Prolonged bed rest without adequate mobilization is often associated with increased risk of pulmonary complications, including hypoxia, atelectasis, and hospital-acquired infections such as ventilator-associated pneumonia. For patients too weak or unstable to be sufficiently mobilized during critical phases of acute illness, treatment has included medical personnel (e.g., nurses) manually turning the patient from side to side for fixed intervals of time, often termed “lateral rotation therapy” (LRT). Manually manipulating the patient supported on a patient support apparatus above a floor surface is associated with risk to the patient and caregivers alike.
The advent of integrating LRT with the patient support apparatus improved pulmonary outcomes and also facilitated prevention of skin-related complications. Early manifestations of integrated LRT included articulating a frame of the patient support apparatus to correspondingly rotate the patient from side to side. More recently, inflatable bladders have been provided within the mattress with the bladders inflatable in a coordinated manner to rotate the patient from side to side. With a mattress cover coupled to the mattress, it is appreciated that increasing the volume of the mattress (and/or the volume within the mattress cover secured to the mattress) requires a corresponding increase in surface area of the mattress cover. In other words, the mattress cover must expand or otherwise provide slack to prevent the cover from impeding the expanding volume of the mattress during the LRT or patient turning operation. The problem is particularly pronounced at the sides of the mattress and mattress cover.
Many known mattress covers are fraught with shortcomings. Solely forming the mattress cover from elastic material(s) is insufficient for most applications. The elastic materials often expand by 25-50%, whereas LRT often requires expansion of the mattress cover by greater than 100%. For another example, systems independent to the mattress cover having mechanisms to permit expansion and force retraction of the mattress cover are complex, expensive, and unsatisfactory.
Furthermore, the shape of the upper surface of the mattress cover is also altered during LRT. Effectuating the patient turning operation in which one portion of the mattress is expanded (e.g., the upper surface of the mattress cover is urged upwardly) may result in a generally concave or arcuate contour of the upper surface of the mattress cover supporting the patient. Often, the altered shape results in excess slack or wrinkles on the upper surface of the mattress cover (despite the paradoxical benefit of excess slack at the sides of the mattress cover). The wrinkles are potential points or areas of increased pressure with risk of pressure ulcers, irritation and discomfort to the patient.
Therefore, a need exists in the art for a mattress cover for a mattress providing rotation therapy to the patient supported on the patient support apparatus that overcomes one or more of the aforementioned disadvantages.
Advantages of the present disclosure will be readily appreciated as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings.
The patient support apparatus 30 may include a base 36 adapted to rest upon a floor surface, and a patient support deck 38 coupled to the base 36. In certain embodiments, an intermediate frame 40 is spaced above the base 36 with the patient support deck 38 coupled to or disposed on the intermediate frame 40. A lift device 42 may be operably coupled to the intermediate frame 40 and the base 36 for moving a patient support portion 44 to be described relative to the base 36. In the exemplary embodiment illustrated in
In certain embodiments, the patient support deck 38 includes articulating sections 48 configured to articulate the patient support portion 44 between various configurations. The articulating sections 48 may include a fowler, a seat section, a thigh section, a leg section, and the like, movably coupled to actuators 50. For example, the fowler may be moved between a first position in which the patient P is supine, as illustrated in
The patient support apparatus 30 includes the mattress 34 coupled to or supported on the patient support deck 38.
Referring now to
The mattress 34 includes a patient turning device 60. The patient turning device 60 may be defined as a layer within the mattress 34 disposed intermediate the upper surface 52 and the lower surface 54, as shown in
An inner membrane layer 64 may be provided within the mattress 34. In one example, the inner membrane layer 64 is in fluid communication with a source of air (not shown) circulated through the inner membrane layer 64 to control humidity of the mattress cover 32. In the exemplary embodiment of
In certain embodiments, the mattress 34 (or the mattress cover 32) include a fire barrier layer (not shown). The fire barrier layer may be positioned intermediate the patient turning device 60 and the inner membrane layer 64. One exemplary fire barrier layer suitable for the present application is provided under the tradename Nomex (DuPont Company, Wilmington, Dela.). A self-healing layer (not shown) may be provided and positioned, for example, in direct contact with the upper layer 58 or intermediate the upper layer 58 and the patient turning device 60. The self-healing layer may be formed from a low-durometer poured urethane with the capability of self-sealing in the event of small, inadvertent punctures from sharps (e.g., a hypodermic needle). It is to be understood that the arrangement of the specific layers of the mattress 34 is not specifically limited to those set forth above. Further, in certain embodiments the mattress 34 may include more or fewer layers. For example, the mattress 34 may not include the upper layer 58 with the mattress cover 32 in contact with one of the patient turning device 60, the inner membrane layer 64, the mattress core layer 66, and the like.
The mattress cover 32 is coupled to the mattress 34. The mattress cover 32 defines the patient support portion 44 adapted to cover the upper surface 52 of the mattress 34. Thus, absent bedding and the like, the patient P is supported by and in contact with the patient support portion 44 of the mattress cover 32. In certain embodiments, the mattress cover 32 may be coupled to the mattress 34 so as to substantially encase the mattress 34. Referring to
In certain embodiments, the mattress cover 32 includes a fastening device 72 coupling two portions of the mattress cover 32 such that the mattress cover 32 is removably coupled to the mattress 34.
The patient support portion 44 includes an outer periphery 74 sized so that a majority of the patient P is supported on the patient support portion 44, particularly during the movement therapy. In one example, the outer periphery 74 is defined by the edges between the patient support portion 44 and the peripheral portions 70 of the mattress cover 32. In another example, the outer periphery 74 is defined by boundaries of a predetermined area of the patient support portion 44 with the area adapted to support the patient P during the movement therapy. It is shown in
Referring now to
The mattress cover 32 must expand or otherwise provide slack to prevent the mattress cover 32 from impeding increasing the thickness T of the mattress 34 (e.g., expanding of the inflatable bladders 62). The mattress cover 32 includes an augmenting feature 76 associated with one of the peripheral portions 70. The augmenting feature 76 is adapted to move between a stored configuration in the absence of the movement therapy, and a deployed configuration in response to increasing the thickness T of the mattress 34 during the movement therapy. It is to be understood that the augmenting feature 76 may include more than one augmenting feature associated with more than one of the peripheral portions 70. In one example including the mattress 34 having a conventional shape, each of four of the peripheral portions 70 may be associated with the augmenting feature 76. The augmenting feature 76 is represented schematically in
In the exemplary embodiment of
In one example, the concertinaed material 78 is fabricated from thermoformed plastic formed in the concertinaed manner illustrated in
In the exemplary embodiment illustrated in
With the exemplary embodiments of
Referring to
For both function and aesthetics it is generally desirable to maintain the fold of material 88 adjacent the peripheral portion 70 with the augmenting feature 76 in the stored configuration. The present disclosure contemplates doing so in several manners. In one exemplary embodiment, the augmenting feature 76 includes a coupler 94 coupled to either the peripheral portion 70 or the fold of material 88, and a counterposing coupler 96 coupled to the other. The couplers 94, 96 may include snaps, clips, hook and eye connections, adhesive, and the like. In one example shown in
In certain embodiments, additional couplers 98, 100 are positioned at or near the patient support portion 44. With reference to
The augmenting feature 76 of the mattress cover 32 may include a resilient member 102 coupled to the fold of material 88 at or near the free end 92. The resilient member 102 is adapted to bias the fold of material 88 towards the stored configuration. In other words, the resilient member 102 is adapted to bias or urge the free end 92 of the fold of material 88 to the position adjacent the peripheral portion 70. With continued reference to
In another exemplary embodiment, the resilient member 102 is coupled to the fold of material 88 at or near the free end 92 and to the peripheral portion 70 of the mattress cover 32 (to which the fold of material 88 is coupled at the coupled end 90). In many respects similar to the aforementioned exemplary embodiment, the resilient member 102 is adapted to bias the fold of material 88 towards the stored configuration, or to the position adjacent the peripheral portion 70. The resilient member 102 is elastically tensioned by a force, in this example a force in a direction generally axial to a direction of the resilient member 102.
In certain embodiments, the resilient member 102 may be an elastic band. The elastic band may be coupled at one end to the fold of material 88, and at the other end to one of the peripheral portions 70, 70′. The elastic band is elastically tensioned by the forces, axial or transverse, associated with the augmenting feature 76 moving from the stored configuration the deployed configuration in response to increasing the thickness T of the mattress 34 during the movement therapy. As is understood with elasticity generally, the elastic band is biased to return an untensioned state, which includes the fold of material 88 positioned adjacent the peripheral portion 70. In another exemplary embodiment, the resilient member 102 may be an elongate rod 104. Referring to
With continued reference to
As mentioned above, the mattress cover 32 may not substantially encase the mattress 34. In other words, the mattress cover 32 may lack one or more of the bottom portion 68 and/or the peripheral portions 70 covering the respective surfaces of the mattress 34. One exemplary embodiment of the mattress cover 32 not substantially encasing the mattress 34 is shown in
The mattress cover 32 removed from the mattress 34 by slidably moving the lower edge 110 along the sides 56 of the mattress 34 (i.e., the mattress cover 32 of the present embodiment may not include the fastening device 72 (see
In certain embodiments, the lower edge 110 may be coupled to a mechanical system adapted to permit controlled movement of and provide retraction of the mattress cover 32 relative to the mattress 34 in response to increasing and decreasing of the thickness T of the mattress 34, respectively, during the movement therapy. For example, a spring-loaded roller (not shown) may be provided adjacent to the peripheral portion 70 or within the mattress cover 32 (or the mattress 34). The spring-loaded roller may include a torsion spring biasing the roller to furl the lower edge 110 of the mattress cover 32 about the roller. During the movement therapy, the forces associated with increasing the thickness T of the mattress 34 are sufficient to overcome the biasing forces provided by the torsion spring, and the mattress cover 32 unfurls from the roller providing slack to accommodate the upward movement of the upper surface 52 of the mattress 34. As the upper surface 52 moves downwardly, the biasing forces provided by the torsion spring urge the mattress cover 32 to furl the lower edge 110 of the mattress cover 32 about the roller. In some respects, the spring-loaded roller may be considered another exemplary embodiment of the augmenting feature 76 of the present disclosure.
Referring to
The patient support portion 44 and the bottom portion 68 may overlap adjacent to opposing sides 56 of the mattress 34, as shown in
An exemplary operation of the mattress cover 32 of the present embodiment will now be described. The patient support portion 44 is coupled to the bottom portion 68 with the resilient members 116 such that the mattress cover 32 substantially encases the mattress 34. The patient support portion 44 and the bottom portion 68 overlap adjacent to opposing sides 56 of the mattress 34. During the movement therapy the thickness T of the mattress 34 increases (i.e., the upper surface 52 moves upwardly in the elevational view of
In the exemplary embodiment illustrated in
In exemplary embodiments of the present disclosure discussed to this point, providing the movement therapy included increasing the thickness T of the mattress 34 with the patient P disposed thereon. For example,
The patient turning device 60 is adapted to move at least a portion of the mattress 34 to provide the movement therapy. The patient turning device 60 may be actuated by, for example, the inflatable bladder(s) 62 being selectively inflated with fluid from the fluid source (not shown).
The patient turning device 60, while external to the mattress 34, may be covered by or disposed within the mattress cover 32. The mattress cover 32 includes the patient support portion 44 covering the upper surface 52 of the mattress 34, the bottom portion 68 coupled to the patient support portion 44, and the peripheral portions 70 extending between the patient support portion 44 and the bottom portion 68. The patient support portion 44 includes the outer periphery 74 sized so that the majority of the patient P is supported on the patient support portion 44 within the outer periphery 74 during the movement therapy. The peripheral portions 70 cover the sides 56 of the mattress 34.
The bottom portion 68 (and in certain embodiments the peripheral portion 70) covers the inflatable bladder(s) 62 of the patient turning device 60. In the exemplary embodiment illustrated in
The aforementioned arrangement is such that the patient turning device 60, and in certain embodiments the mattress 34, is substantially encased within the mattress cover 32. Thus, when the patient turning device 60 and the mattress 34 is substantially encased within the mattress cover 32, it is understood that mattress cover 32 must expand or otherwise provide slack to prevent the mattress cover 32 from moving in response to expansion of the inflatable bladders 62 during the movement therapy. The mattress cover 32 includes the augmenting feature 76 associated with one of the peripheral portions 70. The augmenting feature 76 is adapted to move between the stored configuration in the absence of the movement therapy, and the deployed configuration to accommodate the movement of the mattress 34 during the movement therapy in manners previously described. The augmenting feature 76 is represented schematically in
Referring to
The patient support portion 44 may be include a first area 124 formed from a first material having a first elasticity, and a second area 126 formed of a second material having a second elasticity. For example,
As mentioned, the first area 124 is formed of the first material with higher relative elasticity than the second material, and the first area 124 is positioned adjacent to the opposing sides 122 of the patient support portion 44. With concurrent reference to, for example,
In certain embodiments, the first material has high breathability. One material having suitable breathability is Gore-Tex™ fabric manufactured by W. L. Gore & Associates, Inc. (Newark, Dela.). A moisture resistant layer may also be laminated with the mattress cover 32 to form a membrane, or alternatively the first area 124 may be thermally treated to modify the physical properties of the first material. In certain embodiments, the second area 126 has high elasticity. One material having suitable elasticity is Lycra® fabric, a registered trademark of Invista Inc. (Wichita, Kans.).
The first area 124 and/or the second area 126 may be fabricated from layers that are separately extruded then assembled by adhesion or thermal fusion. In another example, the layers are knit from yarns having different fiber properties such as fiber weight. The fibers may be arranged in three-dimensional layers to vary density, direction, and/or tension (e.g., anisotropic fibers). The fibers may be coated to further impart desired physical properties. In other examples, the fabrics may be laminated by spraying a screen print with materials having selected properties. It is further contemplated that advanced manufacturing techniques, such as three-dimensional printing, may also be implemented to tailor the location and orientation of the elastic expansion of the first material and/or the second material within the first area 124 and/or the second area 126, respectively. Additive manufacturing techniques may provide for control of local surface shear and microclimate properties of one or more of the layers of the mattress cover 32 and/or the mattress 34 (see, for example,
The present disclosure contemplates that the advantageous features of the mattress cover 32 described throughout the present disclosure may be provided on a mattress overlay with the bottom portion 68 of the mattress overlay adapted to be positioned on and comformable to the upper surface 52 of the mattress 34. The mattress overlay, including the mattress cover 32, includes a cushioning layer (e.g., the mattress core layer 66 of
It will be further appreciated that the terms “include,” “includes,” and “including” have the same meaning as the terms “comprise,” “comprises,” and “comprising.” Moreover, it will be appreciated that terms such as “first,” “second,” “third,” and the like are used herein to differentiate certain structural features and components for the non-limiting, illustrative purposes of clarity and consistency.
Several configurations have been discussed in the foregoing description. However, the configurations discussed herein are not intended to be exhaustive or limit the invention to any particular form. The terminology which has been used is intended to be in the nature of words of description rather than of limitation. Many modifications and variations are possible in light of the above teachings and the invention may be practiced otherwise than as specifically described.
The subject patent application claims priority to and all the benefits of U.S. Provisional Patent Application No. 62/611,207 filed on Dec. 28, 2017, the disclosure of which is hereby incorporated by reference in its entirety.
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Number | Date | Country | |
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20190201261 A1 | Jul 2019 | US |
Number | Date | Country | |
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62611207 | Dec 2017 | US |