U.S. patent number 3,859,982 [Application Number 05/326,375] was granted by the patent office on 1975-01-14 for apparatus for supporting patient during rotation with provision for fluid administration and discharge.
This patent grant is currently assigned to Picker Corporation. Invention is credited to Robert L. Dove.
United States Patent |
3,859,982 |
Dove |
January 14, 1975 |
APPARATUS FOR SUPPORTING PATIENT DURING ROTATION WITH PROVISION FOR
FLUID ADMINISTRATION AND DISCHARGE
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.
Inventors: |
Dove; Robert L. (University
Heights, OH) |
Assignee: |
Picker Corporation (Cleveland,
OH)
|
Family
ID: |
23271943 |
Appl.
No.: |
05/326,375 |
Filed: |
February 24, 1973 |
Current U.S.
Class: |
600/433; 601/158;
601/24; 5/601; 5/607; 5/621; 5/910; 378/208 |
Current CPC
Class: |
A61B
6/0428 (20130101); Y10S 5/91 (20130101) |
Current International
Class: |
A61B
6/04 (20060101); A61g 013/00 () |
Field of
Search: |
;128/2R,1B,2A,134,133,204,24,240,241,230,101,236,214F,297,298
;119/96,103 ;269/322,323,328 ;250/441,442,444-446,450,451,456
;222/103,146 |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
General Electric X-Ray Corp., Model D3-38 Diagnostic X-Ray Unit;
6-24-41..
|
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Recla; Henry J.
Attorney, Agent or Firm: Watts, Hoffman, Fisher & Heinke
Co.
Parent Case Text
CROSS REFERENCE TO RELATED PATENT AND APPLICATION
X-RAY APPARATUS, U.S. Pat. No. 2,872,584 issued Feb. 3, 1959 to R.
C. Schiring et al.
Method and apparatus for immobilizing a patient, Ser. No. 111,602
filed Feb. 1, 1971 by Waldo H. Kliever, issued Jan. 8, 1974 as U.S.
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 configurations are
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
patient's 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 patient's 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 patient's 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 sheet-like 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 patient's 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 patient's 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 provided for
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 patient's 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 patient's 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 air-tight 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 patient's 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.
Claims
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 patient's body;
b. air impervious means including a flexible air impervious member
for positioning over said portions of the patient's 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 patient's neck to dispose
the patient's head outside of said chamber;
c. said support means including head engaging means removably
supported on one of said end plates for releasably engaging the
patient's 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
patient's body to hold said portions of the patient's 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 patient's 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 patient's 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
patient's body to hold said portions of the patient's 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 patient's body;
b. air impervious means including a flexible air impervious member
for positioning over said portions of the patient's 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
patient's body to hold said portions of the patient's body against
said support means; and,
e. connection means for establishing 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,
c. 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 patient's mouth, while said rectal
dispensing unit has a dispensing tube coupled to a rectal
dispensing nozzle positionable in a patient's 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;
c. 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;
d. 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.
Description
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 patient's
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 patient's 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 region;
FIG. 5 is an enlarged plan view of the region around the injection
needle as seen from the plane indicated by the line 5--5 in FIG.
4;
FIG. 6 is an enlarged cross-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 pad;
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 14--14 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 21--21 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 13, 14 are secured to opposite
ends of the table body 12. The supporting structures 13, 14
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 15 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, form-fitting couch.
The rotatable platform 15 comprises a trough-like rigid center
panel 20 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 30 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
patient's 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 air-tight 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 arrangement, 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 16 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 admission of 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 60 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 70 is also
carried by the trough 20. The support 70 includes an upstanding
plate 71 secured to a 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 patient's head and lower his feet, the
support 70 serves to engage the patient's 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 patient's 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
patient's head and for the patient's arms where these extremities
are not enclosed within the restraining garment 16. A pair of
support bars 80 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, 85e are formed at the inner ends of the
counterbores 85b, 85c. 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
86b of the rubber sleeve 86 extends into the counterbore 85c to a
position adjacent the shoulder 85e.
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 87f to slide freely
therealong. The aperture 87e, 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 patient's 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 patient's
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 60 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 65 is moved into
position. The support panel 70 may also be brought into position
adjacent the patient's feet.
3. The garment 16 is draped over the patient and the neck aperture
is slipped over the patient's head. If a sleeved garment is used,
the sleeve apertures are positioned over the patient's arms. The
aperture drawstrings 31, 34, 35 are then made secure to seal the
garment about the patient's 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 80 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 95 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 105 is secured
by 2 inch wide surgical adhesive tape 106 to the patient's 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 of a 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 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 FIGS. 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 nozzle 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 an oral 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 160
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 170 is normally positioned within the patient's mouth and the
rib 171 outside the mouth. The patient's 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 180 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
filler 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.sub.2 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 150 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 the details 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.
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