The field includes a warming device constituted of a clinical garment with a flexible inflatable convective apparatus supported on an inside surface of the garment for warming peripheral parts of the patient when the apparatus is inflated with warmed air.
Intraoperative hypothermia due to anesthetic redistribution is difficult to treat mainly because it is the result of large internal heat flows from the core to the peripheral thermal compartments and not by the relatively low heat transfer rate from the cutaneous surface. For this reason, patient warming before surgery (“prewarming”) with inflatable convective thermal devices is used to prevent hypothermia due to redistribution during surgery. Examples of such devices include inflatable thermal blankets such as are sold by Arizant Healthcare Inc. under the BAIR HUGGER® brand. It is often desirable that the thermal device used for prewarming also be available to warm the patient during and after surgery. However, during intraoperative use, thermal blankets must be removed or rearranged to allow access to the operative field. Typically, if the patient is hypothermic following surgery, another thermal blanket must be used to re-establish normothermia.
Recently-developed perioperative convective warming technology has increased the versatility of convective clinical warming by combining inflatable convective apparatuses with clinical garments. Examples include patient warming gowns such as are sold by Arizant Healthcare Inc. under the BAIR PAWS® brand. In this regard, a “patient warming gown” is a warming device constituted of a clinical gown equipped with at least one inflatable convective warming apparatus attached to the gown. A patient wearing the gown is warmed by circulation of thermally-conditioned air emitted into the gown from a convective apparatus. Patient warming gowns are exemplified by the warming devices described and claimed in U.S. Pat. Nos. 7,226,454; 7,276,076; 7,364,584; 7,819,911; 7,846,192; 7,862,599; 8,070787; and, 8,192,475.
Patient warming gowns can simplify the perioperative warming process and save money by eliminating the costs and procedures of buying, storing and using multiple items like cotton gowns, cotton blankets, and inflatable thermal blankets. A single patient warming gown can warm many types of medical procedures, including those involving upper body, torso, or lower body. Nevertheless, there is still a need for greater versatility in warming more specialized procedures, such as those involving thoracic, abdominal, or pelvic access.
A patient warming gown with peripheral warming is constituted of a clinical garment with a convective apparatus supported on an inside surface of the garment for warming one or more limbs when the apparatus is provided with warmed air. The convective apparatus includes a central member, one or more peripheral diffusers, and one or more non-kinking flexible ducts. Each duct connects a peripheral diffuser with the central member. One or more inlet ports are provided in the convective apparatus to receive the end of an air hose.
The central member of the convective apparatus is attached to the inside surface of the clinical garment. An inlet port opens through the garment into space within the central member. The diffusers may be folded, rolled, or contracted and retained on the garment and then unfolded or unrolled or expanded and deployed for operation when needed.
The convective apparatus is constituted of flexible fabric parts which are assembled to form inflatable structures in the central member, the diffusers, and the ducts. In response to a stream of pressurized air flowing into the convective apparatus through an inlet port, the central member inflates. In some aspects, the central member has a permeable wall and emits air through the air-permeable wall when inflated. When a diffuser is unfolded, unrolled, or expanded, air flowing from the central member, through a duct to the diffuser, inflates both of those parts and is emitted through an air-permeable wall in the diffuser.
A patient dons the patient warming gown. An air hose coupled to an inlet port conducts a stream of warmed pressurized air into the inflatable structure in the central member, causing the central member to inflate. If the ducts and diffusers are folded, rolled, or contracted and retained, the patient is warmed principally by the central member. Alternatively, one or more of the peripheral diffusers can be released, unfolded and deployed to also warm the patient peripherally.
A device for warming the body of a person to provide thermal therapy and/or thermal comfort includes a clinical garment and at least one convective apparatus supported on an inside surface of the garment. In this regard, a “clinical garment” is a garment that is typically used to temporarily clothe a patient in a clinical setting. Examples of a clinical garment include patient gowns, hospital gowns, examination gowns, and other equivalents. The clinical setting may be a medical or dental office or clinic, a hospital, or any facility or institution that provides medical or dental treatment to patients. A convective apparatus receives and distributes at least one stream of warmed pressurized air in a structure for being disposed on, adjacent, or next to the core and/or the limbs of a body. When pressurized with warmed air, a convective apparatus emits warmed air through one or more permeable walls.
The preferred clinical garment is a hospital gown. With at least one convective warming apparatus supported on an inside surface of the gown, the device is referred to as a “patient warming gown.”
In one aspect, a patient warming gown may be worn by a person where it receives a stream of warmed pressurized air, distributes the pressurized air within a convective apparatus, and emits the air through one or more permeable walls of the convective apparatus to warm the person's body.
In another aspect, the patient warming gown may be employed to provide therapeutic warming during surgery. In this regard, the patient warming gown may be adapted for therapeutic warming by operating the convective apparatus for use intraoperatively while the clinical garment is adjusted so as to provide access to the surgical site.
In some aspects of the patient warming gown illustrated and discussed below, convective apparatuses are inflatable. That is, their structures, flaccid when not in use, tauten when receiving a stream of pressurized air.
Refer now to the figures, in which a person 11 wearing a patient warming gown 20 with provision for peripheral warming is illustrated in
With reference to
In response to inflation, pressurized air is emitted through the air-permeable walls 62 and 64.
In some aspects, the convective apparatus 60 is configured prior to use as shown in
In some aspects each folded diffuser of a second pair of peripheral diffusers 63b fits into an area of the inside surface 43, above the lower hem 47 of the clinical garment 22. The folded peripheral diffusers 63b may be retained by, for example, tape 66 acting between inside surface 43 and the folded diffusers. The folds are preferably made so as to position the diffusers 63b between the lower hem 47 and the pair of ducts 65b that are connected to the diffusers. In this manner, the peripheral diffusers 63b are releasably retained on the clinical garment, preferably inside a lower portion of the garment 22, on the lower surface. Generally, the diffusers of the pair of diffusers 63b may be folded, rolled or gathered in any way that achieves the desired length reduction and neat compaction useful for stowing and retention of the diffusers 63b, and unfolding them for deployment to the legs of a person. In this manner, the peripheral diffusers 63b are releasably retained on the clinical garment, preferably in a folded configuration, on a lower portion of the inside surface 43.
With reference to
With reference to
An inflatable convective device 60 shown in the figures and described herein may be constructed using techniques and materials which are known in the art, or which are equivalent thereto. The specific details of construction and materials that are described are meant for illustration only. The convective apparatus 60 is formed or assembled separately from the clinical garment and then attached to its inside surface by tape, sewing, gluing, heat sealing, hook-and-loop, adhesion, stiction, or welding, or any combination of these. Generally, the construction and materials with which the central member 61 and peripheral diffusers 63 of the inflatable convective device 60 may be made include two or more sheets of flexible material that are brought together and bonded, joined, or sealed at a periphery to form inflatable space. Within the peripheral seals, the shapes and airflow characteristics of the inflatable space are established by stake points, and/or elongate seals. The sheets of material of which these elements are formed may be made of synthetic or natural materials, or a natural/synthetic blend. The sheet or sheets forming one side of an inflatable structure are made, or processed, to form an inflatable structure having an air-permeable wall with a surface through which pressurized air that inflates the structure, circulates, passes or exits toward the body of a person clothed in the clinical garment. Inlet ports, with provision for retention of an air hose nozzle, are provided for admitting a stream of warmed, pressurized air into the pneumatic structure, from an air hose connected to a heater/blower unit. The warmed air circulating through the surface causes the person to be warmed. Although convection is the principal mode of warming, the structure itself, when inflated with warmed air, radiates heat as well. Further, where the structure contacts the person's body, heat may also be transferred by conduction. Illustrative examples of inflatable thermal device construction and operation are described in U.S. Pat. Nos. 7,520,889 and 7,871,428. Illustrative examples of heater/blower construction and operation are described in U.S. Pat. Nos. 6,876,884; 7,819,911; and 7,976,572. While a convective device can be supported on an inner surface of the garment, as illustrated in
With reference to
In some aspects, the elements 61, 63, and 65 of the convective device 60 are constructed as separate pieces and then joined together by bonding, joining, or sealing. In other aspects, automated manufacturing techniques and machines may be adapted, built, developed, and/or assembled to continuously form convective devices, and to join them with clinical garments. See U.S. Pat. No. 8,192,475 in this regard.
FIGS. 1 and 5-7 illustrate methods with which the patient warming gown 20 is used for warming the periphery of a person during a perioperative sequence. In
Various phases of the perioperative cycle are shown in
In
In
The openings 80 in the clinical garment 22 that are seen in
During the post-operative phase, the openings 80 can be closed by tape so as to retain warmed air around the patient, and the patient can be warmed by operation of the central member 61 and any one or more of the peripheral diffusers 63.
Manifestly, the ducted construction of the convective device 60 provides significant convenience during the intra-operative phase. The lateral positioning of the ducts 63b with respect to the axis 49 of the clinical garment affords unimpeded access through the clinical garment to the patient's abdominal, pelvic, and upper thigh areas. Separation of the constructions of the diffusers 63 and ducts 65 from the clinical garment provides great flexibility in positioning those elements with respect to the clinical garment and the locations of the patient's limbs during and after surgery. The pleated ducts permit the peripheral diffusers to be moved in several planes of rotation so that the diffusers remain inflated.
Embodiment 1. A warming device, comprising: a clinical garment having a surface; and, an inflatable convective warming apparatus on the surface; wherein, the convective warming apparatus includes an inflatable central member attached to the surface, at least one inlet port, and at least one permeable peripheral diffuser that is separate from the clinical garment and coupled to the central member by a pleated, non-kinking duct.
Embodiment 2. The warming device of Embodiment 1, wherein the at least one permeable peripheral diffuser is releasably retained in a folded, rolled, or contracted configuration on the clinical garment.
Embodiment 3. The warming device of Embodiment 1 or 2, wherein the at least one permeable peripheral diffuser and the duct are inflatable.
Embodiment 4. The warming device of Embodiment 3, wherein the central member and the at least one peripheral diffuser have respective air-permeable walls.
Embodiment 5. The warming device of Embodiment 4, wherein the duct is non-permeable.
Embodiment 6. The warming device of any one of Embodiment 1 to Embodiment 5, wherein the at least one permeable diffuser includes at least two permeable diffusers, each coupled to the central member by a respective non-permeable duct, and each positioned on the clinical garment to align with a respective arm of a patient.
Embodiment 7. The warming device of any one of Embodiment 1 to Embodiment 6, wherein the at least one permeable diffuser includes at least two permeable diffusers, each coupled to the central member by a respective non-permeable duct, and each positioned on the clinical garment to align with a respective leg of a patient.
Embodiment 8. A warming device, comprising: a clinical garment having a surface; and, an inflatable convective warming apparatus on the surface; wherein, the convective warming apparatus includes an inflatable central member attached to the surface, at least one inlet port, at least one pair of air-permeable peripheral diffusers that are detachable from the clinical garment, and at least one pair of circumferentially pleated ducts, each duct connecting a respective air-permeable diffuser to the central member.
Embodiment 9. The warming device of Embodiment 8, wherein each air-permeable peripheral diffuser is releasably retained in a folded configuration on the clinical garment.
Embodiment 10. The warming device of Embodiment 8 or Embodiment 9, wherein the air-permeable peripheral diffusers and the ducts are inflatable.
Embodiment 11. The warming device of Embodiment 10, wherein the central member and the air-permeable peripheral diffusers have respective air-permeable walls.
Embodiment 12. The warming device of Embodiment 11, wherein the ducts are non-permeable.
Embodiment 13. The warming device of any one of Embodiment 8 to Embodiment 12, wherein the air-permeable diffusers are positioned on sleeves of the clinical garment to align with the arms of a patient.
Embodiment 14. The warming device of any one of Embodiment 8 to Embodiment 13, wherein the air-permeable diffusers are positioned near a lower hem of the clinical garment to align with the legs of a patient.
Embodiment 15. The warming device of any one of Embodiment 8 to Embodiment 14, wherein the at least one pair of air-permeable peripheral diffusers includes first and second pairs of air-permeable peripheral diffusers that are separable from the clinical garment, and the at least one pair of ducts includes first and second pairs of ducts, in which each duct of the first pair of ducts connects a respective air-permeable diffuser of the first pair of air-permeable peripheral diffusers to the central member; and, each duct of the second pair of ducts connects a respective air-permeable diffuser of the second pair of air-permeable peripheral diffusers to the central member.
Embodiment 16. The warming device of Embodiment 15, wherein the first pair of air-permeable diffusers are positioned on sleeves of the clinical garment to align with the arms of a patient and the second pair of air-permeable diffusers are positioned near a lower hem of the clinical garment to align with the legs of a patient.
Embodiment 17. A method of operating a warming apparatus including a clinical garment with an inflatable convective warming apparatus on a surface of the clinical garment in which the convective warming apparatus includes an inflatable central member attached to the surface, at least one inlet port, and at least one permeable peripheral diffuser coupled to the central member by a duct, comprising: disposing the clinical garment on a person; deploying the permeable peripheral diffuser on a leg of the person; and providing a stream of warmed, pressurized air into the central member.
Embodiment 18. The method of Embodiment 17, wherein the permeable peripheral diffuser is releasably retained on the clinical garment and deploying the permeable peripheral diffuser includes releasing the permeable peripheral diffuser from the clinical garment, and placing the permeable peripheral diffuser on the leg.
Embodiment 19. A method of operating a convective warming apparatus including a clinical garment with an inflatable convective warming apparatus on a surface of the clinical garment, in which the convective warming apparatus includes a permeable central member attached to the surface, at least one inlet port in the central member, and at least one permeable peripheral diffuser coupled to the central member by a duct, comprising: retaining the permeable peripheral diffuser in a folded configuration in the clinical garment; disposing the clinical garment on a person; unfolding the permeable peripheral diffuser; and, placing the permeable peripheral diffuser over a leg of the person.
Embodiment 20. The method of Embodiment 19, further including connecting an air hose to the inlet port, and providing a flow of heated air through the air hose.
Various modifications and alterations to this invention which do not depart from its scope and spirit will become apparent to those skilled in the art. Consequently, it should be understood that this invention is not intended to be unduly limited by the illustrative embodiments and examples set forth herein and that such examples and embodiments are presented by way of example and that the scope of the invention is intended to be limited only by the claims set forth herein as follows.
Filing Document | Filing Date | Country | Kind |
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PCT/US2013/067475 | 10/30/2013 | WO | 00 |
Number | Date | Country | |
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61736863 | Dec 2012 | US |