Mobile Fluoroscopic Unit For Bedside Catheter Placement

Abstract

The invention relates to a mobile fluoroscopic unit in the form of a four wheeled cart for facilitating bedside catheter placement. The unit is equipped with integrated X-ray and television viewing apparatus which permits the visualization and accurate positioning of vascular catheters.

Description

The invention relates to a mobile fluoroscopic unit in the form of a four wheeled cart for facilitating bedside catheter placement. The unit is equipped with integrated X-ray and television viewing apparatus which permits the visualization and accurate positioning of vascular catheters.

Emergency or elective catherization of the vascular system at the bedside of a patient is becoming increasingly necessary for diagnostic and therapeutic purposes. For example, in instances where a patient is to be administered to or treated with a pacemaker unit, the pacemaker wires are fed through the veins in the patient's right arm or neck to his heat. At the shoulder region there is a fork in the vein with one branch leading to the heat and the other branch leading to the brain. It is thus necessary to be able to some how view the progress of the wires through the vein because there is no other way of determining whether the wires will take the correct route to the heart.

It is presently hospital procedure to wheel the patient to a specially equipped X-ray room where the feeding of the pacemaker wires is viewed on a television screen which is operably attached to the X-ray machine. Although this hospital procedure is technically effective, a serious drawback or disadvantage of it is the time it takes to fetch the patient from his room and deliver him to the X-ray room. X-ray rooms contain expensive equipment and the number of such rooms in a hospital are thus necessarily limited. A patient's room in a large hospital might very well be located a relatively great distance from a suitably equipped X-ray room and the time required to get him there could prove fatal or very damaging.

The present invention constitutes a portable unit, in the form of a four-wheeled cart, which is equipped with integrated X-ray and television viewing apparatus. In more technical terms the invention is a mobil cart for the visualization and accurate positioning of vascular catheters or, in still other terms, a mobile image intensifier unit for the fluoroscopic visualization of intravascular procedures or vascular catherization.

The inventive concept involves, in addition to providing the X-ray and television equipment for the cart, the sizing and shaping of the cart to make it practical and suitable for bedside use. In particular the cart has (1) a height approximately equal to hospital bed height so that a patient may be moved easily from the bed to the cart, (2) a length of somewhat under 3 feet, which is approximately half of the height of an average adult, to allow the cart to be limited to a practical size by permitting the patient's body to be supported jointly by the cart and by his bed, and (3) a movable support for the patient's right arm which support can be stored in a retracted or out-of-the-way position so it does not project laterally from the cart while the cart is being wheeled through the hospital halls. The cart size, with respect to its length and width dimensions, thus facilitates the easy transportation of the cart through hospital corridors and elevators and its convenient positioning in a small or crowded hospital room.

A main object of the invention, therefore, is to provide new and improved apparatus for the visualization and accurate positioning of vascular catheters at the bedside and surgery.

Other objects of the invention will become apparent from the following specification, drawings and appended claims.

In the drawings:

FIG. 1 is a perspective view of the mobile cart embodying the invention, the cart having a panel portion thereof shown broken away to reveal equipment inside the cart;

FIG. 2 is a different perspective view of the cart illustrated in FIG. 1, the cart being shown in use in a hospital room environment with a patient lying on the cart and two doctors in attendance; and

FIG. 3 is a fragmentary perspective view of the cart's retractable support for supporting a patient's right arm while the pacemaker wires are being inserted in the artery thereof.

Referring to the drawings, the cart as shown in FIG. 1 has a rectangularly shaped paneled body 10 mounted on four wheels which include a pair of front wheels 12 and a pair of swiveled rear wheels 13. The top side 16 of the body 10 is approximately 33 by 27 inches and is cushioned to provide a comfortable support for the upper portion of a person's body. The height of the top side 16 relative to the floor is approximately 35 inches which is a generally standard height for hospital beds.

A boom 20 having a vertically extending leg 21 and an attached upwardly inclined arm 22 is mounted on one side of the body 10. Boom 20 has a horizontally extending arm 24 which is pivotally attached to the boom 20 at the junctions of the legs 21 and 22 thereof for movement in a horizontal plane. Mounted on the outer end of arm 24 for pivotal movement about a vertical axis is a television receiver 26. The position of boom 20 is longitudinally adjustable by reason of being mounted in and relative to a slot construction 27 in the side wall of the cart. Slot 27 is protected from stray radiation by sliding panels which are not shown.

At the upper end of the boom arm 22 is mounted an X-ray head 28 which provides a source of X-rays and is rotationally adjustable about a horizontal axis with an adjusting mechanism 30 to provide for fine alignment with the image tube of the intensifier assembly 40.

Within the inner confines of the rectangularly shaped body 10 is known apparatus of the type disclosed in a patent to R. A. Marquis, U.S. Pat. No. 3,515,870, issued June 2, 1970, titled "X-Ray System for Superimposing the Image of a Reference Object and an X-Ray Image." Briefly, this apparatus comprises a fluoroscopic device which includes an image intensifier tube. The image intensifier tube in turn includes a fluorescent screen comprising a photon emitting phospher in intimate contact with a photoelectric element which is adapted to emit electrons in response to the photon energy emitted by the phospher. At the opposite end of the image intensifier tube there is a second fluorescent screen which converts electrons striking its outer surface into photon energy. A conventional TV camera with a suitable lens system between the camera and the image intensifier tube is provided and the camera is electrically connected to the TV viewer 26. A control panel 31 for all the electrical apparatus embodied in the cart is mounted as illustrated in one of the side panels of the cart body portion 10.

Internally of the cart is a power supply contained in a box 36 and television camera control equipment contained in a box 38. Also incorporated internally of the cart is an image intesifier assembly 40 and a close coupled television camera assembly 42 which is electrically connected to the TV receiver 26.

At the top of the body portion 10 of the cart, and at one end and at one side thereof, is an arm support 44 which is mounted for pivotal movement about a vertical axis. The arm support has a position within the confines of the edges of the top side 16 when the car t is idle or being transported but is swingable out to the position illustrated in FIGS. 2 and 3 when the cart is being used in connection with treating a patient. Arm support 44 is provided with a detent ratchet arrangement (not shown) which maintains the support at 15.degree. increments up to 90.degree. .

The cart is usable for the emergency and elective vascular catherization in humans anywhere in the hospital. Specifically, it can be used at a patient's bedside, in an emergency room and in an operating room. In a cardiac emergency requiring vascular catherization the cart is quickly wheeled to a patient's room and to one side of his bed 45. Other related uses for the cart are (1) the placement of a catheter in the pulmonary trunk via the jugular, cubital or sub-clavian vein to monitor pressure of the failing heart as an aid to determining appropriate therapy and (2) the placement of vena cava filter for emboli entrapment.

Claims

We claim:

1. A mobile cart for the fluoroscopic visualization of vascular catherization comprising a rectangularly shaped paneled body portion having a planar top side, wheel means supporting said body portion, a vertically extending support means attached to said body portion, an X-ray head providing a source of X-rays mounted on said support member, an electronic image intensifier tube assembly mounted internally of said body portion in alignment with said X-ray head, said assembly including a television camera, a television receiver mounted on said support means and being electrically connected to said tube assembly, said top side having an elevation of approximately three feet, and an elongated arm support pivotally mounted to said top side of said body portion.

2. A mobile cart according to claim 1 wherein the dimensions of said top side are approximately 33 by 27 inches.