The present invention is directed toward a mattress system that allows the mattress to provide various functions.
Mattress systems can have a mattress material and a mattress function. The mattress materials can have cushioning materials. The cushioning materials include and are not limited to a conventional spring mattress, fluid bladders, gelastic material, foam and combinations thereof. The mattress materials can include (i) a crib around the cushioning material's perimeter, (ii) a partial crib around portions of the cushioning material's perimeter, (iii) support material positioned below the mattress material, and (iv) nothing surrounding the cushioning material. Whatever surrounds or does not surround the cushioning material, the mattress material has a top surface, a bottom surface, a head end, a foot end, a right side and a left side. Conventionally, the mattress material has a sheet overlying at least the top surface.
The sheet can be a natural fabric, a polymeric fabric, a MRSA resistant fabric or combinations thereof. The sheet's objective is to ensure the mattress material(s) is separate from the patient positioned over the mattress' top surface. That separation is desired so the patient does not soil or damage the mattress materials.
Depending on the mattress material used and the position of the mattress materials, the mattress system can perform one or more of the following known functions:
Rotating the patient on an inflatable mattress is a well known method to decrease and possibly avoid the formation of bed sores on immobile patients. Such a method is disclosed in U.S. Pat. No. 5,794,289 which is commonly assigned and is hereby incorporated by reference.
In U.S. Pat. No. 5,794,289, Wortman et al. describe a mattress unit having a plurality of air cells. The mattress unit rotates a patient by controlling the air pressure in each air cell by inflation and deflation. To rotate a patient to its right side requires deflating the right air cells and inflating the left air cells of a conventional rotation bladder embodiment. The rotation bladder embodiment is normally positioned below a patient surface contact bladder. That way, one side of the rotation bladders can be deflated and the patient does not bottom out unless there is an unintentional leak in the bladder or a CPR dump protocol is initiated. In the '289 patent, if the mattress is to be planar with a surrounding crib, the rotation bladders are inflated to a level that allows the top surface of the patient surface contact bladder to be level with the top surface of the crib.
The air pressure required to rotate the patient depends on the patient's weight, body type and various other parameters. The quantity of air pressure that rotates one patient, i.e., 30 degrees may rotate another patient, i.e., 5 degrees. For example, two female patients weigh 130 pounds, one patient is pear-shaped and the other is apple-shaped. The pear-shaped patient rotates 15 degrees with 10 mm Hg while an apple-shaped patient rotates 7 degrees with 10 mm Hg. Obviously each patient is unique and different. Therefore, the programming that controls the air pressure in each mattress unit must be altered to comply with each patient.
Programming an air pressure mattress unit requires a skilled technician. The skilled technician analyzes each patient and alters the programming to attain the desired rotation and air pressure. One means to avoid the expensive technician's analysis and re-programming is to create a self-monitoring mattress.
Previous self-monitoring air pressure mattresses have utilized electrical signal transmission devices and electrical signal receiving devices that sandwich the top and bottom of each bladder to monitor the bladder size. The bladder size corresponds to the desired rotation and air pressure. Such signal devices are disclosed in U.S. Pat. Nos. 7,322,947 and 5,926,883 (also commonly assigned and incorporated by reference) in addition to U.S. Pat. No. 5,794,289.
Vibration & Low Air Loss Therapy
In expired U.S. Pat. No. 4,280,487; Jackson discloses a vibratory patient support system for providing therapeutic vibrational action or forces to a patient suffering from a respiratory ailment. The vibratory patient support system includes a rigid support frame (a bed frame) and numerous fluid bladders positioned upon the support frame with each fluid bladder having an upper surface so that the fluid bladders form a patient support surface. The fluid bladders are pressurized and maintained at a predetermined pressure. This predetermined pressure may be a patient height and weight specific pressure profile. A vibrating component is provided separate from the apparatus for pressurizing and maintaining the fluid bladders at the predetermined pressure. The vibrating component vibrates at least a portion of the patient support surface at a predetermined frequency. In this manner, the fluid bladders are maintained at their predetermined pressure and the portion of the patient support surface are simultaneously vibrated at the predetermined frequency. The vibrating devices are further variably controllable so that an operator can vary the frequency, magnitude or amplitude, and duration of the vibrating therapy. The vibratory patient support system may include a specialty low air loss (apertures in the bladders that allow air to escape from the bladder toward the patient) bed configuration including vibrating means for vibrating a portion of the patient support surface of the low air loss sacs at the predetermined frequency.
Wave Therapy
Wave therapy is incorporated in numerous mattress systems manufactured by Gaymar Industries, Inc. A description of wave therapy is referred as an alternating pressure mattress system. The alternating pressure mattress system has a mattress including a plurality of narrow, parallel, closely-spaced, horizontally adjacent air sacks. Every other one of the air sacks forms a first group of air sacks being commonly connected for the introduction there into of pressurized air and the other air sacks form a second group of air sacks and being commonly connected for the introduction there into of pressurized air. A pump supplies the pressurized air to the first and second groups of air sacks and a control apparatus alternatingly inflates and deflates the first and second groups of air sacks for selected periods of time to create the wave therapy.
Vibration, Percussion & Rotation Therapy
In U.S. Pat. No. 7,111,348; Ellis et al. disclose a “mattress assembly includes a bottom cover having a bottom surface and upwardly extending sidewall surrounding bottom surface to define an interior region. Straps are coupled to bottom cover for securing the mattress assembly to a bed frame if desired. A plurality of air cushions are configured to be located within the interior region of mattress assembly. A pair of rotation cushions are located on bottom surface. The rotation cushions are stored in a normally deflated configuration on the bottom surface. Rotation cushions are selectively inflated and deflated to control rotation therapy of a patient located on the mattress assembly . . . . A pair of proportional valve assemblies are located in interior region adjacent a head end. A lower head cushion is located within interior region adjacent head end. Lower body cushions are located in the interior region spaced toward the foot end from lower head bladder. Transversely-extending support surface bladders are located on top of other bladders within a continuous interior volume of interior region. Support surface cushions cooperate to define a core portion and include a head cushion, a chest cushion [chest support surface cushion includes internal percussion/vibration (P/V) bladders], a seat cushion, and a foot cushion. Support cushions include inner bladder sections and outer bladder sections which are separately controllable from an air supply source. Air enters the mattress assembly from a blower or air supply of an air system through inlet. Inlet is coupled to an inlet of a percussion/vibration valve. Air supply through inlet is also coupled to valves via flexible, cloth tubes respectively.”
Deep Cell and Low Air Loss Therapy
For a number of years, Gaymar has been manufacturing its Sof-Matt RSM Low-Air-Loss Mattress System. That mattress system 10 is illustrated at
The air pump 114 provides air to the air bladder at least at two different inflation modes. The first inflation mode is referred to as maximum volume as illustrated in
The hammock effect is sometimes correlated to increased tissue interface pressure, which is normally undesirable. Since the crib and bladders only form a hammock effect in the normal operating mode, the crib in Gaymar's Sof-Matt RSM Low-Air-Loss Mattress System is not a restraint because the patient can roll (a) off the patient support device or (b) into a position between the crib and the bed railing since the bladder's top surface 82 and crib's top surface 30 remain within a similar plane (item 40).
XPRT Mattress System
Gaymar Industries manufactures its XPRT mattress. The XPRT mattress is a self-contained pulmonary therapy mattress with selectable rotation, percussion, vibration, turn assist (a form of rotation therapy), automatic low-air-loss that also provides pressure relief. The bladders that provide those therapies are positioned within a crib. Those numerous therapies make it difficult to impossible for the XPRT mattress to form an external receiving cavity to receive secondary cushion embodiments that provide alternative cushion therapies.
Overlay Rotation Therapy
Flick in U.S. Pat. No. 6,079,070 discloses a rotation mattress overlay. The overlay is designed to be positioned over a mattress system not within the mattress system. A problem with an overlay embodiment is that the crib conformation is unable to be effectively used as a restraint to protect the user from falling off the mattress or the mattress overlay.
Compartment Mattresses
There are mattress systems having a plurality of self-contained mattress modules that are connected together like a puzzle. That puzzle embodiment allows the user of the mattress to select the desired hardness for each module and incorporate a bed pan or washing capabilities instead of a mattress module. Examples of such mattresses are disclosed in U.S. Pat. No. 1,276,361 (Hobert—Aug. 20, 1918); U.S. Pat. No. 1,528,066 (McEntire—Mar. 3, 1925); U.S. Pat. No. 6,523,198 (Temple—Feb. 25, 2003); and U.S. Pat. No. 7,197,780 (Petrie—Apr. 3, 2007).
On Oct. 4, 1977, Esquivel obtained U.S. Pat. No. 4,051,566 for a “Mattress with Modifiable Cavity for Pregnant Women.” This mattress system had a mattress section that moved (a) down to form a cavity to accommodate the lady's expanding abdomen and (b) up to a normal planar surface configuration to accommodate the lady's normal abdomen.
A mattress system has a cover, a crib, and a fluid bladder system. The crib surrounds the perimeter of the fluid bladder system and the cover overlies the top surface of the crib and fluid bladder system. The fluid bladder systems provide at least one conventional bladder therapy to a patient positioned on the mattress system. The fluid bladder system interconnects to the crib to not form a hammock effect so the crib functions as a restraint. The fluid bladder is also designed to bottom out to form an exterior cavity. A second cushion is inserted into the exterior cavity and positioned so the crib continues to function as a restraint. The second cushion provides a therapy to the patient that is different from the fluid bladder system.
The sheet 202 can be a natural fabric, a polymeric fabric, a MRSA resistant fabric or combinations thereof. The sheet's objective is to ensure the mattress material(s) is separate from the patient positioned over the mattress' top surface. That separation is desired so the patient does not soil or damage the mattress materials.
The first fluid bladder system 14a provides at least one of the above-identified mattress functions: (a) rotation therapy; (b) vibration therapy; (c) percussion therapy; (d) wave therapy; (e) low air loss therapy; (f) decrease tissue interface pressure therapy; and/or (g) thermal energy transfer therapy. For this application, we will assume the first fluid bladder system 14a decreases tissue interface pressure therapy through a deep cell bladder system.
As illustrated in
For purposes of this invention, the inflatable bladder 122 is a deep cell inflatable bladder. A deep cell inflatable bladder is preferably at a minimum five inches in height.
The restraint-crib 12a is positioned adjacent to and attached (a) 199a to the cushioning section's right side 144 and (b) 199b to the cushion's left side 146, as best seen at
An alternative embodiment has the “bladder positioned adjacent to the left side restraint” 122a attached 199b to the restraint 110 at intermittent locations that are separated by distances about equal to the width of the bladders 122, and the “bladder positioned adjacent to the right side restraint” 122b attached 919a to the restraint 110 at intermittent locations that are separated by distances about equal to the width of the bladders 122. The alternative embodiment has the left side 146 attached 199b to the restraint-crib 12a at intermittent locations that are separated by distances about equal to the width of the bladders 122, and the right side 144 is attached 919a to the restraint-crib 12a at intermittent locations that are separated by distances about equal to the width of the bladders 122.
The restraint-crib 12a extends the entire length of the right side 144 and left side 146. The restraint-crib 12a can be fluid bladders, foam, foam beads, gels, batting, or other suitable materials for restraining a user. What ever the restraint-crib material, the restraint-crib 12a is attached and in some case fluidly interconnected to the cushioning section 14. The restraint-crib can be covered by the conventional impermeable, medically accepted cover 202. Preferably the restraints are foam like materials surrounded by a cover and portions of the restraint (or restraint's cover) attaches to each bladder 120.
The bladder 122 and the restraint-crib 12a are attached 199 (a) directly to each other through heat welding, sonic welding, stitching or other conventional attachment methods used in the mattress industry or (b) indirectly to each other for example through a strap. The strap has a first end and a second end. The first end attaches to the bladder 122 and the second end attaches to the restraint-crib 12a. The straps are attached to the bladder or restraints through heat welding, sonic welding, stitching, other conventional attachment methods used in the mattress industry or combinations thereof. The attachment 199 should be sufficient to withstand the pressures applied by a patient positioned on the restraint/cushioning system 100 and the internal pressure provided by the fluid pump 114.
The fluid pump 114 inflates the bladders through at least two inflation modes. The first inflation mode is maximum inflate. Maximum inflate means every bladder 122 is fully inflated which results in every bladder's top surface 124 being on or within approximate area of the same plane as the restraint-crib' top surface 3. The maximum inflate is used when the patient is being transferred by patient assistants or the patient is authorized to egress from the restraint/cushioning system 100.
The second inflation mode is the normal operating mode. The normal operating mode provides sufficient inflation to prevent the patient from bottoming out and sufficient pressure to decrease (a) the formation of debuticus ulcers and (b) the tissue interface pressure. The tissue interface pressure decreases because the hammock effect is avoided.
The hammock effect is avoided and the restraints perform as restraints when the pump is in the normal operating mode involves attaching 199 the bladder 122 to restraint-crib's interior surface 154 at a first predetermined distance (x) below the restraint's top surface 30 and a second predetermined distance (y) above the restraint's bottom surface 32.
The first predetermined distance x is the distance below the restraint's top surface 30 wherein the restraint-crib 12a during the normal operating mode performs as a restraint as illustrated in
Bottoming the First Fluid Inflatable Bladder
As previously stated, bottoming the inflatable bladder is undesirable in prior mattress systems unless CPR is to be performed. Bottoming, however, is desired in this application when a second cushioning system 300 is used. To provide an alternative cushion embodiment without removing the first fluid bladder positioned under the first sheet 202, the first fluid bladder is bottomed out to form an external cavity 313 and the second cushioning system 300 having a second cushion material 310 is positioned between the patient and the bottomed out first fluid bladder as illustrated in
The second cushion material 310 provides a second cushion embodiment that differs from the first fluid bladder's embodiment. The second cushion embodiment can be (1) a gelastic cushion, (2) a foam cushion, (3) a fluid bladder embodiment that provides (a) rotation therapy, (b) vibration therapy, (c) wave therapy, percussion therapy, (d) low air loss therapy, (e) thermal energy transfer therapy, (f) decreased tissue interface pressure (i.e., deep cell bladders), and (g) combinations thereof, and (4) combinations thereof. Some requirements for the second cushion material 310 are that the second cushion 310 provides different therapy functions than the first bladder embodiment that is positioned within the interior cavity 36. By positioned within the exterior cavity 313, the second cushion 310 contacts or comes close to contacting portions of at least opposing interior wall surfaces 337a, b that define the exterior cavity 313. The exterior cavity 313 is superimposed over the cavity 36. While securely positioned in the exterior cavity 313 the second cushion 310 has a top surface 312 positioned below the crib's top surface 30 plane. That way the crib 12a retains its restraint characteristics of inhibiting the patient from falling off the mattress system 10a while the second cushion 310 is used.
The cavity 36 can receive one or more second cushion materials 310. If additional second cushion materials are used in conjunction with a first second cushion material 310, the additional second cushion materials can provide the same therapy functions as the first bladder embodiment.
Gelastic Material
A gelastic material is a tri-block copolymer composition that provides elasticity and support. The compounds and how to create the gelastic materials are disclosed in U.S. Pat. No. 5,994,450 to Pearce and/or U.S. Pat. No. 5,633,286 to Chen. In U.S. Pat. Nos. 6,026,527 and 5,749,111, Pearce discloses the gelastic material can be made into a solid object or a cushion having columns.
The columned gelastic cushion material has been used by Gaymar, the assignee of this application, in its Isoflex mattress products. The columned gelastic material provides a non-powered mattress design that effectively redistributes pressure and manages shear, as well as treats patients with all stages of wounds.
Second Sheet
In a preferred embodiment, the second cushion material 310 is positioned within a second sheet 340. The second sheet should be used to not soil or damage the second cushion material. The second cushion material is positioned between (a) the patient and (b) the first sheet, and the deflated or deflating first fluid bladder 14a.
Installation of Second Cushion Material
In a preferred embodiment, the second cushion material 310 is positioned between the patient and the first sheet while the first fluid bladder 14a is in the process of bottoming out, and not bottomed out. By inserting the second cushion material 310 at that time, the patient does not bottom out. As previously stated, bottoming out could significantly increase the patient's tissue interface pressure, which is undesired. At the same time, if the first fluid bladder 14a is fully inflated while the second cushion material 310 is being positioned between the patient and the first sheet, the patient could fall off the mattress 10a. Again that result is undesirable. As such, an opportune time to initiate the insertion of the second cushion material 310 onto the first sheet 202 is when the first bladder 14a is in the process of deflating and the restraint-crib 12 acts as a restraining device.
If the second cushion 310 is a fluid bladder embodiment, the second cushion 310 can be interconnected to pump 114 or a second pump 114a. Obviously, if the fluid bladder provides rotation therapy
Alternative Bladder Systems
Generically, the first bladder 14a and the second cushion material 310 can provide a rotation function. For purposes of this description, we will address the bladder embodiment in relation to the first bladder 14a with the understanding that the bladder configuration can also be used with the second cushion material 310.
The rotation therapy is accomplished with at least a first rotation bladder 80 on the right side of the interior cavity 36 and a second rotation bladder 82 on the left side of the interior cavity 36 as illustrated in
In
Likewise, if the patient positioned over the mattress system 10a is to be rotated to its right side, the second rotation bladder 82 is fully inflated while the first rotation bladder 80's upper surface 86 is maintained level with the crib's upper surface 30, as illustrated at
The bladder 80 and the interior cavity 36 are attached 199 (a) directly to each other through heat welding, sonic welding, stitching or other conventional attachment methods used in the mattress industry or (b) indirectly to each other for example through a strap. The attachment 199 should be sufficient to withstand the pressures applied by a patient positioned on the mattress system 10a and the internal pressure provided by a fluid pump 114.
The fluid pump 114 inflates the bladders through at least two inflation modes. The first inflation mode is maximum inflate. Maximum inflate means every bladder 14 is fully inflated which results in every bladder's top surface being on or within approximate area of the same plane as the crib's top surface 30. The maximum inflate is used when the patient is being transferred by patient assistants or the patient is authorized to egress from the mattress system 10.
The second inflation mode is the normal operating mode. The normal operating mode provides sufficient inflation to prevent the patient from bottoming out and sufficient pressure to decrease (a) the formation of debuticus ulcers and (b) the tissue interface pressure. The tissue interface pressure decreases because the hammock effect is avoided. “Bottoming” refers to any state where the bladder's top surface 66 is depressed to a point that it contacts the bladder's lower surface 67, thereby markedly increasing the interface pressure where the two surfaces contact each other and is not normally desired unless CPR needs to be administered.
The hammock effect is avoided and the crib perform as a restraint when the pump is in the normal operating mode involves attaching 199 the bladder 14 to each crib interior surface 36 at a first predetermined distance (x) below the crib's top surface 30 and a second predetermined distance (y) above the crib's interior cavity's bottom surface 152.
The interior cavity's bottom surface 38 may be foam material as illustrated or the support structure for the mattress system 10a.
In yet another alternative embodiment of the present invention, the cushioning section 14a, 310 may be of the alternating pressure type, i.e., it has at least two series of alternating cells, which are alternately inflated and deflated, one series of cells being inflated while the other series of cells is deflated. Such alternating pressure type cushions are disclosed, for example, in U.S. Pat. Nos. 5,794,289 and 5,901,393, which are hereby incorporated by reference in their entirety.
There have also been provided cushion and pump combinations in which alternate air chambers are alternately inflated and deflated to relieve excess pressure on patients at risk of developing pressure ulcers or to relieve excess pressure on patients with pressure ulcers (e.g., the Airflo Alternating Pressure System from Gaymar Industries, Inc.).
Micro-vents and/or low air loss tubes may also provided to produce a gentle flow of air beneath the patient to help minimize moisture build-up.
In a further embodiment of the present invention, the cushioning sections 14a, 310 may include a device for measuring the internal pressure of the cushioning sections 14a, 310. Typically, such devices activate a light when the internal pressure of the cushioning section 14a, 310 is below a certain level, indicating a bottoming condition. The device may be integrated into the valve through which fluid is being fed into the cushioning section 14a, 310. Such devices are well known in the art and are described, for example, in U.S. Pat. No. 5,140,309, which is hereby incorporated by reference in its entirety.
Although preferred embodiments have been depicted and described in detail herein, it will be apparent to those skilled in the relevant art that various modifications, additions, substitutions, and the like can be made without departing from the spirit of the invention and these are therefore considered to be within the scope of the invention as defined in the claims which follow.
This application claims priority to U.S. provisional patent application Ser. No. 60/984,047; that was filed on Oct. 31, 2007.
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