|Publication number||US3859982 A|
|Publication date||Jan 14, 1975|
|Filing date||Feb 24, 1973|
|Priority date||Feb 24, 1973|
|Publication number||US 3859982 A, US 3859982A, US-A-3859982, US3859982 A, US3859982A|
|Inventors||Robert L Dove|
|Original Assignee||Picker Corp|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (9), Referenced by (17), Classifications (12)|
|External Links: USPTO, USPTO Assignment, Espacenet|
United States Patent [1 1 Dove [ APPARATUS FOR SUPPORTING PATIENT DURING ROTATION WITII PROVISION FOR FLUID ADMINISTRATION AND DISCHARGE  Inventor: Robert L. Dove, University Heights,
 Assignee: Picker Corporation, Cleveland,
 Filed: Feb. 24, 1973  Appl. No.: 326,375
 US. Cl 128/2 R, 128/298, 250/441, 269/322  Int. Cl A6lg 13/00  Field of Search 128/2 R, l B, 2 A, 134, 128/133, 204, 24, 240, 241, 230, 101, 236,
 References Cited UNITED STATES PATENTS 1,995,583 3/1955 Sanderson 128/30 2,872,584 2/1959 Schiring et al.... 250/444 2,967,524 1/1961 Christensen 128/24 R 3,051,164 8/1962 Trexler 128/1 B Jan. 14, 1975 3,211,149 10/1965 Fono 128/241 3,286,693 11/1966 Clarke et a1, 3,642,006 2/1972 Wobbe 3,655,178 4/1972 Vezina 3,783,863 l/l974 Kliever 128/134 OTHER PUBLICATIONS General Electric X-Ray Corp., Model D3-38 Diagnostic X-Ray Unit; 6-24-41.
Primary Examiner-Richard A. Gaudet Assistant Examiner-Henry J. Recla Attorney, Agent, or Firm-Watts, Hoffman, Fisher & Heinke Co.
 ABSTRACT A tubular plastic garment positioned around a patient and around a rotatable patient supporting platform is sealed at opposite ends to the platform and partially vacuum evacuated by vacuum units carried on opposite ends of the platform. Pressure differential forces are thereby created which hold the patient comfortably but securely against the platform for rotation therewith. Fluids are admitted and discharged through the garment by means of a specially designed sealing disc. A remotely operable dispenser system is provided for orally or rectally dispensing fluids to the patient.
19 Claims, 21 Drawing Figures PATENTEU JAN 1 41975 3, 859,982
SHEET 3 0F 5 APPARATUS FOR SUPPORTING PATIENT DURING ROTATION WITH PROVISION FOR FLUID ADMINISTRATION AND DISCHARGE CROSS REFERENCE TO RELATED PATENT AND APPLICATION X-RAY APPARATUS, US. Pat. No. 2,872,584 issued Feb. 3, 1959 to R. C. Schiring et a1.
Method and apparatus for immobilizing a patient, Ser. No. 111,602 filed Feb. 1, 1971 by Waldo I-I. Kliever, issued Jan. 8, 1974 as US. Pat. No. 3,783,863.
BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates generally to a novel and improved system for supporting patients during rotation and more particularly to methods and apparatus for supporting patients during medical procedures which require successive repositioning of the patient.
2. Prior Art A number of medical procedures require that a patient be successively positioned in a plurality of positions. Several types of diagnostic X-ray studies, for instance, call for moving the patient through a series of particular orientations not only to provide accurate control of the direction of radiation passing through the body and to view a particular region of the patient from different angles,- but also to control and trace the travel and accumulation of various fluids which are administered to the patient.
Patient supporting X-ray tables of a variety of configurationsare known which are designed to provide'wide latitude in patient movement. Where, however, such tables tilt or rotate during patient positioning, a restraining device of some sort must be used to keep the patient on the table. The most widely used restraining devices are straps which are cumbersome to use, which sometimes result in an obstruction to radiation, which are a source of discomfort if not pain, to a patient, and which often induce negative anticipations such as the fear of falling.
Conventional techniques of strapping a patient to a table and then moving the table to an attitude where much, if not all, of the patients weight is supported by the straps is often painful even to patients who are in relatively good health. The discomfort attendant the use of these patient restraints is sometimes so great as to militate against their use with aged or very ill patients who are often in need of the diagnostic techniques which require their use.
The referenced application discloses an improved patient restraining device in the form of a thin transparent plastic film which is positioned over portions of the patients body. A vacuum seal is provided between the edges of the plastic sheet and the table, and a partial vacuum is drawn between the sheet and the table. By this arrangement, atmospheric pressure serves to hold the patient on the table in a gentle and comfortable manner, but with sufficient force to support the patient even when the table is entirely inverted.
The referenced application clearly represents a substantial improvement in patient restraining devices. Prior art restraining devices commonly provided relatively narrow straps which were drawn tightly against a limited area of the patient thereby concentrating a relatively large force in a relatively small area. This arrangement was not only uncomfortable but occasionally served to restrict the patients breathing and blood flow. In contradistinction to such prior art arrangements, the apparatus of the referenced application establishes a mild reduction in air pressure within a sheetlike covering that restrains a patient. Although the air pressure reduction is so mild as to be practically unnoticed by the patient, the pressure differential across the plastic sheet is sufficient to establish a force which will firmly hold the patient on the table. Since this force is distributed over a large portion of the patients body, there is little danger of it adversely affecting the patient in any manner.
The teachings of the referenced application do not include the provision of a specially contoured table for comfortably supporting patients of a wide variety of body builds. Rather, the referenced application discloses the use of a flat, perforated, table top having a vacuum manifold under it. In addition, the teaching of the referenced application does not include provision for admitting and discharging fluids to the patient while he is restrained on the table top. Various X-ray procedures not only require that fluids be passed through the restraining garment, but also that they be administered in controlled quantities and under sufficient pressure to assure their delivery regardless of the attitude in which the patient may be positioned. Accordingly, the present invention is directed to improvements over the teaching of the referenced application which improve the patients comfort still further and provide versatility in use.
SUMMARY OF THE INVENTION The present invention provides novel and improved apparatus and methods for supporting patients, and for dispensing controlled amounts of fluids through the plastic sheet which defines a vacuum evacuated region around the patient.
A patient rotator is provided including a trough-like patient supporting platform suspended between a pair of rotatably mounted end structures. In the preferred embodiment, the ends of the platform are provided with vacuum evacuation units which rotate with the platform.
A sheet-like garment of thin transparent plastic is providedfor positioning around the patient and around the supporting platform to establish an air-evacuable region. Two types of garments are provided, one being sleeveless and the other being provided with apertured sleeves through which the patients arms extend to expose his hands and portions of his arms to the region outside of the garment. The sleeveless garment is used except where the radiologist may require access the patients arms for administration of medication, or may require the patient to use his hands in carrying out a medical procedure.
Both types of garments have neck apertures. The neck and arm apertures are all provided with drawstrings for drawing the garment snugly about the patient's neck and arms to establish a seal.
The garment may be positioned on the patient and the aperture drawstrings secured before the patient is positioned on the rotator platform. The preferred procedure is to position the patient on the platform and then drape the garment over him and around his neck and arms. Where the preferred procedure is used, the garment in no way obstructs the positioning of the patient on the platform.
Unlike the apparatus of the referenced application, an air-tight seal is not formed between the garment and the table top periphery. Rather the garment is drawn around the bottom of the patient supporting platform and opposite sides of the garment are sealed by an airtight zipper-like seal. With opposite sides of the plastic sheet sealed together, a tube of plastic is formed which encompasses the patient and the platform. The ends of this tube are then sealed about the ends of the platform to define a vacuum evacuable region. Accordingly, there is no need to provide a perforated table top or vacuum manifold beneath the patient. The plastic sheet serves to collect all fluids, etc., which may discharge from open wounds to the patient.
Several types of patient positioning pads are provided. Prone positioning and supine positioning head and arm rest pads are removably secured to the head end of the rotatable platform. A movable foot rest as well as legs support pads and the like are positionable as desired along the platform and held in place by the pressure differential forces.
A pair of hand-holds are provided to support the patients arms. A padded head-supporting strap mounts on the hand-holds and is provided with ear-reliefs. The hand-holds are removably supported on the head-end structure and are provided with means to puncture the plastic garment during installation, and means for sealing the garment around the punctures.
Fluids are passed through the garment by means of a specially designed sealing disc. A variety of fluid devices such as enema tubes and compression bladders are connectable with the sealing disc to receive and discharge fluids through the garment.
A specially designed remotely operable dispensing system is provided for orally and rectally dispensing controlled amounts of fluids. The dispensing system includes a console control panel and a plurality of remote dispensing units. The remote units each include a collapsible fluid carrying bag disposed between a pair of movable jaws. Jaw movement is remotely controllable to provide controlled fluid discharge from the bags.
Accordingly, it is a general object to provide novel and improved patient supporting apparatus and methods with provision for the fluid administration and discharge.
Other objects and advantages of the present invention will become apparent from the following description of the preferred embodiment.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view of an X-ray table including the novel and improved patient support device of the present invention;
FIG. 2 is a side elevational view of the apparatus of FIG. 1 with a patient positioned on the apparatus in the supine position, and showing a compression bladder positioned on the patients abdomen;
FIG. 3 is a side elevational view of the apparatus with a patient positioned in the prone position, and showing an enema device communicating with the patients rectum;
FIG. 4 is a side elevational view of the apparatus with a patient positioned in the prone position, and showing an injection needle inserted into the patient's spinal regm;
FIG. 5 is an enlarged plan view of the region around the injection needle as seen from the plane indicated by the line 55 in FIG. 4;
FIG. 6 is an enlarged eross-sectional view of one of the combination head clamp and arm supports shown prior to its being attached to the head end plate;
FIG. 7 is an enlarged cross-sectional view of the head end portion of the apparatus of FIG. 1 depicting the path of air flow through the head end vacuum unit and showing the supine position head support detached;
FIG. 8 is a perspective view of the compression bladder shown in FIG. 2;
FIG. 9 is a perspective view of the head supporting P FIG. 10 is a perspective view of the garment which is positioned around the patient and the rotator platform;
FIG. 11 is an enlarged perspective view illustrating the method of joining opposite sides of the garment;
FIG. 12 is an enlarged end view of the joined garment sides illustrating the structure which forms therebetween;
FIG. 13 is a perspective view of one of the expansible members used to seal the ends of the garment about the ends of the rotator platform;
FIG. 14 is an enlarged cross-sectional elevational view of a sealing disc used to provide fluid communication through the garment, as seen from the plane indicated by the line l4l4 in FIG. 3',
FIG. 15 is an elevational view of the sealing device of FIG. 14 being used with a single fluid conduit as shown in FIG. 2;
FIG. 16 is a perspective view of a dispenser system including the dispenser units used to dispense controlled amounts of fluids both orally and rectally to the patient;
FIG. 17 is a top plan view of a collapsible dispensing bag used in each of the dispenser units shown in FIG. 16;
FIG. 18 is a side elevational view of the collapsible bag of FIG. 17;
FIG. 19 is an end elevational view of the mouthpiece structure forming part of the dispenser bag;
FIG. 20 is a top plan view of a portion of one of the dispenser units with portions thereof broken away to illustrate the details of construction; and,
FIG. 21 is an enlarged cross-sectional view of the solenoid operated tube clamp used in the dispenser units, as seen from the plane indicated by the line 2121 in FIG. 20.
DESCRIPTION OF THE PREFERRED EMBODIMENT Referring to FIG. 1, an X-ray table including a patient support system constructed in accordance with the present invention is shown generally at 10. The table 10 includes a stationary base or pedestal 11 and a body 12 which is tiltable in the conventional manner between generally horizontal and generally vertical planes. The referenced patent discloses and claims such a tiltable table.
A pair of supporting end structures l3, 14 are secured to opposite ends of the table body 12. The supporting structures l3, l4 rotatably mount a patient support platform 15. As will be explained in greater detail, a thin plastic sheet 16 is disposed around the platform 15 and around portions of a patient positioned on the platform so as to provide a transparent tube-like garment encompassing portions of the patient and the platform 15. The ends of the garment are sealed to the platform and a partial vacuum is drawn in the region defined by the garment. Ambient air pressure then exerts a restraining force on the confined portions of the patient of sufficient mangitude to hold the patient in place on the platform as the platform 15 is rotated and as the table body 12 is tilted. The restraining force exerted by ambient air pressure is distributed evenly across the confined portions of the patient and as such is quite painless to the patient. In fact, when the platform 15 is entirely inverted such that the patient is suspended by the force of ambient air pressure alone, the accompanying sensation is one of great comfort which can be likened to the sensation of lying on a soft, formfitting couch.
The rotatable platform 15 comprises a trough-like rigid center panel suspended between elliptical end panels 21, 22. The end panels 21, 22 are supported on stub shafts 23, 24 shown in dotted lines in FIG. 2. The.
stub shafts 23, 24 are journaled by the supporting structures 13, 14. A motor 25 carried interiorally of the head end supporting structure 13, as best seen in FIG. 7, is drivingly coupled to the stub shaft 23 so as to rotate the platform 15 to any desired angle.
The plastic garment 16 which is used to surround portions of the patient and the platform 15 is shown in FIG. 10. The garment 16 comprises a transparent sheet of vinyl plastic, preferably about 4 mills in thickness. A neck aperture is provided with a drawstring 31. The garment embodiment shown has apertured sleeves 32, 33 which are provided with drawstrings 34, 35. A sleeveless garment, not shown, is ordinarly used where no access to the patients arms or hands is required.
The longitudinally extending edges 36, 37 are provided with extruded zip-lock seam formations, as shown in FIGS. 11 and 12. The extruded seam formations 36, 37 have interlocking projections and grooves. Once the end regions of the formations 36, 37 have been pressed together to initiate the formation of a seal therebetween, the remainder of the seal is effected simply by moving a slide member 38 along the partially assembled seam in the manner of a slide fastener. Such slide fastener seam structures are known and commonly used on re-usable plastic clothes bags, food bags, small brief cases and-the like.
The garment 16 is preferably fitted about the neck and around the arms of a patient after the patient is positioned on the platform 15. The zip-lock edges 36, 37 are then joined beneath the platform 15 to effect an airtight seal. This gives the garment 16 a tube-like configuration open at both ends.
The ends of the garment tube are then sealed about the end plates 21, 22. Each of the end plates 21, 22 is provided with an annular peripheral recess, one of which is shown at 40 in FIG. 7. The ends of the tube are positioned so as to overlie the recesses 40. Extensbile sealing rings 41, as shown in FIG. 13 are then positioned around the ends of the garment tube, 16 so as to clamp the garment into the grooves 40. Mating male and female connectors 42, 43 are provided on the sealing rings 41 to hold their ends together. By this arrange ment, an air tight seal is formed between the ends of the garment 16 and the end plates 21, 22.
Vacuum evacuation of the chamber defined by the garment l6 and the end plates 21, 22 is effected by substantially identical foot end and head end vacuum units carried by the platform 15 for rotation therewith. The head end vacuum unit is shown generally at 45 in FIG. 7. A motor driven blower 46 is disposed within a shround 47. The blower draws air through an aperture 48 in the shround and exhausts it into a chamber 49 formed within the end plate 21. Discharge openings 50 vent the chamber 49 to the atmosphere so as to discharge the air evacuated by the blower 46 from within the garment 16.
The blower 46 and shround 47 are disposed within a fluid-tight fire proof blower housing 51. Several airflow paths indicated by the arrows 52 are provided for the admissionof air from the garment 16 into the housing 51 both from above and below the platform 20.
Two types of detachable headrests are provided for attachment to the housing 51. A first type, which is employed where the patient is to assume the supine position of FIG. 2, is shown at in FIG. 7. A second type which is employed where the patient is to assume a prone position, is shown in dotted lines at 61 in FIGS. 3 and 4. Each of these headrests are specially configured so as to receive and comfortably resiliently support the head and neck portions of a patient. The headrests 60, 61 are attached to the housing 51 by cooperating male and female snap-together fasteners 62, 63, as shown in FIG. 7.
A removable lower leg and foot support cushion for use with patients in the prone position is shown in dotted lines at 65 in FIGS. 3 and 4. The underside of the cushion 65 is convex so as to conform to the curvilinear cross-section of the trough 20. The cushion 65 is movable along the length of the trough 20 for positioning as required to support a particular patient. The ambient air pressure forces which clamp the legs of the patient toward the trough 20 are sufficient to hold the cushion 65 in place and accordingly the cuchion 65 is not fastened to the trough 20.
A movably positioned supine foot rest and support is also carried by the trough 20. The support 70 includes an upstanding plate 71 secured toa pair of side members 72, 73. The side members 72, 73 carry positioning blocks 74 having downwardly projecting teeth which cooperate with slotted racks 75 along both sides of the trough 20. By this arrangement, the support 70 can be lifted so that the toothed blocks 74 disengage the racks 75, and then positioned as desired along the trough 20. When the table body 12 it tilted so as to raise the patients head and lower his feet, the support 70 serves to engage the patients feet and provide added patient support. Through apertures (not shown) extend through the plate 71 so that the support 70 in no way hinders the flow of air during evacuation of the garment 16.
The vast majority of the patients body is, in accordance with the present invention, held in place by ambient air pressure acting against such portions of the patient as are enclosed within the garment 16. An auxiliary system of support is provided for the patients head and for the patients arms where these extremities are not enclosed within the restraining garment 16. A pair of support bars are removably secured to the head end plate 21 for this purpose.
Referring to FIG. 6, the support bars 80 each include a generally cylindrical rods 81. One end of each of the rods 81 is provided with a threaded region 82 which is pointed at its terminus 82a. The other end region 83 is knurled and has a rounded tip 83a. A region 84 of reduced diameter is formed intermediate the end regions 82, 83.
A handle-shaped sleeve 85 is secured to the rod 81. The sleeve 85 has an axially extending through aperture 85a, both end regions of which are counterbored to an enlarged diameter as shown at 85b, 85c. Annular shoulders 85d, 852 are formed at the inner ends of the counterbores 85b, 850. The sleeve 85 is pressed onto the rod 81 with the aperture 85a in firm mating contact with the knurled surface 83. The counterbore 85b surrounds the reduced diameter rod portion 84 in spaced relationship thereto.
A hollow rubber sleeve 86 rounded at its outer end 86a is pressed onto the outer end region of the knurled surface 83. The inner end 8612 of the rubber sleeve 86 extends into the counterbore 85c to a position adjacent the shoulder 85c.
An annular metallic sealing member 87 is positioned over the threaded end region 82 of the rod 81. The sealing member 87 includes a generally cylindrical hub portion 87a terminating in a planar inner end surface 87b, and a radially extending flange portion 87c terminating in a planar outer end surface 87d. A through aperture 87e extends between the end surfaces 87b, 87d and is threaded, as indicated at 87f, for a short distance adjacent the end surface 87b. During assembly, the sealing member 87 is threaded onto the rod 81 until the threaded region 87f passes fully over the threaded rod portion 82 and into surrounding relationship with the reduced diameter rod portion 84. Once the threaded region 87f has passed fully over the threaded rod portion 82, the sealing member is slidably mounted on the rod 81 for axial movement therealong. The hub portion 87a is of such diameter as will slip-fit within the counterbore 85b. The reduced diameter rod portion 84 is of such diameter as will permit the threaded region 87fto slide freely therealong. The aperture 87c, in similar fashion, is slidable along the threaded rod portion 82.
A compression coil spring 88 surrounds the reduced diameter rod portion 84 in the annular space between the rod portion 84 and the counterbore 85b. Opposite ends of the spring 88 engage the shoulder 85d and the end surface 87b to bias the sealing member to the safety position shown in FIG. 6. When the sealing member is in this safety position, the sealing member fully surrounds the pointed end 82a of the rod 81.
The head end panel 21 is provided with a pair of raised bosses 90 for securing the support bars 80 to the end panel 21. Threaded apertures 91 are provided in the bosses 90 to receive the threaded end regions 82 of the rods 81.
Installation of the support rods 80 is performed after the patient is in position of the trough 20 and after the head end of the garment 16 has been secured to the end panel 21. The support bars 80 are then attached to the head end plate 21 by positioning the sealing members 87 adjacent the bosses 90 and exerting an axial force on the rods 81 to compress the springs 88 and cause the pointed end regions 82a to puncture the garment 16 adjacent the threaded apertures 91. The rods 81 are then rotated to thread the regions 82 into the apertures 91. During this rotation of the rods 81, the sealing members 87 do not rotate but rather serve to clamp the garment 16 against the end plate bosses 91. By this arrangement the support rods 80 are secured to the end panel 21 without causing any significant break in the vacuum seal between the garment 16 and the end panel 21.
A head engaging pad 95 is supported by the rods 81 as shown in FIG. 9. The pad 95 comprises a resilient block 96 of vinyl foam. The central region 97 of a strap formed from such nylon tape closure material as is sold under the trademark VELCRO by American Velcro, Inc. of Manchester, New Hampshire, is adhered to the top of the block 96. With the pad 95 in place on the patients head, the ends 98, 99 of the VELCRO strap are wrapped around the rods 81 and pressed in place against the central region 97 so as to hold the pad 95 in place.
The pad 95 is used both with patients in the supine and prone positions, as shown in FIGS. 2 and 3. The block 96 is provided with relieved regions 100 in order to accommodate the patients ears.
The procedure of positioning a patient on the rotatable platform 15 and securing the patient thereto prior to rotation preferably comprises the following steps:
1. Depending upon whether the patient is to assume a supine or prone position, the proper head and shoulder supporting pad or 61 is selected and snapped into place on the platform 15.
2. The patient is helped into position on the platform 15. If the patient is prone positioned, the foot support is moved into position. The support panel may also be brought into position adjacent the patients feet.
3. The garment 16 is draped over the patient and the neck aperture is slipped over the patients head. If a sleeved garment is used, the sleeve apertures are positioned over the patients arms. The aperture drawstrings 31, 34, 35 are then made secure to seal the garment about the patients neck and arms.
4. The zip-lock edges 36, 37 are secured together and the ends of the garment are sealed to the platform ends by the rings 41, whereby the garment is fully'sealed to define an evacuable region.
5. The support bars are brought into alignment with the apertures 91 and the garment 16 is punctured as the bars are threaded into place. The head engaging pad is then secured in place on the bars 80. If the patient is supine positioned and the sleeved garment is used, his hands are positioned on the bars 80, as shown in FIG. 1.
6. The head and foot end vacuum units are then energized to effect a vacuum evacuation flow rate proportional to the weight of the patient. This creates pressure differential forces which are sufficient to hold the patient in place during rotation. As will be apparent, greater pressured differential forces are required with heavier patients. The patient is then ready to be examined.
Two systems of access may be used to administer radiographic fluids through the garment 16. One such system is illustrated in FIGS. 4 and 5 wherein an opening 105, typically about 5 inches square, is made in the garment and the perimeter of the opening is secured by 2 inch wide surgical adhesive tape 106 to the patients skin to provide an air tight seal. Injections may then be administered through the opening 105 as needed, without disturbing the vacuum evacuated environment of the garment 16. The opening 105 is normally formed and the tape 106 normally put in place prior to the vacuum evacuation of the garment 16.
A second system of transferring medications and other fluids through the garment 16 is illustrated in FIGS. 1-3 and 14, 15. A specially designed poppet sealing disc 110 is provided, through which fluid conduits may extend to establish fluid communication through the garment 16. The garment material nearest to the periphery of the disc 110 is sealed to the disc 110 by means of a rubber band 112.
The disc 110 comprises a pair of circular metal plates 115, 116 which sandwich a circular sheet of gum rubber 117. The metal plates 115, 116 are ofa larger diameter than the gum rubber sheet 117. By this arrangement, an annular recess 118 is defined around the perimeter of the assembled disc. Accordingly the rubber band 112 draws the garment 16 into the recess 118 and serves to seal the garment 16 against the gum rubber sheet 117.
The disc 110 is supported by a bracket 120. A threaded fastener 121 extends through aligned apertures in the plates 115, 116 and the sheet 117, and is threaded into a threaded aperture 122 in the bracket 120. By this arrangement, the fastener 121 not only serves to rigidly connect the assembled disc 110 to the bracket 120, but also serves to clamp the plates 115, 116 against the gum rubber sheet 117.
The bracket 120 may selectively be secured to the support panel 70, as shown in FIG. 2, or to the end panel 22, as shown in FIG. 3. An elongated threaded fastener 125 extends through an aperture 126 in the bracket 120 and is selectively engageable with threaded apertures 126, 127 in the panels 70, 22. A knurled head 127 formed on the fastener 125 facilitates attachment and removal of the bracket 120.
Fluid communication is established through the disc I 110 by means of conduits 130, 131. Aligned apertures 132, 133, 134 provided through the plates 115, 116 and the sheet 117 receive the conduits 130, 131. The apertures 132, 133 are larger in diameter than are the apertures 134. By this arrangement, while the apertures 134 in the gum rubber sheet 117 securely engage and seal around the conduits 130, 131, the conduits fit quite loosely in the apertures 132, 133.
The conduits 130, 131 preferably comprise flexible tubes with connectors 136, 137 secured thereto. The connectors 136, 137 have stem portions 138, 139 which extend internally of the flexible tubes 130, 131 to reinforce such portions of the tubes as extend through the disc 110. The conduits 130, 131 are easily removed from the disc 110 simply by pulling them through the aligned apertures 132, 133, 134. Where only one conduit 131 is required, as illustrated in FIG. 15, a solid metallic plug 140 is provided for sealing the unused disc aperture 134. A chain 141 is secured to the plug 140 to prevent the loss of the plug 140 during periods of non-use.
The upper ends of the connectors 136, 137 may be coupled to sources of presurized fluid or to a vacuum evacuation apparatus as required for a particular medical procedure. Apertures 111 are formed in the garment 16 in alignment with the connectors 136, 137 to expose the connectors 136, 137 to expose the connectors 136, 137 outside the garment.
The conduits 130, 131 may connect with any of a number of well-known devices such as the enema nozzle 142 shown in FIG. 3. The ocnduits may also connect with devices specially designed for use with the patient positioning system of the present invention, such as the compression bladder 143 shown in FlGS. 2 and 8.
The compression bladder 143 preferably comprises a peripherally laminated assembly of rigid and flexible clear vinyl sheets 144, 145 forming an internal pocket within which an expansible bladder 146 is positioned. The compression bladder 143 is supplied with a controlled amount of compressed air through the conduit 131 and is used to exert a force on a selected region of the patient, such as the abdominal region.
The sealing disc 110, the conduits 130, 131, the noz zle 142, and the compression bladder are normally put in position after the patient is assisted onto the platform but prior to the sealing of the garment 16. The aperture 111 is also formed in the garment 16 and the seal effected around the disc 110 prior to the vacuum evacuation of the garment.
A dispensing system for dispensing controlled amounts of fluid either orally or rectally to a patient is illustrated generally at 150 FIG. 16. The system 150 includes a remote control console 151 connected by electrical cables 152, 153, 154 to dispensing units 155, 156, 157. The dispensing units each house a compressible fluid containing bag, and means for compressing the bag to dispense fluid therefrom, as will be explained presently.
The dispensing unit 155 is anoral dispenser, which is typically used to dispense a controlled quantity of barium solution into the mount of a patient. The dispensing unit 155 comprises a housing carrying a transparent hinged door 161. Latches 162 releasably hold the door 161 closed.
A dispensing tube 163 projects through an opening 164 in the housing. As shown in FIGS. 17, 18 the tube 163 connects at one end with a specially configured mouthpiece 165 and at the other end with an expansible, collapsible bellows-type vinyl bag 166.
The tube 163 is a flat vinyl type which is normally collapsed so as to hold a minimal amount of air. The mouthpiece 165 is formed of soft vinyl material and includes a pair of outwardly extending peripeheral ribs 170, 171 defining a recess 172 therebetween. The rib is normally positioned within the patients mouth and the rib 171 outside the mouth. The patients teeth and lips align with the recess 172 such that the patient can bite the mouthpieces so as to close off the flow of fluid from the bag 166.
The bag 166 is expansible, as illustrated in FIG. 18. A filler neck 173 and cap 174 are provided for filling the bag 166. A releasable clamp 175 is positioned on the tube 163 to prevent the discharge of fluid while the tube is inserted into the dispenser.
The dispenser units 155, 156, 157 are substantially identical in construction and accordingly only one of them dispenser will be described in detail. Referring to FIG. 20, a laterally extending partition divides the interior of the housing 160 into a dispensing chamber 181 and a valving chamber 182. The bag 166 typically holding 300 cc of barium solution, is positioned within the dispensing chamber 181 between a pair of relatively movable jaws 183, 184. The tube 163 extends through an opening 185 in the partition 180 and into the valving chamber 182. A stationary jaw 187 and a spring-biased movable jaw 186 releasably clamp the tube 163 to control the flow of fluid from the bag 166, as will be explained.
The relatively movable dispensing jaws 183, 184 are provided with a recess 190 which can accommodate the bag filler cap 174 such that the bag 166 can be inserted between the jaws 183, 184 with the tiller cap 174 received in either of the recesses 190. The jaws 183, 184 are supported on threaded mounting blocks 191, 192. The block 191 has an aperture 193 provided with right-hand threads, while the block 192 has an aperture 194 provided with left-hand threads. A shaft 195 having right-hand and left-hand threaded portions 196, 197 is threaded through the blocks 191, 192. The ends of the shaft 195 is journaled by bearings 198 mounted interially of the housing 160. By this arrangement, rotation of the shaft 195 is one direction will cause the jaws 183, 184 to move apart so as to receive the bag 166 therebetween, while rotation in the opposite direction will cause the jaws 183, 184 to move together so as to compress the bag 166.
A reversible variable speed drive motor 200 is provided to rotate the shaft 195. The motor 200 has a drive shaft 201. A gear 202 is mounted on the drive shaft 201. The shaft 195 carries a gear 203 which meshes with the gear 202 so as to drivingly connect the motor 200 and the shaft 195.
The valving jaws, 186, 187 are provided with rounded tube engaging surfaces 206, 207. Referring to FIG. 21, the jaw 186 is slidably mounted on a pair of guide rods 208, 209 and is biased toward the jaw 187 by a spring 210. The jaw 187 is rigidly secured to the housing 160.
In the case of the rectal dispenser, a solenoid 211 is provided to move the jaw 186 away from the jaw 187 to permit fluid flow through the tube 163. The solenoid 211 is not essential to dispensing fluid from the bag but is essential where fluid is to be returned to the bag. A controlled movement of the jaws 183, 184 will induce a control pressure within the barium-filled vinyl bag 166 and will force barium solution into the tube 163. As the pressure of the fluid in the tube 163 increases, the spring-loaded jaw 186 is forced open. When a predetermined quantity of barium solution has pass through the tube 163, the pressure within the tube will decrease permitting the jaw 186 to close.
The addition of the solenoid 211 to the retical dispenser unit will permit the retraction of the dispensing valve jaw 186 thereby permitting the return of barium and/or Co to the vinyl bay when the jaws 183 and 184 have been fully retracted.
Referring to FIGS. 20, 21, the guide rods 208, 209 have end portions 212, 213 which extend through apertures in a bracket 214 mounted on the housing 160. The end portions 212, 213 are threaded so as to receive nuts 215 which clamp the bracket 214 thereby rigidly mounting the guide rods 208, 209. The movable jaw 186 is provided with through apertures 216, 217 which slidably receive the guide rods 208, 209. The guide rod 208 extends to a position spaced from the fixed jaw 187 in order to permit the insertion and removal of the tube 163 between the jaws 186, 187. The guide rod 209 extends through an aperture 128 in the jaw 187 and is provided with a threaded end 219 which carries a nut 220.
The movable jaw 186 is provided with a closed end aperture 221 which receives an actuating rod 222. The rod 222 is rigidly secured to the jaw 186 as by a pin 223. The bracket 214 is provided with a through aperture 224 which is aligned with the aperture 221 and which slidably receives the actuating rod 222. The spring 210 is a compression coil spring which is positioned around the rod 222 between the bracket 214 and the movable jaw 186.
The solenoid 211 is carried by the housing 160 and has an armature 230. Connection is made between the armature 230 and the actuating rod 222 by a U-shaped bracket 231. The bracket 231 is rigidly secured to the armature 230. The actuating rod 222 has an enlarged head 232 provided with an annular groove 233. The bracket 231 has a slotted end region 234 which engages the groove 233 so as to connect the bracket 231 to the rod 222.
The dispensing units 156, 157 are typically used to rectally dispense barium solution and pressurized carbon dioxize gas. The units 156, 157 has dispensing tubes 240, 241 extending therefrom. The tubes 240, 241 may be provided with quick-coupler connectors 243 which are received by the apertures 134 of the sealing disc 110. In the alternative, the dispensing units 156, 157 can be placed inside the vacuum evacuated environment of the garment 16.
The dispensing unit 156 can be used by itself to rectally dispense barium solution through a nozzle 244, as shown in FIG. 16. Alternatively, the dispensing units 156, 157 can be hooked in parallel to selectively rectally dispense barium solution and compressed air through a nozzle 245.
Each of the dispensing units 155, 156, 157 is provided with control buttons 250, 251, 252. The buttons 250 connect with suitable electrical controls for actuating the motors 200 to set the jaws 183, 184 in a predetermined initial position to dispense a controlled amount of fluid, such as 10 cubic centimeters with each button depression. The buttons 251 connect with suitable control circuitry for reversing the dispensing motors 200 so as to open the dispensing jaws 183, 184. The buttons 252 connect with suitable safety switches which are operable to de-energize the control circuitry for each respective dispensing unit.
The control console 151 is provided with selector buttons 260, 261, 262 for selecting which one of the dispensing units 155, 156, 157 is to receive its remotely relayed commands. Whereas the. individual dispensing units have buttons 250 which are operable to dispense a single controlled amount of fluid, such as 10 cubic centimeters, the console 151 is provided with a series of buttons 263, 264, 265 which are operable to dispense different preselected quantities of fluid such as 10 cc, 25 cc and 35 cc. The console 151 is also provided with buttons 266, 267 for reversing the dispensing motors 200 and for deenergizing the dispensing system control circuitry.
A pair of switches 268, 269 are also provided for energizing the solenoids 211 of the rectal barium and air dispensing units 156, 157.
In operation, the dispensing system is normally hooked up after the patient is assisted onto the platform 15 but prior to the sealing of the garment 16. The
oral, rectal or air dispenser units can be used individually or together as required and are all remotely controlled from the console 151. Since the dispensing units 155, 156, 157 dispense their respective fluids under pressure, the system is operable to dispense controlled amounts of fluid regardless of the attitude in which the patient is positioned.
Although the invention has been described in its preferred form with a certain degree of particularity, it is understood that the present disclosure of the preferred form has been made only by way of example and that numerous changes in therdetails of construction and the combination and arrangement of parts may be resorted to without departing from the spirit and scope of the invention as hereinafter claimed.
What is claimed is:
1. A patient support system comprising:
a. a patient support means including a platform supported near opposite ends by a pair of end plates and defining a surface which, in cross section, has the configuration of an open curve for receiving portions of a patients body;
b. air impervious means including a flexible air impervious member for positioning over said portions of the patients body and for positioning around portions of said support means to define an evacuable chamber encompassing said portions, said member being provided with opening means for receiving the neck of the patient and for establishing a seal around the patients neck to dispose the patients head outside of said chamber;
. said support means including head engaging means removably supported on one of said end plates for releasably engaging the patients head, said head engaging means including support rod means having a pointed end region for puncturing said member upon being attached to said one end plate, and having means for sealing said member around the puncture regions produced when connection is made between said support rod means and said one plate;
d. means for sealing said member about such other portions of the patient and such other portions of said support means as extend outside said evacuable chamber, and for sealing portions of said member about the periphery of said end plates;
e. evacuation means for evacuating air from said chamber to create a pressure differential force acting on said portions of the patients body to hold said portions of the patients body against said support means.
2. The patient support system of claim 1 wherein said support rod means comprises a pair of support rods having threaded portions for connection to said one end plate, and each of said support rods is provided with means for sealing said member around the puncture regions produced when connection is made between said support rods and said one end plate.
3. The patient support system of claim 1 wherein said head engaging means includes a resilient head engaging structure carried on said support rod means.
4. A patient support system comprising:
a. patient support means including a platform defining a surface which, in cross section, has the configuration of an open curve for receiving portions of a patients body, said support means additionally including a foot support structure movably positioned along said platform for engaging the feet of a patient positioned on said platform;
b. air impervious means including a flexible air impervious member for positioning over said portions of the patients body and for positioning around portions of said support means to define an evacuable chamber encompassing said portions;
c. means for sealing said member about such other portions of the patient and such other portions of said support means as extend outside said evacuable chamber;
(1. evacuation means for evacuating air from said chamber to create a pressure differential force acting on said portions of the patients body to hold said portions of the patients body against said support means; and,
e. connection means carried by said foot support structure for establishing fluid communication through said member and including means for sealing said member about said connection means.
5. A patient support system comprising:
a. patient support means defining a surface which, in cross section, has the configuration of an open curve for receiving portions of a patients body;
b. air impervious means including a flexible air impervious member for positioning over said portions of the patients body and for positioning around portions of said support means to define an evacuable chamber encompassing said portions;
c. means for sealing said member about such other portions of the patient and such other portions of said support means as extend outside said evacuable chamber;
d. evacuation means for evacuating air from said chamber to create a pressure differential force acting on said portions of the patients body to hold said portions of the patients body against said support means; and,
e. connection means forestablishing fluid communication through said member for admitting and discharging fluids to and from various devices positioned within said chamber.
6. The patient support system of claim 5 additionally including an enema solution injector means positioned within said chamber and coupled to said connection means for receiving and discharging enema solution.
7. The patient support system of claim 5 additionally including compression bladder means positioned within said chamber between a selected portion of the patient and adjacent portions of said member, said compression bladder means being coupled to said connection means to receive and discharge fluid so as to expand and contract thereby exerting a controlled force on said selected portion of the patient.
8. A patient support system comprising:
a. a patient support platform rotatably mounted by a pair of end structures for receiving, supporting, and rotating a patient about an axis;
b. pressure differential force creating means including a garment disposed about portions of a patient and extending into contact with said platform to establish a vacuum evacuable chamber encompassing said patient portions, sealing means for sealing said garment around such portions of the patient and the platform as may extend beyond the bounds of said chamber and means for at least partially evacuating said chamber to establish pressure differential forces acting against said patient portions to hold the patient against said platform; and,
0. connection means engaging portions of said garment and establishing a seal therewith around an opening formed through said garment, said connection means having apertured portions which extend across said opening to provide at least one passage for transmitting fluid through said garment.
9. The patient support system of claim 8 wherein:
a. said connection means includes a disc-like structure having at least one aperture formed therethrough to receive a fluid conduit and having a continuous groove around the periphery thereof; and,
b. an expansible means is provided for clamping said portions of said garment in said groove to establish a seal between said disc-like structure and said garment.
10. The patient support system of claim 9 wherein:
a. said disc-like structure comprises a pair of generally circular plates sandwiching a disc of resilient material having a diameter less than the diameter of said plates, whereby said peripheral groove is defined between said plates radially outwardly of said disc; and,
b. said plates and said disc have coaxially aligned openings formed therethrough to define said aperture.
11. The patient support system of claim 10 wherein the opening through said disc is of such diameter as will permit the disc to establish a seal with said conduit.
12. The patient support of claim 8 additionally including a remotely operable dispensing system coupled to said passage means for dispensing controlled amounts of fluid through said garment to the patient positioned therein.
13. The patient support system of claim 12 wherein said dispensing system includes at least one dispensing unit including a collapsible fluid-carrying bag and means for collapsing said bag so as to dispense fluid therefrom.
14. The patient support system of claim 13 wherein said dispensing system includes both oral and rectal dispensing units, said oral dispensing unit being provided with a dispensing tube the end of which is positionable in a patients mouth, while said rectal dispensing unit has a dispensing tube coupled to a rectal dispensing nozzle positionable in a patients rectum.
15. The patient support system of claim 12 wherein said dispensing system includes:
a. housing means;
b. collapsible fluid receiving bag means disposed within said housing means;
0. a fluid dispensing conduit communicating with said bag means and extending exteriorally of said housing; and,
d. power operated means for controllably collapsing said bag means to dispense a controlled amount of fluid through' said conduit.
16. The dispensing system of claim 15 wherein said power operated means includes a pair of relatively movable jaws disposed on opposite sides of said bag means.
17. The dispensing system of claim 16 wherein said power operated means further includes motor driven means for moving said jaws selectively toward and away from each other.
18. The dispensing system of claim 15 additionally including valving means disposed within said housing for selectively clamping or opening said conduit to permit or prevent the flow of fluid therethrough.
19. An apparatus for administering fluid to a patient held under restraint, comprising:
a. a patient support defining a surface which, in cross section, has the configuration of an open curve for receiving and positioning a patient in a desired attitude;
b. a flexible air impervious garment positionable around portions of a patient and around portions of said support to establish an evacuable region encompassing said portions;
c. sealing means for sealing said garment about such other portions of the patient and said support as extend beyond the bounds of said region;
(1. evacuation means in communication with said region for evacuating air therefrom to establish pressure differential forces acting on said portions to restrain the patient in place on said support;
e. said conduit means extending through said garment establishing fluid communication between from within said region to without said region for administering fluid to the patient; and
f. said sealing means additionally includes means for sealing said garment in regions where said conduit means extend therethrough.
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