The present device belongs to the field of medical-health equipment, and more specifically to the field of pre-hospital medical emergency and patient transport equipment and devices. The device constitutes a “specific immobilisation device” (or its abbreviation, SID) which allows a perfect “en bloc” immobilisation of the site of injury and the affected lower limb in cases of femoral neck fracture, and the main purpose of which is to enable an efficacious, efficient, and effective rescue of the injured subject, all without requiring the administration of medication to the patient, and accordingly without requiring the intervention of a medical professional during the rescue process. This device can also be used with the same efficacy, efficiency, and effectiveness as a specific immobilisation device (SID) in cases of pelvic fracture, femoral fracture, knee fracture, and fracture from the proximal tibia to the knee.
The idea to create this device comes from the need observed by a professional in his day-to-day activity as part of an out-of-hospital medical emergency team, who finds that current rescue teams do not have any specific immobilisation device for femoral neck fractures which allows evacuating an injured patient with his injured limb completely and properly immobilised.
For descriptive purposes, “rescue process” (understood as a whole, i.e., from the moment the emergency team reaches the scene of the accident in response to a distress call until the moment the patient is brought to a traumatologist in an emergency department in the hospital area) shall herein be understood as being made up of three phases: (i) a first phase of evacuating the patient from the place where he lies to the rescue vehicle, (ii) a second phase consisting of transferring the patient in the corresponding rescue vehicle, and (iii) a third phase consisting of hospital staff receiving the patient in the hospital.
At present, a professional rescuer reaches the scene of the accident and performs a first evaluation of the injured subject to establish the extent of his injury/injuries. At present, in cases in which the patient is suspected of having a femoral neck fracture injury, emergency professionals will proceed to get (without using any specific device) the injured subject off the ground with a “scoop stretcher” and keep him still on the stretcher with the fastening straps that are provided. The subject is evacuated without any type of specific immobilisation and is only “properly immobilised” upon reaching the emergency vehicle when he is placed on a so-called “vacuum mattress” (a general immobiliser designed for use with polytraumatism patients) that has been previously spread over the stretcher of the rescue vehicle or ambulance.
The use of said “vacuum mattress” as an immobiliser in case of such a specific and localised fracture has the drawback of making the patient feel uncomfortable and overwhelmed while he is being transported to the hospital, given that the mattress immobilises the entire body of the patient, not allowing any part of his body to move. Furthermore, the current lack of specific immobilisation in cases of femoral neck fracture exacerbates the pain experienced by the injured subject during his evacuation from the place where he lies to the rescue vehicle. Said lack of specific immobilisation in this first rescue phase (and the subsequent exacerbation of the pain that takes place) makes it necessary to administer medication (morphine derivatives, pain killers) in order to make the pain the patient experiences during said process more bearable. The use of said immobilisation technique today, used exclusively during the trip for transferring the patient in the vehicle to the hospital, not only makes it necessary, as mentioned, for the evacuation from where the patient lies to the rescue vehicle to be carried out without any type of specific immobilisation, but also makes it necessary to deprive the patient, upon his arrival to the hospital, of the immobilisation provided to him by the “vacuum mattress” so that he can be transferred to a hospital stretcher, where the injured limb of the patient will once again be without any type of specific immobilisation during the first hospital stage, i.e., reception, evaluation, and x-rays.
In cities, the evacuation of the patient from inside offices to the ambulance usually involves the added difficulty of having to carry the patient down to the street from a certain floor. This entails putting the patient in a tilted position (if the patient is carried down using the stairs) or even a vertical position (if the patient is carried down using the lift). Placing the patient in said position without a specific immobilisation (bearing in mind that the general immobilisation, i.e., the “vacuum mattress”, is not put in place until the patient reaches the stretcher of the emergency vehicle) causes a great deal of pain that the patient must withstand and cope with however he can.
Precisely said lack of specific immobilisation leads to the intervention of a physician being imperative in these cases; in other words, in Spain, an entire advanced life support (ALS) team [which, in Spain, is made up of a physician, a nurse, and a emergency medical technician] must go to the scene of the accident so that they can treat the injured patient to ease his pain. In Spain, medication is an advanced life support technique that the two emergency medical technicians (EMTs) of a basic life support (BLS) team is not authorized to perform.
Accordingly, despite the amount of time [transferring to/from the vacuum mattress] and resources [physician/medication] invested today in rescuing an injured subject with femoral neck fracture, pain is still very much present during evacuation, given that the patient is conscious and the medication (morphine derivative), administered by protocol, reduces but does not eliminate pain that is exacerbated by the handling and movements typical of a rescue of this type. The foregoing may apply to those cases in which the injured patient lies in a place that is hard, difficult, or impossible for the rescue vehicle to access, such as, for example, at sea, in the countryside, on a mountain, etc; or in those cases in which a physician is not available or cannot reach the injured subject on time, with professional rescue staff who are not physicians going to the scene.
The device that will be described below is therefore defined as a specific immobilisation device (SID) for cases of femoral neck fracture, an injury for which the pre-hospital emergency staff in Spain are not currently using any type of specific immobilisation device (SID).
The design of the device allows the rescue staff to carry out rescue operations, maximally reducing the pain experienced by the injured subject as a result of the handling and movements typical of the evacuation, the transfer to the hospital centre, and the reception of the patient by hospital staff.
The specific immobilisation device has the following outstanding features:
Anatomical shape: the anatomical shape with which the specific immobilisation device has been designed allows immobilising the patient efficiently, where it perfectly adapts to the anatomy of persons of any type, as will be seen below.
Central guide having a telescopic structure: the guide allows aligning the affected lower limb when there is a fracture, adapting its length to the physical characteristics (leg length) of the injured subject, and accordingly allowing the “en bloc” immobilisation of the affected extremity, completing a perfect immobilisation of the affected limb from the pelvis to the ankle.
Central guide with traction function: the central guide allows the limb to go back to its original position and to remain in said situation throughout the entire process of rescuing, evacuating, and transporting the patient to the hospital. The purpose of traction is to minimize the pain suffered by the patient due to the fracture (femoral fracture or fracture from the proximal tibia to the knee, and in some cases femoral neck fracture) so that the patient can be rescued without having to administer any medication. Traction will be performed forward or backward according to the type and characteristics of the injury suffered by the subject, preventing the injury from worsening.
Materials used for the outer cover: (i) non-slip materials: the material covering the guide is a non-slip material, furthermore having small, strategically placed, silicone ovals or ovals which are made of another material having similar characteristics or properties to reinforce said function. In this manner, the patient is prevented from painfully sliding down when he is placed in a tilted or vertical position during evacuation; (ii) hygienic materials that are easy to clean and maintain: the material covering the outside of the immobilisation device is easy and fast to clean, where it can be quickly put in use again after a prior intervention that has ended; impermeable materials: the material covering the outside of the device is impermeable so that it can be used in any condition and under any circumstance, particularly regardless of adverse weather conditions; (iii) highly-resistant materials: the material used is highly resistant, preventing degeneration (rips, tears, etc.) by abrasive contact with the surface on which the patient lies (floor of a home, pavement, stony ground, etc.).
Viscoelastic material in the padded interior of the device: the inner viscoelastic material dampens irregular movements during transfer and absorbs vibrations produced during said transfer, preventing the patient from feeling more pain and the need to use the vacuum mattress. Furthermore, it favours (without compression on the injured area and the affected limb) adaptability of the immobilisation device to the specific anatomy of the injured subject and thereby perfect immobilisation.
Radiotransparent or radiotranslucent materials: the fact that the present immobilisation device is designed and made with materials translucent to x-rays makes it easier to be able to subject the injured patient to said x-ray session without having to remove the immobiliser (SID). In other words, there will be no need to bother the patient until he is brought to the traumatologist of an emergency department.
Ease of use, polyvalency, flexibility, adaptability, and versatility: the specific immobilisation device herein described is very easy to use, where it can be used as soundly by all types of professionals and trained rescue staff with or without experience. The light weight and compact design of the device all constitute advantages for the professional who has to go to where the injured subject is. The present device can be used by all types of professional rescue teams (without the team having to have a physician), being particularly useful for rapid intervention units having different professionals working in consecutive shifts. It can be adopted by any rescue team worldwide, i.e., without any type of geographical limitation; the device lends itself to an easy production and marketing adapted to the specific requirements of different health regulations worldwide and to the requirements of different rescue units existing around the world.
The present device can also be put to use in all types of environments: urban, rural, mountain and high-lying mountain environments; in a maritime area; etc., and can be used in all types of conditions (ranging from simple falls at home or on the street to injuries in hard-to-access areas, a natural disaster area, or conflict-affected areas) and circumstances (indoor/outdoor, day or night, high or low temperatures, or adverse weather conditions, etc.). The device can be applied in a wide range of situations in combination with other specific/general immobilisation systems, where it can be used on all types of injured subjects regardless of age, build, and sizes. The device has been conceived to be used on a large majority of the population (which, according to recent statistical studies, has a waist circumference of 81 to 127 cm). The straps of the upper bands have a large size to firmly hold large-sized patients. Pregnant women can be taken care of using the device (SID) without putting the foetus or the mother in harm's way.
The advantages provided by the use of this device as will be described below are at least the following:
1. Maximum pain reduction: the use of the present device allows minimizing the pain caused as a result of the handling and movements typical of the process of rescuing the injured subject and transferring him to the hospital, improving patient care and well-being. The use of the present specific immobilisation device (SID) has a fundamental advantage with respect to the current way of evacuating, transferring, and receiving the injured subject in the hospital. The present device allows the patient to have his affected limb perfectly immobilised throughout the entire process, thereby eliminating the extra pain suffered by the patient as a result of the handling, movements, vibrations, and shifting typical of the entire rescue process. This advantage is particularly significant in those cases in which the patient cannot remain in a horizontal position once he has been restrained on the “scoop stretcher” in which he is evacuated; i.e., in those cases in which the rescue staff must tilt the stretcher and cause the patient to be in an upright position in order to go down the stairs (gradual tilting) or to use a lift for evacuation (almost vertical maximum tilting).
2. Speed and time saving: the design and features of the device make it easier for rescue to be carried out with a single specific immobilisation method which can be used throughout the entire process, i.e., during evacuation to the rescue vehicle, during transfer to the hospital centre (without being transferred to the vacuum mattress), and during handling and movement (without transfers) in said centre (including during x-ray session), and allows the time period that elapses from the moment the accident is reported to the moment the patient is brought to the traumatologist of an emergency department to be drastically reduced.
3. Lower risk of the injury worsening: in addition to eliminating pain, by means of perfect and total immobilisation of the affected limb (using its traction function, if necessary), the present immobilisation device prevents risks such as the injury worsening and even the possibility of an internal vessel rupture due to friction with the fractured bone during evacuation.
4. Savings on medical resources: Firstly, the use of the present device (SID) means that the use of medication (morphine derivatives, pain killers) used today with the described technique is unnecessary. Secondly, the use of the immobilisation device (SID) means that the use of the “vacuum mattress” for transferring the patient to the hospital is unnecessary. Thirdly, its polyvalency, the fact that a range of functions can be performed simultaneously, i.e., the fact that the immobiliser (SID) can also be used with the same efficacy, efficiency, and effectiveness for the specific immobilisation of another type of fractures (pelvic fracture, femoral fracture, knee fracture, and fracture from the proximal tibia to the knee, as well as a range of abdominal injuries) may lead to emergency services not having to carry with them other “pelvic belt”-type devices (for pelvic fractures and abdominal injuries) and/or “traction splint”-type devices (for femoral fractures and fracture from the proximal tibia to the knee) in addition to the SID. The functions of these two devices can be performed by the device (SID) herein described.
5. Savings on human resources: as discussed above, in Spain, the human team of ALS (advanced life support) units is made up of three professionals: a physician, a nurse, and a emergency medical technician (EMT), and the team of a BLS (basic life support) unit is formed by two EMTs; i.e., the BLS team is made up of only two professionals, neither of whom is authorized to medicate the injured patient. In this sense, the use of the immobilisation device (SID) allows the rescue of an injured subject in the case of a femoral neck fracture to be carried out by a BLS unit, making the intervention of an ALS unit unnecessary, i.e., making the intervention of a nurse and a physician unnecessary. The fact that the rescue process can be carried out by a BLS team, the number of which is far greater in the ambulance fleet of a city, allows the few available ALS units (as well as the limited number of physicians and nurses making up said local team) to be free to attend to more serious accidents that necessarily require the intervention of ALS units, (i.e., a physician and nurse).
6. High cost savings: the use of the described device therefore entails a significant cost savings advantage, providing, in this sense, not only significant advantages in terms of the quality of patient care, but also significant economic-financial advantages for the company providing the ambulance and/or rescue service as well. Each of the improvements and savings mentioned above (such as for example: (i) speed and subsequent time savings in each service that is performed; (ii) savings caused by the medication supplied with the current technique being made unnecessary and the need to carry different equipment to perform functions which the immobiliser (SID) can perform by itself being made redundant; (iii) savings on human resources leading to the presence of a physician for evacuating the patient, and therefore the presence of a complete ALS team, being unnecessary) entail saving the high added cost resulting from the use of the current rescue technique.
To complement the description of the immobilisation device at hand and for the purpose of helping to better understand the features thereof, a set of drawings of a selected preferred practical embodiment is attached as an illustrative and non-limiting integral part of said description. It must be borne in mind that identical or duplicate or equivalent or similar structures, elements, or parts appearing in one or more of the drawings are generally designated with the same natural reference number, optionally with an additional letter or additional letters to distinguish between objects or variants of similar objects, and they may not be named and/or described repeatedly. The dimensions of the components and features shown in the drawings are also chosen for the sake of convenience or clarity of presentation and are not necessarily shown to scale or in actual perspective. Finally, for the sake of convenience or clarity, some elements or structures are not shown or are shown only partially and/or with a different perspective or from different viewing points.
In view of the mentioned drawings and according to the adopted numbering, a preferred embodiment of the immobilisation device at hand, which comprises the parts and elements that are indicated and described in detail below, can be seen therein. Said description relates to one or more non-limiting examples of preferred variants of a practical embodiment of the immobilisation device (SID). This invention is not limited by the variants described or by the drawings shown, where it can be carried out to practice in different ways with different configurations, variations, and with variable dimensions. The terminology used herein must not be construed as limiting, unless otherwise specified. Likewise, the titles of the section used herein are for the sake of convenience and must not be interpreted as limiting the scope of the specific immobilisation device (SID) shown herein.
As discussed above, the immobilisation device (SID) constitutes a newly developed specific immobilisation device which allows a perfect “en bloc” immobilisation of the site of injury and the affected lower limb in cases of femoral neck fracture, the main purpose of which is to enable the efficacious, efficient, and effective, and particularly pain-free, rescue of the injured subject, all without requiring the administration of medication to the patient, and accordingly without requiring the intervention of physicians and/or nurses during the rescue process. This device can also be used with the same efficacy, efficiency, and effectiveness as a specific immobilisation device in cases of pelvic fracture, femoral fracture, knee fracture, and fracture from the proximal tibia to the knee.
The present specific immobilisation device (SID) comprises the following elements, all of them roughly shown in the attached
Central Guide (100)
This is a central component which, like a spinal cord, performs the function of a backbone and a support for the assembly of the immobilisation device, said component being in the form of a rigid central guide having an adjustable telescopic structure (100). This structure in turn has the following elements:
Central Casing (200): Fixed Rigid Element
This constitutes the first of the two segments making up the mentioned central guide having a telescopic structure (100). The casing (200) represents the main support element of the central guide (100) and of the assembly of the device.
As can be seen in detail in
Cover: the entire immobilisation device (SID), i.e., both the central casing (200) and the so-called upper bands or wings (600), lower bands or wings (800), and where appropriate, intermediate bands or wings (700), are covered by respective thin polyvinyl chloride layers (or another material having similar characteristics or properties). As indicated in
Interior of the central casing (200): the interior of the central casing houses the second segment (300) of the telescopic structure of the central guide (100) which, when extended using the gear mechanism (500) that can be seen in detail in
Rails: The two solid guides (301) and (302) having a rectangular section that have been described and form the structure of the mentioned extendable segment (300) of the telescopic central guide (100) are always kept in place and aligned as a result of U-shaped rails (208) that run along the entire length of the inner side of the smaller faces (203) and (204) of the casing (see
Cut-out: The lower half of the outer face (202) of the casing (200) has a cut-out (210) which enables the connection of the gear system (500) housed therein with a lever or handle in the form of an outer wheel (501) through which the aforementioned mechanism (500) is manually operated (see
Lid: As mentioned above, the upper side (205) of the casing (200) is blocked off forming a closed structure with the same physical characteristics as the rest of the structure of the casing (200). In contrast, the lower end (206) of said casing (200) is open in principle. However, this lower end (206) will be depicted as being sealed by a lid (211) [see
Accordingly, the central casing (200), as a fixed element of the central guide (100), allows performing the following functions: (i) the function of a backbone and support, like a spinal cord, for the assembly of the device (SID), the function of a casing, housing the extendable or telescopic element, as well as the mechanism regulating same, allowing access through the structure thereof to operate it from the outside; (ii) the function of supporting and stabilizing the affected lower limb with the injured subject in a vertical, horizontal, or titled situation; (iii) the function of aligning the affected lower limb; (iv) the function of preventing the body of the patient from sliding when he is in a tilted or vertical position on the spine board during evacuation; (v) and finally, it is a key piece that enables the integral function of the device, which is to provide a perfect and specific immobilisation which allows pain to be maximally reduced during the handling and movement of the patient in a pre-hospital rescue operation (made up of the three mentioned phases: evacuation, transport, and reception) without requiring the presence of a physician and nurse, and without the administration of medication to ease the pain.
Telescopic Segment (300): Rigid Extendable Element
As discussed above and as can be seen in
These guides (301) and (302) have a solid tubular structure with a rectangular section, where they can be manufactured from aluminium (or another material having similar characteristics/properties). Additionally, both guides are maintained as a rigid equidistant assembly by respective tubular elements welded (preferably) in a perpendicular manner (to the guides) at both ends of the segment [upper section (304) and lower section (305)] forming a rectangular tubular structure with a closed perimeter (300). The mentioned four sections comprise the two long sections and the two short sections, where the two opposing long sections are identical to one another and the two opposing short sections are identical to one another, and they (preferably) have an identical tube section. The observer will not be able to see the two short sections given that the upper end of the extendable segment of the guide (300) is always inside the casing (200), with the stop in the form of a flange (209) mentioned above assuring that this is the case; and the lower end is embedded in what is referred to as an “ankle band” (400) for descriptive purposes, making the observer feel like the structure is only made up of an independent double tubular guide. Said structure is therefore extremely robust and compact, being resistant to deformations that may be caused by rough and unpractised use of the immobilisation device (SID).
As discussed, the extendable segment (300) of the telescopic central guide (100) provides support at its lower distal end (305) to the so-called “ankle band” (400), forming a T-shaped structure (seen clearly in
The casing (401) is completely covered by a layer of polyvinyl chloride (or another material having similar characteristics/properties) and has two rectangular metal washers (or washers made of another material having similar characteristics/properties), being arranged around the perimeter of both guides (301) and (302), performing the function of protecting the cover material from possible friction and wear due to the intensive use of the central guide (100).
The extendable element (300) of the central guide (100) allows achieving the following functions: (i) the function of aligning the affected limb in cases of femoral neck fracture; (ii) the function of enabling the traction of the affected limb by means of using the millimetric gear mechanism provided for the use thereof in the case of femoral fracture or fracture from the proximal tibia to the knee; (iii) the function of reducing haematomas and the worsening of the injury or fracture in the preceding cases; (iv) the function of reducing pain when resetting the bone in the affected limb; and in any case (v) the function of specifically immobilising the affected limb and both lower limbs en bloc.
Lower “Ankle Band” (400)
This band (400), referred to as “ankle band” for descriptive purposes (as it performs the function of fixing the central guide (100), securing the lower end (102) thereof to the ankle of the injured subject) is secured to the distal end (305) of the rigid extendable component (300) of the central guide (100) arranged perpendicular to the backbone (103) of the telescopic central guide (100), forming a T-shaped structure therewith (
The casing (401) made of high-density polyethylene (or another material having similar characteristics or properties) housed therein constitutes the base on which there is adhered (with industrial contact adhesive) a larger trapezoidal central element (402) made of high-density polyester foam (or another material having similar characteristics or properties) (
The assembly is covered by two sheets, i.e., an inner sheet in contact with the patient and covering the padded face (405) (see
Two short straps: two straps (411) and (412) extending perpendicular to the backbone (103) of the immobilisation device (SID) in the same direction of the bands (403) and (404) are sewn on the outer face (406) of the cover layer by means of seams (415) sewn with a nylon thread (or another material having similar characteristics or properties). These straps will be manufactured from a mixed fabric of nylon and polyester (or another material having similar characteristics or properties) and incorporate a contact-type quick fastening and unfastening system, i.e., VELCRO® (414), that is fixed to the straps by means of perimetral seams (416) sewn with a nylon thread (or another material having similar characteristics or properties), said straps surrounding the ankle of the affected leg, and completing and enabling the holding of the described ankle bands (403) and (404) (see
Long strap: additionally and as can be seen in
*/*/ Velcro®-type fasteners: both short straps (411) and (412) have a female (or smooth) fastening side (designated with the letter F in the corresponding
Padded band: finally, reference is made to a small padded band (417) on which the patient's foot rests and the purpose of which is to prevent chafing. The band will be sewn forming a seam (418) with a nylon thread (or another material having similar characteristics or properties)] along the lower edge of the “ankle” band (400); it will be padded with a high-density polyester foam (or another material having similar characteristics or properties), and it will be covered with polyvinyl chloride material (or another material having similar characteristics or properties) identical to the one used for the cover of the rest of the immobilisation device (SID).
This element (“ankle band”) allows performing the following functions: (i) complete fastening of the device (SID) to the ankle of the injured subject (which will be placed at a different height depending on the particular anatomy of the subject); (ii) enables perfect “en bloc” immobilisation and alignment of both limbs in conjunction with the telescopic element (300) of the guide (100), and therefore a safe and pain-free evacuation.
Operating Mechanism (500)
The central guide (100) of the SID having, as mentioned, a telescopic structure consisting of two segments (200) and (300) can be adjusted by means of an internal mechanism (500). As can be seen in
The upper section of the shaft of the larger gear or gear ring (504a) is fixed to the “handle” in the form of a “wheel” (501). This wheel is manufactured from high-density polyethylene (or another material having similar characteristics or properties) and enables manually operating the internal gear mechanism. It must be pointed out that said “handle” is covered with a rough anti-slip material (or another material having similar characteristics or properties) to make it easier to grip same in all types of conditions. When said upper section of the shaft of the larger gear or gear ring is manually operated (by pulling it outward), the lower end of the shaft (506) comes out of the notch (510) provided for that purpose at the central point of the “larger gear” or “gear ring”. When said handle (501) is no longer operated, said lower end of the shaft (506) again rests in said notch (510). The lower section of the shaft (507a) of the larger gear and the lower portion (507b) of the shaft of the smaller gear remain in place as a result of the notches (510a) and (510b) with a high border (see
There is a need to highlight that although the millimetric “bite marks” marking almost the entire inner face of both guides (301a) and (302a) are identical (in the sense that they have the same dimensions), they are not placed in a symmetrical manner, one in front of another. In other words, in order to allow both guides [(301) and (302)] to be extended or withdrawn in unison, they are “synchronized”, in a manner of speaking, in an asymmetrical position, one with respect to the other. Likewise, it should be borne in mind that the “bite marks” depicted in
In this manner, through the described manual operation [pulling on the lever or handle (501)], the internal mechanism of the immobilisation device (SID) performs three functions: (i) on one hand, it keeps the extendable telescopic segment (300) of the guide (100) held inside the casing (200) when it is withdrawn or in standby; (ii) on the other hand, it allows extending the telescopic or extendable segment (300) of the guide (100), aligning the affected limb and holding it securely in place once the “ankle band” (400) has been placed at the level of the ankle of the injured subject; (iii) finally, in cases of femoral fracture and fracture from the proximal tibia to the knee, the millimetric gear mechanism (500) described above is designed to allow the mentioned telescopic segment (300) of the guide (100) to be extended “millimetre by millimetre” by means of rotating the wheel, which allows a delicate and precise traction of the affected lower limb.
Upper Bands or Wings (600), Intermediate Bands or Wings (700), and Lower Bands or Wings (800)
Once again, these elements of the immobilisation device (SID) are referred to as “bands” or “wings” only for mere descriptive purposes and without having any limiting character whatsoever. As can be seen particularly in
The bands or wings emerge from both sides of the segment of the central guide (100) referred to as “central casing” (200) and extend in a perpendicular line in the direction opposite the vertical backbone (103) of the central guide (100). The aforementioned bands or wings provide the device (SID) with both vertical rigidity and horizontal flexibility as a result of the unique longitudinal equidistant arrangement of a series of sheets which together form a type of semi-rigid “endoskeleton” (900) shown in
“Endoskeleton” Made of Cut-Out Sheets (900)
Each of the side bands or sections extending on each side of the guide (601) and (602), (701) and (702), as well as (801) and (802) has an endoskeleton (900) formed by a series of rigid independent sheets (901) that run parallel to the central casing (200), along the entire interior of the device, in a continuous and longitudinal manner (see
This type of inner longitudinal “infrastructure” is formed by sheets (901) made of rigid high-density polyethylene (or another material having similar characteristics or properties) with cut-outs (907) [
The aforementioned cut-outs (907) have a variable configuration, the central point of which coincides with the imaginary longitudinal axis (908) of each of the sheets (901) at hand [see
Each of the sheets (901) has adhered (with industrial contact adhesive) [depicted in
Function: The described endoskeleton (900) allows simultaneously combining the functions of (i) providing vertical rigidity to the assembly, extending the patient stabilization and alignment function fundamentally carried out by the central guide (100), and (ii) enhancing the flexibility and horizontal anatomical adaptation function of the bands or wings of the immobilisation device (SID) (or parallel symmetrical sections) with respect to the body of the patient. Combining both functions described above is what ultimately allows the pain-free handling, evacuation, and transfer of the patient without any medicinal products and without the intervention of any professional practitioner in pre-hospital stage of the patient's care.
Covering or cover of the device (910) and (911): As can be seen mainly in
Longitudinal multi-tunnel (semi-cylindrical channel) system (914): The longitudinal assembly of the sheet of rigid high-density polyethylene (901) and the strip or layer of superimposed viscoelastic material (906) is covered by respective layers of polyvinyl chloride [on its outer or non-padded face (911) and the inner or padded face (910)], being “perfectly fixed” in a equidistant manner as a result of the parallel longitudinal seams (912) attaching or fixing both sheets or inner cover layer (910) and outer cover layer (911) separating same, creating “in an alternating manner” a design consisting of padded semi-cylindrical channels (914) containing the assembly of the sheet (901) and viscoelastic material (906) and longitudinal notches in the form of a seam (912) parallel to the preceding ones [see
The alternating arrangement of semi-cylindrical channels (914) [with the sheet (901) and the viscoelastic material (906) therein] and vertical longitudinal notches (seams) (912) gives the inner face of the immobilisation device (SID) a “padded appearance” [see
Outer face of the device (911): In contrast and as can be seen in
Function: The bands (600), (800), and where appropriate (700) perform two simultaneous functions: (i) they extend from the central casing (200) and provide the necessary longitudinal or vertical rigidity as a result of the assembly of parallel equidistant sheets (901) forming the endoskeleton (900) thereof; (ii) said bands in turn provide the necessary flexibility and horizontal adaptability to go around the body of the injured subject, moulding itself to the unique and specific anatomical contour of the individual at hand (without compression).
Borders of the Bands of the Device (913)
The assembly formed by the central casing (200) of the guide (100) and the described sections, i.e., the set of wings/bands (600), where appropriate the set of wings/bands (700), and the set of wings/bands (800), has a band or border (913) running uninterrupted along the perimeter thereof, fixing the two layers of polyvinyl chloride (or another material having similar characteristics or properties) forming the cover of the entire device, i.e., of the padded face (910) and of the non-padded face (911) [
Fastening Straps with Anchoring in the Form of Velcro (or the like)
The six mentioned sections, i.e., the upper sections (601) and (602) [
In terms of the anchoring system, the immobilisation device (SID) has a Velcro®-type quick fastening and unfastening system. The straps of the bands or wings of the device (600), where appropriate (700), and (800) always have “the Velcro® side” of the fastener on the outer face (604), (704), and (804) of the corresponding strap. Both straps in each of the bands or wings, such as (605/606), (705/706), and (805/806), for example, have two female sections in the inner portion of the strap followed by a male section at the end farthest away therefrom (designated with the letter F (for female) and M (for male), respectively, in
The described fastening and unfastening system has an additional element, i.e., the sliding rings or arcs [designated as (609) [
3. Complementary Elements. Cushions
The “cushion” (920) depicted in
Method of Using the SID
The basic phases of a method of using the present device are described below, said method comprising the following steps:
The emergency team (which is made up in Spain, by law, of two or three professionals) or rescue team goes to where the injured subject is located, regardless of whether he is on a public street, inside a building, in a rural area, etc.
The emergency team or rescue team performs a quick assessment of the injured subject to establish the extent of his injury/injuries. In the event that the injured subject shows signs and symptoms suggesting a femoral neck fracture injury, the emergency professional (paramedic, physician, nurse, or emergency medical technician) or rescue professional will use this new immobilisation device (SID) in the manner described in detail below.
The immobilisation device (SID) at hand will be placed, open or extended, resting on its outer or non-padded face, on a spine board, parallel to the injured subject at the height of his hip.
One of the health professionals or rescuers will slide the immobilisation device (SID) under the injured subject while his teammate holds the patient in the lateral decubitus position, with the affected limb held in place.
So while one of the professionals places and holds the patient in the lateral decubitus position and the other holds the affected lower limb, they will both proceed to slide the spine board along with the immobilisation device arranged thereon under the patient at the suitable height together and at the same time using their free hands (i.e., this action will be performed depending on the height of the site of the injury or fracture).
Once the patient is moved back to the supine decubitus position, the professional assures that the patient is suitably located on the immobilisation device (SID).
For the purpose of assuring a suitable venous return, rescuers will proceed to adjust the fastening straps from the bottom up, first adjusting the straps of the lower bands or wings (at the tibial level), then the straps of the intermediate bands or wings (at the femoral level) if they are included in the configuration of the specific immobiliser (SID), and finally the straps of the upper bands (at the hip and/or pelvic level).
In the exceptional case where the anatomy of the injured subject so requires, the emergency staff or rescuer will place during the preceding process cushions which are provided and which the staff or rescuer believes are necessary in order to fill the anatomical gaps left by the particular anatomy of the injured subject, thereby assuring perfect immobilisation of the patient.
Once the patient has been immobilised at the indicated height, the telescopic or movable section of the guide is placed and adjusted with respect to the height of the ankle of the patient. The guide will be extended depending on the length of the affected limb of the patient, so that the “ankle band” and its straps are aligned parallel to the ankle (or ankles) of the injured subject.
The straps of the ankle of the affected limb are then adjusted.
Traction: In the case of a hip fracture, a femoral fracture, and a fracture from the proximal tibia to the knee, traction is applied (downward or upward, depending on the case) to the affected lower limb with the guide to align the fracture, thereby minimizing pain and compensating for the lack of medication. In the case of a pelvic or knee fracture, traction would not be necessary.
Distal pulse: Once traction is applied to the limb, the distal pulse is taken to check for the existence of blood flow and thereby distal tissue oxygenation.
For the patient to form “a block” making his evacuation easier, the second strap of the device in the “ankle band” is adjusted. The strap is long enough to go around both extremities, the one affected by the injury and the one not affected, forming a “block” which completely stabilizes and immobilises the extremities “en bloc”, minimizing movements, vibrations, and accordingly pain.
Finally, the patient is fastened to the spine board on which he rests already immobilised using the provided fastening straps, and he is then evacuated to the vehicle used in the corresponding rescue service or operation.
In contrast with the current technique described above, the use of the immobiliser (SID) allows the patient to be transferred directly to the hospital, without having to be moved to the vacuum mattress, i.e., the use of the immobiliser (SID) allows the patient to be transferred to the hospital centre using the same resources [spine board and immobiliser (SID)] with which he has been evacuated.
The type of material used in the design and manufacture of the immobilisation device (SID) allows subjecting the patient to x-rays upon reaching the hospital without having to remove the immobilisation (under normal circumstances, i.e., using the current technique, the patient must first be moved from the vacuum mattress to a stretcher or bed). The patient is finally transferred from the x-ray department to be cared for by the traumatologist of an emergency department without any need to remove the immobiliser (SID) on which the patient is placed during evacuation and without any need to repeatedly move the patient. This results in an excellent quality of patient care throughout the entire process, i.e., patient handling and movement at the scene of the accident, evacuation and transfer, reception, and initial hospital care.
General: The present device has been described using descriptions of variants thereof that are provided by way of example and do not intend to limit the scope of the utility model or preclude other variants. The variants that have been described comprise various features that are not all necessarily required in all the variants of the invention. Some variants of the invention use only some of the features or possible combinations of features. Alternatively and additionally, parts of the variants that are described or illustrated as a unit can be housed in two or more separate entities which act together or otherwise carry out the described or illustrated function. Alternatively or additionally, parts of the variants that are described or illustrated as two or more separate physical entities can be integrated in a single entity for carrying out the described or illustrated function. Variations relating to one or more variants can be combined in all possible combinations with other variants. In the specifications and claims, unless otherwise particularly specified, when the operations or actions or steps are listed in a certain order, the order may vary in any practical manner. The terms used in the following claims must be interpreted, without limitation, as being characterized or described in the specification.
Number | Date | Country | Kind |
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P201500885 | Nov 2015 | ES | national |
P201600913 | Oct 2016 | ES | national |
Filing Document | Filing Date | Country | Kind |
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PCT/ES2016/000130 | 11/23/2016 | WO | 00 |