment in the depth of a liquid pool providing a floating support for an invalid.
In accordance with the above objects, one feature of this invention resides in an improved support for a liquid filled body support cushion contained by a pair of side panels pivoted around a horizontal base structure to enable the panels to be adjusted in their degrees of relative inclination whereby a liquid impervious flexible envelope containing the supporting fluid medium can conveniently be shifted in position to alter the depth of the supporting pool of liquid.
Another feature of the invention is an arrangement of fastening means to secure the flexible envelope containing the liquid supporting medium to the underlying support structure whereby control of the positioning of the envelope is facilitated and movement thereof during adjustment is constrained.
A third feature of the invention involves a supplemental cushioning structure to augment the flotation cushion without impairment of the aforenoted features.
DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective of the body support system of this invention showing an invalid floating in a cushion according to the invention;
FIG. 2 is a perspective of the system of FIG. 1 showing an invalid positioned for treatment with the flotation pool dispersed to expose the invalid;
FIG. 3 is an enlarged sectional view of the system of the preceding figures taken along the line 33 of FIG. 1;
FIG. 4 is a view as FIG. 3 with the system adjusted to provide maximum pool depth for patient support;
FIG. 5 is a view as FIG. 3 with one side defining the pool lowered;
FIG. 6 is a view as FIG. 3 with both sides defining the pool lowered;
FIG. 7 is a detailed cross sectioned end view of a portion of the support underlying the flotation cushion taken at the center of the bed as viewed in FIGS. 3 to 6 showing a resilient cushioning between the primary support and the flotation cushion and a means of securing the envelope of the flotation cushion against displacement; and
FIG. 8 is a side elevation in schematic form showing a modification of the flotation cushion concept where cushioning is provided for localized body regions.
3 DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention is illustrated as applied to a bed A cushioned support is provided for the entire body of an invalid by in effect floating the invalid in a pool of liquid, conveniently water. An envelope 11 for the liquid is made up of liquid impervious flexible sheet material such as neoprene coated nylon fabric fabricated into an upper and lower face 12 and 13 joined at their margins in a liquid tight joint 14. The lateral extent of the envelope 11, when arranged as a full cushion for a bed 9 is of a length slightly exceeding the length of the bed and a width exceeding the width of the invalid by at least twice the depth of the pool of liquid required to float the invalid free of the underlying support surface. The upper and lower surfaces 12 and 13 of the envelope are coextensive so that upon raising the distal portions 14 and bringing them toward each other to enable the lower surface 13 to define a cupped container for the flotation liquid, the upper surface has excess material available to conform to the invalids body. When the envelope 11 is filled with liquid to an extent sufficient to raise the invalid free of the underlying support, as shown in FIG. 1, the free upper surface 13 imposes the supporting force of the liquid displaced by the invalid uniformly over the supported region of the body of the invalid thereby effectively floating that region.
While the cushioning system should be of dimensions which minimize the volume of liquid required to separate the inner surfaces of faces 12 and 13 and thereby lift the invalid free of the underlying support for the envelope, a large range of sizes of invalids should be accommodated by a given envelope. The body conformation of invalids may vary as to width and depth so that the width and depth of a pool of liquid providing floating support will vary between individuals. Accordingly a thin person can be floated in a shallower pool than that required to float a fat person or a person having a thick body. The present system is arranged so that the envelope can be contained in a region which is shallow and wide or narrow and deep with a range of intermediate cross-sectional dimensions where as the width is decreased the depth is increased because the length of the constant volume envelope remains substantially constant. This is accomplished by providing a range of positions in which the longitudinal edges of the envelope are maintained both as to their lateral separation from each other and their height above the underlying major area of envelope support.
The patient enfolding, upper face 12 of envelope 11 materially restricts the accessibility of the patient to those ministering to him. In order to expose the patient for examination and treatment the supporting pool of liquid is effectively removed from beneath the patient to gently lower him to the supporting surface underlying lower face 13 of envelope 11. The supporting liquid exceeds the patients weight and is a significant load to be manipulated by nurses and attendants.
Manipulation of the liquid pool as between the conditions illustrated in FIGS. 1 and 2 is facilitated by the mounting for envelope 11, A conventional headboard 16 and footboard 17 are joined by side rails 18 secured thereto by brackets 19 to provide a mounting for en velope support panel 21. The panel 21 can be of a rigid material extending between the opposite side rails. Advantageously it is of sufiicient strength and rigidity to sustain the invalid and pool of liquid without supplemental bracing and is supported along its longitudinal margins, as shown in FIG. 3, by the inwardly projecting flanges 22 on the side rails 18. A wood or pressboard panel of about three quarters of an inch thickness and suitably sealed on its surface against penetration by liquids for sanitary purposes, has been found satisfactory for panel 21. Lateral constraint is imposed on the envelope 11 while supported on panel 21 by means of wings or sideboards 23 extending between the headboard 16 and footboard 17 and pivotally mounted along their longitudinal margin 24 adjacent panel 21 as by means of hinges 25 secured to panel 21 and sideboard 23. The hinged margins 24 of the opposed sideboards 23 are spaced on the horizontal, primary support panel at the minimum width dimension of the cushioning system. This spacing is thus dependent upon the maximum body width which is to be accommodated for a maximum flotation pool depth condition.
The width and depth of the pool of liquid contained by envelope 11 can be regulated for a given volume of liquid by the positioning of sideboards 23. As shown in FIGS. 3 and 4 the sideboards can be maintained at various positions around the pivot axis at their edges 24 as defined by their hinges 25 such that the width of the pool in envelope 11 is a function of the angular relationship of the sideboards 23 to the panel 21. Thus the cross-section of the pool can be varied from an inverted truncated triangle of the general from a FIG. 3 to a rectangle as in FIG. 4 depending upon the position of sideboards 23. As the shape approaches a rectangle the pool is confined to a narrower upper base and its constant volume of liquid is therefore constrained to a greater depth with maximum depth achieved with the sideboards perpendicular to the horizontal panel 21.
The several positions of the sideboards 23 can be maintained by suitable latching mechanism. For example, sliding bolts 26 can be secured to the sideboards 23 on their outer surfaces adjacent their ends at a given distance from their pivot axis and arranged to cooperate with latch means mounted in an arcuate array around the pivot axis of the sideboard 23 at a radius therefrom equal to the spacing of the bolt 26 therefrom. In the sheet metal panels 27 and 28 of headboard 16 and footboard 17 such latches can be an array of holes 29 into any of which the bolt 26 can be extended. An aperture 30 in the footboard is provided to accommodate a catheter since the raised sides and footboard impose an undesirable hydrostatic head if a catheter is passed over their upper margins.
With both sideboards 23 lowered as shown in FIGS. 2 and 6 the liquid flows from beneath the invalid and he rests on the underlying support 21. With side panels 23 of a material similar to panel 21 a step is present in the support area along edge 24, as can be seen in FIGS. 3 to' 6. In order to minimize the effect of this step and to cushion the patient from the support, a pad 32 of resilient material such as foamed polyurethane,
advantageously of a thickness somewhat in excess of the height of the step at edge 24, is positioned over the area of panel 21 between the sideboards 23.
When unrestrained, the liquid filled envelope 11 has a great freedom of motion and at times becomes unmanageable, particularly, when a patient is positioned on the envelope. Thus when the sides of the envelope are lowered the liquid tends to flow to the lowest portion thereof and when such portion is unsupported the unbalance of the weight of accumulated liquid tends to p ll the envelope toward the pocket 34, of FIG. 5, causing a further unbalance. In order to overcome the effect of these forces the envelope 11 is secured to the supporting structure, bed 9, as by fastening it to the sideboards 23 which are, in turn, fastened to the support board 21 such that the degree of shifting of the envelope is constrained. Thus, as viewed in FIGS. 5 and 6 while the liquid may tend to flow from the higher portions of the envelope 11 the displacement of the envelope is restricted by the tension in the 'upper face 12 as in the region 33 of FIG. 5 so only a limited displacement into the pendant region 34 will occur.
Envelope 11 is secured to sideboards 23 along its longitudinal dimension by means of tabs 35. Advantageously each tab 35 can be provided with a batten pocket in which a batten 36 is fitted to distribute the support uniformly along the envelope. Screws or other fasteners 37 extend through batten 36 and tab 35 and into the sideboard 23 to fasten the envelope margins. Alternatively snap fasteners can be secured to tab 35 with complementary fasteners secured to the outer face of sideboard 23. A further constraint can be imposed upon envelope 11 without unduly restricting the freedom of the upper face 12. The loose state of the envelope provided to enhance its conforming action in supporting the invalid, tends to permit the envelope to shift to the low side as the pool developes and thereby even tends to shift the invalid toward the low side as illustrated in FIG. 5. A retainer is provided for the lower face of the envelope to militate against such shifting and to assure the proper recentering of the envelope and the object supported in floatation thereby when the opposed sideboards 23 are raised. As best seen in FIG. 7, a tab 38 extends along the outer side of lower face 13, for example, cemented to its outer surface along its centerline and extends through a suitable slit 39 in pad 32. The tab is then turned to be parallel to support board 21 and secured thereto by fasteners 41. As in the case of the side tabs 35, the bottom tab can have a batten pocket 42 in which a batten 43 is inserted to distribute the stress or it can have snap fasteners. Alternatively a pair of tab branches can be provided so they can be spread in opposite directions parallel to the panel 21 and each secured thereto in the manner illustrated.
A further constraint on the shifting of the filled envelope 11 is provided by limits or stops 20 for the wings 23. These stops 20 can be in the form of right angle brackets secured to the headboard 16 and footboard 17 to prevent the uncontrolled rotation of the wings 23 onto the patient 10. This can occur under the circumstances illustrated in FIG. when the raised sideboard 23 is not controlled in its position either by manual constraint or by being latched by the engagement of bolt 26 in an aperture 29. The unbalanced mass of liquid in the pendant region 34 can pull the free upper longitudinal edge of the opposite sideboard 23 only until it engages stop Other adjuncts of the support system include means for filling and emptying the envelope 11 of liquid. Ordinarily water is used to fill the envelope. It can be introduced into and drained from the envelope by means of a faucet 40 as shown in FIGS. 3 to 6 mounted rigidly in the horizontal support panel 21 forming the base of the unit. A suitable flexible hose, not shown, can extend from a nipple or other connector on the upper face of panel 21 to the envelope 11. A screw coupling on the faucet 40 enables a hose to be coupled from a source of water in the building housing the cushoning system to fill the system and to a drain to empty it. A further refinement is to provide two faucets 40, one at either end of the support panel 21, and employ a source of water of controlled temperature to maintain a desired temperature for the cushion system by admitting water at one end and discharging it from the opposite end.
While the support system underlying the liquid envelope 11 has been shown with wings 23 which are manually manipulated it is to be appreciated that mechanisms can be incorporated to move the wings. Screw driven lifts can be arranged to raise the wings either individually or simultaneously and can be powered by an electric motor or by manual cranks.
While the above described embodiment shows a full length flotation pad which offers support along the entire body of the invalid it is to be appreciated that the principles of flotation can be employed to support limited body regions. For example the region of the heels and of the buttock are subject to occulsion of the lymph fluid due to the body weight concentrated as a high pressure adjacent the bones of these regions. A flotation cushion system localized to the heels as at 45 and to the buttock as at 46 are shown in FIG. 8. It will be noted that the general construction of these systems corresponds to that of the previously described cushion and adjustable cushion support in that each comprises a liquid filled, fabric envelope 47 which extends transverse of bed 48 and may be overlying or adjacent and contiguous with a conventional mattress or mattress sections 49. The envelope is sup ported at its sides by wings 51 hinged at locations along their inner edges and parallel to the longitudinal axis of the bed 48. The depth of the pool within envelope 47 is adjusted by the angular relationship of support wings 51 to the horizontal and the envelope is secured to the edges of the wings paralleling and remote from the hinged edges as at 52. A center tab corresponding to tab 38 of FIGS. 1 to 7 can be utilized to further constrain the envelope 47 and where a cushioning pad is provided beneath the envelope 47 it can be arranged to accommodate the coupling of the center tab to the primary support panel corresponding to panel 21. Supports in the form of legs 50 can be mounted to brace the Wings 51 relative to the side rails of the bed or the primary support panel extending horizontally across the bed.
A localized flotation pad system as shown in FIG. 8 permits the upper portion of the patients body to be elevated as by pivoting mattress support section 53 to a raise the mattress.
The present invention lends itself to modification and variations as in the form and materials employed in the support structure for the floatation cushion and the means of orienting the wings to the primary support. Accordingly, it is to be understood that the above embodiments are presented as illustrative and are not to be read as imposing limitations on the invention.
What is claimed is:
1. A cushioning system for invalids comprising an envelope of a flexible, liquid impervious, sheet material closed upon itself to form a container for liquid, said container having a lateral extent greater than the portion of the invalid to be supported; a body of liquid within said envelope upon which a portion of the invalid is supported at least in part by displacement of said liquid; and a support for said envelope including a horizontal region, first and second opposed side regions extending upwardly from said horizontal region, and means for pivotally mounting said first side region along an axis adjacent and generally parallel to said horizontal region.
2. A combination according to claim 1 including positioning means for said first side region for maintaining said side region at any of a selected plurality of inclinations with respect to said horizontal region.
5. A combination according to claim 1 including means for pivotally mounting said second side region along an axis adjacent said horizontal region and generally parallel to said pivot axis of said first side and positioning means for said second side region for maintaining said side region at any of a selected plurality of inclinations with respect to said horizontal region.
4. A combination according to claim 1 wherein said side regions are spaced in parallel along their edges adjacent said horizontal region and said support regions are rectangular plane. panels.
5. A combination according to claim 1 including means to secure said envelope to said support.
6. A combination according to claim 5 wherein said means to secure said envelope to said support secures said envelope along said side region sides remote from said horizontal region.
7. A combination according to claim 1 including means to secure said envelope to said horizontal region.
8. A combination according to claim 1 wherein said side regions are spaced in parallel along their edges adjacent said horizontal region and including a resilient pad generally coextensive with said horizontal region between said side regions.
9. A combination according to claim 8 wherein said pad has a slit extending between its opposed major faces;
a tab secured to the lower major face of said envelope and 1 extending through the slit in said pad and means securing said tab to said horizontal region of said support.
10. A support for an envelope of a flexible, liquid impervious, sheet material closed upon itself to form a container for liquid, and providing cushioning for a body by displacement of said liquid comprising a primary panel adapted to be mounted with its major face horizontal, first and second side panels, means mounting said side panels with a first longitudinal edge adjacent the major face of said primary panel and a second longitudinal edge elevated from the major face of said primary panel, and means to reduce the elevation of said second longitudinal edge of at least one panel to essentially the level of the major face of said primary panel.
11. A combination according to claim 10 wherein said first longitudinal edges are spaced and parallel on said major face of said primary panel and including a hinged connection between said primary panel and each of said first longitudinal edges.
12. A combination according to claim 10 wherein said primary panel has a width corresponding to the width of a bed and is adapted to be supported by a bed.
13. A combination according to claim 1 including means to support said first side region within essentially the same plane as said horizontal region; and wherein said envelope has a lateral extent perpendicular to said pivotal mounting means in the location of the envelope upon which a portion of the invalid is to be supported at least equal to the coupled side region and horizontal region 8 when said regions are positioned in essentially the same plane.
14. A combination according to claim 3 including means to support said side regions having a minimum inclination approaching the plane of said horizontal region and wherein said envelope has a lateral extent perpendicular to said pivotal mounting means in the location of the envelope upon which a portion of the invalid is to be supported at least equal to the coupled side regions and the portion of the horizontal region intermediate the adjacent edges of said side regions when said side regions are positioned in minimum inclination.
References Cited UNITED STATES PATENTS 3,477,071 11/1969 Emerson 5348X 3,340,550 9/1967 Hopkins et a1. 5348 3,108,293 10/1963 King 5--348 1,943,888 l/1934 Ewald 5--62 FOREIGN PATENTS 550,650 5/1932 Germany 5--348 BOBBY R. GAY, Primary Examiner P. A. ASCHENBRENNER, Assistant Examiner U.S. Cl. X.R. 560