All publications, including patents and patent applications, mentioned in this specification are herein incorporated by reference in their entirety to the same extent as if each individual publication was specifically and individually indicated to be incorporated by reference.
The current practice in operating rooms and intensive care units is to have an anesthesia system separate and unattached to the patient support, hospital bed, transport gurney, surgical gurney or the like. Furthermore, monitoring equipment, cables, anesthesia tubing and possibly an I.V. (intravenous fluid) set-up typically extend from the respective device to the patient on the patient support or gurney. Transporting patients from one treatment area to another requires multiple personnel and can be cumbersome. Additionally, the maneuverability of both the equipment and the medical personnel are impeded about the treatment room because of such devices.
In the instance of robotic assisted radiation therapy, it is customary to have an anesthesia system move in tandem, alongside and be separate from a patient positioner system. For background, a patient positioner system can be used to move the patient support from the mobile transport gurney to a treatment position, such as for photon, proton, electron and heavy ion radiation therapy, or the like. A patient positioner system comprises a mechanical (typically robotic) support system that moves along multiple translational and rotational axes within a gantry for radiation to align the patient in proper position for receiving the radiation beams.
The equipment arrangement in the treatment room with an independent anesthesia and monitoring system leads to possible conflict in patient positioner movement. This limits the range of motion for the robotic patient positioner system (“PPS”), all the while simply adding more equipment to the treatment room.
Another direct consequence of the existing practice outlined above has to do with the duration of time that the treatment room is being occupied. In any medical setting, the duration of occupancy of a treatment room is extended when a patient is anesthetized in the treatment room before the treatment procedure commences and similarly when the patient is recovered from the anesthesia in the treatment room after the procedure is completed. In the instance of radiation beam therapy systems that have multiple treatment rooms and share resources such as the radiation source, the duration of occupancy in a treatment room is of great importance. Ultimately it impacts the system workflow and efficiency of the patient throughput.
In addition, another disadvantage of the current practice in treatment rooms (both for robotic assisted radiation therapy and other medical treatment rooms) involves the overall patient experience. Irrespective of the treatment procedure, patients can become scared, unable to relax and experience heightened anxiety as part of undergoing treatment.
For the various reasons discussed above and not limited thereto, an improved system for transporting and treating anesthetized patients in a treatment environment is needed that will contribute to patient workflow efficiencies, improve safety and maneuverability within the treatment room, as well as be beneficial to the patient experience.
A mobile anesthesia system is provided that overcomes the disadvantages in moving patients requiring anesthesia and meets the above objectives in medical environments, more specifically radiation beam therapy systems. In some embodiments, the mobile anesthesia system can include a safe and effective PPS that upholds a patient support couch with a rail system to support an anesthesia and patient monitoring system. The patient support couch can be configured with a frame affixed to a rail system which the anesthesia machine and associated equipment slide along. The rail system provides for movement along the length of the couch from a stowed position beyond the foot of the patient to a temporary, forward position over the body of the patient and within reach of the anesthesiologist. The rail system can also include a treatment position where the system is in use but outside of the zone of treatment (i.e., does not interfere with treatment).
Some embodiments include a safe and secure means of getting a patient into position for receiving treatment while optimizing the maneuverability of the equipment and the personnel about the treatment room. Furthermore, the ability to anesthetize and possibly also recover a patient from the anesthesia in a comfortable and less intimidating environment than the treatment room would help improve the patient's treatment experience as well as reduce the occupancy time of the treatment room.
In an additional aspect, there is provided mobile anesthesia system having a patient support configured for use with a robotic patient positioning system; a sliding rail system disposed on the patient support; and an anesthesia machine coupled to the slide rail system and configured to move along the rail system from a stored configuration to a treatment configuration.
In one alternative embodiment, the patient support is a robotic couch. Still further, the robotic couch is divided into a treatment zone and an anesthesia machine support zone and the sliding rail system is disposed completely outside of the treatment zone. The patent treatment zone may include a thermoplastic support and support zone may include a non-thermoplastic or a metal support plate. The patient support may also comprise a carbon fiber material that is radiolucent to the radiation used to treat the patient. The sliding rail system is positioned on the patent support no as to not interfere with the patient treatment. In addition, the material used to fabricate the robotic couch in the treatment zone is selected to reduce interference with a treatment procedure performed on the patient supported by the robotic couch and the material used to fabricate the robotic couch in the anesthesia machine support zone is selected without regard to interference with a treatment procedure performed on the patient supported by the robotic couch.
In additional aspects, the sliding rail system includes a pair of rails arranged one each on opposite sides of the patient support. Alternatively, the rail system has a single rail on one side of the patient support. In another variation, the sliding rail system is configured to allow horizontal movement of the anesthesia machine relative to the patient support. In another alternative, there is a horizontal rail system and then a second sliding rail system oriented relative to the patient support for vertical movement of the anesthesia machine relative to the patient support. The support rail or rails may be mechanically or motor assisted as well as provided with locking mechanisms to the anesthesia machine in one or both of a horizontal and vertical position relative to the patient or patient support.
There may also be provided a pivoting arm connected between the anesthesia machine and the sliding rail system or a support arm attached to the rail system. In one aspect, the anesthesia machine moves along the rail system when transitioning from a stored configuration to a treatment configuration. The anesthesia machine is positioned near a first end of the patient support in the stored configuration and is positioned near a second end of the patient support in the treatment configuration. Still further, there may also be provided a foot support positioned on the patient support to separate the patient near the first end from the anesthesia machine near the second end. In one alternative, the first end is beyond the feet of a patient on the patient support and the second end is above a patient on the patient support. The first end may also be beyond the patient's head or at the distal end of a patient support surface.
In one embodiment, there is a strut extending between patient support and the anesthesia machine to maintain the position of the anesthesia machine above the patient. The strut may also include any of a wide variety of mechanisms to support the weight of the anesthesia machine as well as provide for an adjustable height above the patient. In one embodiment, the strut includes a hydraulic ram coupled at one end to the anesthesia machine and at another end to the patient support.
In one embodiment, the anesthesia system also includes a portable gas system in communication with the anesthesia machine. The portable gas system moves along with the patient support when the patient is positioned for a therapy and remains in position relative to the patient support while the patient is receiving therapy. There is also provided a suitable gas switch or valve bank that permits a user to align the anesthesia machine to receive treatment gas or gases from the portable tanks on the anesthesia machine or from a supply of gases, such as from a medical facility where a patient is being treated. Still further, the anesthesia machine may also include a switching mechanism configured to switch the gas supply for the anesthesia machine between the portable gas system and a medical facility gas system.
In additional aspects, there is provided a method of providing anesthesia to a patient positioned to receive a robotic assisted radiation therapy. The method of providing anesthesia proceeds by positioning a patient on a robotic couch in a location remote to a radiation therapy treatment room used to perform the robotic assisted radiation therapy; administering anesthesia to the patient from an anesthesia machine attached to the robotic couch while the patient and the robotic couch are in the location remote to the radiation therapy treatment room; placing the robotic couch under the control of a patient positioning system in the radiation therapy treatment room; and maneuvering the patient and the robotic couch into a treatment position while administering anesthesia to the patient from the anesthesia machine.
There may also be the added step of using a portable gas system in communication with the anesthesia machine during the placing step and the maneuvering step. Still further, there may also be a step of switching an anesthesia machine gas source between a portable gas system and a medical facility gas system while performing the administering step. One alternative step may also include moving the anesthesia machine relative to a portion of the robotic couch using a sliding rail system coupled to the robotic couch. In additional embodiments, there may be the step of moving the anesthesia machine from a stowed configuration to a treatment configuration before the administering step. Another step may include a method where the administering step also includes supplying gas to the anesthesia machine from a portable gas system that moves along with the robotic couch while the robotic couch is under the control of a patient positioning system. There is also the step of transferring the patient support from a transport gurney to the robotic couch. This transferring step occurs during the administering step, in some aspects. Still further, the method may include transporting the patient from the remote location to a treatment location. In addition, the method may include delivering a robotic assisted radiation therapy to the patient, including treatment of the patient with a proton beam. Still further, the transporting step may also include maintaining the anesthesia machine in a stowed position on the robotic couch while transporting the patient from a position remote to a radiation therapy treatment room to the radiation therapy room. There may also be the additional step of moving the anesthesia machine from a stowed condition to a treatment condition above the patient while performing the administering step.
These and various other features and advantages of the present invention will become better understood as the following detailed description is studied in conjunction with the accompanying drawings, where:
The anesthesia machine 102 can comprise controls 106 for the administration of anesthesia to a patient, and a portable gas system 108 configured to allow administration of anesthesia to the patient during transport as well as before, during and after treatment. The portable gas system 108 can include cylinders of essential anesthetic gases, including oxygen, medical air, nitrous oxide, for example. The portable gas system can be affixed to mobile anesthesia system in various ways, such as directly affixed to the anesthesia machine or to the patent support. The portable gas system can also be part of an independent means of transporting or delivering the anesthetic gases with the anesthesia machine. The anesthesia machine can further include any number of features typically found in anesthesia machines, including a power supply, reserve gas cylinders, flow meters, pressure gauges, vaporizers, ventilators, physiological monitors (e.g., heart rate, ECG, blood pressure, oxygen saturation, etc), breathing circuits, heat exchangers, and suction, for example. Other and further modifications may include incorporating poles and hooks to securely support or stow any additional items necessary for the treatment, such as fluids or medications.
In another embodiment, a foot support 103 may be included which can provide a guide for ensuring the clearance of the patient's feet by the anesthesia machine. While this can serve as an added safety measure, the foot support can be sized so as to not obstruct the view of the medical practitioners. In other embodiments, the foot support can be latticed or transparent so as to not obstruct the view of the medical practitioners. In another embodiment of a mobile anesthesia system, a monitor 105 can be included as part of the mobile anesthesia system for patient monitoring purposes. The monitor 105 can be mounted to provide for the capability of pivoting for adjustment of the position and viewing angle of the monitor.
In some embodiments, the mobile anesthesia system can further comprise a rail system 110 disposed on the patient support. As shown in
In the embodiments of
Referring to
To load the anesthesia system 102 from the patient support to the portable anesthesia cart 300, the rails 310 of the portable anesthesia cart can be aligned with the rails of the patient support (i.e., the end of rail system). If the patient support includes a safety stop, the safety stop can be removed or adjusted to accommodate for offloading the anesthesia machine 102 from the patient support 104 as previously described. In some embodiments, multiple anesthesia machines, such as portable or fixed anesthesia systems, can be incorporated or loaded onto a single portable anesthesia cart.
In
Once the transport gurney is locked into place, the PPS 506 can then mechanically retrieve the patient support from the transport gurney and then move the patient into the proper position to receive the treatment. Conversely, when the patient's treatment is complete, the PPS can then replace the patient support back onto the transport gurney. Further details on the interaction between a PPS and a patient support are described in U.S. patent application Ser. No. 12/208,852, titled “Imaging Positioning System Having Robotically Positioned D-Arm”, filed on Sep. 11, 2008. The mobile anesthesia system is a truly unique solution, particularly in robotic assisted radiation therapy, for the ability to administer anesthesia to a patient before, during and after treatment without interruption and reducing potential for interference of peripheral equipment with the movement and positioning of the patient positioner during treatment.
In the embodiment of
This mobile anesthesia system can also be used in the normal operating room (“OR”) when equipped with any equivalent patient transport and positioning system known in the art. The advantages for normal operating room treatments would be numerous, including the ability to anesthetize an anxious patient in a calm, comfortable environment other than the operating room then transport the patient to the treatment room. Similarly, if a patient were to arrive into the emergency room (“ER”) with a broken bone, for example, anesthesia could be administered to the patient before being transported to the treatment room for setting the fractured bone.
Methods of treating a patient are also provided. The methods can use any of the mobile anesthesia systems described herein. In one embodiment, a method of treating a patient comprises positioning a patient on a patient support, and administering anesthesia to the patient with an anesthesia machine to the patient support.
The method can further comprise the step of moving the anesthesia machine from a stowed configuration to anesthesia prep position before the step of administering anesthesia to the patient. In some embodiments, the rail system is configured to allow only a horizontal movement of the anesthesia machine along the patient support. In other embodiments, the rail system is further configured to allow first a vertical movement of the anesthesia machine and then a horizontal movement to position the anesthesia equipment above and in close proximity to the clinician (see
In some embodiments, the method comprises administering anesthesia to the patient in a remote location separate from a treatment room. The treatment room can be a location configured for photon, proton, electron and heavy ion radiation therapy, or the like. The remote location can be, for example, a waiting room, a recovery room, an emergency room, or a preparation room separate from the treatment room. The method can further comprise the step of transporting the patient from the remote location to the treatment room.
The administering anesthesia step can further comprise administering anesthesia to the patient with a portable gas system. In some embodiments, the method can further comprise the step of switching from the portable gas system to a medical facility gas system. It should be noted that when the anesthesia machine is hooked up to the medical facility gas system, there may be wires or tubes extending away from the anesthesia machine and patient support. However, these components can be connected to the anesthesia machine so as not to interfere with the physician, the patient, moving the anesthesia machine between the stowed position and the anesthesia prep position, or with moving the patient support between various treatment positions. Anesthesia can continue to be administered to the patient with the medical facility gas system after the switching step. In sonic embodiments, anesthesia can be administered to the patient during the switching step.
The method can further comprise the step of transferring the patient support from a transport gurney to a robotic couch. In some embodiments, the transferring step occurs before, during or after the administering anesthesia step. The anesthesia machine moves with the patient support during the transferring step. As described above, all features of the anesthesia machine are contained within the patient support, and thus all features will move with the patient support during the transferring step without interfering with the environment, the physician, or the patient.
In yet another embodiment, the method comprises the step of delivering proton or radiation therapy to the patient. The proton or radiation therapy can be delivered to the patient while the patient is being administered anesthesia.
Additional details of the gurney illustrated and described in, for example,
As for additional details pertinent to the present invention, materials and manufacturing techniques may be employed as within the level of those with skill in the relevant art. The same may hold true with respect to method-based aspects of the invention in terms of additional acts commonly or logically employed. Also, it is contemplated that any optional feature of the inventive variations described may be set forth and claimed independently, or in combination with any one or more of the features described herein. Likewise, reference to a singular item, includes the possibility that there are plural of the same items present. More specifically, as used herein and in the appended claims, the singular forms “a,” “and,” “said,” and “the” include plural referents unless the context clearly dictates otherwise. It is further noted that the claims may be drafted to exclude any optional element. As such, this statement is intended to serve as antecedent basis for use of such exclusive terminology as “solely,” “only” and the like in connection with the recitation of claim elements, or use of a “negative” limitation. Unless defined otherwise herein, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The breadth of the present invention is not to be limited by the subject specification, but rather only by the plain meaning of the claim terms employed.
This application claims the benefit under 35 U.S.C. 119 of U.S. Provisional Patent Application No. 61/304,278, filed Feb. 12, 2010, titled “Robotic Mobile Anesthesia System”, which is incorporated by reference in its entirety.
Number | Date | Country | |
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61304278 | Feb 2010 | US |