U.S. patent application number 12/009448 was filed with the patent office on 2008-07-31 for thigh support with free space for popliteal fossa.
Invention is credited to Matt DuDonis.
Application Number | 20080178390 12/009448 |
Document ID | / |
Family ID | 39666281 |
Filed Date | 2008-07-31 |
United States Patent
Application |
20080178390 |
Kind Code |
A1 |
DuDonis; Matt |
July 31, 2008 |
Thigh support with free space for popliteal fossa
Abstract
An exemplary embodiment providing one or more improvements
includes cushions which support a patient's thighs and lower legs
and which have cut out areas in the areas of the patient's
popliteal fossa at the back of the patient's knees. By avoiding
contact with the popliteal fossa complications such as compression
of the patient's nerves and blood vessels are avoided. This
prevents the harmful effects of pressure on the popliteal fossa in
loss of sensation in the lower legs and feet, and occlusion of
blood and lymph vessels in the lower legs. A number of embodiment
cushions are disclosed, some embodiments comprised of a relatively
firm core foam material with a relatively softer viscoelastic foam
in areas which are in contact with the patient's skin.
Inventors: |
DuDonis; Matt; (Sarasota,
FL) |
Correspondence
Address: |
WILLIAM S RAMSEY, ESQ
5253 EVEN STAR PLACE
COLUMBIA
MD
21044
US
|
Family ID: |
39666281 |
Appl. No.: |
12/009448 |
Filed: |
January 18, 2008 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
60897780 |
Jan 26, 2007 |
|
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Current U.S.
Class: |
5/632 ; 5/648;
5/655.3; 5/655.5 |
Current CPC
Class: |
A47C 20/021
20130101 |
Class at
Publication: |
5/632 ; 5/648;
5/655.3; 5/655.5 |
International
Class: |
A47C 20/00 20060101
A47C020/00; A47C 17/86 20060101 A47C017/86; A47C 16/00 20060101
A47C016/00 |
Claims
1. A therapeutic cushion for a supine or side lying patient
comprising: support means for the patient's upper leg, and support
means for the patient's lower leg, wherein the cushion has a
contoured free space between the upper leg support means and the
lower leg support means which prevents contact between the cushion
and the patient's popliteal fossa.
2. A therapeutic cushion for a supine or side lying patient
comprising: a rectangular heel elevator support for supporting the
patient's lower legs with the patient's feet extending over the end
of the heel elevator support, a rectangular wedge-shaped
supplemental support for supporting the patient's upper legs, a
connector which connects the heel elevator support with the
supplemental support, the connector having a cut out or contoured
free space below the patient's popliteal fossa area whereby the
patient's upper legs are supported by the supplemental support, the
patient's lower legs are supported by the heel elevator support,
the patient's feet and heels are extended from the end of the heel
elevator support, and no surface is in contact with the patient's
popliteal fossa.
3. The therapeutic cushion of claim 2 wherein the cushion is
constructed of fill comprised of foam, polyester fiber, gel
materials, water or other fluids including air, and covered by a
fill impervious cover.
4. The therapeutic cushion of claim 2 wherein the cushion is
constructed of one or more layers of foam.
5. The therapeutic cushion of claim 2 wherein the heel elevator
support, supplemental support, and connector is comprised of
foundation foam and the heel elevator support and supplemental
support has a layer of viscoelastic foam covering the foundation
foam in areas of patient contact.
6. The therapeutic cushion of claim 2 wherein the connector is a
connector arm connecting the heel elevator support and supplemental
support, the connector arm stiff enough and long enough to maintain
a separation between the heel elevator support and supplemental
support which approximates the length of a patient's popliteal
fossa.
7. The therapeutic cushion of claim 2 wherein the heel elevator
support, connector, and supplemental support are comprised of a
single piece of foundation foam.
8. The therapeutic cushion of claim 2 wherein the rear end of the
heel elevator support is the highest portion of the therapeutic
cushion and the height of the upper surfaces of the heel elevator
support and supplemental support taper from the rear end of the
heel elevator support to the bottom of the therapeutic cushion at
the front end of the supplemental support.
9. The therapeutic cushion of claim 2 further comprising bolsters
on the edges of the upper surface of the heel elevator support.
10. The therapeutic cushion of claim 2 further comprising cavities
for the patient's legs on the surface of the upper surface of the
heel elevator support.
11. The therapeutic cushion of claim 2 wherein the cushion has a
width which approximates the width of a patient's bed.
12. The therapeutic cushion of claim 2 wherein the cushion has a
width which approximates one half of the width of a patient's
bed.
13. The therapeutic cushion of claim 2 wherein the connector is
integral with and in combination with the supplemental support, and
the heel elevator support and combination connector and
supplemental support are connected by a flexible strap hinge
attached to the bottom of the heel elevator support and the
combination connector and supplemental support.
14. The therapeutic cushion of claim 2 wherein the connector is
integral with and in combination with the supplemental support, and
the heel elevator support has a cover and the combination connector
and supplemental support has a cover, and the covers are connected
by a flexible hinge.
15. The therapeutic cushion of claim 14 wherein the cushion is
constructed of fill comprised of foam, polyester fiber, gel
materials, water or other fluids including air, and covered by a
fill impervious cover.
16. The therapeutic cushion of claim 2 wherein the heel elevator
support, connector, and supplemental support are covered by a
water-resistant cover.
17. The cover of claim 16 comprised of thermoplastic polyurethane
film or water-resistant coated fabric material.
18. The cover of claim 16 wherein the cover is comprised of nylon
taffeta.
19. The cover of claim 16 wherein the bottom of the cover has a
non-slip coating.
20. The process of preventing and treating heel pressure ulcers,
improvement of blood circulation in the legs or relief of back pain
in a supine patient in a bed without injury to the patient's
popliteal fossa comprising the step: a. placing the leg or legs of
a patient in need of such preventing or treating of heel pressure
ulcers or improvement of blood circulation in the legs or relief of
back pain on a therapeutic cushion comprising: rectangular heel
elevator support for supporting the patient's lower legs with the
patient's feet extending over the end of the heel elevator support,
a rectangular wedge-shaped supplemental support for supporting the
patient's upper legs, and a connector which connects the heel
elevator support with the supplemental support, the connector
having a cut out or contoured free space located below the
patient's popliteal fossa whereby no surface is in contact with the
patient's popliteal fossa.
21. The process of claim 20 wherein the therapeutic cushion of step
a. is constructed of fill comprised of foam, polyester fiber, gel
materials, water or other fluids including air, and covered by a
fill impervious cover.
22. A hemispheric-shaped log roll cushion for a supine patient
comprising: an arc-shaped rear end, a connector having a cut out or
contoured free space on the top surface, and an arc-shaped rear
end, the front end, connector and rear end comprised of a single
piece of foam.
23. The log roll cushion of claim 22 wherein a layer of
viscoelastic foam is attached to the top surfaces of the rear end
and the front end.
24. The log roll cushion of claim 22 wherein the cushion further
comprises a water-resistant cover.
25. The log roll cushion of claim 24 wherein the cover is comprised
of thermoplastic polyurethane film or coated fabric material.
26. The log roll cushion of claim 24 wherein the cover is comprised
of nylon taffeta.
27. The log roll cushion of claim 24 wherein the cover has a bottom
which has a non-slip coating.
28. The process of preventing and treating heel pressure ulcers,
improvement of blood circulation in the legs or relief of back pain
in a supine patient in a bed without injury to the patient's
popliteal fossa comprising the step: a. placing the leg or legs of
a patient in need of such preventing or treating of heel pressure
ulcers or improvement of blood circulation in the legs or relief of
back pain on a log roll cushion comprising: an arc-shaped rear end,
a connector having a cut out on the top surface, an arc-shaped rear
end, the front end, connector and rear end comprised of a single
piece of foam.
29. The process of claim 28 wherein the therapeutic cushion of step
a. is constructed of fill comprised of foam, polyester fiber, gel
materials, water or other fluids including air, and covered by a
fill impervious cover.
Description
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] This application claims priority to provisional application
Ser. No. 60/897,780 filed Jan. 26, 2007.
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
[0002] Not Applicable.
THE NAMES OF THE PARTIES TO A JOINT RESEARCH AGREEMENT
[0003] Not Applicable.
REFERENCE TO A "SEQUENCE LISTING," A TABLE, OR A COMPUTER PROGRAM
LISTING APPENDIX
[0004] Not Applicable.
BACKGROUND
Description of Related Art Including Information Disclosed Under 37
CFR 1.97 and 37 CFR 1.98
[0005] Therapeutic cushions are cushions used for the prevention or
treatment of a disease or condition in a supine patient confined to
a bed. Examples of therapeutic cushions include heel elevators and
log roll cushions.
[0006] Embodiments of the present application are cushions which
achieve the desirable redistribution of pressure of a patient's
body on the cushion while eliminating the risk of injury to the
popliteal fossa.
[0007] U.S. Pat. No. 4,639,960 discloses a pneumatic cushion
comprised of wedge shaped components. The cushion maintains the
popliteal fossa at an elevation of 120 to 150 degrees, but has no
provisions for avoiding contact between that anatomical feature and
the cushion.
[0008] U.S. Pat. No. 4,665,573 discloses a contoured body support
cushion with a convex structure in the area of the knees which
raises the surface some 31/2 inches where the popliteal fossa is
located on the average person.
[0009] U.S. Pat. No. 5,398,354 discloses a mattress with a hollow
portion which receives a soft resilient pillow insert for
cushioning the heels of the user.
[0010] U.S. Pat. No. 6,256,822 discloses a patient support system
mattress with side bolsters to prevent falling from the bed and a
cutout saddle which allows easy entry onto the mattress.
[0011] U.S. Pat. No. 6,634,045 (incorporated herein by reference)
discloses a supplemental support which may be integral to or
separate from a heel elevator support.
[0012] U.S. Pat. No. 7,007,330 discloses a patient turning and
lifting device which includes body support with side rails, a
pillow, and a saddle support pad to support the patient's buttocks
and thighs. In addition, inflatable bladders allow the patient to
be shifted from one side to another.
[0013] U.S. Design Pat. No. D357,740 discloses a lateral surgical
patient support cushion which has a traverse notch area. It is
comprised of two foam components connected at one end of the
traverse notch area.
[0014] Patent Application Publication No. US2005/0005358,
incorporated herein by reference, discloses an aid which assists a
caregiver in rotating and positioning immobile patients. The aid
has a strong resilient foam core which resists compression by a
patient, yet also has a yielding surface foam layer which avoids
trauma to the patient's skin.
[0015] The foregoing examples of the related art and limitations
related therewith are intended to be illustrative and not
exclusive. Other limitations of the related art will become
apparent to those of skill in the art upon a reading of the
specification and a study of the drawings.
BRIEF SUMMARY
[0016] Embodiments include a therapeutic cushion for a supine or
side lying patient comprising support means for the patient's upper
leg, and support means for the patient's lower leg. The cushion has
a contoured free space between the upper leg support means and the
lower leg support means which prevents contact between the cushion
and the patient's popliteal fossa.
[0017] Embodiments include a heel elevator cushion for use by
patients without injury to the popliteal fossa area at the back of
the knees. Embodiments include a rectangular heel elevator support
having a front end and a back end, a left and a right side, and a
top and a bottom surface, the support having a width from the left
side to the right side approximating or less than the width of a
bed, the support having a length from the front end to the back end
approximating the length of a patient's leg from knee to Achilles
tendon, the support having from the top surface to the bottom
surface a height adequate to stimulate circulation in the lower
legs. The cushion includes a rectangular wedge-shaped supplemental
support having a front end and a back end, a left and a right side,
and an upper surface and a lower surface, the supplemental support
having a length from the front end to the back end approximating
the length of a patient's leg from the hip to the knee, the
supplemental support tapering in height from back end of the
supplemental support having a height approximating the height of
the front end of the heel elevator support to the front end of the
second cushion where the upper surface meets the lower surface. The
heel elevator support and supplemental support are separated by a
rectangular connector having a front end and a back end, a left and
a right side, and an upper surface and a lower surface, the
connector having a length from the front end to the back end
approximating the length of a patient's popliteal fossa, the
connector having a height less than the height of the front end of
the first cushion adequate to prevent contact of a patient's
popliteal fossa with the connector when the patient's legs are
supported by the heel elevator support and the supplemental
support. The back end of the connector is connected to the front
end of the heel elevator support and the front end of the connector
connected to the back end of the supplemental support. The supports
are comprised of a core foam overlaid by a viscoelastic patient
contact foam and the cushions are covered by a cover comprised of
water-resistant elastomer material.
[0018] Also disclosed are embodiments of a log roll cushion for
supporting the thighs and lower legs of immobile patients without
injury to the popliteal fossa area at the back of the knees.
Embodiments include a cushion having a front and rear end, a left
and right edge, an upper and lower surface, the cross-section of
the cushion in the approximate shape of a hemisphere with a cut-out
approximately between the front and rear ends of the cushion, the
cut-out dividing the cushion into a front portion and a rear
portion, the width of the cushion approximating the width of a bed,
the length of the front portion approximating the length of a
patient's thighs, the length of the rear portion approximately the
length of a patient's lower legs, and the depth of the cut-out
adequate to avoid contact of the cushion with the popliteal fossa
areas at the back of the patient's knees. The cushion is comprised
of a core foam overlaid by a viscoelastic patient contact foam and
the cushion is covered by a cover comprised of water-resistant
elastomer material.
[0019] The following embodiments and aspects thereof are described
and illustrated in conjunction with systems, tool and methods which
are meant to be exemplary and illustrative, not limiting in scope.
In various embodiments, one or more of the above-described problems
have been reduced or eliminated, while other embodiments are
directed to other improvements.
[0020] In addition to the exemplary aspects and embodiments
described above, further aspects and embodiments will become
apparent by reference to the drawings and by study of the following
descriptions.
BRIEF DESCRIPTION OF THE DRAWINGS
[0021] FIG. 1 is a perspective view of a first embodiment heel
elevator cushion in used by a patient.
[0022] FIG. 2 is a cross-sectional view of the first embodiment
heel elevator cushion taken along line 2-2 of FIG. 1.
[0023] FIG. 3 is a perspective view of a second embodiment heel
elevator cushion.
[0024] FIG. 4 is a cross-sectional view of a second embodiment heel
elevator cushion taken along line 4-4 of FIG. 3.
[0025] FIG. 5 is a cross-sectional view of a first embodiment heel
elevator support taken along line 5-5 of FIG. 1.
[0026] FIG. 6 is a cross-sectional view of a second embodiment heel
elevator support taken as along line 5-5 of FIG. 1 when the second
embodiment heel elevator support is used rather than the first
embodiment heel elevator support.
[0027] FIG. 7 is a cross-sectional view of a third embodiment heel
elevator support taken as along line 5-5 of FIG. 1 when the third
embodiment heel elevator support is used rather than the first
embodiment heel elevator support.
[0028] FIG. 8 is a perspective view of a log roll cushion in use by
a patient.
[0029] FIG. 9 is a cross-sectional view of a log roll cushion taken
along line 9-9 of FIG. 8.
[0030] FIG. 10 is a perspective of a third embodiment heel elevator
cushion in use by a patient.
[0031] FIG. 11 is a cross-sectional view of a third embodiment heel
elevator cushion taken along line 11-11 of FIG. 10.
[0032] FIG. 12 is a perspective view of a fourth embodiment heel
elevator cushion.
[0033] FIG. 13 is a cross-sectional view of a fourth embodiment
heel elevator cushion taken along line 13-13 of FIG. 12.
DETAILED DESCRIPTION
[0034] Therapeutic cushions are cushions used for the prevention or
treatment of a disease or condition in a patient confined to a bed
in a supine or side lying position. Examples of therapeutic
cushions include heel elevators and log roll cushions. It is
anticipated that the popliteal fossa-sparing features of the
disclosed embodiments can be used with other therapeutic cushions
equivalent to the disclosed embodiments.
[0035] Heel elevators are used in the prevention of the development
of pressure ulcers, an important goal in the treatment of immobile
patients. Heel pressure ulcers are caused by contact of the back of
the heel with the bed or bedclothes. Heel pressure ulcer prevention
in supine patients can be achieved by the use of cushions under the
lower legs which support the ankles and feet, thereby preventing
any contact of the heels with any surface.
[0036] Another use for heel elevators is to improve circulation in
the legs by elevating the lower legs above the level of the heart.
Such elevation has the desirable effect of insuring adequate
drainage of blood and fluid out of the lower extremities.
[0037] When the lower legs and heels are elevated on a therapeutic
cushion or pillows, there is always a small span that is created
between the support surface and the posterior surface of the
thighs. This is often tolerated well by the patient, but comfort
and clinical efficacy can be greatly enhanced by also supporting
the thighs. This has a positive effect on the redistribution of
pressure, since a greater percentage of the overall area of the
body is in contact with a supporting surface. By increasing the
area of supported body surface the average pressure per surface
area on the patient's skin is reduced. This effect is referred to
as pressure redistribution. It is desirable to have the legs in
contact with and supported by the greatest possible area of support
as possible, as this reduces the average pressure of the support
against the skin, thereby reducing the incidence of pressure
ulcers.
[0038] Supporting the thighs and lower legs with cushions is not
without disadvantages. The most important disadvantage is that
there will likely be a cushion surface in contact with the area at
the back of the knee known as the popliteal fossa. The popliteal
fossa contains easily damaged nerves, blood vessels, glands,
ligaments, tendons and soft tissue. Pressure on the popliteal fossa
forces the anatomical features contained in this structure upward
against the bony prominent bony structures at the ends of the femur
and tibia. The nerves, blood vessels, muscles, tendons and glands
may be damaged by such pressure, with subsequent attendant injury
to the lower legs and feet through congested blood flow and loss of
sensation.
[0039] In particular, pressure on or compression of the nerves in
the popliteal fossa causes damage which reduces sensation in the
lower legs and feet. Loss of sensation in the feet reduces the
chances of early detection and cure of foot injuries. In addition,
pressure on blood vessels in the popliteal fossa leads to
congestion of blood flow to and from the lower extremities. Such
congestion inhibits healing leading to progression of disease and
often to amputation. It will be appreciated that a patient confined
to a bed may be debilitated by vascular disease, diabetes, cancer
or stroke, edema or other conditions; all of which make the
popliteal fossa and the anatomical features contained inside more
vulnerable to injury.
[0040] The use of any therapeutic cushion runs the risk of
stimulating the formation of pressure ulcers on the portion of the
patient's body in contact with the surface of the cushion. This
risk is reduced by the use of viscoelastic foam in the portion of
the cushion in contact with the patient's body. An additional
approach is to reduce the pressure of the cushion on the patient'
prominent body contact points, the so-called bony prominences such
as the ankle, heel, and hip. Advanced practices achieve this
reduction of contact point pressure by increasing the total area of
the patient's body in contact with the body support, the
redistribution of pressure. By expanding the area of contact of the
patient's body with the support surface, the pressure on the bony
prominences is reduced.
[0041] Log roll cushions are cushions having the rough shape of a
rolled up blanket which extends from one side of a bed to the
other, hence the name "log roll." Log roll cushions are placed
under and raise the knees of a supine patient lying on his or her
back. Such cushions are used to relieve the pressure on the
patient's lower back and thereby reduce back pain.
[0042] The Popliteal Fossa.
[0043] The popliteal fossa or space is a lozenge-shaped space at
the back of the knee-joint. Laterally it is bounded by the biceps
femoris above, and by the plantaris and the lateral head of the
gastrocnemius below. Medially it is limited by the semitendinous
and semimembranosus above, and by the medial head of the
gastrocnemius below. The innermost surface or floor is formed by
the popliteal surface of the femur, the oblique popliteal ligament
of the knee-joint, the upper end of the tibia, and the fascia
covering the popliteus; the fossa is covered in by the fascia
lata.
[0044] The popliteal fossa contains the popliteal vessels, the
tibia and the common peroneal nerves, the termination of the small
saphenous vein, the lower part of the posterior femoral cutaneous
nerve, the articular branch from the obturator nerve, a few small
lymph glands, and a considerable quantity of fat. The tibial nerve
descends through the middle of the fossa, lying under the deep
fascia and crossing the vessels posteriorly from the lateral to the
medial side. The common peroneal nerve descends on the lateral side
of the upper part of the fossa, close to the tendon of the biceps
femoris. On the floor of the fossa are the popliteal vessels, the
vein being superficial to the artery and united to it by dense
areolar tissue; the vein is a thick-walled vessel, and lies at
first lateral to the artery, and then crosses it posteriorly to
gain its medial side below; sometimes it is double, the artery
lying between the two veins, which are usually connected by short
transverse branches. The articular branch from the obturator nerve
descends upon the artery to the knee-joint. The popliteal lymph
glands, six or seven in number, are imbedded in the fat; one lies
beneath the popliteal fascia near the termination of the external
saphenous vein, another between the popliteal artery and the back
of the knee-joint, while the others are placed at the sides of the
popliteal vessel. Arising from the artery, and passing off from it
at right angles, are its genicular branches.
[0045] The use of any therapeutic cushion under the knees runs the
risk of congesting blood flow and compressing nerves in the
popliteal fossa, which is directly behind the knee.
[0046] FIG. 1 is a perspective view of a first embodiment heel
elevator cushion 100 in use by a patient. FIG. 1 shows a patient
lying in a supine position on his or her back, in particular the
torso 14, left leg comprising thigh or upper leg 15, knee 16, lower
leg or calf 18, and foot 19. The popliteal fossa 17 is on the
bottom side of or behind or underneath the knee. Also visible is
the right leg comprising thigh or upper leg 20, knee 21, lower leg
or calf 18, and foot 19. The popliteal fossa 22 is on the bottom
side of or behind or underneath the knee.
[0047] The first embodiment heel elevator cushion 100 is comprised
of a heel elevator support 25 connected to a connector 75, which is
in turn connected to a supplemental support 50.
[0048] In use, the thighs 15 and 20 rest on the upper surface 56 of
the supplemental support 50. The popliteal fossas 17 and 22 are
suspended above the hemispheric bore, groove or contoured free
space comprising the upper surface 81 of the connector 75. The
lower legs 18 and 23 rest on the upper surface 35 of the heel
elevator support 25 and in this embodiment are restrained from
movement off of the heel elevator support by bolsters, also called
ramparts or palisades. Left bolster 39 and right bolster 37 are
located on the edges of the heel elevator support and extend above
the upper surface 35 of the heel elevator support. The feet 19 and
24 are suspended over the back end 41 of the heel elevator support
and the heels do not come in contact with any support surface or
bedclothes. Suspension of feet and heels without contact with any
surfaces helps prevent and treat heel pressure ulcers.
[0049] The length of the heel elevator support approximates the
length of a patient's lower legs, the length of the supplemental
support approximates the length of a patient's upper legs, and the
length of the connector approximates the length of a patient's
popliteal fossa. In one embodiment the length of the heel elevator
cushion is 29 inches and the width is 27 inches. The length of the
heel elevator support is 13 inches and the height is 13 inches. The
height of the bolsters is 1.5 inches and the width is 1.5 inches.
The length of the upper surface of the supplemental support is 9.5
inches, the height of the supplemental support at the connector is
7.5 inches, and the length of the supplemental support at the
bottom is 5.8 inches. The length of the connector is 10.2
inches.
[0050] The thickness of the viscoelastic foam covering the upper
surfaces of the heel elevator support and the upper surface of the
supplemental support is 1.5 inches.
[0051] In embodiments the length of the heel elevator cushion is
from 24 to 36 inches and the width is 22 to 36 inches. The length
of the heel elevator support is from 10 to 16 inches, the height is
from 10 to 16 inches. The height of the bolsters is 0.5 to 3 inches
and the width is 0.5 to 3 inches.
[0052] In embodiments the length of the upper surface of the
supplemental support is from 6 to 16 inches, the height of the
supplemental support at the connector is from 6 to 9 inches, and
the length of the supplemental support at the bottom is from 4 to 9
inches. The length of the connector is from 8 to 16 inches.
[0053] In embodiments which support both legs of a patient the
width of the heel elevator cushion approximates the width of a
hospital bed, approximately 25 inches to 35 inches.
[0054] In embodiments which support only one leg of a patient the
width of the heel elevator cushion approximates one half of the
width of a hospital bed, approximately 10 inches to 17 inches.
[0055] In embodiments which are constructed of viscoelastic foam
layered on top of structural foam the thickness of the viscoelastic
foam covering the upper surfaces of the heel elevator support and
the upper surface of the supplemental support is from 0.5 to 3
inches.
[0056] FIG. 2 is a cross-sectional view of the first embodiment
heel elevator cushion taken along line 2-2 of FIG. 1. In this
embodiment the heel elevator support 25, connector 75, and
supplemental support 50 are combined in a single piece of
foundation foam material 29, with the border between heel elevator
support and connector indicated by dashed line 31 and the border
between connector and supplemental support indicated by dashed line
33. A layer 52 of viscoelastic foam covers the upper surface 56 of
the supplemental support 50; and a similar layer 27 covers the
entire upper surface of the heel elevator support 25, including the
upper surface of the right bolster 37, and the upper surface of the
heel elevator support 25, not visible in FIG. 2 but indicated by
dashed line 35. The viscoelastic foam layer on upper surface 35 is
at 28. The approximately hemispheric upper surface 77 of the
connector, also termed a contoured free space, is low enough to
prevent contact of the patient's popliteal fossas with any surface.
The back end of the heel elevator support is at 41. All surfaces of
the first embodiment heel elevator cushion are covered by a cover
90.
[0057] FIG. 3 is a perspective view of a second embodiment heel
elevator cushion 200. In the second embodiment the heel elevator
support 225 has a left bolster 239, a right bolster 237, a flat
upper surface 235 and is covered on all sides by a cover 294. The
wedge shaped supplemental support 250 has an upper surface 256 and
is covered on all sides by a cover 292. The second embodiment heel
elevator cushion 200 has a second embodiment connector 275, in this
embodiment comprising a left connector arm 277 and a right
connector arm 279.
[0058] A variety of connector embodiments are contemplated, some
connectors may extend from one side of the heel elevator support to
the other, or may consist of a single arm. In embodiments the
connectors must be stiff enough to maintain a cut out or distance
between the heel elevator cushion and the supplemental support
adequate to prevent contact between the patient's popliteal fossas
and any portion of the heel elevator cushion or supplemental
support, also termed a contoured free space. Connectors which are
adjustable in length are specifically contemplated. Connectors that
are welded or cut in such a way that they are a feature of the
thigh support and or lower leg support cushion are also
contemplated. Connectors with flexible connections with the heel
elevator cushion and the supplemental support are contemplated,
such as tape, adhesive, straps or other types of fasteners. Such
flexible connections allow the folding of the heel elevator
cushions for storage and shipping purposes. In addition, such
flexible connections allow the supports to articulate when used
with mechanical beds commonly found in the healthcare setting.
[0059] FIG. 4 is a cross-sectional view of a second embodiment heel
elevator cushion taken along line 4-4 of FIG. 3. In this embodiment
the heel elevator support 225, connector 275, and supplemental
support 250 are individual units. The heel elevator support 225
comprises a single piece of foundation foam 229 with a layer 227 of
viscoelastic foam at the top and internal surface of the right
bolster 237. The flat upper surface is indicated by dashed line 235
and the viscoelastic layer by 228. The back end of the heel
elevator support is at 241. All surfaces of the second embodiment
heel support 225 are covered by a cover 294. Embodiments that are
not with a cover are also contemplated.
[0060] The right connector arm 279 is a portion of the second
embodiment connector 275. The connector arm is connected at one end
to the heel elevator support 275 and at the other end to the
supplemental support 250.
[0061] The second embodiment supplemental support 250 is shown in
FIG. 4. The foundation foam 254, the upper surface 256, the
viscoelastic foam layer 252, and the cover 292 which covers all
surfaces of the second embodiment supplemental support are
shown.
[0062] FIG. 5 is a cross-sectional view of a first embodiment heel
elevator support 25 as taken along line 5-5 of FIG. 1. Visible in
FIG. 5 is a foundation foam 29, viscoelastic foam layer 27 which
covers the areas of the support which may contact the patient user,
in particular the upper surface 35 of the support, the internal
surface 32 and top 34 of left bolster 39, and internal surface 36
and top 38 of right bolster 37. A cover 90 encloses the
support.
[0063] FIG. 6 is a cross-sectional view of a flat embodiment heel
elevator support 425 as taken along line 5-5 of FIG. 1. Visible in
FIG. 6 is a foundation foam 429, and viscoelastic foam layer 427
which covers the areas of the support which may contact the patient
user. A cover 490 encloses the support.
[0064] FIG. 7 is a cross-sectional view of a cavity embodiment heel
elevator support 525 as taken along line 5-5 of FIG. 1. Visible in
FIG. 7 is a foundation foam 529, viscoelastic foam layer 527 which
covers the areas of the support which may contact the patient user,
in particular the upper surface 535 of the support, the left leg
cavity 540 and right leg cavity 550. A cover 590 encloses the
support.
[0065] FIG. 8 is a perspective view of a hemispheric-shaped log
roll cushion 300 in use by a supine patient. The elements of the
patient are as in FIG. 1. The lower legs 18 and 23 of the patient
rest on the surface 335 of the arc-shaped rear end 325, the upper
legs 15 and 20 rest on the surface 356 of the arc-shaped front end
350 of the log roll cushion, and the popliteal fossas 17 and 22 are
suspended above the surface 377 of the hemispheric bore, groove,
contoured free space, or cut out 381 on the top surface of the
connector 375 between the rear end 325 and front end 350. All
surfaces of the log roll cushion 300 are enclosed by a cover 390.
The rear end 325, front end 350 and connector 375 may be
constructed of a single piece of foam or of pieces of foam which
are attached to each other.
[0066] FIG. 9 is a cross-sectional view of a log roll cushion taken
along line 9-9. Embodiments may comprise a single piece of
foundation foam divided by dashed line 331 into a rear end 325 and
connector 375 and dashed line 333 into connector 375 and front end
350. Embodiments comprise foundation foam 329 with upper surfaces
covered by viscoelastic foam, the rear end 325 upper surface 335
covered by viscoelastic foam 327, and the front end 350 upper
surface 356 covered by viscoelastic foam 352. The surface 377 of
the hemispheric cut out 381, also termed a contoured free space, is
shown. All surfaces of the log roll cushion 300 are enclosed by a
cover 390.
[0067] In embodiments which support both legs of a patient the
width of the log roll approximates the width of a hospital bed,
approximately 25 inches to 35 inches.
[0068] In embodiments which support only one leg of a patient the
width of the log roll approximates one half of the width of a
hospital bed, approximately 10 inches to 17 inches.
[0069] In embodiments the length of the rear end approximates the
length of a patient's lower legs, the length of the front end
approximates that of a patients upper legs, and the length of the
cut-out approximates the length of a patient's popliteal fossa. The
depth of the cut-out is adequate to prevent contact of the
patient's popliteal fossa with any surface of the log roll.
[0070] FIG. 10 is a perspective of a third embodiment heel elevator
cushion 400 in use by a patient. The elements of the patient are as
in FIG. 1. The height of the third embodiment cushion is greatest
at the rear of the heel elevator support at the patient's feet and
tapers to the level of the bottom of the cushion at the rear of the
supplemental support at the patient's hips. The patient's upper
legs rest on the supplementary support surface 456, the patient's
lower legs rest on the heel elevator support surface 435, the
patient's feet 19 and 24 (and associated heels) extend beyond the
rear end 441 of the heel elevator support, and the patient's
popliteal fossas are suspended above the approximately hemispheric
cutout area or contoured free space 481 and do not contact the
surface of the connector 477.
[0071] One use for the third embodiment heel elevator cushion is to
elevate the lower and upper legs above the level of the patient's
heart and thereby improve the patient's blood circulation while
simultaneously protecting the patient's heels against heel pressure
ulcers.
[0072] FIG. 11 is a cross-sectional view of a third embodiment heel
elevator cushion taken along line 11-11 of FIG. 10. In this
embodiment the heel elevator support 425, connector 475, and
supplemental support 450 are combined in a single piece of
foundation foam material 429, with the border between heel elevator
support and connector indicated by dashed line 431 and the border
between connector and supplemental support indicated by dashed line
433. A layer 452 of viscoelastic foam covers the upper surface 456
of the supplemental support 450; and a similar layer 427 covers the
entire upper surface 435 of the heel elevator support 425. The
approximately hemispheric upper surface 477 of the groove or bore
or contoured free space 488 of the connector 475 is low enough to
prevent contact of the patient popliteal fossas with any surface.
The rear end 441 of the heel elevator support is shown. All
surfaces of the third embodiment heel elevator cushion are covered
by a cover 490.
[0073] In the third embodiments which support both legs of a
patient the width of the heel elevator cushion approximates the
width of a hospital bed, approximately 25 inches to 35 inches.
[0074] In the third embodiments which support only one leg of a
patient the width of the heel elevator cushion approximates one
half of the width of a hospital bed, approximately 10 inches to 17
inches.
[0075] In the third embodiments the length of the supplemental
support approximates the length of a patient's upper legs, the
length of the heel elevation support approximates the length of a
patient's lower legs, the length of the connector approximates the
length of the patient's popliteal fossa.
[0076] FIG. 12 is a perspective view of a fourth embodiment heel
elevator cushion 500. In the fourth embodiment the heel elevator
support 625 has a flat upper surface 635 and is covered on all
sides by a cover 694. The wedge shaped supplemental support 650 has
an upper surface 656 and is covered on all sides by a cover 692
which also covers the connector 675. The fourth embodiment heel
elevator cushion connector 675 is integral with the supplemental
support 650 forming a combination supplemental support and
connector and has a hemispheric cut out or contoured free space 677
at the top of the connector to accommodate the patient's popliteal
fossa. The heel elevator support cover 694 is connected to the
connector cover 692 by a hinge 696 which is made of the same
material and is integral with and attached to the covers 694 and
692. The covers 694 and 692 and hinge 696 may be constructed of a
single piece of material.
[0077] FIG. 13 is a cross-sectional view of the fourth embodiment
heel elevator cushion taken along line 13-13 of FIG. 12. In this
embodiment the heel elevator support 625, comprises foundation foam
material 629 and is covered by cover 694. The rear end 641 of the
heel elevator support is shown. The connector 675 and supplemental
support 650 are combined in a single piece of foundation foam
material 635, with the border between supplemental support 650 and
connector 675 indicated by dashed line 633, and the cover at 692.
The approximately hemispheric upper surface or contoured free space
677 of the connector is low enough to prevent contact of the
patient popliteal fossas with any surface. The heel elevator
support cover 694 is connected to the connector 675 by a hinge 696
which may be made of the same material and is integral with the
covers 694 and 692. The covers 694 and 692 and hinge 696 may be
constructed of a single piece of material.
[0078] Other equivalent structures and materials for the hinge 696
are contemplated. For example, a fourth embodiment cushion without
a cover uses a hinge constructed of a approximately rectangular
flexible strap attached along the strap long edges to the bottom of
the heel elevator support 625 and to the bottom of the supplemental
support 650. The strap hinge is attached to the supports by any
suitable means such as adhesive, riveting, or sewing.
[0079] The hinge embodiments have the function of connecting the
heel elevator support and the supplemental support and maintaining
them at a suitable distance from each other and a suitable
orientation to each other. In addition, the hinges allow the
vertical articulation of the supports which allow conformation to
the articulation of many hospital beds.
[0080] A number of heel elevator cushion embodiments have been
disclosed along with a number of embodiments of heel elevator
supports. It is contemplated that any embodiment heel elevator
support can be used in any embodiment heel elevator cushion.
[0081] Although embodiments in which the cushion or log roll is
constructed of foam are disclosed, construction from other
equivalent weight supporting materials is contemplated. Polyester
fiber fill, various gel materials, water or other fluids, including
air, are contemplated as filling materials. In such embodiments the
fill material is contained within a cover impervious to the
fill.
[0082] The foundation foam used in embodiments is any suitable
strong, resilient, high modulus of elasticity foam material, such
as polyurethane foam, copolymer foam, or latex foam. In embodiments
a preferred foam is polyurethane foam. Foam is available in
variations; such as a 1 A high resiliency; HD high density, VE
viscoelastic, which has very high density. Latex foam has the
disadvantage of possibly inducing allergic reactions to the foam.
In embodiments an antimicrobial additive is included in the foam.
The foundation foam in embodiments has a density of 1.4 to 4.6
pounds per cubic foot and an indention force deflection of 30 to
80.
[0083] The viscoelastic foams on the outer surfaces of embodiments
are of lower density and lower resilience than that of the
foundation foams, although the viscoelastic foams may have the same
chemical compositions as foundation foams. Viscoelastic foams have
a density of not less than 1.2 pounds per cubic foot and an
indention force deflection equal to or less than 30.
[0084] In embodiments viscoelastic foams are attached to the
foundation foam by adhesives, such as polyurethane adhesive.
[0085] In embodiments an antimicrobial additive is included in the
foam. One antimicrobial is solutions of 10,10'-oxybisphenoxarsine,
which is available from Rohm and Haas, Philadelphia, Pa. under the
trademark VINIZEN.
[0086] In embodiments the covers are comprised of water-resistant
elastomer material. In embodiments a preferred material is
thermoplastic polyurethane film manufactured by J.P. Stevens
Elastomerics of Holyoke, Mass.
[0087] In embodiments using elastomer material the covers are
comprised of panels attached to each other by radio frequency
welding. Other equivalent suitable methods for attaching the panels
together, such as sewing, heat sealing, or gluing with permanent
adhesives, such as epoxy adhesives, are contemplated.
[0088] In embodiments intended for multiple uses the cover is
comprised of water-resistant coated fabric material. In embodiments
a preferred material is 70 denier nylon taffeta manufactured by
Stafford Textiles of Toronto, Ontario, Canada. Other suitable
fabric materials may be used, such as vinyl and rayon.
[0089] In embodiments the fabric material cover is coated with a
suitable water-resistant polymer such as polyurethane, butyl
rubber, vinyl, and thermoplastic urethane. In embodiments a
preferred coating includes polycast coat laminate and antimicrobial
additives.
[0090] In embodiments using fabric material covers, cover panels
are attached to each other by sewing along the seams. In
embodiments a zipper is used to allow the insertion and removal of
the cushions from the covers. Other suitable methods for attaching
the panels together, such as radio frequency welding, heat sealing,
or gluing with permanent adhesives, such as epoxy adhesives, may be
used. Other suitable equivalent means for reversible opening and
closing covers, such as hook and loop closures, buttons, and snaps
are contemplated. In embodiments there are no seams on the patient
contact areas of the cover, in particular, on the upper
surfaces.
[0091] In embodiments the interior side of the cover, the side
facing the cushion, is treated to make it waterproof, for example,
coated with polyurethane or butyl rubber.
[0092] In embodiments the upper side of the cover, the side to
which the patient is exposed, is made of friction and shear
reducing fabric, such as nylon or polyurethane fabric.
[0093] In embodiments, a variety of materials may be used as a
non-slip coating applied to the side of the bottom of the cover
which makes contact with the sheet and mattress. Any durable
suitable material which provides a slip-resistant or non-slip
effect which prevents or retards the sliding of the cushion on the
surface of the bed may be used. Non-slip material sold under the
trademark SOFTGRIP BLUE #2915C by Ventrex, Inc., Great Falls, Va.
Other suitable materials include tapes having an antislip surface
and self-adhesive backing, such as tapes available under the
trademark ANTI-SLIP GRIP TAPES from All-tapes.com, Chatsworth,
Calif. Other antislip materials include general purpose tapes and
treads available from Martinson-Nicholls, Inc. Willoughby, Ohio
under the trademark 3M SAFETY WALK and NAMCO trademark vinyl
backing mats and nitrile rubber gripper backing are available from
North American Mat Company, Hollandale, Minn.
[0094] Therapeutic cushion and log roll embodiments are used by
placing cushion or log roll under the supine patient's leg or legs
with the popliteal fossa region over a void in the cushion or log
roll. The functions of the cushions or log rolls of this
application include prevention or treatment of heel pressure
ulcers, improvement of blood circulation in the legs, and relief of
back pain.
[0095] While a number of exemplary aspects and embodiments have
been discussed above, those of skill in the art will recognize
certain modifications, permutations, additions and sub combinations
thereof. It is therefore intended that the following appended
claims and claims hereafter introduced are interpreted to include
all such modifications, permutations, additions and
sub-combinations as are within their true spirit and scope.
* * * * *