Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
  • A61G7/00—Beds specially adapted for nursing; Devices for lifting patients or disabled persons
  • A61G7/05—Parts, details or accessories of beds
  • A61G7/057—Arrangements for preventing bed-sores or for supporting patients with burns, e.g. mattresses specially adapted therefor
  • A61G7/05769—Arrangements for preventing bed-sores or for supporting patients with burns, e.g. mattresses specially adapted therefor with inflatable chambers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
  • A61G2203/00—General characteristics of devices
  • A61G2203/30—General characteristics of devices characterised by sensor means
  • A61G2203/34—General characteristics of devices characterised by sensor means for pressure
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
  • A61G2203/00—General characteristics of devices
  • A61G2203/30—General characteristics of devices characterised by sensor means
  • A61G2203/40—General characteristics of devices characterised by sensor means for distance

Definitions

• Method and apparatus for supporting an element to be supported in particular the body of a patient allowing support to a predetermined waterline.
• the invention relates to a method and an apparatus for supporting an element to be supported, in particular a body of a patient, allowing an equilibrium support of the element to be supported, essentially corresponding to a waterline. of it predetermined.
• a device for supporting an element to be supported, in particular the body of a patient who must be bedridden or immobilized for an extended period of time, generally mainly known as a mattress, is well known. It is also well known that bed rest or prolonged immobilization leads to complications, in particular pressure sores.
• document FR-A-2 707 874 discloses a mattress intended in particular to avoid decubitus which provides at least one closed chamber or with controlled exhaust, flexible, inflatable under pressure as a function of the maximum insertion distance. authorized in the support of the element to be supported, this insertion distance being intended to be fixed is of the order of 12 to 17 cm.
• This prior document therefore provides for a slaving of the filling or evacuation means for filling or deflating said chamber until bringing the sinking to about the set sinking distance.
• the measurement of the driving-in distance value is carried out using a capacitive device referenced 9, 10 which is clearly visible in FIGS. 1 and 4 of this document FR-A-2 707 874.
• EP-A-676 158 a method and a system for supporting an element to be supported, in particular the body of a patient, allowing a support at a controlled depth of penetration, essentially constant by using a device for measuring the penetration distance different from the previous document in that the measuring means comprise on the one hand a metallic element in the form of a thin sheet placed towards the upper face of the support element cooperating with at least one inductive device forming a position detector secured to the lower face of the support element.
• a slaving of the filling or deflating of the chamber of the support element is intended to result in the previously fixed insertion distance, and whatever the weight of the element to be supported, in particular the body of a patient.
• the solutions of the prior art offer a good weight / body surface ratio, in other words a good distribution of the patient's weight on the support device, but they have the disadvantage of not systematically causing the depression of the body of each patient precisely at a natural balance providing the ideal weight / body surface area distribution ratio. Therefore, the present invention aims to solve the new technical problem of providing a solution which allows to support an element to be supported, in particular the body of a patient, essentially at a position of natural equilibrium. which corresponds substantially to a waterline that is preferably defined beforehand.
• the invention also aims to solve this new technical problem in particular in the context of patient support, in order to obtain the expected performance in terms of prevention or treatment of complications linked to bed rest or prolonged immobilization, and particularly depending on the mo ⁇ hological characteristics of the visible submerged part, in particular the weight and the co ⁇ oreal surface, more generally the weight and the surface of the element to be supported.
• the main object of the present invention is also to solve the new technical problem consisting in providing a solution which makes it possible to analyze and control the insertion of an element to be supported, in particular the cost of a patient, in the support device and the reaction of said support device exerted on the element to be supported, in particular the cost of a patient, so that optimal pressures are applied to the co ⁇ oreal surface in contact with the support device, which is particularly sought in the prevention and treatment of complications related to prolonged bed rest and immobilization, including pressure sores.
• the present invention provides for the first time a solution to all of the technical problems previously stated in a simple, inexpensive, safe and reliable manner, easy to implement and usable on an industrial and medical scale.
• the present invention provides a method of supporting an element to be supported, in particular the cost of a patient, comprising the provision of at least one support device comprising at least one closed chamber or with controlled, flexible, inflatable exhaust, said chamber having an upper face and a lower face; means for filling or evacuating a fluid for filling said chamber being provided as well as means for measuring the distance separating said upper face relative to said lower face, characterized in that a device is further provided measurement of the reaction of the support device relative to the mo ⁇ hological data of the element to be supported, characterized in that one proceeds to the measurement of the insertion distance of the element to be supported in the support device, the reaction of the support device to the depression of the element to be supported and these two measures are combined to bring the element to be supported substantially at equilibrium corresponding substantially to a predetermined waterline.
• the aforementioned combination of the measurement of the driving-in distance and of the measurement of the reaction of the support device comprises a summation of these two values.
• this method is characterized in that the measurement of the reaction of the support device comprises the measurement of the pressure in said chamber at said measured insertion distance.
• this method is characterized in that the aforementioned summation consists of a summation of the value of driving-in distance and of the value of pressure in the chamber.
• this method is characterized in that the aforementioned combination of insertion distance value and reaction measurement value is compared with a reference value characterizing the depression equilibrium value of the element to be supported corresponding substantially to the predetermined water line of said element to be supported.
• this method is characterized in that the aforementioned predetermined reference value defining the equilibrium corresponding substantially to the waterline is fixed to achieve the expected performance in terms of prevention or treatment of the patient, particularly complications related to bed rest or prolonged immobilization, especially bedsores.
• this method is characterized in that the operation of the filling or evacuation means is controlled by results of the above combination of the driving distance and the measurement of the reaction of the support device.
• a support device or mattress comprising a multitude of cushions or tubes which can be deflated alternately individually, sequentially, in particular one carries out a sequential deflation one on two, one on three or one on four or one on n, thus making it possible to avoid relatively high pressures to the various parts of the element to be supported, in particular of the cost of a patient , which are detrimental to the treatment and comfort of certain types of Patients, in particular patients who have undergone a skin transplant or patients who are subject to acute pain following certain diseases.
• the present invention also provides an apparatus for supporting an element to be supported, in particular the cost of a patient, comprising at least one support device comprising at least one closed chamber or with controlled, flexible exhaust, inflatable, said chamber having an upper face and a lower face, means for filling or discharging a filling fluid from said chamber as well as means for measuring the distance separating said upper face relative to said lower face, characterized in that it further comprises a device for measuring the reaction of the support device relative to the mo ⁇ hological data of the element to be supported, a control system comprising means for combining the measurement of the driving-in distance provided by the measurement device and the measurement of the reaction provided by the reaction measurement device, to bring the element to sup bring substantially to equilibrium corresponding substantially to a predetermined waterline.
• the device for combining the control system summons the measurement of the driving distance with the measurement of the reaction provided by the device for measuring reaction.
• this device is characterized in that the reaction measurement device comprises a device for measuring the pressure in the chamber of the support device at the measured insertion distance.
• this device is characterized in that the combination device is connected to a comparison device which performs a comparison of the combination value provided by the combination device with a reference value provided by a reference device, this reference value characterizing the depression equilibrium value of the element to be supported corresponding substantially to the line predetermined buoyancy of this element to be supported.
• this device is characterized in that the aforementioned predetermined reference value and defining the equilibrium corresponding substantially to the waterline is fixed to achieve the expected performance of prevention or treatment of the patient, particularly the complications linked to bed rest or prolonged immobilization, in particular pressure sores.
• this device is characterized in that it comprises a servo-control device providing servo-control of the operation of the filling or evacuation means as a result of the aforementioned combination of the driving-in distance and the measuring the reaction of the measuring device.
• the device is characterized in that it comprises a support device or mattress comprising a multitude of cushions or tubes which can be deflated alternately individually, sequentially, in particular one in two, one out of three, one out of four or one out of n.
• FIG. 1 is a side view along arrow A of Figure 2 of an element to be supported, here supporting on the one hand a patient P 1 shown in solid lines whose mo ⁇ hological characteristics are relatively more important than the mo ⁇ hological characteristics of the patient P2 represented in a thin line, the two patients PI and P2 being represented in the supported state substantially at equilibrium corresponding substantially to a predetermined waterline, indicated by the dashed line and referenced LF;
• FIG. 2 is a view similar to Figure 1 but according to arrow B in Figure 1;
• FIG. 3 is a view of a currently preferred embodiment of a support apparatus according to the present invention showing on the one hand a PI patient supported substantially at equilibrium according to the views of Figures 1 and 2, but showing the essential means of the invention making it possible to achieve a substantially balanced support;
• FIG. 5 is a longitudinal sectional view showing another particular embodiment in which the support device comprises a multitude of independent individual inflatable tubes which can be provided with a sequential individualized deflation, one in two, one in three, or one out of four as shown, or one out of n.
• a currently preferred embodiment of a support device according to the present invention is represented by the general reference number 10.
• This support device makes it possible to support an element, in particular as shown, the costs of a PI patient or the cost of another P2 patient with different mo ⁇ hological characteristics.
• This device 10 comprises a support device proper 11 comprising at least one closed chamber or with controlled exhaust ia, flexible, inflatable, which can for example be composed of a multiplicity of inflatable tubes communicating with each other, said chamber ia being inflatable by means of filling represented by the general reference number 50, for example constituted by pumping means allowing the pumping of a filling fluid in said chamber.
• This chamber ia has an upper face 12 serving as a support for the element to be supported PI or P2, a lower face 13 which can, for example, rest indirectly on a bed base (not shown here) or equivalent means.
• the filling means 50 such as pumping means make it possible to fill the chamber 11a with a filling fluid such as a gas, in particular air, or a liquid, in particular water.
• Means 52 for evacuating fluid from the chamber, such as a valve are also provided.
• This device also includes means 21 for measuring the distance d separating the upper face 12 relative to the lower face 13 of the chamber l ia.
• the apparatus further comprises a device 30 for measuring the reaction of the support device 11 relative to the mo ⁇ hological data of the element to be supported PI or P2, as well as a control system comprising, in the context of the invention, means 42 for combining the measurement of the driving-in distance provided by the measurement device 20 with the measurement of the reaction provided by the reaction measurement device 30.
• the control system 40 comprising the combination device 42 uses the result of the combination of these two measures to bring the element to support PI or P2 substantially to equilibrium corresponding substantially to the line of predetermined buoyancy referenced LF, by action on the filling means 50 or discharge means 52 as defined below.
• the reaction measurement device 30 comprises a device 43 for measuring the pressure p in the chamber l ia at the measured insertion distance d.
• the combination device 42 of the control system 40 performs the summation of the measurement of the driving-in distance d with the measurement of the reaction provided by the measuring device of reaction 30, in particular of the pressure supplied by the pressure measuring device 43.
• the combination device 42 is connected to a comparison device 46 which performs a comparison of the combination value provided by a measurement device. combination 42 with a reference value supplied by a reference device 45, this reference value characterizing the depression equilibrium value of the element to be supported PI or P2 corresponding substantially to the predetermined water line LF of this element to support PI or P2.
• the comparison device 46 compares the combination value obtained supplied by the combination device 42 with the reference value provided by the reference device 45 and in the case where the result of this comparison is different from 0, the comparison device 46 transmits information to a servo device, comprising for example here an integral proportional regulation stage 47 and a control device proper 48, performing the servo filling or evacuation of the chamber l ia, respectively by the command filling means 50, either by controlling the discharge valve 52.
• a servo device comprising for example here an integral proportional regulation stage 47 and a control device proper 48, performing the servo filling or evacuation of the chamber l ia, respectively by the command filling means 50, either by controlling the discharge valve 52.
• the device 20 for measuring the driving-in distance d may comprise a metal sheet 21 integral in displacement with the upper face 12 of the support device 11 cooperating here with an impedance variator element 22 such as for example an induction choke, itself again cooperating here with a shielding element 24 such as a shielding induction choke whose purpose is to ensure the independence of the measurement with respect to the surrounding metallic mass, the position of the impedance variator element and of the shielding element being fixed, here outside the chamber l ia, and also having a fixed position relative to the face lower 13 of the chamber 11a, which makes it possible to measure the variable distance d between the metal sheet 21 of variable position and the impedance variator element 22 of fixed position.
• an impedance variator element 22 such as for example an induction choke
• a shielding element 24 such as a shielding induction choke
• the impedance variator element 22 as well as the shielding element 24 here form an integral part of a measurement bridge 200 which is shown in detail in FIG. 4 and which forms part of an electronic circuit which the 'we can see in Figure 4 and which will be described in detail below. It will naturally be noted that when the result of the difference between the combination value supplied by the combination device 42 and the reference value of the reference device 45 is zero, the equilibrium point is reached which corresponds substantially to the line of LF predetermined floatation sought and the servo system is no longer activated. With reference to FIG. 4, a currently preferred electronic circuit has been described which implements the design of the essential members as described in FIG. 3.
• the oscillator 100 generates a sinusoidal signal maintained by the transistor 1001, the frequency of which is fixed by the inductive impedance of the measurement system 4 . in parallel with the capacitive impedance of the oscillator produced by the elements 1002 & 1003.
• the measurement bridge 200 When the metal sheet 21, such as an aluminum sheet is at most close to the impedance variator element 22, here a measurement reactor 22, the measurement bridge 200 is in equilibrium.
• the sinusoidal signal entering the bridge at points 2 & 4 is evenly distributed in the branches of the measuring bridge because here the measurement inductors 22 and shielding 24 have the same impedance.
• the signal between points 1 & 3 of the bridge is zero .
• This sinusoidal signal is transformed into a DC voltage by the diode 414 and the capacitor 415 via an impedance adapter 413.
• the reference device 45 The reference device 45
• a fixed voltage reference which is generated by the operational amplifier 450, serves as a reference for the processing of the regulation system.
• a pressure sensor 430 disposed at a suitable location on the support element, here a mattress, associated with a specific supply produced by the element 431, provides a direct tension proportional to the air pressure of the mattress. Knowing that the mattress is a closed envelope, the pressure variations are the image of the reaction of the support relative to the depression of the patient whose electrical image is provided by the self-measurement 22 integrated in a measurement device.
• measurement 41 including the measurement bridge 200 described above.
• the elements 432, 433, 434 amplify this signal to give it a value which is consistent with the signal supplied by the measurement of the device 41 with self 22 integrated in the bridge 200.
• 435 is an impedance adapter.
• the adjustment setpoint device 44 gives a DC voltage which is adjusted using the potentiometer 440. This adjustment is provided to compensate for any dispersions.
• a summator 42 produced with an operational amplifier 420 gives at its output a voltage equal to the sum of the three DC voltages processed by 41, 43, 44. At the equilibrium point, this sum is equal to the reference voltage entering l differential amplifier stage 46 described later.
• the differential amplifier 46 A differential amplifier 46 produced with an operational amplifier 460 gives at its output a voltage equal to 2 times the reference voltage minus the output voltage of the adder 42. At the regulation point this voltage is equal to the voltage reference. If the system is not at its equilibrium point, the output is equal to the reference voltage +/- the voltage proportional to the difference.
• the proportional / integral regulation device 47 serves to amplify the difference measured at 46 while delaying the sudden variations of these differences in order to avoid pumping phenomena or untimely changes in operating state.
• 471 measures the difference
• 470 is an integrator that delays variations in this gap.
• the outputs of these two elements enter at 472 which amplifies the difference in proportion to its duration.
• the device for controlling the filling or evacuation means 48 comprises two window comparators which define a range of low lift 480 and a range of high lift 481. These two ranges of lift overlap.
• the zone common to the two ranges is the optimum lift zone and corresponds to the output value of 47.
• the output "A" of 480 changes state and the logic system 482 makes start filling via the command 484 which actuates the pumping means 50.
• the output "B" of 481 changes state and the logic system 483 starts the evacuation via the command 485 which actuates the evacuation valve 52.
• FIG. 5 a particularly interesting embodiment of the invention has been shown and which finds application in the context of alternating inflation, in English "alternating pressure mode", with a support device or mattress comprising a multitude of cushions or tubes 111, 112,
• the invention which makes it possible to find a support balance substantially along the waterline, provides a decisive advantage by making it possible to avoid relatively high pressures at the various parts of the body which are detrimental from the point of view of care, for example in the case of skin grafts, or from a comfort point of view.
• the invention makes it possible, in fact, by obtaining a permanent equilibrium substantially on the waterline, maintaining a pressure lower than the non-vascularization pressure during the phases where the tissues are subjected to the pressure exerted by the surface. therapeutic during alternating or "alternating" operation of the type represented in FIG. 5.

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• Health & Medical Sciences (AREA)
• Veterinary Medicine (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Nursing (AREA)
• Invalid Beds And Related Equipment (AREA)
• Radiation-Therapy Devices (AREA)
• Length Measuring Devices With Unspecified Measuring Means (AREA)
• Mattresses And Other Support Structures For Chairs And Beds (AREA)
• Measuring And Recording Apparatus For Diagnosis (AREA)
• Apparatus For Radiation Diagnosis (AREA)

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• 1996
  • 1996-12-23 FR FR9615848A patent/FR2757377B1/fr not_active Expired - Fee Related
• 1997
  • 1997-12-22 EP EP97952969A patent/EP1009263B9/de not_active Expired - Lifetime
  • 1997-12-22 JP JP52847098A patent/JP2001506892A/ja active Pending
  • 1997-12-22 WO PCT/FR1997/002376 patent/WO1998027849A1/fr not_active Ceased
  • 1997-12-22 AU AU56676/98A patent/AU5667698A/en not_active Abandoned
  • 1997-12-22 AT AT97952969T patent/ATE243966T1/de not_active IP Right Cessation
  • 1997-12-22 DE DE69723319T patent/DE69723319T2/de not_active Expired - Lifetime
  • 1997-12-22 CA CA002274951A patent/CA2274951C/fr not_active Expired - Fee Related
  • 1997-12-22 BR BR9714052-0A patent/BR9714052A/pt not_active IP Right Cessation
  • 1997-12-22 US US08/995,183 patent/US6009580A/en not_active Expired - Lifetime
• 2007
  • 2007-06-20 JP JP2007163205A patent/JP2007307393A/ja active Pending

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