Patent Grant
7217186
The invention comes within the technological sphere of ventilation devices fitted with an airflow diffuser to protect a sensitive zone against the entry of outside contamination. It concerns devices for decontaminating a gaseous fluid, of aerological isolating type, that is to say intended to deliver a flow of decontaminated air or to extract a flow of contaminated air, within a spatial part of a room. The invention specifically relates to the technological area of aerological isolating devices:
The ambient air of premises is permanently contaminated by microorganisms derived from persons or the environment (bacteria, viruses, yeasts, moulds, . . . ). The human body is therefore surrounded by a considerable number of micro-organisms. The germs in the air have twofold origin: environmental and human.
Aerological biocontaminating vectors of human origin contain rhino-pharyngeal droplets, called Pflügge droplets (emitted when speaking, coughing or sneezing) of a diameter generally lying between 5 and 100 microns. As and when they settle, these droplets lose their water content, reducing their diameter down to as far as 0.5 microns forming droplet nuclei. These are all the more dangerous as they are concentrated in germs, they remain in suspension in air for a long time and may enter the respiratory tracts. In a hospital environment, airborne flora of human origin also contains bacteria from cutaneous and possibly digestive commensal flora of the surgical team, medical team and patients.
Environmental aerological biocontaminating vectors especially contain particles of dust or fabric coated with microorganisms. Airborne flora of outside air is mostly made up of bacilli, micrococci, staphylococci. Gram negative bacilli and anaerobic bacteria are also found. Yeasts and fungi also belong to this environmental flora (e.g. aspergillus fumigatus . . . ). Finally, contaminated liquid particles are found in air caused by disturbance of contaminated water media (Legionellosis . . . ).
In the air, the lifetime of bacteria is sufficiently long for them to be considered as potential infection agents. Being a vector of intra-hospital contamination, air disperses particles carrying microorganisms over greater or lesser distances and insidiously promotes gradual contamination of the hospital environment. Several factors contribute towards the development of microorganisms in hospitals—firstly modern air treatment technologies (air conditioning) which, despite their beneficial effects, also set up dangerous germ reservoirs in piping, and secondly the increasing use of antibiotics, antiseptics and disinfectants which has led to the selection of increasingly resistant germs. At the same time, medical techniques have been developed in hospitals that are more and more advanced but also more aggressive for patients, while these patients have become more immunocompromised and therefore with high risk of infection. This accounts for the increasing occurrence of nosocomial infections caused by germs in the hospital environment (which usually have little intrinsic virulence) affecting patients with reduced resistance.
At the international conference on nosocomial infections in 1970, Brachman estimated that 10 to 20% of endemic nosocomial infections are airborne.
Some of these microroganisms colonise patients' respiratory tracts and may, in weaker patients, be the cause of respiratory nosocomial infection.
In addition, to protect patients with low resistance to infection, the use of invasive procedures (that is to say investigation procedures or treatment which enters the skin, mucosa or a natural cavity of the body) can only be considered in a controlled microbial aerological environment.
The prevention of nosocomial diseases in hospitals requires breaking the chain of transmission of infectious agents, in particular the chain of airborne contamination.
To achieve this, a distinction is made between protective septic isolation intended to prevent a patient carrying a bacterial or viral infection, or who is colonised by a germ, from diffusing this infection. This is the case in particular for patients suffering or suspected to be suffering from contagious respiratory infections such as tuberculosis. On the other hand, a patient at risk is likely to be infected by the environment, by other patients, or by visits. Such patients must be given aseptic protective isolation. This type of case is normally found in burns units, haematology, oncology or transplantation departments. This particularly concerns patients who are immunocompromised through illness, neutropaenia treatment or suffering from medullary aplasia. The purpose of aseptic protective isolation is to avoid contact between a person and a pathogenic agent. These microorganisms may always be pathogenic (tuberculosis bacillus . . . ) or potentially pathogenic when they contaminate persons with reduced immune response (pyocyanic bacillus, aspergillus, . . . ). It sets out to protect immunocompromised patients against all contamination of environmental or human origin (environment, staff, other patients, visitors . . . ).
Traditionally, the decontamination of airborne microorganisms around a sensitive area by means of ventilation is made:
A distinction is made between two types of clean or isolation rooms in the hospital sector:
The invention concerns isolators both under positive pressure for aseptic isolation and under negative pressure for septic isolation.
Isolators or “bubbles” placed inside a room are generally made up of an envelope which surrounds:
The conventional decontamination method consists of causing a very large quantity of air to enter the isolation room, or the effective volume of the isolator. The effect of adding of this quantity of air is:
The air is filtered upstream from the flow in aseptic rooms or isolators, and downstream from the flow in septic rooms or isolators.
It is frequent practice for local air treatment to use an isolating device comprising a diffuser with variable geometry.
In the remainder of the description, the following equivalent terms will be used indifferently: diffuser or air diffusion chamber. Also the following will be used indifferently: air diffusing portion or air diffusion plenum.
In the great majority of devices of the prior art, the air diffuser is in a single block (that is to say it comprises only one air diffusion portion) and can be adjusted.
A first category of mobile aeraulic isolation devices comprises single block diffuser devices connected to their base (which includes an air purifying system) via a flexible duct to enable air to pass.
U.S. Pat. No. 4,163,650 Watson et al. describes a floor mobile device comprising a mobile cabinet on wheels equipped with decontamination means (formed of an ioniser and an electrofilter) and a fan. A hose is connected to the cabinet and leads to a conical-shaped diffuser.
U.S. Pat. No. 4,512,245 Goldman describes a device for local extraction of fumes comprising an air treatment unit connected by a flexible air suction tube to an exhaust outlet.
U.S. Pat. No. 5,129,928 Chan et al. describes a portable device for locally reducing the concentration of allergens in air. The system comprises a base fitted with a fan, pre-filters, and a flexible air duct leading to a conical diffusing head fitted with a filter.
U.S. Pat. No. 5,281,246 Ray et al. describes an air purifier intended to aspirate and filter fumes. It is formed of a cabinet on wheel, fitted with filters and fans. A conical deflector is connected to an articulated duct conveying the aspirated air towards the treatment cabinet.
U.S. Pat. No. 5,290,331 Miles et al. describes a cylindrical head for diffusing decontaminated air placed in a localised area, connected by a flexible air tube to an air ventilation and decontamination system.
The isolators in this first category, having a single block diffuser connected to an articulated or flexible duct, can only be used for treating air over small areas, owing to the mechanical impossibility of the duct to carry a large diffuser.
Patent DE 3639708 Kreyenberg Karl Heinz describes a variant of isolator in this first category, formed of a single block diffuser of semi-torus shape provided with air diffusion holes and connected via a flexible pipe to a box unit containing decontamination and air pressurizing means, placed on a floor mobile base frame. The diffusing torus is arched over the patient to create a protective air curtain of semi-cylindrical shape.
A second category of mobile aeraulic isolation device comprises single block air diffusing devices articulated on a mobile base frame.
U.S. Pat. No. 3,724,172 Wood describes an aseptic isolator with a diffuser joined to a mobile base frame and positioned at the head or side edge of the bed setting up a flow of air parallel to the mattress. In its versions adaptable to the head of the bed, the diffuser is fixed at the top of the mattress and can pivot with the latter. This device does not give satisfactory use since the diffuser is too close to the sensitive zone (patient's head and body) and the horizontal position of the air flow brings interference with the pillow and patient's body setting up turbulence.
U.S. Pat. No. 3,385,036 Webb describes an isolator with a conical diffuser fitted on the inside with a filter, placed at the end of a positioning arm mounted on a mobile frame, and connected to a fan integral with the frame via a flexible pipe. The diffuser is in a single block and can be inclined.
U.S. Pat. No. 3,820,536 Anspach, Jr et al. and U.S. Pat. No. 4,045,192 Eckstein et al and patent DE 20018765U Laflow Reinraumtechnik each describe an isolator formed of an articulated box unit mounted on a floor mobile frame, comprising decontamination and air pressurizing means and leading to an angle-adjustable single block diffuser.
U.S. Pat. Nos. 4,272,99 and 6,099,607 Haslebacher describe an isolator formed of a box unit containing decontamination and air pressurizing means placed on a floor mobile frame and connected to a single block air diffuser via a flexible articulated pipe. So that the single block diffuser is angle-adjustable.
U.S. Pat. No. 5,312,465 Riutta describes an isolator formed of a box unit comprising decontamination and air pressuring means, placed on a floor mobile frame and connected to a plenum made up of an inflatable bag fitted with a diffuser at its end. The diffuser is single block and angle-adjustable.
U.S. Pat. No. 5,487,766 Merlin R. Vannier describes an isolator formed of a floor mobile frame surmounted by a box unit fitted with a horizontal extraction hood, including decontamination and air pressurizing means, and surmounted by a horizontal single block diffuser with vertical lower diffusion. The diffuser is connected to the box by a height-adjustable air pipe so that the vertical position of the diffuser can be adjusted.
The isolators in this second category, with a single block diffuser articulated on a mobile chassis, are unable to provide both a sufficiently large diffusion surface for the horizontal coverage of a large-size sensitive area (greater than the size of a hospital bed for example, i.e. approximately 2.2 m×1 m) and possible passage through a doorway (approximately 0.8 m wide) smaller in size than the sensitive area.
A third category of mobile isolators comprises devices formed of a tent with an inner monolithic diffuser. A device of this type with a fixed bar frame is described in patent GB 1066145 Bunyan John. Another device of this type with a fixed frame in inflatable tubes is described in U.S. Pat. No. 5,832,929 Yamaha Isao et al.
The tent isolators in this third category with a monolithic diffuser have the drawback firstly of being distressing for persons inside, patients in particular; and secondly of having difficult access for care givers if these tents are used for patient isolation; and finally they require time-consuming installation procedure.
A fourth category of mobile aeraulic isolation device comprises variable geometry air diffusion devices of multi-block type; that is to say comprising several (at least two) plenums (air diffusion portions). This is the prior art that is closest to the invention. A device of this type is described in U.S. Pat. No. 3,935,803 Louis Bush. It is a mobile aeraulic isolation device for a sensitive zone (a bed) against contaminating airborne aerosols, also comprising a twin-block diffuser (or air diffusion chamber—that is to say with two connected plenum portions) giving this air diffuser variable geometry (that is to say mobility of one plenum portion relative to the other).
This isolation device comprises a console air diffuser made up of two rigid air diffusion plenums, mechanically connected to each other, and mobile relative to one another each having a lower planar air-diffusing surface that is porous to air. Means of relative movement, formed by a horizontal axis and fixation means in horizontal or vertical position, enable a second downstream mobile rigid air diffusion plenum positioned at one end to pivot relative to the other first, fixed, rigid upstream air-diffusing plenum. They also enable this second mobile rigid plenum to be tilted in relation to the chassis, in two distinct relative positions. In a first position shown in
In the other position, shown in
The device also comprises a vertical chassis-cabinet, whose width is substantially the same as the width of the bed and includes physical means for decontaminating moving air formed of filters and air pressurizing means formed by a fan.
Aeraulic connection and air circulation means (formed by this chassis-cabinet) aeraulically connect the fan, the filters and the two rigid air diffusion plenums of the air diffuser, forcing the air to pass through their air diffusing porous surfaces.
The mobile supporting chassis-cabinet is connected mechanically and rigidly to the first fixed upstream plenum and indirectly to the second mobile downstream plenum of the air diffuser. It gives rigid support to the cabinet containing the air decontamination filters, fan for pressurizing air and the aeraulic connection assembly. The chassis is fitted with means for horizontal movement of the chassis relative to the floor, formed of casters.
This mobile twin-block aeraulic isolation device of the prior art, with variable geometry diffuser, indeed has the advantage of being able to diffuse filtered air over the entire upper surface of a bed and can be folded away.
One first essential aspect of this device of the prior art is that it comprises only one plenum that is mobile relative to its mobile supporting chassis-cabinet, the other is fixed.
Yet there are two main sizes for hospital beds:
One consequence of the geometry of the system, apparent in the description, is that the minimum sizes of this system of the prior art to protect a hospital bed are:
It therefore appears that in folded position, the smallest dimension of this device of the prior art is its width (width of the plenums). It is therefore in longitudinal direction, that is to say along the axis of the plenums, that it passes more easily through a doorway. So that in folded position, the minimum door width through which the device can be passed is greater than the width of the bed it is to protect (i.e. 47 inches or 120 cm) and is equivalent to the width of its plenums.
Yet, outside the hospital (or industrial) environment, the most frequent door size found in homes is approximately 205 cm high and 80 cm wide i.e. 81 inches×31 inches.
So that the first defect of this system of the prior art, having a single mobile plenum, is that its geometry does not allow its use in home hospitalisation applications, in particular for the treatment of immunosuppressed patients at home, since it cannot pass through standard doorways.
A second defect of this system of the prior art is that the effective width of the plenums it can use is limited by door widths. So that the volume of protection surrounding the patient is itself restricted. This is adverse to patient comfort and protection.
A second essential particular aspect of this device of the prior art is that its physical means for air decontamination are chiefly located in the body of its chassis-cabinet and are formed of filters. On account of this configuration, the chassis-cabinet takes up much space: width substantially equivalent to that of the bed, 47 inches i.e. 120 cm and depth 30 inches i.e. 76 cm. So that either the chassis-cabinet is placed at the foot of the bed in which case it completely blocks out the patient's view in this direction, leading to a feeling of imprisonment detrimental to patient comfort. Also it also blocks out the view of medical staff attending the patient. In addition, its large size makes this configuration impossible in most rooms. Either the chassis-cabinet is placed at the head of the bed, as shown in
So that a third defect of mobile aeraulic isolation devices with variable geometry, twin-block diffuser and one single mobile plenum (such as described above) is that when they are used to protect beds, the most sensitive area, the head of the bed is next to that part of the device which is the most closed and most voluminous vertically. It will be understood that this considerably hampers access by medical staff to the sensitive area via the head of the bed (which is the part of the bed which requires most access by attending staff: tube insertion, intravenous drips, disinfection, hygiene . . . ). So that these devices hinder the work of hospital staff.
In addition, the head of the bed is the area with the least available floor and vertical space. The treatment cabinet uses all the rear volume of the sensitive zone formed by the head of the bed. And the head of the bed is precisely where by tradition the majority of the room's technical equipment is located (monitoring equipment, resuscitation equipment, gas inlets . . . ) So that these devices disorganize and hinder the functioning of technical equipment.
A fourth defect of mobile aeraulic isolation devices with variable geometry twin-block diffuser and a single mobile plenum (such as described above) is that the mobile supporting trolley is of fixed geometry. For reasons of space, the length of the frame parts of this trolley is far smaller than the overall length of the diffuser when corbelled in opened operating use. It will be understood that on this account the device of the prior art has very precarious balance when opened for use.
A fifth defect of mobile aerological isolation devices with variable geometry twin-block diffuser and a single mobile plenum (as described above) is that the different mass parts (chassis-cabinet . . . ) giving counterweight to prevent collapse of the device when the corbelled diffuser is in open operating position, are fixed relative to the polygonal centre of sustentation. So that there is no means to offset displacement of the centre of gravity towards the free end of the device when the mobile plenum is opened for use. For this reason, the equilibrium of the device of the prior has further precariousness when opened for use.
A sixth defect of mobile aeraulic isolation devices with variable geometry twin-block diffuser (such as described above) is that their lateral air curtain is insufficient to prevent penetration inside the sensitive bed zone of Pflügge droplets emitted by visitors or attending staff when speaking, coughing or sneezing. These Pflügge droplets generally have a diameter of between 5 and 100 microns and are emitted at very high speed (at times close to the speed of sound). S that the curtain of air is not able to stop their passage on account of their high kinetic energy. This obliges visitors and attending staff to wear a mask close to the device if the device is used to protect a patient with very low immunity response, which is nonetheless its chief function.
A seventh defect of mobile aeraulic isolation devices with variable geometry twin-block diffuser (such as described above) is that their lateral air curtain is generally very noisy and energy-consuming.
An eighth defect of mobile aeraulic isolation devices with variable geometry twin-block diffuser (such as described above) is connected with their first particular aspect described above. The minimum lateral space required by this device in movement position is equivalent to the width of plenum protection. So that it is not possible provide these plenums with sufficient width so that, within the protected surface underneath the plenums, they can house visitors or attending staff and/or equipment to make life more pleasant for patients (tables, lounge chair, reading chair . . . ). Otherwise the device could not go through doorways.
The invention concerns a mobile aeraulic isolation device with multi-block, variable geometry air diffusion chamber to protect a sensitive area such as a bed against contaminating airborne aerosols.
The isolation device of the invention is of the type comprising an air diffusion chamber (or diffuser) formed of at least two rigid air diffusion plenums, mechanically connected to each other so that they are mobile relative to one another. Each of the two rigid plenums is delimited by an outer envelope of substantially parallelepiped shape (optionally dihedral) with substantially rectangular cross-section having an air diffusing undersurface that is substantially planar and porous to air, to allow air diffusion through it. The outer envelope of each plenum, at least at one first contact end, is provided with a first free end contacting surface (open) substantially perpendicular to the corresponding diffusing surface. This first free end contacting surface is surrounded by a so-called intermediate ring joint plane of substantially identical size and geometry for both rigid plenums.
The invention specifically relates to mobile plenum aeraulic isolation devices, that is to say also comprising means of relative movement for at least one first mobile plenum relative to the other second mobile plenum, and enabling them to be positioned relative to one another in at least two distinct relative positions, including a so-called open relative position and a so-called closed relative position.
In the open relative position, the first diffusing surface of the first mobile plenum is substantially coplanar and abutting, substantially in the extension of the second diffusing surface of the second mobile plenum. The intermediate joint planes of the mobile plenums are immediately adjacent so that the mobile plenums are hermetically coupled.
In the other so-called closed relative position, the first diffusing surface of the first mobile plenum does not lie in the extension of the diffusing surface of the second mobile plenum. Also, the intermediate joint planes of the mobile plenums are distanced from each other and uncoupled.
An aeraulic isolation device with mobile plenum according to the invention is of the type fitted with at least one physical means for decontaminating air moving through it, and with at least one air pressurizing means. It is equipped with aeraulic connection and air circulation means, which aeraulically connect the air pressurizing means, the physical air decontamination means and a second free inlet surface of at least one of the two rigid plenums of the air distribution chamber, forcing the flow of air to pass through the porous air diffusing surfaces when the plenums are in open, hermetically coupled position.
An aeraulic isolation device with mobile plenum of the invention is of the type placed on a mobile supporting chassis, mechanically connected to the two rigid plenums of the air diffusion chamber, to the one or more physical air decontamination means, to the air pressurizing means and to the aeraulic connection means. This mobile supporting chassis is equipped with means for horizontal movement of the chassis relative to the floor.
One first particular aspect characteristic of the mobile aeraulic isolation device of the invention compared with mobile plenum systems of the prior art is that, in addition, it comprises at least one complementary means for absolute movement of the group of two rigid plenums relative to the mobile supporting chassis. So that that mobile aeraulic isolation device with mobile plenums of the invention is easily recognizable in that its first rigid plenum and its second rigid plenum for air diffusion are both mobile, both relative to one another and relative to the chassis.
In the remainder of the description and drawings, three different variants of embodiment of the invention will be described, differing in the nature of the combined kinematics:
Therefore:
a show a first variant of embodiment of a mobile aeraulic device (1a) of the invention provided with:
a is an upper rear perspective view of a mobile aeraulic isolation device 1A (of standard plenum width type) in open position (fixed in use) covering a hospital bed.
b is an upper rear perspective view of a mobile aeraulic isolation device 1a (of large plenum width type) in open position (fixed in use) covering a hospital bed.
a and 6b are left upper(overhead) rear perspective views of the diffuser and of a mobile aeraulic isolation device 1a in open position (fixed in use).
a to 9h are rear upper perspective views of the different phases of setting up a mobile aeraulic isolation device 1a from closed position (for floor movement) to open position (fixed in use):
a: in floor movement position, global recessed vertical position of the plenums, with downstream plenum folded drawer fashion inside the upstream plenum, feet raised,
b: global recessed position, with downstream plenum folded, feet lowered,
c: global recessed position, with downstream plenum folded, feet lowered, shoe blocks resting
d: global intermediate position with downstream plenum folded, and partial rotation of the group of two plenums,
e: global horizontal forward position of plenums, with downstream plenum folded,
f: global horizontal, forward position of plenums, with downstream plenum half-opened,
g: global horizontal forward position of the plenums, with downstream plenum opened and covering a bed,
h: in use mode with curtains and covering a bed.
a and 16b are left views and in upper rear perspective of the diffuser and mobile aeraulic isolation device 1b in open position (fixed in use).
a to 19h are an upper rear perspective views of the different phases in setting up a mobile aeraulic isolation device 1b from a closed position (floor movement) to the open position (fixed in use).
a: in floor movement mode, global vertically recessed position of plenums with downstream plenum folded against the upstream plenum, feet raised,
b: global recessed position, with downstream plenum folded, feet lowered,
c: global recessed position, with downstream plenum folded, feet lowered, shoe blocks resting
d: intermediate global position with downstream plenum folded and partial rotation of the group of two plenums,
e: global horizontal forward position of the plenums with downstream plenum folded,
f: global horizontal forward position of the plenums with downstream plenum half-opened,
g: global horizontal forward position of plenums with downstream plenum opened and covering a bed,
h: in-use mode with curtains, covering a bed.
a and 26b are left views in upper front perspective of the diffuser of a mobile aeraulic isolation device 1c in open position with hoods dismounted.
a is a front perspective view of a mobile aeraulic isolation device 1c in closed position, hoods removed.
b is a front perspective view of the hoods of a mobile aeraulic isolation device 1c in closed position.
a to 28f show the different phases in setting up a mobile aeraulic isolation device 1c, from closed position (so-called floor movement position) to open position (so-called fixed in use position):
a: closed position next to a hospital bed, left view,
b: semi-closed position with rotation axis of plenums brought forward, front perspective view,
c: semi-closed position: with rotation axis of plenums brought forward and front plenum raised and fixed, front perspective view,
d: open position, with rotation axis of plenums brought forward, front and back plenums raised and fixed, hoods partially open, in bottom position, front perspective view,
e: open position with rotation axis of plenums brought forward, front and rear plenums raised and fixed, hoods closed, in top position, front perspective view,
f: opened, top position on hospital bed, rear perspective view.
a is a detailed view in upper front perspective of the sliding means for the rotation axis of the mobile plenums and of the means for locking the front plenum relative to the chassis.
b is a detailed view in rear perspective of the mobile, releasable interlocking means of the mobile plenums.
a and 30b are front perspective partial left side views of the chassis alone in closed position.
a is detailed rear perspective view showing the air intake of the physical decontamination means and the base of the chassis.
b is a schematic diagram of the principle of inner organization of the physical decontamination means.
a show a mobile aeraulic isolation device 1a of the invention in a first variant of embodiment comprising:
A mobile aeraulic isolation device 1a according to this first variant of the invention is shown: in global closed position, so-called floor movement position M in
It will be noted that the mobile aeraulic isolation device 1a is equipped with a twin-block air diffusion chamber (or diffuser) 4 of variable geometry type. With reference to
With reference to
In a so-called open relative position (OP) shown in
In another closed relative position (CL) shown in
In exploded view
As shown in
One first essential provision, characteristic of the invention is apparent in
A second essential provision, characteristic of the invention is that the opening kinematics of mobile aeraulic isolation device 1a via the combination of relative movement means 10 and absolute movement means 13 make it possible to position mobile plenums 5,6 in at least two global positions relative to chassis 12.
In a so-called fixed in-use global position U regarding sensitive area 2 shown in
In the other global position, so-called floor movement position M, shown in
With reference to
A fourth provision, characteristic of the recommended use of mobile aeraulic isolation device 1a of the invention lies in the fact that its relative movement means 10 for plenums 5,6 shown in more detail in
A fifth provision, characteristic of recommended use of the mobile aeraulic isolation device 1a of the invention, consists of providing it with complementary sealed closing means 300 in closed relative position CL. These are shown in
A sixth provision, characteristic of recommended use of the mobile aeraulic isolation device 1a of the invention is shown in
A seventh provision, characteristic of recommended use of the mobile aeraulic isolation device 1a of the invention is shown in
An eighth provision, characteristic of recommended use of the mobile aeraulic isolation device 1a of the invention is also shown in
A ninth provision, characteristic of recommended use of the mobile aeraulic isolation device 1a is shown in
A tenth provision, characteristic of recommended use of the mobile aeraulic isolation device 1a is described with reference in particular to
Fixed portions 131, 134 of lower fork 126 of mobile trolley 125 have wheels 141,142,143,144 with a horizontal rotating axis Ir. Mobile portions 133, 136 are fitted with support shoes 335, 336 to improve the equilibrium of the device 1a when in in-use position U such as described in
An eleventh provision, characteristic of recommended use of the mobile aeraulic isolation device 1a, is described with particular reference to
A twelfth advantageous provision for use of the mobile aeraulic isolation device 1a is described with reference to
A thirteenth advantageous provision for use of the mobile aeraulic isolation device 1a is that, in complementary fashion, the other side surfaces of the two curtains 151,152 are provided, substantially at mid-height, with holes whose closure can be deactivated 340. This enables the passing of small-sized items required for patient care such as trays, instruments. In the embodiment described in
A fourteenth advantageous provision for use of the mobile aeraulic isolation device 1a concerns the configuration of its aeraulic means described in
A fifteenth advantageous provision for use of the mobile aeraulic isolation device 1a is shown in
Preferably, these muffling means 313 for air-conveyed noise are made up of two groups of muffling elements 313a, 313b positioned inside vertical column 331 of chassis 12 of which one 313a is positioned upstream and the other 313b is positioned downstream from the air pressurizing means 25. The muffling means 313 for air-conveyed noise are preferably according to the invention formed of panels 316 in sound-absorbing material. For this purpose a microbiologically neutral material is advantageously used, such as glass wool panels whose two surfaces and edges are coated with a protective PTFE film. One provision recommended by the invention is that muffling means 313 for air-conveyed noise are made up of:
A sixteenth advantageous provision for use of the mobile aeraulic isolation device 1a, concerns an industrial embodiment of the lower air diffusing surface 7,8 of the two mobile plenums 5,6 of the mobile aeraulic isolation device 1a described in
With reference to
An aeraulically decontaminated hospital bed 190 of the invention is formed by the combination between:
An aeraulically decontaminated hospital bed 190 of the invention is recognisable in particular by the fact that its rigid plenums 5,6 are mobile relative to one another and both plenums are mobile relative to chassis 12 of the mobile aeraulic isolation device 1a, 1b, 1c.
One configuration preferred by the invention for an aeraulically decontaminated bed 190 is remarkable in that mobile chassis 12 of the mobile aeraulic isolation device 1a and its decontamination means 20,21,22,23 are arranged at the foot of bed 191, and in that the second rigid downstream mobile plenum 6 for air diffusion the furthest away from chassis 12 is positioned on the side of and above the head of bed 191.
a describes a mobile aeraulic isolation device 1a in use position U, in which the width of the plenums is substantially equal to the width of bed 191 it is to protect.
A seventeenth advantageous provision for use of the mobile aeraulic isolation device 1a is described in
With this provision it is possible to protect the sensitive area, such as the patient and the bed together with accessories, furniture (chair, console, hygiene equipment, . . . ) and monitoring or treatment devices. This also allows attending staff or visitors to be included under the flow, thereby limiting opening and closing of the curtains and providing improved protection.
A mobile aeraulic isolation device 1b according to this second variant of the invention is shown: in global closed position, so-called floor movement position M in FIG. 11—and in global open position, so-called fixed in-use position U covering a medical bed 191 in
It will be seen that the aeraulic isolation device 1b of this second variant identically reproduces most particular aspects of aeraulic isolation device 1a described above in the first variant. The common elements are denoted with the same references in drawings 11 to 20. It appears unnecessary to repeat their description.
AN eighteenth advantageous provision for use of the mobile aeraulic isolation device 1b is seen in FIGS. 13,14 and 15. Its relative movement means 10 for plenums 5,6 is formed by a relative rotation axis 11a around a hinge connected respectively to each of the first two contact ends 5c, 6c of the envelope of plenums 5,6.
This hinge forming the relative rotation axis 11a is shown in more detail in
A nineteenth advantageous provision for use of the mobile aeraulic isolation device 1b is shown in FIGS. 13,14,16 and 17. The mobile aeraulic isolation device 1b comprises mobile releasable means 17,305,306 for relative interlocking of rigid plenums 5,6 in their relative movement. They are formed of interlocking elements 305a, 305b, 306a, 306b integral with plenums 5,6 ensuring firstly their locking in open relative position OP, so that mobile plenums 5,6 are coupled rigidly and hermetically and their first and second diffusing surfaces 7,8 are coplanar, and ensuring secondly their unlocking for placing in closed relative position CL. It will be seen that the different interlocking elements 305a, 305b, 306a, 306b of this mobile releasable relative interlocking means 17 of plenums 5,6 are integral with plenums 5,6 and fully mobile relative to mobile supporting chassis 12 via relative movement means 10 and complementary absolute movement means 13.
a show a mobile aeraulic isolation device 1c of the invention in a third variant of embodiment comprising:
A mobile aeraulic isolation device 1c of this third embodiment is shown: in closed global position, so-called floor movement position M in
It is seen that the aeraulic isolation device 1c of this third variant identically reproduces most of the particular aspects described above for the first variant 1a of the invention. The common elements are denoted with the same references in drawings 21 to 33a. It appears unnecessary to repeat their description.
The aeraulic isolation device 1c comprises relative movement means 10 for the plenums formed of: two hinges 9a, 9b integral with two abutting edges of plenums 5,6, and pivots 19a, 19b shown in
With reference to
In the variant of the invention shown in the drawings and recommended by the invention, the first rigid upstream plenum 5 and the second rigid downstream plenum diffusing air are both mobile and adjustable relative to chassis 12 in two distinct relative positions.
In fixed in-use position U above bed 191 shown in
In the other floor movement position M shown in FIGS. 21,27b, the floor projection surface PM1 of the first mobile diffusing surface 7 of the first mobile plenum 5 and floor projection PM2 of the second mobile diffusing surface of the second mobile plenum 6 are zero and are therefore of minimum size LM1,LM2. The two diffusing surfaces 7,8 are vertical.
Relative movement means 10 formed of two hinges 9a, 9b and pivots 19a, 19b shown in
Physical air decontamination means 20 of moving air crossing through them ensure decontamination of airborne aerosols. In the variant shown, air pressurizing means 25 are seen,
Also, aeraulic connection 30 and air circulation means aeraulically connect air pressurizing means 25, physical air decontamination means 20 and the two rigid air diffusing plenums 5,6 of air diffuser 4. They force the airflow F to pass through the porous air diffusing surfaces 7,8.
With reference to
With reference to
Horizontal sliding means 13 of rotation axis 11b of plenums 5,6 relative to frame 12 are fitted to device 1c. They are formed of two extendable horizontal slide rails 14a, 14b of “drawer” type integral with the chassis and positioned in its upper part. The two pivots 19a, 19b slide horizontally on rollers along and between the two slide rails 14a, 14b.
In floor movement (or closed) position M shown in
With reference to
With reference to
Referring to
Their bending at hinge 10 is guided by shaped parts 230a, 230b described below. Retraction of springs 211a, 211b offsets the weight of plenums 5,6 and aids their extension until they reach their coplanar in-use position U.
Shown in transparency in
In
With reference to
a, 26b show that the first 5 and second 6 rigid air-diffusing plenum are each formed of a group G1,G2 of at least one closed, air-distribution diffusing caisson 71,72,73. The front plenum 5 is formed of one diffusing caisson 71. Downstream plenum 6 is formed of two caissons 72,73. Each closed diffusing caisson 71,72,73 has a so-called diffusing surface 7,8a, 8b covered by a wall in diffusing material 81,82,83 porous to air. As shown in detail in
a shows that device 1c comprises means 121 for horizontal movement of physical decontamination means 21,22,23 relative to supporting chassis 12. These are formed of two slide rails 122,123 that are horizontal and integral with chassis 12 on which a mobile frame 124 slides horizontally. Physical decontamination means 21,22,23 are positioned on and fixed onto mobile frame 124.
It is seen that horizontal movement means 121 for physical decontamination means 21,22,23 relative to supporting chassis 12 have two extreme positions. In in-use position U shown in
a, 31, 32 show that mobile supporting chassis 12 comprises a lower mobile trolley 125 that is fork-shaped 126. It is formed of two horizontal, parallel supporting arms 127,128 distant from one another. The supporting arms 127,128 of chassis 12 are formed of several horizontal portions 131,132,133,134,135,136 connected together and mobile relative to one another. In the version recommended by the invention shown in
In
With reference to
In another variant (not shown) vertical channelling means 150 for airflow may be formed of curtains sliding on a rail positioned at the lower part 167 and on periphery P of air diffuser plenums 5,6.
In a further variant (not shown) these channelling curtains comprise a plurality of abutting parallel strips. This facilitates hand access for medical staff to attend a patient in the bed protected by the system 1c.
In another variant (not shown) vertical channelling means 150 for airflow also comprise a combination of: detection means (of movement of persons and/or increase in contamination)—and activation means for the level (and/or position relative to plenums) of vertical channelling means 150 of airflow in relation to the measurement taken by the detection means. This makes it possible only to activate the air channelling means, in particular to lower or slide the curtains into active position, when a visitor is present or when there is movement inside the room which risks increasing contamination.
In the configuration recommended by the invention, it is seen in
b is a schematic diagram of a recommended example of configuration of physical decontamination means 20. Thy are contained inside a metal parallelepiped envelope 200. The air derived from foot end 197 of bed 191 enters via an air intake 194 fitted with a coarse disposable pre-filter 201. The coarse pre-filter 201 is intended to block large particles, “fluff”, textile dust . . . which may be present under bed 191. The air then passes through an inlet noise muffler 202, then an electric fan 25, an outlet noise muffler 203 and finally through air sterilisation reactor 204 before reaching the outlet collar 205 which is connected to one of aeraulic lines 101 supplying one of the plenums.
Preferably, the invention recommends using a sterilisation reactor of the type described in patent U.S. Pat. No. 5,474,600 “apparatus for biological purification and filtration of air”. Preferably a device for amplifying electrostatic fields will be used of the type described in French patent application FR 99 14899 and an ionic emission device of the type described in French patent application FR 00 16607.
a to 28f describe the opening sequence of device 1c from its floor movement position M to its fixed in-use position U.
On the basis of the described invention, the applicants have developed a mobile protective isolation device for immunocompromised and/or fragile persons called ImmunAIR™. This device is equipped with 4 physical decontamination means of the type described above. When in in-use position U, it can cover and protect a hospital bed with a size of: length 2.4 m, width: 1.05 m by means of a uniform sterilised vertical airflow at low speed 640 m3/hour, i.e. approximately 210 sterilised air changes per hour within the 3 m3 of isolator covering the bed. In the room of an immunocompromised patient occupying the bed, it can also generate a vertical airflow of 640 m3/hour ensuring 25 sterilised air changes per hour in the room. It forms a “mobile sterile room” which can be set up or taken down in less than 10 minutes.
In folded floor movement position M, its vertical cross size is: width 0.760 m and height 1.98 m. So that the device can easily be passed through a doorway of standard size: width 0.8 m and height less than 2 m.
By means of the so-called PLASMER sterilisation technique described above, the aeraulic load loss is approximately 250 Pascals and the noise level is 43 DB. It ensures destruction of mycoses, bacteria, spores and viruses in the room.
Tests in hospital rooms, initially with massive contamination (>300 cfu/m3 bacteria and 285 cfu/m3 in fungi) have shown complete biodecontamination under the airflow for total flora (bacteria) and fungi in less than 20 minutes. Repeated measurements under the flow for several hours have shown stability over time of absolute decontamination at less than 1 cfu/m3. In a room with average contamination (29 cfu/m3 total flora and 38 cfu/m3 fungi) room decontamination was ascertained (outside the flow) in less than 20 minutes to reach stabilised contamination values of less than 4 cfu/m3 total flora and <2 cfu/m3 fungi.
In a hospital environment, the device can substitute for laminar flow rooms for the protective isolation of weakened or immunosuppressed patients. It can also, for an investment that is approximately 4 times less and operating costs that are 5 to 10 times less, substitute for laminar flow clean rooms to provide protective isolation equipment in: district hospitals, clinics and functional rehabilitation centres for immunosuppressed patents. Finally it can be used for early home discharge of immunosuppressed or aplasic patients.
The applications of the protective isolation device of the invention firstly concern haematology departments for aeraulic protection of patients undergoing bone marrow homografts and in haemopathy cases leading to severe neutropaenia. In oncology departments, it is recommended for patients with solid tumours that are particularly unresponsive and require aggressive chemotherapy or extended high dose corticotherapy. It is of particular use in serious burns departments. Finally, it is recommended in intensive care units, in particular for patients undergoing immunosuppressive treatment for solid organ transplants and patients requiring transient intensive care subsequent to haemopathy with therapeutic aplasia.
In the entire above description, particular attention was focused on aseptic isolation of immunosuppressed patients. The airflow in this case is directed from the diffusers towards the area over the bed. It will easily be understood that the invention also adapts to septic isolation of contagious patients by reversing the direction of airflow.
One first advantage of the mobile aeraulic isolation device with variable geometry air diffuser and two mobile plenums according to the invention is that it can be used to form a mobile room with absolute sterility, that can be provisionally installed inside a patient's room and folded up into a size enabling it to pass through a standard doorway approximately 205 cm high and 80 cm wide, i.e. approximately 81 inches×31 inches. This means that the device of the invention can be used for home medical care, especially to treat immunosuppressed patients at home.
A second advantage of the device of the invention is that the effective width of the plenums it uses is not limited by the width of doors through which it must pass through. So that the volume of protection surrounding the patient is not itself limited. This is beneficial to patient comfort and protection.
A third advantage of the device of the invention is that it leaves the head of the patient's bed entirely free and in no way hinders the positioning of medical technical equipment placed at the top of the bed (monitoring devices, resuscitation devices, gas outlets . . . )
A fourth advantage of the device is that it provides greater stability when in use.
A fifth advantage of the device is that its mobile geometry can offset displacement of the centre of gravity to the free end of the device when the two plenums are joined in in-use position, to increase its stability.
A sixth advantage of the device is that by means of its mobile accessory curtains it can improve air pressure over the bed and accelerate evacuation of parasite contamination. They stop the penetration into the sensitive bed area of Pflügge droplets emitted by visitors or attending staff when speaking, coughing or sneezing. They facilitate visitor and personnel accesses to the bedside of highly immunosuppressed patients.
A seventh advantage of the device is that its aeraulic design makes it less noisy and less energy-consuming.
An eight advantage is to enable mobility through any doorway or window and hence great adaptability from one hospital room to another and/or from one hospitalised patient's home to another. So that it ensures greater capacity of use and better amortization of operational costs.
A ninth and chief advantage of the invention is that, in closed floor movement position, the size of the device is much smaller than that of devices of the prior art which can cover and protect a bed. This provides better mobility.
The scope of the invention is to be considered more in relation to the following claims and their legal equivalents than to the examples given above.
| Number | Date | Country | Kind |
|---|---|---|---|
| 01 16851 | Dec 2001 | FR | national |
| Filing Document | Filing Date | Country | Kind | 371c Date |
|---|---|---|---|---|
| PCT/FR02/03436 | 10/9/2002 | WO | 00 | 1/18/2005 |
| Publishing Document | Publishing Date | Country | Kind |
|---|---|---|---|
| WO03/056253 | 7/10/2003 | WO | A |
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| 6099607 | Haslebacher | Aug 2000 | A |
| 6162118 | Arts et al. | Dec 2000 | A |
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| 23 43 015 | Feb 1975 | DE |
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| 1 295 551 | Nov 1972 | GB |
| WO 85 04240 | Sep 1985 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 20050136827 A1 | Jun 2005 | US |
