Patent Application
20100071137
The present invention is directed to a fluid bladder mattress system.
Inflatable therapeutic supports for patients have been well known for many years. Such therapeutic supports include inflatable mattresses and cushions.
Most therapeutic supports are designed to reduce “interface pressures.” Interface pressures are the pressures encountered between the therapeutic support and the skin of a patient positioned on the therapeutic support. It is well known that interface pressures can significantly affect the well-being of immobile patients in that higher interface pressures can (a) reduce local blood circulation, (b) cause bed sores and (c) cause other medical complications. With inflatable mattresses, such interface pressures depend (in part) on the air pressure within the inflatable bladders.
Every inflatable therapeutic support has at least one bladder. That bladder has a top surface capable of receiving an object like a patient, a bottom surface that is opposite the top surface, and at least one side surface positioned between the top and bottom surfaces. The bladder surfaces can be a fluid impermeable material, fluid permeable material or combinations thereof depending on the desired application. For example, the bladder material can be a polymeric material, for example, vinyl, polyethylene, polyurethane or combinations thereof. The bladder can be made from a single piece of material or a plurality of materials to obtain the desired results. These various surfaces define a bladder cavity that receives a fluid.
The bladder cavity receives the fluid, normally air or an aqueous solution, through an inlet from a fluid source. The fluid travels from the fluid source through a conduit(s) and the fluid's flow, flow rate, and temperature (those characteristics and others are commonly referred to as therapeutic fluid traits) are normally controlled by a control unit.
The control unit, for example, has a plurality of input keys interconnected to at least a microprocessor. The patient or patient's caregiver essentially controls the therapeutic fluid traits through the input keys. The term input keys means a keyboard system, switches, software chips, levers, dials or any other conventional device that is used as an input device by the patient or patient's caregiver to control the operation of the therapeutic fluid traits.
In the microprocessor embodiment, the microprocessor receives the desired instructions from the input keys. From those instructions, the microprocessor processes those instructions to transmit the desired signals to operate a pump, an air compressor, a heater, a cooler, a fan, valves and/or switches that push, pull and/or allows (by potential energy contained in the bladder(s)) a fluid into, through or to pass into a first conduit(s) to the respective bladder(s) at the desired therapeutic fluid traits. Prior to entering the conduits, the fluid is contained within a heated reservoir, a cooled reservoir, an ambient reservoir, ambient environment and/or combinations thereof; a.k.a., fluid source.
From this fundamental understanding of inflatable bladders, the variations of bladders are evident. For example, some bladders (1) have the inlet removed after the fluid is inserted into the bladder cavity so the bladder is a self-contained, static bladder and (2) retain the inlet so the bladder is a dynamic bladder that can receive and/or release fluid from the bladder cavity.
In the dynamic bladder embodiment, the fluid exits the bladder through at least one outlet. In one version, the fluid exits the outlet (a.k.a., the inlet) through the first conduit to return to the fluid source. In other versions the fluid exits the outlet (not the inlet) through a second conduit to a receiving unit (distinct from the fluid source) or the fluid source. Another version has the surface of the bladder having a plurality of apertures designed to release a portion of the fluid (normally air) toward the object positioned above the inflatable bladder (a.k.a., low-loss bladder). Other outlet versions have combinations of the above-identified outlet versions.
There may be alternative embodiments to these generic descriptions of dynamic bladders and control units. The bladders may have alterations to (1) generate desired fluid flow patterns within the bladder, (2) obtain desired bladder firmness and (3) allow the bladder adaptability for the therapeutic support system. To obtain such results and others like it, the bladders could have predetermined button welds, welds, and slits along welds. Welds are locations where the bladder's top surface is connected to the bladder's bottom surface.
One example of a therapeutic patient support system having a therapeutic bladder is disclosed by Hand et al. in expired U.S. Pat. No. 5,606,754. Hand et al. disclose “a . . . patient support system [having] a rigid support frame [and] a plurality of inflatable [bladders] supported upon the support frame with each [bladder] having an upper surface so that the plurality of [bladders form] a patient support surface. The inflatable [bladders] are pressurized and maintained at a predetermined pressure. This predetermined pressure may be a patient height and weight specific pressure profile.” It is known that the bladders can be positioned horizontally (a.k.a., perpendicular to a patient properly positioned on the therapeutic support) and/or vertically (a.k.a., parallel to a patient properly positioned on the therapeutic support) in relation to the support frame. This therapeutic patient support system embodiment utilizes a standard therapeutic fluid bladder.
When the bladders on a standard support frame are positioned horizontally, the bladders can be divided into at least two sets (1-2-1-2) to provide wave therapy. Wave therapy is accomplished when (a) the first set of bladders receives fluid and, at the same time, the second set of bladders releases fluid; and then (b) the second set of bladders receives fluid and, at the same time, the first set of bladders releases fluid. That process causes a wave sensation under the patient. The wave therapy can occur with additional sets of bladders, for example “1-2-3-4-1-2-3-4”, “1-3-2-1-3-2” and variations thereof.
The wave therapy, in one embodiment, is accomplished by (a) the first bladder set interconnects to the control unit through a primary first conduit system; and (b) the second bladder set interconnects to the control unit through a secondary first conduit system. To obtain the desired wave therapy, the control unit positions a valve that transmits fluid to either the primary first conduit system or the secondary first conduit system in predetermined time frames to obtain the wave motion. The control unit can also alter the valve so the primary first conduit system and the secondary first conduit system receive fluid simultaneously if no wave therapy is desired.
Turn-assist bladder therapy is an obvious variation of a rotating bladder therapy. The rotating embodiment is used to decrease sores on immobile patients. An example of a rotating (turn-assist) therapy 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, Gaymar describes a rotating bladder system 10 having upper and lower right side rotating bladder(s) 12a,b and upper and lower left side rotating bladder(s) 14a,b positioned below a surface bladder 180. The rotating bladders rotate a patient positioned on the surface bladder by controlling the air pressure in the right set of rotating bladders and the left set of rotating bladders. The right rotating bladder set is inflated and deflated simultaneously; likewise the left rotating bladder set is inflated and deflated simultaneously. This is accomplished by having the bladders 12a,b interconnected to the control unit 20 through a first conduit 16 and the bladders 14a.b interconnected to the control unit 20 through a second conduit 18 as illustrated in
To rotate a patient 11 to its right side requires decreasing the air pressure in the right set of rotating bladder(s) 12a,b while increasing the air pressure in the left side rotating bladder 14a,b so the left side is higher than the right side as illustrated in
To rotate the patient to the patient's left side requires decreasing the air pressure in the left side rotating bladder(s) 14a,b and increasing the air pressure in the right side rotating bladder 12a,b, so it is opposite of what is illustrated in
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, e.g., 30 degrees, may rotate another patient, e.g., 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 and the control unit has to be controlled to provide the desired rotation for each patient.
As clearly set forth in Hill-Rom's U.S. patent application publication number 2006/0168736, turn-assist bladders and rotational bladders are essentially synonymous—“a turn-assist cushion or turning bladder or rotational bladder 74 . . . .” If there is a difference between a turn-assist bladder and a rotation bladder, the difference is in the software used in the control unit. In the rotation bladder embodiment, the control unit (1) has the bladders in a set position—planar which can be completely deflated or just partially inflated, (2) rotates the patient, through the bladders, in a first direction by inflating one set of rotating bladders (for example the right set), (3) reverts the bladders to the set position, (4) rotates the patient, through the bladders, in a second direction by inflating the other set of rotating bladders (for example the left set) and (5) reverts to the set position. The turn-assist bladder embodiment, in contrast, eliminates the third step. Accordingly, it seems relatively obvious that the technology for the turn-assist embodiment is an obvious variation of the rotation bladder embodiment by merely altering the software used in the control unit so the bladders are rotated from a first direction to a second direction without the intermediate step of reverting to a set position.
In the prior art and as previously described above, the upper section and the lower section for each right and left set of rotational (or turn-assist) bladders are inflated at the same time to obtain the desired rotation. Moreover, the rotational (or turn-assist) bladders are positioned below other bladders or other cushion materials. See FIG. 11 (rotational bladders 184, 188 are under cushion 180) in U.S. Pat. No. 5,794,289; FIGS. 17 to 19 (rotational bladders 145, 146, 147, 148 are under cushion 182) in U.S. Pat. No. 6,584,628; FIG. 3 (rotational bladders 80 are below cushion 60) in U.S. patent application publication number 2006/0168736; and FIG. 4 (rotational bladders 110 are positioned below cushions 33) in U.S. Pat. No. 6,499,167. In other words, the rotating (turn-assist) bladders are positioned below another cushion which the patient is designed to be positioned upon.
Like the standard bladder therapy system, the rotating bladder therapy system can also provide wave therapy. In most embodiments, the wave therapy, on a rotating bladder therapy system, occurs when (1) the rotating bladders are in the set position—generally planar—and (2) the wave therapy bladders are positioned above the rotating bladders. The wave therapy bladders are not the same as the rotating (turn-assist) bladders. Rotating (turn-assist) bladders do not perform wave therapy. One reason wave therapy is not performed by the rotating bladders is because the rotating bladders are positioned below another bladder.
Programming an air pressure cushion unit requires a skilled technician. The skilled technician analyzes each patient and alters the programming to attain the desired air pressure. One method to avoid the expensive technician's analysis and re-programming is to create a self-monitoring mattress.
Previous self-monitoring air pressure cushions have utilized electrical signal transmission devices and electrical signal receiving devices. In one embodiment, the transmission device is a part of the top surface of a bladder and the receiving device is a part of the bottom surface of the bladder. That means the transmission and receiving devices are separated by a bladder cavity. By monitoring the duration of the signal from the transmitter to the receiver, the operator can monitor the size of the bladder. The size of the bladder corresponds to the air pressure and, it desired, the rotation of the patient. Such signal devices are disclosed in U.S. Pat. No. 5,794,289. Those signal devices generate electrical signals, like rf signals, that may, however, adversely effect other medical equipment. In particular, Wortman et al. disclosed (without reference numbers):
[There] is illustrated an inflatable cushion which is shown to be similar to cushion but may be any other suitable inflatable cushion. The cushion is provided with button welds to prevent ballooning thereof. The cushion has upper and lower surfaces. Cushion inflation is related to the distance between the upper and lower surfaces.
In order to prevent bottoming-out from occurring and to more precisely regulate the cushion inflation, the cushion is inflated so that the distance between the upper and lower surfaces is a predetermined distance. A transmitter coil and a receiver coil are provided adjacent the upper and lower surfaces, and the distance there between is related to the signal strength of a signal transmitted there between. Alternatively, the coil may be provided adjacent the lower surface, and the coil provided adjacent the upper surface.
In any case, those Gaymar patents illustrate that controlling the air in a cushion is desirable to prevent bottoming and prevent excess pressure being applied to the patient. “Bottoming” refers to any state where the upper surface of any given cushion is depressed to a point that it contacts the lower surface, thereby markedly increasing the interface pressure where the two surfaces contact each other. Prior to bottoming occurring, the pressure exerted by the bladder on the skin of the object becomes excessive. Those bottoming sensors are acceptable but Gaymar has been seeking to improve such sensors and/or eliminate them. The improvements are made for numerous reasons. Some of these reasons are and not limited to cost, reliability, easiness or difficulty to install and adjust the system, and simplicity. In addition, the bottoming sensor should be able to diminish the chance of bottoming out and also decrease the chance that the cushion will exert too much pressure to the patient.
Currently, rotating bladders are positioned below other bladders. That “other bladder over the rotating bladder” embodiment decreases the rotating bladders' efficiency of providing the desired rotation therapy. Merely removing the other bladder causes other problems for example bottoming out. The bottoming out problem with rotating bladders has been previously discussed above. The bottoming out issue remains a problem when the other bladders are removed to maximize the rotating bladder's therapy efficiency. Moreover, positioning bladders or other resilient materials (foam or gelastic material) below the rotating bladders is not desired because the rotating bladders are positioned over a non-secure, non-rigid material.
A different bladder embodiment is disclosed by Stryker's U.S. Pat. No. 5,325,551. In the '551 patent, Stryker disclosed a bladder completely filled with foam having apertures and the air circulates through those apertures. Stryker wrote (without reference numbers), “An inflatable air bladder of generally rectangular shape rests on the bottom sheet between the side elements [of a mattress] so that three sides of the air bladder engage the respectively concave surfaces [of the mattress]. The vertical thickness of the air bladder is substantially equal to the vertical thicknesses of side elements and head element [of the mattress]. The end of the air bladder remote from element is approximately flushly aligned with the adjacent end surfaces of the side elements. The internal construction of the air bladder is described in more detail later. Two air hoses each communicate with the interior of the air bladder at opposite corners of the end nearest the foot end of the mattress. The air hoses have at the outer ends thereof respective conventional connector elements . . . . The foam elements are somewhat stiffer than the pressurized bladder, and thus serve as a frame which helps to keep a patient centered on the bladder. Also, after giving a hypodermic injection, hospital personnel sometimes insert the needle temporarily into a mattress while completing other tasks. In the preferred embodiment, the six inch horizontal width of foam elements and the two inch vertical thickness of foam sheets [positioned over the bladders] protect against puncture of the bladder in the event a hypodermic needle is inserted into the mattress unit . . . . The air bladder is filled by a foam sheet which is of generally rectangular shape. In the preferred embodiment, the foam sheet has an ILD for the foam material itself which is less than 15 lbs. The foam sheet has above it an upper sheet and has below it a lower sheet. In the preferred embodiment, the [foam] sheets are made of polyurethane-coated nylon. The [foam] sheets are bonded in a conventional manner to the surfaces of the foam core, and along the peripheral edges of the foam core the [foam] sheets are bonded to each other in a conventional manner.
The foam core has a plurality of horizontal cylindrical holes extending transversely therethrough. The holes soften the [foam] sheet, and also facilitate rapid air movement within the bladder so that pressure equilibrium is quickly restored after a change. It should be noted that the spacing between adjacent holes is, for the four holes at the head end of the bladder and the three holes at the opposite end, approximately half the spacing between adjacent holes in the center region of the bladder. The holes increase the softness of the air bladder, and in particular can be used to give the foam sheet an effective ILD value which is less than the rated ILD value of the material of the foam sheet when no holes are present, and in fact the provision of holes allows the foam sheet to be given an effective ILD value which is less than the lowest ILD foam material readily available on the commercial market. By varying the spacing between adjacent holes in different portions of the foam sheet . . . respective portions of the foam sheet can be given different effective ILD values. In the preferred embodiment, the holes are all of uniform diameter and the spacing between adjacent holes is varied, but it will be recognized that an equivalent result can be achieved by varying the diameters of the holes while maintaining a uniform spacing between adjacent holes, or by varying both the diameters and the spacing. Also, of course, the effective ILD of the foam can be relatively uniformly reduced by using uniformly spaced holes of equal diameter. The result is that different portions of the bladder will exhibit different stiffness properties even though the same air pressure is present throughout the bladder.” (Bolded words for emphasis.) A problem with that embodiment is that the foam is really the cushion material, not the air in the bladder. It is preferred that the fluid in the air bladder be the principal source of pressure applied to the patient, not the foam. Moreover, a bladder filled with foam is unable to be a rotating bladder or a wave bladder since the foam does not expand with air.
In U.S. Pat. No. 6,554,785; Sroufe et al. wrote, “An orthopedic device of a therapeutic nature which includes an air bladder and an overlying gel bladder. The air and gel bladders are joined and are secured within a retainer which is adapted to be placed about a body part of a patient with the air or gel bladder being positioned next to the body part.” The gel bladder is positioned over the air bladder so the gel bladder is the principal bladder that contacts the patient.
In U.S. Pat. No. 6,306,112; Bird wrote, “A therapeutic ankle support brace bladder pad member having a pair opposed surfaces defining an inflated air support pocket and a second support pocket containing gel material and filler apparatus materials, is disclosed. An overlay fabric material is integrally attached to the bladder, provides additional support and enables removable attachment of the bladder to side support members of a therapeutic brace.” That means the air bladder contacts first portion of a patient and gel bladder contacts a second portion of the patient.
In U.S. Pat. Nos. 6,306,112 and 6,554,785, the inventors fail to disclose a dynamic air bladder or a resilient member in a dynamic air bladder or equivalents thereof. Instead the inventors concentrate on applying the desired gel cushion characteristics to one part of a patient's body and air cushion characteristics to a second part of a patient's body.
Those problems are solved by the current invention that is disclosed in the present application.
A fluid bladder system has a conventional fluid bladder and a resilient member in the fluid bladder. The resilient member is of a size that it allows the fluid in the fluid bladder to be the principal support applied to the patient. The resilient member only applies a force to the patient only after the patient displaces the fluid in the fluid bladder so the resilient structure is the only entity that inhibits the patient from bottoming out.
a illustrates a side view of
b illustrates an embodiment of
c illustrates an embodiment of
The present invention is directed to a variation of a bladder that can be used as a static bladder and/or preferably a dynamic bladder to provide support, wave therapy, a rotational (turn-assist) therapy, percussion therapy, access ability, or variations and combinations thereof. To merely illustrate the present bladder invention, we will concentrate on the rotational (turn-assist) support system 110 as an example.
The present rotational (turn-assist) support system 110 is similar to the prior art rotational (turn-assist) support system 10. One of the similarities is that the rotational (turn-assist) bladders 122, 124, 132, 134 are positioned on a rigid, secure support surface 102. The support surface 102 can be a part of a rigid and secure mattress, a rigid, secure foam surface, a solid surface or any other location that provides support to a patient. The variations are in the rotational (turn-assist) bladder 122, 124, 132, 134 and possibly, in certain embodiments, the control unit 210. The rotational (turn-assist) bladder system 110 can extend the entire length of the support surface 102 as illustrated in
As illustrated in
Unlike the prior art, the rotational (turn-assist) bladder system 110 can be positioned immediately below a patient 200, as illustrated at
There can be optional covers, blankets (conventional, conductive and/or convective) and/or pads (incontinence, heating, cooling, and/or positioning), not shown, positioned between the patient 200 and the rotational (turn-assist) bladder system 110.
Within each bladder 122, 124, 132, 134 and as illustrated in
In a preferred embodiment the resilient structure 92 extends the width of the bladder, but it can be a shorter width depending on where the patient is most likely to be bottomed out during the respective therapy. The resilient structure 92 can be a foam, a gelastic surface (see U.S. Pat. No. 7,076,822 to Pearce and U.S. Pat. No. 6,767,621 to Flick [commonly assigned], which are hereby incorporated by reference), and a resilient structure enclosed in a bladder material (identified above).
As illustrated in
The principle of how the control unit 210, as illustrated schematically at
Recall that the control unit 210, for example, has a plurality of input keys 216 interconnected to at least the microprocessor 214. That microprocessor 214 interconnects to pumps, coolers, heaters, fans, valves and/or switches (collectively box 216) that push, pull and/or allows (by potential energy contained in the bladder(s)) a fluid into, through or pass into the conduit(s) 123, 125, 133, 135 to the respective bladder(s) 122, 124, 132, 134. Prior to entering the conduits, the fluid is contained within a reservoir and/or ambient environment; a.k.a., fluid source. The fluid source can be within the control unit 210 or exterior to the control unit 210. Likewise the input keys 216 can be a part of the control unit 210, tethered to the control unit 210 or remotely interconnected to the control unit 210.
The control unit 210 can be positioned within the support system 100 or exterior to it. It depends on how the product is to be designed.
For this example, we will assume the patient will be initially turned to the left side. Obviously, the patient can be turned to the right side first, as well. It merely depends on (1) which side the patient wants to be positioned on first and/or (2) how the patient's assistant (including and not limited to a nurse, a nurse practitioner, a nursers aide, an aide, a friend, and/or a family member), who can control the support surface, wants the patient to be positioned first.
The first right section 122 and the second right section 124 are inflated at the same time (same as the prior art) as illustrated in
In a first embodiment, once the patient is properly rotated (turned) to the desired angle with both bladders 122, 124 (as illustrated in
Once the patient's assistant is completed caring and treating the initial predetermined area, the section 122 is inflated to the desired rotation level and the section 124 can be deflated to expose a second predetermined area of the patient as illustrated in
Alternatively, when the section 122 is being inflated the section 124 can be simultaneously deflated to expedite the transition process.
It does not matter which section 122, 124 is deflated first or second in this first embodiment, so long as the patient's assistant has the opportunity to expose a predetermined area to care and treat the patient while the patient remains in the rotated position.
A second embodiment occurs when the sections 122, 124 are being inflated at different times or different rates as illustrated in
Alternatively, when the slow section is being inflated the fast section can be simultaneously deflated to expedite the transition process.
A third embodiment occurs when the patient is rotated to the right side so sections 132 and 134 are inflated for rotation purposes. This third embodiment is the same as the first and second embodiments except the sections are on the opposite side of the support surface.
The bladder sections 122, 124, 126, 132, 134, 136 can be positioned horizontally and/or vertically as defined above.
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 commonly assigned U.S. Pat. Nos. 5,794,289 and 5,926,883; which are hereby incorporated by reference. Those signal devices generate signals, like rf or light signals, that determine the proper level of inflation in the rotating (turning) bladders.
The conduits can be conventional tubing used in the therapeutic industry. The conduits can have additional valves like a one-way passage valve.
It is intended that the above description of the preferred embodiments of the structure of the present invention and the description of its operation are but one or two enabling best mode embodiments for implementing the invention. Other modifications and variations are likely to be conceived of by those skilled in the art upon a reading of the preferred embodiments and a consideration of the appended claims and drawings. These modifications and variations still fall within the breadth and scope of the disclosure of the present invention.
