This disclosure relates generally to patient transport in hospital and clinical environments, and other medical or patient care settings. In particular, the disclosure relates to the physical process of patient transfer from one surface to another, for example between beds or gurneys in an operating room, or in an examination, laboratory, treatment or recovery location.
In the day to day operations of a hospital, many patients are moved. In many instances, patients are ambulatory and can move from a hospital bed to a wheelchair to be moved yet again. Many patients are not ambulatory. These patients must also be moved with the assistance of nursing and medical staff. Non-ambulatory patients are moved from a hospital bed to a gurney whenever there is a need to move a patient to a new area. Once moved to the new area, they are moved again into a new room or other environment.
When a patient undergoes surgery, even the ambulatory patient is generally rendered non-ambulatory due to the effects of anesthesia. Generally, the anesthesia does not wear off shortly after concluding the operation. A patient is generally moved from the operating table in an operating suite to a bed in a recovery room. In the recovery room, the patient is observed until they “wake up” after the anesthesia wears off. In the recovery room, a nurse can also keep an eye on many patients in the event something should go wrong shortly after an operation.
Once the patient awakens or recovers sufficiently, the patient is then moved again to a hospital room. Most patients are rendered non-ambulatory by virtue of the operation. As a result, the nursing and medical staff must move the patient onto a gurney for transport back to the recovery room. Generally, the patient stays on the gurney while in the recovery room. Upon recovery, the patient is then moved on the gurney to the hospital room. Once at the hospital room, the patient is moved from the gurney to the hospital bed by medical staff, or the nursing staff.
A common prior art device used to move a patient is shown in
At this point, the patient is generally only partially on the device 100. The medical or nursing staff may have to push and/or pull the patient across the device to effect a transfer across surfaces. Once on the transportation device 100, the patient must be pushed and/or pulled across and over the device 100. The patient rolls over the transportation device 100 and the individual rollers as the patient is transported to the next surface.
The current device has potential problems. The ride for the patient may be uncomfortable, as the dorsal aspect of the patient does not move smoothly across the belt surface due to the open spaces between the rollers, which are located beneath the belt. This bumpy ride is stressful on patients being transported. For example, patients that have just completed an operation are many times still being monitored during transport and into the recovery room. The monitoring information taken during transport, such as heart rate, ECG (electrocardiograph), blood pressure, and respiratory rate show that the patient undergoes stress.
Another potential problem is related to the hospital staff, such as the nursing staff or medical staff. In moving the patient, the staff must bend over two surfaces and push and/or pull the patient. This method is inherently inefficient due to accepted principles of physics, e.g., friction. This can cause injuries and resulting workman's compensation claims. Also, for patients of significant size and/or weight, additional hospital staff may be required for the physical task of moving the patient from one surface to another with the existing transportation device. These injury and labor force issues can add substantially to the cost of operating a hospital.
Various examples and embodiments described herein relate to a method and a system for transferring objects, such as patients or other bodies, in a hospital or clinical setting, for example in an operating suite. Additional examples and embodiments relate to patient transfer devices, patient transfer systems, and materials for use with such systems, including, but not limited to, single-use transfer sheets configured for patient transfer using the patient transfer devices. Further examples and embodiments relate to devices, systems and methods for transferring a patient or other body between surfaces, for example between beds, gurneys or other locations in a hospital operating room, and in other clinical, laboratory, examination, treatment, transportation and recovery environments.
It should be noted that there are spaces 141, 142, 143, 144, 145, 146 between the rollers 111, 112, 113, 114, 115, 116, 117. In the spaces 141, 142, 143, 144, 145, 146 there may be essentially no support. The continuous band or belt 130 of the prior art is generally flexible.
When supporting an object in the spaces 141, 142, 143, 144, 145, 146 between the rollers 111, 112, 113, 114, 115, 116, 117 the continuous band or belt 130 flexes or sags. When an object is small it travels between a high position on top of a roller 111, 112, 113, 114, 115, 116, 117 and lower position in a space, such as spaces 141, 142, 143, 144, 145, 146 between the rollers 111, 112, 113, 114, 115, 116, 117. When a large flexible object is transported using the transport device, a flexible outside surface of the object will travel between these positions.
In some instances, a human being is transported using the prior art transport device 100. Human beings and other animals have an integumentary system. The integumentary system is the organ system that protects the body from damage, and includes the skin and its appendages (including, e.g., hair, scales, feathers, and nails, depending on the corresponding animal characteristics). The integumentary system has a variety of functions, such as to waterproof, cushion, and protect the deeper tissues, and to excrete wastes and regulate temperature. The integumentary system is also the attachment site for sensory receptors to detect pain, sensation, pressure, and temperature. In humans, the integumentary system is the largest organ system.
When a human body is the object being moved, first portions of the integumentary system are supported by the elongated rollers 111, 112, 113, 114, 115, 116, 117, while adjacent portions of the integumentary system are supported at lower positions by the belt 130, spanning spaces 141, 142, 143, 144, 145, 146 between the rollers 111, 112, 113, 114, 115, 116, 117. This is due to the flexible nature of skin in its function to cushion organs within the body. As a human is transported over the device 100, the skin or integumentary system undulates. This is stressful on the body. The stress occurs both when the human is conscious and unconscious.
During surgery, the body is carefully monitored. The monitoring continues after surgery. For certain medical or surgical procedures, some patients require monitoring during transfer from the surgical surface to the transport surface. Other patients are also monitored as they convalesce in a post-surgery recovery room. Monitoring information such as heart rate, ECG (electrocardiograph), blood pressure, and respiratory rate indicate that the patient undergoes stress during transfer.
In addition to producing stress, the transport device 100 also translates as the patient is moved. In other words, the elongated rollers 111, 112, 113, 114, 115, 116, 117 roll along the continuous belt 130, which, in turn, is rolled over the surfaces between which the patient is being transported. Such an arrangement can result in high localized loading at the rollers and may require more force to move a patient.
Other workers can push the human to help move or transfer the patient from one surface to the other surface. Pushing on the human body adds to stress. The workers generally must bend, push and pull, and this causes the workers stress as well, which can result in injury.
At the end of its use, the material 150 is placed in the laundry, laundered and reused.
System Design
The patient transfer system 300 includes a housing 310 dimensioned to span a distance between the first surface 301 and the second surface 302. The housing 310 is also made sufficiently strong so as to have the strength to not fail while spanning the distance. The patient transfer system 300 may include a first elongated roller 320 positioned along a first edge or first side cap 311 of the housing 310, and a second elongated roller 322 positioned along a second edge or second side cap 312 of the housing 310.
The patient transfer system also includes a support system or structure 400. The support system 400 includes a set of individual supports 412, 414, 416 (e.g., as shown in
A top bridge cover 421 is attached to the individual supports 412, 414, 416 to form a bridge 420. The bridge 420 can also have a bottom bridge cover 621 (e.g., as shown in
The top bridge cover 421 flexes a limited amount during transport of an object, such as a patient, but may be much more rigid than a belt material. The bridge 420 supports the object as it is transported using the patient transfer system 300. When the object is a patient, the patient is supported so that the skin or the integumentary system undulates less than when the prior art device 100 is used. This reduces the stress placed on the patient when moved with the patient transfer system 300 when compared to the prior art device 100. The bridge 420, in one embodiment, forms a support surface having a first portion which is substantially the same height as the first elongated roller 320 and a second portion which is substantially the same height as the second elongated roller 322.
The patient transfer system 300 may also include a continuous belt 330. The continuous belt 330 is positioned in conveying relation with respect to the first roller 320 and the second roller 322 and with respect to the bridge 420. The first roller 320, the second roller 322, a major portion of the supports 412, 414, 416 and a major portion of the bridge 420 are positioned within the continuous belt 330. A portion of the continuous belt 330 conveys the body while another portion of the continuous belt 330 passes through the housing 310.
The housing 310 includes a bottom 314. The bottom 314 includes a first major surface abutting the first surface 301 and the second surface 302, and includes a second major surface on the inside of the housing. The continuous belt 330 does not touch the first surface 301 or second surface 302. The continuous belt 330 passes over the second major surface. In other words, the continuous belt passes over the top of the second major surface on the inside of the housing 310.
The elongated rollers 320, 322 are positioned substantially within the housing 310 and above the second major surface of the bottom 314 of the housing 310. In another embodiment, the surface of the bridge 420 of the support system 400 is approximately the same height as one of the first end and the second end of the housing. The continuous belt passes over the support structure and specifically over the support surface as the continuous belt is moved to transfer the body. The support surface, in some embodiments, includes a material which lessens the friction occurring between the support surface and the belt.
Now looking at
In another embodiment, the support system can be formed of a solid material. In still other embodiments, the number of supports forming the frame can be varied. Furthermore, different types of materials can be used for the bridge cover 421 and the bridge cover 621. Bridge cover 421 is on one side of the supports 412, 414, 416 and bridge cover 621 is on the other side of the supports 412, 414, 416.
In one exemplary embodiment, the continuous belt 330 is made of an elastomeric material so as to cushion the object to be transferred. The continuous belt 330 may be sufficiently thin so as to fit between the space between the roller 320 and the edge 311, and the space between the roller 322 and the edge 312 of the housing 310. The thickness of the belt 330 can also be selected to allow the belt to flex. In other words, the belt material 330 may be sufficiently flexible so that it can wrap around the rollers 320, 322 and most of the support system 400.
If the object to be moved is a human, the elastomeric material of the continuous belt 330 cushions the patient during a transfer. In another embodiment, a thinner cloth-like material is used in the continuous belt 330. It should be noted that any suitable type of material that is sufficiently flexible and sufficiently thin to fit between a roller and an edge of the housing can be used.
When the continuous belt 330 is made of an elastomeric material it somewhat conforms to the body during transfer. When the body to transfer is that of a human being or animal, the conformance of the belt provides some comfort to the animal or human being.
The continuous belt can be sufficiently thin so as to remain clear of the housing during operation of the continuous belt. The continuous belt can also be sufficiently thin so as to allow the use of a transfer sheet. If the continuous belt is too thick, the belt could become caught within the housing, for example. If the continuous belt is too thick, it may allow the continuous belt to be used but prevent operation of the device when a transfer sheet is used.
In one embodiment, the first and second elongated rollers 320, 322, respectively, are positioned inboard with respect to the first edge or side end cap 311 and the second edge or side end cap 312 of the housing 310.
In the embodiment shown in
As seen in
The less slope between the edge or end caps 311, 312 of the housing 310 and the bottom of the housing 314, the gentler the transition area 611, 612. The transition area 611, 612 is generally longer with gentler slope. The transfer device 300 will be wider with transition areas having a gentler slope.
The width of the transfer device 300 is one consideration in the design of the device. Other design considerations can be the comfort of a human, when the human is the object to be moved, or the bulkiness of the device 300 when handled by hospital personnel in an operating suite or around the hospital.
Transfer Sheet
In operation a transfer sheet 700 is used to provide additional cushioning and to provide a clean surface on which to transport a body. The transfer sheet, in the embodiment shown, also may include absorbent material. In another embodiment, the transfer sheet is formed from a permanent material and is adapted to receive an absorbent material. The absorbent material will absorb fluids that may be produced or come from the patient. Any suitable sort of absorbent material can be used.
There may be limits as to the thickness of the transfer sheet 700. The transfer sheet 700, when used, fits in a space between the outer surface of the continuous belt 330 when positioned on one of the rollers 320, 322 and the edge 311, 312 of the housing respectively. The thickness is denoted by the variable “t” shown in
The transfer sheet 700 has a width, W. In embodiments, the width, W, is less than the width of the continuous belt 330, whereas with a width of the transfer sheet 700 wider than the continuous belt 330, the transfer sheet 700 may bind the transfer device 300.
Looking at
The top layer 730 is permeable or will allow fluids to pass to the absorbent layer 720. The transfer sheet 700 also includes a first edge 711 and a second edge 712. In one embodiment, the edges 711, 712 are perforated or have the earmarks from a perforated connection to another transfer sheet.
The adhesive used is generally a releasable type of adhesive, such as an adhesive similar to that used on a POST-IT note from 3M of St. Paul, Minn. The releasable adhesive will allow the strip to be applied to a surface and removed without leaving an adhesive residue on the surface.
In still another embodiment, the adhesive strip is covered with a strip of material to seal the adhesive until it is exposed for use. This material may be of the peel and stick type. The transfer sheet 700 can be bunched up along one of the edges 711, 712 and used to move an object such as a patient. In one embodiment, the transfer sheet 700 can include hand hold openings.
System Storage
Now referring to both
The wall mounted bracket 900 has an upper portion 910 and a lower portion 912. The upper portion 910 is substantially parallel with the lower portion 912. The lower portion 912 abuts the wall 902. The lower portion 912 is attached to the wall via any suitable type of fastening device, such as lag bolts, screws, or the like. The lower portion 912 can be attached using an adhesive. In some embodiments, both an adhesive and one or more fasteners are used to attach the lower portion 912 of the wall bracket 900 to the wall 902.
When attached, the upper end 910 is free and spaced from the wall at a distance which is greater than the width of the patient transfer device 300. The patient transfer device can then be stowed along the wall, and produce a minimal footprint. The patient transfer device 300 also does not interfere with the ground. In many instances, for example, the floor is kept clean so having the patient transfer device off the floor is helpful in that it does not need to be moved to clean a room.
The wall bracket 900 can be used in any type of room, including surgical suites, patient rooms, or hallways near a plurality of patient rooms. The device can also be used in transport vehicles, such as ambulances or helicopters, or rescue boats.
Stored above the wall mounted bracket 900 is a roll of transfer sheets 700. The transfer sheets 700 are formed in a roll 930 and can be easily deployed.
In use, the patient transfer device 300 is removed. A transfer sheet is torn off the roll along a perforated edge, such as edge 712. The adhesive can then be used to removably attach the transfer sheet 700 to the belt 330 of the transfer device 300. In other embodiments, the transfer sheet 700 may be attached to the patient transfer device 300 before being removed from the storage spot of the wall mounted bracket 900.
In one embodiment, the upper portion 910 of wall mounted bracket 900 is attached to the lower portion by a spring hinge 914. The spring hinge 914 allows the upper portion 910 to fold down and provide a substantially vertical working surface for the patient transfer device 300 as a transfer sheet is being loaded thereon. After the transfer sheet 700 is loaded onto the patient transfer device 300, the spring hinge 914 moves the upper portion 910 back to a position proximate the wall to which the wall bracket 900 is mounted.
In still another embodiment, the roll of transfer sheets can be placed or mounted in a suitable housing. The housing can be attached to an appropriate surface. The housing protects the roll of transfer sheets 700.
Method of Operation
Applying the transfer sheet to the continuous belt includes removing a peel and stick type covering from an adhesive strip, and placing the adhesive strip of the transfer sheet onto the continuous belt of the patient transfer device. Generally, the adhesive strip will be applied to the belt near the edge that will be initially placed under the patient. The belt is moved to place a portion of the transfer sheet into the opening between the housing 310 and the edge of the belt 330, as depicted herein (step 1116). This may be referred to as loading the transfer sheet onto the patient transfer device (step 1116).
The patient or other body to be moved is then rolled away from the patient transfer device (step 1118), the patient transfer device is placed adjacent the patient (step 1120), and the patient is then rolled back onto the patient transfer device (step 1122). The patient or other body to be moved is now partially on the patient transfer device. The transfer sheet can then be pulled and the body pushed to place the patient onto the continuous belt and transfer the patient from the first surface to a second surface (step 1124).
At least one portion of the transfer sheet contacts the continuous belt. The patient continues to be moved until it is on the second surface (step 1126). The patient can then be tilted or rolled away from the patient transfer device (step 1128), and the patient transfer device can then be removed (step 1130) and the patient can be rolled onto the second surface (step 1132).
Transfer Sheet Materials
As shown, the sheet is a relatively thin and tough plastic sheet that is dimensioned so that it fits on the continuous belt 330, 1850. In operation, the sheet 1205 fits between the transfer sheet 700 and the continuous belt 330, 1850. For example, the sheet can be positioned when it is determined that the body to be moved, such as a heavy patient, may be large enough so that pulling on the transfer sheet 700 alone may rip the transfer sheet 700. Alternatively, the supplemental sheet 1205 can be bonded to the transfer sheet 700, for example to the bottom surface of transfer sheet 700, in a laminated transfer sheet configuration.
The sheet 1205 is made of a tough plastic that can be grabbed and moved with little chance of tearing. In one exemplary embodiment, the sheet 1205 is made of polyethylene having a thickness of approximately 20 mils.
As shown, the sheet 1205 has a first edge 1201 and a second edge 1202. The sheet 1205 can have a first set of handholds 1211 positioned near the first edge 1201 and a second set of handholds 1213 near the second edge 1202. In another embodiment, the sheet can include a foam material. The foam material provides for further cushioning of the body during transport. In some embodiments, the foam is added to the sheet 1205 to provide a composite sheet that is both strong and cushioned. In another embodiment, the sheet may be entirely made of foam material.
Drive System and Controls
In some embodiments, the patient transfer device 300 includes a drive mechanism 1210.
The drive mechanism, in one embodiment, includes an electric motor or drive system 1210, such as a brushless induction motor. The electric motor turns a shaft or shafts 1212 and 1212′ coupled to at least one or both of the elongated rollers 320, 322. The shaft 1212, 1212′ turns and drives the rollers 320, 322. The shaft 1212, 1212′ turns one way to rotate the roller in a first direction and turns another way to turn the roller in the opposite direction. In one embodiment, shafts 1212, 1212′ are connected so that rollers 320, 322 can be rotated freely to override the drive motor 1210.
In one embodiment, the motor 1210 includes a gearbox having a set of pawls that are used to drive the shaft in a first direction. If the rollers are turned faster than the driven speed, the pawls merely ride over an adjacent drive position to allow the rollers to free wheel in the driven direction. This is helpful in the event the drive mechanism is not moving fast enough and the people overseeing the transfer of the patient want to expedite the transfer, such as in an emergency situation. In addition, if there is a loss of power, it may be necessary in order to move the patient, or other body to be transferred.
As discussed above, the patient transfer device may be bi-directional because the shafts 1212, 1212′ can be driven in a first direction and in a second direction. The second direction may be the reverse or opposite the first direction.
It is contemplated that sensors can be used to automatically determine which way to drive the rollers. In one embodiment, accelerometers are used to detect tilt and to detect which of the sides of the transfer device 300 contacts a surface first. This will generally indicate the side of the transfer device 300 that is placed under the patient or other body or object to be moved. In another embodiment, each edge of the transfer device 300 is provided with a stress or strain gauge. The stress or strain gauge can be used to detect a force, such as a partial weight of a patient or other body or object on one edge of the transfer device.
In either embodiment, detecting the patient or other body to be moved using a strain gauge or by detecting the tilt of the device 300, the top surface or exterior portion of the continuous belt is driven away from the patient or other body to be moved so as to move the patient or other body to a position on the surface of the device 300. In some embodiments, inertial activation is used to determine the direction to drive the belt. It should also be noted that one or more of these types of sensors can be combined to form a more robust system.
In one embodiment, the electric motor is powered by a battery. In one exemplary embodiment, the wall bracket can include a charger system that charges the battery by induction technology. The motor within the patient transfer device 1200 may be an induction motor.
The charger may be provided within the wall bracket 900 and positioned in charging relation to the motor within the patient transfer device 1200. Induction or contact points can be located within the patient transfer device. The battery within the patient transfer device 1200 is then charged whenever the patient transfer device is placed in the wall mounted bracket 900. Therefore, the battery 1220 will be charged and ready when the patient transfer device is needed. After use, the patient transfer device 1200 is placed in the wall mount bracket and recharged again.
In another embodiment, the charger can also be placed in the wall near the wall bracket. In still other embodiments, the wall bracket 900 includes a series of stops to correctly position the patient transfer device with respect to the wall bracket so that the charger within the wall bracket is able to charge the battery 1220.
The patient transfer device 1200 may also include sensors, such as a sensor 1311 and a sensor 1312. Sensor 1311 is associated or positioned on or within a first edge of the housing of the patient transfer device. Sensor 1312 is associated or positioned on or within a second edge of the housing of the patient transfer device 1200. The sensors 1311, 1312 are used to detect the position of the body or other object to be transported.
The sensors 1311, 1312 can be any type of suitable sensor including an optical sensor, a heat sensor, a gyroscopic sensor, an inertial sensor, or a strain gauge, or the like. An optical sensor detects the body in response to a reduced amount of light occurring at one sensor when compared to another optical sensor. A strain gauge will detect weight added to the housing in the area of the sensor location. A heat sensor can sense heat of a patient or other body, for example should the object to be moved be a human being. A gyroscopic sensor senses the axis plane position of a portion of the patient transfer device 1200. An inertial sensor senses the commencement of movement or the stoppage of movement.
The sensors 1311 and 1312 can be used to control movement or driving of the continuous belt 330 so as to make the patient transfer device user-friendly to hospital personnel using the device to transport a patient. More than two sensors can be used in other embodiments.
The edge carrying the sensor 1311 may be the edge initially placed near the body to be moved. The body is typically rolled away from this edge. For example, if a patient is the body to be moved, the patient can be rolled onto his or her side (step 1516). The edge is placed adjacent the body to be moved, and then rolled onto the edge and over the sensor 1311.
The position of the patient is sensed (step 1518). If sensor 1311 is a light sensor, a signal indicating a lack of light or drop in an amount of light is sent to the controller 1310. The controller 1310 can then drive the rollers to move the belt 330 away from the sensor 1311, as depicted herein (step 1520).
In some embodiments, the controller can detect a lack of light for a set time before actually moving. This can prevent detecting an object when there actually was not such an object (such as a user placing a hand on the sensor 1311). In one embodiment, the sensor 1311 can be compared to the sensor 1312. If the two detect equal levels of light, for example, the room could be dark.
In another embodiment, the sensor can be a stress/strain gauge. When the patient or other body is rolled onto the edge containing the sensor 1311, the stress/strain gauge can detect added weight on the frame or the portion of the frame near the sensor 1311. The sensor 1311 can also detect heat or a warm body to determine that a patient is on the frame.
Once an object has been detected, the drive system 1210 drives the rollers away from the edge with the sensor 1311. The drive system 1210 will drive the rollers to move the body (step 1522) and then stop driving the body (step 1524).
There are many suitable options for stopping the rollers. For example, in one embodiment, the drive system 1210 will drive the rollers to move the body until the sensor 1312 detects the body by way of a lack of light, an increase in weight, or by sensing heat at the sensor 1312. In another embodiment, the drive system 1210 can continue to drive the belt for a set amount of time or for a set distance. In a further embodiment, the belt can be driven until a lack of weight, increased light or heat is no longer sensed at the sensor 1312. In still another further embodiment, the drive system 1210 will stop when the load needed to drive the belt increases, which indicates that the body has traveled to the second surface and may now be resting in part on the second surface.
The horizontal component of force needed to overcome friction on the second surface will cause the load on the motor to go high, and the motor associated with the drive system can then be stopped. The patient can be rolled or tilted (step 1526) and the patient transfer system removed (step 1527) and placed back in the wall mounted bracket for recharging (step 1528).
Discussed above is one exemplary control method. It should be noted that other control methods are possible. For example, a sensor able to detect a level surface can be used. The patient transfer device can be placed on the first and second surface and be substantially level. The transfer sheet 700 can be attached to the belt. When the patient or other body is rolled onto its side, the patient transfer device is typically tilted slightly with the low end being nearest the patient or body. Sensing the tilt toward an edge can be a signal to drive the roller in a direction toward the patient to load the transfer sheet 700. The remaining portion of the control method above can then be carried out, as discussed herein.
Described above is a system that can work with a few sensors. It is contemplated that other sensors can be used and produce inputs to a controller to enhance the ease of use for hospital personnel or others that use the patient transfer system.
For example, gyroscopic technology can also be used to sense certain conditions. A gyroscopic sensor can be used to detect a substantially level condition, such as when the patient transfer device is placed between a first surface and a second surface. Once the level condition is detected, the drive system can be enabled or turned on and readied for use.
Using gyroscopic technology, the device can also be disabled or turned off when it is determined to be at an angle greater than a selected threshold, such as 30 degrees with respect to level or horizontal. Levels can also be used to produce inputs for enabling and disabling the device. A sensor can also provide an input to automatically shut off the device when it is within the wall mounted bracket.
The machine can be a personal computer (PC), a tablet PC, a set-top box (STB), a Personal Digital Assistant (PDA), a cellular telephone, a portable music player (e.g., a portable hard drive audio device such as an Moving Picture Experts Group Audio Layer 3 or MP3 player), a web appliance, a network router, a switch, a bridge, or any suitable machine capable of executing a set of instructions (sequential or otherwise) that specify actions to be taken by that machine. Further, while only a single machine is illustrated, the term “machine” shall also be taken to include any suitable collection of machines that individually or jointly execute a set (or multiple sets) of instructions to perform any one or more of the methodologies discussed herein.
The example computer system 2000 includes a processor or multiple processors 2002 (e.g., a central processing unit or CPU, a graphics processing unit or GPU, an arithmetic logic unit, or any or all of these), and one or both of a main memory 2004 and a static memory 2006, which may communicate with each other via a bus 2008.
The computer system 2000 can further include a video display unit 2010 (e.g., a liquid crystal display or LCD, or a cathode ray tube or CRT). The computer system 2000 can also include an alphanumeric input device 2012 (e.g., a keyboard), a cursor control device 2014 (e.g., a mouse), a disk drive or other storage unit 2016, a signal generation device 2018 (e.g., a speaker) and a network interface device 2020.
The disk drive or other storage unit 2016 includes a computer-readable medium 2022 on which is stored one or more sets of instructions and data structures (e.g., instructions 2024) embodying or utilized by any one or more of the methodologies or functions described herein. The instructions 2024 can also reside, completely or at least partially, within the main memory 2004 and/or within the processors 2002 during execution thereof by the computer system 2000. The main memory 2004 and the processors 2002 also constitute machine-readable media.
The instructions 2024 can further be transmitted or received over a network 2026 via the network interface device 2020 utilizing any one of a number of suitable transfer protocols (e.g., Hyper Text Transfer Protocol or HTTP, CAN, Serial, or Modbus). For example, it is contemplated that an application, for example referred to as an app, can be used with a handheld device, such as a smartphone or mobile device available from various carriers, which can be employed as an interface for controlling the patient transfer device.
Other devices can also be provided with applications that can be used to control the patient transfer system. For example, a mobile phone application can be used to enable or turn on the device and issue certain commands needed to move a body. Thus, an application can be used to convert a mobile phone or smart phone into a remote. A dedicated remote can also be provided with the patient transfer device.
While the computer-readable medium 2022 is shown in an exemplary embodiment to be a single medium, the term “computer-readable medium” should be taken to include a single medium or multiple media (e.g., a centralized or distributed database, and/or associated caches and servers), which store the one or more sets of instructions and provide the instructions in a computer, readable form. The term “computer-readable medium” shall also be taken to include any suitable medium that is capable of storing, encoding, or carrying a set of instructions for execution by the machine and which causes the machine to perform any one or more of the methodologies of the present application, or a medium that is capable of storing, encoding, or carrying data structures utilized by or associated with such a set of instructions.
The term “computer-readable medium” shall accordingly be taken to include, but not be limited to, solid-state memories, optical and magnetic media, tangible forms and signals that can be read or sensed by a computer. Such media can also include, without limitation, hard disks, floppy disks, flash memory cards, digital video disks, random access memory (RAMs), read only memory (ROMs), and the like.
The computer system or part of a computer system can be used as the controller 1310 in the drive system of the patient transfer device. In addition, the patient drive system can be provided with any type of suitable interface for receiving signals over a link, such as an internet link, RF link, infrared link or the like.
The exemplary embodiments described herein can be implemented in an operating environment comprising computer-executable instructions (e.g., software) installed on a computer, in hardware, or in a combination of software and hardware. Modules as used herein can be hardware or hardware including circuitry to execute instructions. The computer-executable instructions can be written in a computer programming language or can be embodied in firmware logic.
If written, for example, in a programming language conforming to a recognized standard, such instructions can be executed on a variety of hardware platforms and provide for interfaces to a variety of operating systems. Although not limited thereto, computer software programs for implementing the present method(s) can be written in any number of suitable programming languages such as, for example, Hyper Text Markup Language (HTML), Dynamic HTML, Extensible Markup Language (XML), Extensible Stylesheet Language (XSL), Document Style Semantics and Specification Language (DSSSL), Cascading Style Sheets (CSS), Synchronized Multimedia Integration Language (SMIL), Wireless Markup Language (WML), JAVA, JINI, C, C++, Perl, UNIX Shell, Visual Basic or Visual Basic Script, Virtual Reality Markup Language (VRML), or using other compilers, assemblers, interpreters or other computer languages or platforms.
System Storage Alternatives
Space in an operating suite can be precious. By orientating the wall mounted bracket 1700 vertically, there is less of a footprint with respect to the floor of the operating suite. In this manner, the wall mounted bracket 1700 can allow space for other equipment to be placed into the operating suite.
In this embodiment, the roll 930 of transfer sheets 700 is also mounted vertically. It should be realized that the roll 930 of transfer sheets 700 can also be mounted horizontally. In fact, one of the wall bracket or roll can be mounted substantially horizontally and the other of the wall bracket or roll can be mounted substantially vertically in various exemplary embodiments.
In each of the various embodiments, the wall bracket 900, 1700 may be provided with a set of contacts for a contact charger. The patient transfer device 300 can have a corresponding set of contacts which make contact with the set of contacts associated with the device 300. The contacts can be used to recharge the motor inside the device 300.
Similarly, the device 300 and the wall mounted brackets can also include a non-contact charging system which can be used to charge the motors associated with the device 300. In one embodiment, the non-contact charging device can include a set of coils associated with the patient transfer device 300 and another set of coils associated with the wall bracket 1700. An alternating current passed through the coils in the wall bracket can induce an alternating current in the coils of the transfer device. These can be rectified and used to charge a storage device, such as a battery.
In such an embodiment, there may be no electrical contacts, which is advantageous if the operatory includes the use of combustible gases and the like. In another embodiment, the wall mounted bracket can be provided with electrical contacts that make contact with the patient transfer device so that it is charged when placed in the wall mounted bracket 1700.
The wall mounted bracket 1700 includes an upper portion 1710 and a lower portion 1712. In one embodiment, upper portion 1710 is attached to the lower portion 1712 by a hinge or spring hinge 1714. The hinge 1714 allows the upper portion 1710 to fold down and provide a substantially vertical working surface for the patient transfer device 300 as a transfer sheet is being loaded thereon. After the transfer sheet 700 is loaded onto the patient transfer device 300, a spring hinge 1714 can move the upper portion 1710 back to a position proximate the wall to which the wall bracket 1700 is mounted.
Suitable materials for manufacturing the storage bracket include, but are not limited to, plastics and other durable polymers, woods, metals, composite materials, and combinations thereof. In the particular example of
First (device) housing 1721 is attached to a wall or other structure 902 and configured for storing a patient transfer device, for example a device, system or apparatus 300, 1800, 2100 or 2600, as described herein. Second housing 1722 is attached to first housing 1721, and configured for storing one or more transfer sheets or other materials, for example single-use transfer sheets 700, 1900 or 1950, as described herein. Alternatively, second housing 1722 may also be configured for storing additional materials, for example multi-use transfer sheets, linens, and/or spare belts or other parts for the patient transfer device.
Suitable materials for making the components of cart 1750 include, but are not limited to, metals, plastics, polymers, composite materials, and combinations thereof, as described above. Storage bracket 1720 can be configured for storing a patient transfer device or apparatus 300, 1800, 2100 or 2600, and/or one or more transfer sheets 700, 900, or 1950, with or without additional linens, parts, and materials, as described herein. Alternatively, cart 1750 may utilize a storage unit substantial similar to storage bracket 900 or storage bracket 1700, or another suitable storage unit configuration.
Design Alternatives—Transport Device
The patient transfer system 1800 includes a housing 1810 dimensioned to span a distance between the first surface and the second surface. The housing 1810 includes a first elongated frame member or side cap 1811, a second elongated frame member or side cap 1812, a first end cap 1813, and a second end cap 1814. The end caps 1813, 1814 attach to the first and second elongated frame members or side caps 1811, 1812 to form the housing 1810. The housing 1810 is made sufficiently strong so as to have the strength to not fail while spanning a distance somewhat shorter than the length of the end caps 1813, 1814.
The housing 1810 holds a bridge 1840 which is formed from a material sufficiently strong to hold a patient. The bridge 1840 includes a top bridge cover 1842 and a bottom bridge cover 1844. Located between the top bridge cover 1842 and the bottom bridge cover 1844 is a plurality of truss members including truss members 1845, 1846, and 1847.
In this exemplary embodiment, the truss members are part of a matrix of truss members. The truss members provide strength without making the bridge 1840 overly heavy. The bridge 1840 can be made of metal, plastic, fiberglass or the like. The bridge 1840 can also be made of a composite of several materials or additional materials.
It should be noted that the side caps 1811 and 1812 can also include a system of trusses, as shown in
The patient transfer system 1800 may also include a first elongated roller 1820 positioned along the first elongated frame member or first side cap 1811 of the housing 1810, and a second elongated roller 1822 positioned along the second elongated frame member or second side cap 1812 of the housing 1810. The patient transfer system 1800 may also include a set of four connector plates. Two of the connector plates are shown in
One connector plate 1831 is attached to one end of the side cap 1811 and another connector plate is attached to the other end of the side cap 1811. Similarly, there are two connector plates, including connector plate 1832, which are attached to the ends of the side cap 1812.
The rollers 1820 and 1822 are rotatably attached to two connector plates. The end caps 1813 and 1814, in one embodiment, are also attached to the connector plates. For example, the end cap 1813 attaches to connector plates 1831 and 1832.
The frame or housing 1810, the bridge 1840 and the connector plates form a support system 1830 for the patient transfer system 1800. In one embodiment, the bridge 1840 attaches to the end caps 1813 and 1814. In another embodiment, the end caps 1813, 1814 include indents for receiving the end of the bridge. In this way, the bridge does not have to be connected by hardware but can merely slip into the openings or indents in the end caps 1813, 1814. Alternatively, support system 1830 and bridge 1840 may be combined with housing 1810 to form a substantially unitary or solid structure. In some of these embodiments, there may be no moving belt, with direct contact between the transfer sheet (e.g., lower surface) and the support bridge (e.g., upper surface).
As shown in
As shown in
The continuous belt 1850 passes through the housing 1810 and does not contact the major surfaces that a patient is transferred from or to. The continuous belt 1850 passes over the support structure 1830 and specifically over the covers 1844, 1842 and the rollers as the continuous belt is moved to transfer the body. The material used to form the top bridge cover 1842 and the bottom bridge cover 1844, in some embodiments, includes a material which lessens the friction occurring between the covers 1842, 1844 and the belt 1850.
Now looking at
Design Alternatives—Transfer Sheet
The single-use transfer sheet 1900 is similar to the single-use transfer sheet 700. The transfer sheet 1900 also includes a second strip of adhesive 1910 that can be uncovered and used during the initial loading of the transfer sheet 700 onto the patient transfer device or at a later time as needed. The second strip of adhesive may not be used at all by some embodiments.
Bottom or backing layer 1951 is formed of a structural material such as a strong, durable polymer, which may be relatively impervious to fluid flow. Bottom or backing layer 1951 may also include or be formed of a structurally reinforcing material, for example an additional layer of non-woven polymer, or a spun, flash-spun, or woven layer of a fiber material such as a polyamide, aramid, para-aramid, or polyethylene fiber material that is resistant to tearing, such as a nylon, KEVLAR or TYVEK material, or a substantial structural or generic equivalent thereof.
In some embodiments, bottom layer 1951 also includes one or more coatings or impregnated materials selected for permeability or impermeability to water and/or fluid transport. In additional embodiments, bottom layer 1951 includes one or more coatings or impregnated materials selected for other properties such as increased or reduced friction, for example a silicone impregnated nylon or other impregnated material.
Middle or absorbent layer 1952 is formed of one or more absorbent materials provided between bottom layer 1951 and top layer 1953, such as absorbent cloth or textile materials, absorbent or super absorbent polymer materials, and combinations thereof. As shown in
Top layer 1953 may be formed of a relatively permeable material such as a permeable polymer or permeable textile material, or a relatively impermeable material polymer or textile material configured with a plurality of apertures or microapertures. In particular, the materials of top layer 1953 may be selected to enable the transport of fluids including liquids through top layer 1953 of transfer sheet 1950 to middle or absorbent layer 1952 of transfer sheet.
In some applications, transfer sheet 1950 may be provided in sterile form, for example in a burn unit or intensive care unit (ICU) environment, where the infection risk is elevated. In sterile applications top layer 1951 may include a removable cover sheet, which can be used to protect the sterile surface of the transfer sheet prior to use. An antibiotic or antimicrobial material can also be included, for example with silver nitrate impregnated into one or more of layers 1951, 1952 and 1953.
Advanced absorbent materials can also be used to provide additional capacity for specific applications. Sheet qualities may be signaled by a visual cue, for example, color-coded (e.g., green) sheets may signal absorbency suitable for standard catheter laboratory and operating room procedures, and (e.g., pink) sheets may signal absorbency suitable for obstetrics, and other applications where fluid absorption or another attribute is a design consideration. The fluid absorption capacity of a single-use transfer sheet may range up to about a liter (or about 35 ounces) for “standard” applications, e.g., about 800 ml (or about 27 ounces), and up to 1.5 liter (about 50 ounces) or more for “ultra” or “super” absorbent applications, e.g., about 1.6 liter (or about 54 ounces). Additional absorptive material may also be provided in a selected area of the transfer sheet, e.g., a selected central area 1959.
The various layers 1951, 1952, 1953, etc. of transfer sheet 1950 may be bonded together via one or more chemical, mechanical, or thermal processes, for example using a heat seal or thermal bonding technique. In a thermal bonded configuration, the thermal bonding pattern may be configured to discourage delamination and tearing during use of transfer sheet 1950, for example with a thermal bonding pattern or grid spacing ranging from about one inch or less (≦2.54 cm), to about one centimeter or less (≦0.39 inch).
In some applications, adhesive strips or tabs 1955 may be provided with a tab cover 1956, for example in a peel-and stick arrangement with a non-adhesive-backed paper material which can be removed to expose the adhesive prior to use. In these examples, cover tabs 1956 may be larger in dimension than adhesive strip 1955, so that a portion of each cover tab 1956 extends over and out past (beyond) the surface area of adhesive strip 1955 for ease of manipulation and removal, for example when manipulated by care providers wearing gloves.
Ergonomics
Alternatively, device 2100 may be utilized to transfer a patient 2115 or other body from any suitable surface 2121 to any other suitable surface 2122, for example any of a bed, table, or station in a hospital, clinical, home care or patient transportation environment. In each of these applications, the number of care workers 2111-2113 may vary, for example, an additional care worker may be stationed at the head of patient 2115, or there may be fewer (or more) care workers 2111-2113.
In addition, transfer device 2100 provides substantially more uniform support to patient 2115 during the transfer process, with substantially less friction, increasing patient comfort and reducing the risk of strain on health care workers 2111-2113. For example, transfer sheet 1950 may have an extended length EL when loaded onto device 2100, as defined between the body of patient 2115 on first (initial) surface 2121, and the edge or border region of sheet 1950, where it is grasped by health care worker 2113. Where health care worker 2113 is located on the opposite side of device 2100, across (or on) destination surface 2122, this configuration of system 2100 with transfer sheet 1950 can decrease strain by reducing back angle BA, as defined between vertical and a line between the hip and shoulder of health care worker 2113, as shown in
The particular sheet dimensions and usage configurations for system 2100 may vary, depending on application. For example, in one embodiment transfer sheet 1950 may extend for length EL of about twelve to twenty-four inches (or about 30 to about 60 cm) when loaded onto device 2100, as defined from the side of patient 2115 on initial surface 2121 to the edge of transfer sheet 1950, where it is grasped by health care worker 2113 on the side of second (destination) surface 2122. Especially for relatively small-statured health care workers 2113, this may reduce back angle BA substantially as compared to other transfer and transport systems, for example to a range of about 30 degrees or less, or about 45 degrees or less. Extension length EL of transfer sheet 1950 can also be selected for other ergonomic variables, for example in order to reduce wrist-hip distance WH, or to increase eye-hand distance EH.
These configurations of patient transfer system 2100 can provide substantial ergonomic benefits for health care workers 2113, including increased ease of patient transfer with reduced risk of injury due to stress and strain, even for relatively large-statured, heavy or bariatric (e.g., obese) patients or bodies 2115. In contrast to other single-use and disposable linen or sheet materials, transfer sheet 1950 is also configured to provide substantial tensile strength and other structural properties, as described herein, for use in system 2100 for transferring different patients and other bodies 2115 between a range of different initial and destination surfaces 2121 and 2122.
In high-strength and reinforced configurations, for example, transfer sheet 1950 may provide a tensile strength (e.g., a grab tensile strength) of about 30-40 lbf (or about 130-180 N) or more, a bursting strength of about 85 psi (or about 600 kPa) or more, and a tear resistance (e.g., a trapped tear resistance) of about 6-9 lbf (or about 25-40 N) or more, using the materials described herein. Alternatively, transfer sheet 1950 may be provided in a heat-bonded or other multi-layer or multi-ply form, as described herein, in order to provide (for combined layers) a tensile strength of about 6-8 lbf (or about 25-35 N) or more, a bursting strength of about 20 psi (or about 140 kPa) or more, and a tear resistance of about 1-2 lbf (or about 5-10 N) or more.
This additional strength permits a health care worker positioned as the provider at 2113 to pull sheet 1950 with a force so as to overcome the frictional forces retarding patient motion onto the destination surface (although reduced by the present systems and methods), optionally with pushing from provider 2111. Specifically, the tensile strength allows a strong pulling force to be applied to the sheet edge. This allows health care provider 2113 (as seen in
Pull Forces
Based on conservative standards, for a given pulling distance (e.g., about six to seven feet, or about 2 m), where the starting point for the caregivers hands is between the caregiver's waist and upper chest, a single care provider can safely pull a patient weight of a particular value, in a supine to supine transfer. When a patient is transferred laterally with a draw sheet, care providers may exert a pull force of approximately 70-75% of patient weight; that is, the draw sheet system has an equivalent coefficient of friction of about 70-75%, which can be multiplied by the patient weight in order to determine whether the pull force falls within a safe or acceptable range.
For a patent weight of about 100 lbs (440-450 N), for example, the pull force needed in a draw sheet transfer is about 70-75 lbs (310-340 N). This may be enough to exceed the safe value for a single caregiver, depending on body position, pulling distance, and other factors. For other, heavier patients, the required pull forces may exceed the recommended limits for two or more caregivers in typical draw sheet transfer, even when working together in a coordinate fashion.
The patient transfer devices and transfer sheets described herein reduce the required pull forces by reducing (the coefficient of) friction for at least a substantial part, if not most of, the path of movement during the transfer. In particular, use of the disclosed designs show that the pull force required to execute a given transfer may be substantially reduced, as compared to draw sheet transfers and other devices, assuming the same push force is applied.
For example, a disclosed design has been used to transfer patients with weights of up to about 490-500 lbs (2150-2250 N), with BMI of up to about 53. For such larger patient transfers, there may be two pushers and one puller, in addition to staff managing the head and feet. In such cases, a greater proportion of the transfer forces can also be provided by the pushers, who may have less injury exposure due to ergonomic and physiological considerations.
Correspondingly, the transfer sheet strength may be selected to move relatively heavy patients, but with lower push and pull forces due to the transfer system design. For example, the transfer sheet may be designed to have both a minimum strength selected to meet or exceed a preselected or recommended pull force, and a breaking strength selected to act as a mechanical fuse, in order to protect the pulling caregiver when patient weight, body angle and/or other factors may result in an unsafe pull force. In particular, the materials of the transfer sheet may be selected and configured to have strength sufficient to withstand a pull of a selected minimum force, but also have a sheet yield or break limit threshold when subjected to a greater pull force.
Suitable ranges for the minimum pull strength and maximum yield or breaking strength of the transfer sheet include, but are not limited to, about 35 lbs (150-160 N), about 50 lbs (220-230 N), about 75 lbs (about 330-340 N), and about 100 lbs (about 440-450 N), about 150 lbs (660-670 N), and about 200 lbs (880-890 N), or more, and values therebetween. The maximum or yield strength is selected to be higher than the minimum pull strength, for example about twice as high or more, about three times as high or more, about five times as high or more, or about ten times as high, or more. These values can be selected so that the tensile strength of the transfer sheet is sufficient to allow for heavy patient transfers, but also selected at a level that provides a mechanical fuse or failure warning, when the transfer configuration may exceed safe pull force limits.
Additional Design Alternatives—Transfer Device
As shown in
Bridge 2140 is disposed at least partially within housing 2130, and coupled to first and second end caps 2135 and 2136 or other members that transfer weight on bridge 2140 to first and second opposing elongated sides (or elongated frame members) 2131 and 2132. Bridge 2140 can be provided in a roller or roller-less design, and with or without a continuous transfer belt 2150, as described herein.
As shown in
The bottom of housing 2130 extends between first and second ends (or end caps) 2135 and 2136, spanning distance DS between first and second surfaces 2121 and 2122, with first side 2131 supported on first surface 2121 and second side 2132 supported on second surface 2122. This configuration spaces support deck or bridge 2140 and transfer belt 2150 from surfaces 2121 and 2122 while allowing weight on the bridge 2140 to be transferred to these surfaces. Thus, transfer belt 2150 (and any transfer sheet material) can move with the patient from first side 2131 of housing 2130 toward second side 2132, while housing 2130 and device 2100 remains substantially stationary with respect to first and second surfaces 2121, and without contact between transfer belt 2150 or support bridge 2140 and either of surfaces 2121 and 2122.
During the transfer process, the weight of the patient is supported by bridge 2140, for example with vertical (gravitational) loading transferred from the patient body through one or both of transfer belt sheet 1950 and belt 2150, onto top support surface 2141 of bridge 2140. Support deck or bridge 2140 and transfer belt 2150 are isolated from first and second surfaces 2121 and 2122 by the bottom of housing 2130, and by first side 2131 and second side 2132 of device 2100, respectively, but may transfer weight to these surfaces via the structure housing 2130. Similarly, where a transfer sheet 1950 or other material is used, the transfer sheet is spaced from (that is, does not contact) first (initial) surface 2121, reducing the risk of cross-contamination by transport of bedding and other unnecessary materials from first surface 2121 to second surface 2122. This “spaced” or “isolated” patient transfer configuration also reduces the number of manipulations required in each patient transfer, as compared to other devices, and as described herein.
These various embodiments have in common removing the need to lift a patient's full weight in favor of placing the patient on a sheet 1950 that is supported so as to be relatively easily moved with the patient on it. In general, to allow attending providers to perform a transfer, the device and sheet together offer a transfer motion that involves little friction, notwithstanding patient weight. However, if too little friction may mean reduced control of the motion of the patient, particularly if the device 2100 were angled downward toward a destination surface and a patient might gain too much momentum, the device may be equipped with a braking component that can provide or selectively apply friction that allows greater motion control. For example, an adjustable pad may apply a greater of lesser level of friction to continuous belt 2150. Providing for such control may reduce jostling that may cause patient discomfort.
Note that the designations of first and second sides 2131 and 2132 of housing 2130 are arbitrary, as are the designations of first and second ends 2135 and 2136, and first and second surfaces 2121 and 2122. Thus, any or all of these designations may be interchanged or reversed, without loss of generality. For example, support bridge 2140 and belt 2150 may be configured to transfer a patient in either direction, from first side 2131 to second side 2132 of device housing 2130, or from second side 2132 to first side 2131. Housing 2130 of transfer device 2100 can also be rotated in either a horizontal or vertical plane, or both, for example to exchange the respective locations of first and second sides 2131 and 2132 with respect to first and second surfaces 2121 and 2122, and/or to exchange the locations of first and second ends (or end caps) 2135 and 2136.
As shown in
After loading, the exposed end 1957 of transfer sheet 1950 extends from housing 2130 and over top surface 2141 of support bridge 2140 on continuous belt 2150, as shown in
As shown in
Positioning Features
As shown in
Feet 2160 may be formed of a rubberized plastic or other material selected to position housing 2130 on surface 2121 (or 2122), and to hold patient transfer device 2100 substantially stationary with respect to the surface during transport of patient 2115. In particular, the material of feet 2160 can be selected for non-skid performance or increased friction along the bedding or other material forming surface 2121, as compared to the bottom and side surfaces of housing 2130.
Thus, in normal operation device 2100 does not travel with the patient (or other body) during the transfer process, as in some other (e.g., roller board) designs. It is nonetheless recognized that some vertical motion of device 2100 may occur during transfer of body 2115, for example on bedding or other resilient surfaces 2121. In addition, some slippage of feet 2160 and/or sides 2131, 2132 of housing 2130 may also occur, for example over bed linens and other loose materials, or even over a smooth surface such as metal or plastic.
The term “substantially stationary,” therefore, as used with respect to device 2100 and housing 2130 herein, indicates that at least a portion of first side 2131 of housing 2130 remains in contact with first surface 2121 during normal operation of device 2100; that is, during the patient transfer process (e.g., assuming surfaces 21212, 2122 are not greatly different in height), until device 2100 and housing 2130 are manually repositioned. Likewise, the second (opposite) side 2132 may maintain similar contact with the second (destination) surface 2122 during the patient transfer process, until device 2100 and housing 2130 are repositioned. The portions of device 2100 in contact with the respective initial and final surfaces may include, but are not limited to, one or more sides of housing 2130 (e.g., side 2131 and/or side 2132), any contoured region 2170 along the side of housing 2130, and any one or more feet or other positioning features 2160. The positioning features as disposed along a bottom surface of at least one contoured edge region are configured to hold the transfer apparatus substantially stationary with respect to at least one of the first and second surfaces in transfer of a patient.
Alternative Bridge Designs
Positioning features (feet) 2160 may also have a sloped or beveled surface, for example with converging slope FS as shown in
Continuous transfer belt 2150 is positioned in conveying relationship about support bridge 2140 and rollers 2221 and 2222, in order to transfer a patient or other body from first side 2131 of housing 2130 toward second side 2132, or from second side 2132 of housing 2130 toward first side 2131. Thus, the body moves in conveying relationship with transfer belt 2150 (and any transfer sheet 1950), from first side 2131 of housing 2130 (at or proximate first surface 2121) and across support bridge 2140 to second side 2132 of housing 2130 (at or proximate second surface 2122).
Top surface 2141 of bridge 2140 may be coated in order to reduce friction with moving belt 2150, or another reduced friction surface may be used. Suitable coating and surface finishing techniques for reduced friction surfaces include, but are not limited to, powder coating (e.g., a free-flowing, dry powder coating technique), textured surface applications, film coating, vapor deposition, spraying, and other coating and surfacing techniques selected for reduced friction, durability and other properties, as described herein. Transfer belt 2150 may also be provided with a reduced friction (e.g., inner) surface or layer, for example a silicone impregnated nylon or other material, which is selected to reduce friction along the interface between transfer belt 2150 and the facing (e.g., top) support surface 2141, and other areas of contact with support bridge 2140.
In powder coated and other reduced-friction surfaces, the reduction in the friction coefficient may result from a combination of coating materials and texture, e.g., an “orange peel” texture or other irregular texture that reduces the surface area of contact between the top surface of the bridge and the bottom surface of the belt or sheet. Alternatively, a smooth or textured surface may be provided with a different coating material, for example a synthetic resin coating such as a TEFLON coating or a silicone coating material.
With respect to powder coating, there are two coating categories: thermosets and thermoplastics. The thermosetting variety of powder coating material incorporates a cross-linker into the formulation. When the powder is baked, the cross-linker reacts with other chemical groups in the powder to polymerize, improving performance properties. The thermoplastic variety does not undergo additional actions during the baking process, but rather flows out into the final coating.
Suitable polymers used in the disclosed coatings may include, but are not limited to, polyester, polyurethane, acrylics, polyester-epoxy (or hybrid) materials, and “straight” or substantially epoxy materials (e.g., a fusion bonded epoxy material). In production of the powder coating, granules of the selected polymer(s) are mixed with hardener, pigments and other powder ingredients. The mixture is heated in an extruder, rolled flat, cooled and broken into small chips which are milled and sieved to make a fine powder, for application to the selected surfaces of the device.
More generally, the low coefficient of friction for the powder coated surface results from a combination of the powder coated material itself, and the hardness, gloss level, size and physical geometry of the texture. A variety of versatile polymers such as polyester can be used for the coating material, and may be formulated with physical properties selected to produce durable, tough, strong, and resilient coated surfaces. The hardness also contributes to the “slipperiness” of the coating, in that it resists deforming when force is applied, helping to keep the amount of surface area contact lower.
The high points of the hard textured surface act like small ball bearings, as opposed to more compliant or pliable materials like rubber. The textured geometry also has an effect, as it interacts with the belt or sheet material sliding across it. If the texture pattern is too similar to the surface sliding across it, for example, the peaks and valleys can align and “lock” together for an instant, increasing friction and drag forces.
The gloss level of the finish also contributes. If a surface has more of a matte finish, at a microscopic level the particles refract light in all directions because of the misalignment of the particles on the surface, which can also cause an increase in friction. A more “glossy” surface, on the other hand, will be more uniform at a microscopic level, producing a smoother surface and reflecting light in a more uniform manner. This type of surface will not resist material sliding across it as much as a matte surface would.
The same principles can also be applied to the belt and sheet materials, and how they interact with the powder coated (or other friction coated) surface. For fiber materials, in particular, the “hardness,” diameter, weave pattern, stiffness, etc. can be selected for friction properties, so that the sheet or belt slides across the textured powder coated surface with reduced drag forces and energy loss, when operated in the disclosed patient transfer systems.
In this embodiment, transfer sheet 1950 is positioned in direct contact with support bridge 2140; for example, the bottom surface or layer of transfer sheet 1950 and top surface 2141 of bridge 2140, and/or any one or more of bottom surface 2142 of bridge 2140 and the outer surfaces of contoured end members 2231 and 2232 may be in planar contact. Powder coating or another surface coating or finishing technique can be used on any or all of these device surfaces to reduce friction, as described above. In addition, transfer sheet 1950 may be provided with a compatibly low friction bottom layer, e.g., a silicone impregnated fabric or film coating, or other reduced friction material.
A bottom surface of the bottom layer of such a transfer sheet 1950, opposite the absorbent layer and the permeable layer, may comprise a low friction material matched or coordinated with a low friction adjacent surface of the support bridge 2140, and the layers of the transfer sheet may have sufficient tensile strength to allow a patient supported on the sheet 1950 to be pulled across the low friction adjacent surface of the support bridge 2140 of the patient transfer device. Such a transfer sheet 1950 may not typically require adhesive strips or tabs for a belt attachment. For situations where greater control over the motion of a transferred patient is desired (such as if the device 2100 were angled downward toward a destination surface and a patient might gain too much momentum) sheet 1950 may be selected with a low friction bottom layer that affords some friction when it slides across bridge 2140.
As shown in
Bottom housing 2138, bottom frame 2139 and top housing 2149 can be coupled together to form device housing 2130 via by mechanical fastening, or by thermal or chemical bonding. Bridge frame 2148 may be configured to removably receive support bridge 2140 within housing 2130, for example using a keyed pin or other releasable locking arrangement, as described above.
Storage with Sheet Dispenser
In other respects, device 2600 can be configured according to any of patient transfer devices 300, 1800 or 2100, as described herein. In these various embodiments, device housing 2630 spaces bridge 2640 from first and second surfaces 2121 and 2122, so that neither bridge 2640 nor the transfer belt (if used) touches either surface. This improves ergonomics and reduces the risk of cross-contamination, as described above, and device 2600 remains substantially stationary while the patient or other body is transferred from first (initial) surface 2121, at or adjacent first side 2631 of device housing 2630 to second (destination) surface 2122, at or adjacent the opposite (second) side 2632.
Transfer sheets 2650 may be single-use articles with one or more features of transfer sheet 700, 1900 or 1950, or a single-use or multiple use linen or textile/fabric material, as described herein. Transfer sheet 2650 is isolated from first (initial) surface 2221 by housing 2630, reducing the risk of cross-contamination. Transfer sheet 2650 can also be left in place beneath the patient on second (destination) surface 2122, reducing the number of required patient manipulations, as described above.
Alternatively, or in addition, handles or ergonomic features 2710 may also be provided on one or both of sides 2131 and 2132 of housing 2130. Device 2100 may also have alternate configurations, for example as described above for patient transfer devices 300, 1800 and 2600.
Tabbed Sheet Designs
In the particular configuration of
Suitable materials for tabs, bands or straps 2270 include, but are not limited to, the materials used for other components of sheet 700, 1900 or 1950, as described herein. For example, tabs or bands 2270 may be formed as an integral or connected extension of bottom layer 2251, using the same or similar materials as any of bottom layer 2251, middle layer 2252, and/or top layer 2253. Strong reinforcing materials may also be used in tabs or bands 2270, for example a spun polymer or woven fiber material, as described herein.
Free ends 2271 and 2272 of tabs or bands 2270 may be removably attached to sheet 2250 prior to deployment. For example, an adhesive or similar material 2275 may be provided to detachably adhere free ends 2271 and 2272 of each tab or band 2270 to the bottom surface (or base layer) 2251 of sheet 2250. The opposite end of each tab or band 2270 may be permanently or integrally attached or fixed to sheet 2250, for example along one or both of opposite ends or edges 2261 and 2262, as shown in
One relatively common post-operative and recovery complication addressed by a tabbed sheet 2250 is the occurrence of corneal abrasion. Recovering from anesthesia, unconscious or semi-conscious patients may manipulate their arms to “itch” or “scratch” their eyes, for example in a post-anesthesia care unit (PACU) or other recovery environment. Sometimes, this may result in corneal abrasion, or other injury or complication.
Corneal abrasions are among the more frequent ocular complications following general anesthesia, and can present a painful burden to recovering (e.g., postoperative) patients 2115. Corneal abrasions can occur during or in recovery from general anesthesia procedures, monitored anesthesia care, and regional anesthesia applications.
Typically, post-operative eye injuries are attributable to patients 2115 rubbing their eyes, or due to pulse oximeters or bed linens. The etiology and pathophysiology of corneal abrasions in the perioperative period are well defined, and risk factors have been identified in trials.
The risk factors include, for example, patient position (e.g., prone or lateral) and increased procedure length. In particular, longer procedures may pose a greater risk to patients, and practitioners may consider prophylactic lubrication in such cases, particularly when performed in the prone or lateral position.
Depending upon the risk level, tabs 2170 or similar features may be deemed medically advisable or medically necessary, or provided as a standard physician's order. Thus, tabbed or banded sheets 2250 may be utilized as gentle restraints or positioners to prevent or reduce the risk of corneal abrasion and other post-operative injuries, and to reduce the associated rates of re-admission due to such complications.
In the tabbed or banded configurations described herein, extended tabs 2770 can be manipulated to strap, secure or gently “bind” arms 2225 (dashed lines) of patient 2115 to his or her or sides while under the influence of anesthesia, or otherwise in an altered state of consciousness. For example, tabs or bands 2270 may removably adhere to sheet 2250 with glue or other adhesive material 2275 covered with a removable paper or tab, as described above. Alternatively, tabs or bands 2270 may be adhered to one another, or tied together or otherwise mechanically fastened, for example utilizing a string, textile or other woven material extending from or manufactured to together with the material of sheet 2250, as described above.
Generally, applications of a tabbed “wrap” sheet 2250 may be regarded as preventive measure, with sheet 2250 configured to relatively gently hold arms (or other limbs) 2125 of patient 2115 in place during the transfer and recovery process, rather than an outright restraint, as known in the art. Alternatively, the material of extended tabs or bands 2270 may be selected to provide relatively more or relatively less tensile and holding strength and restraint capability, depending upon application. The material characteristics of adhesive 2275 may also be appropriately selected, depending upon the desired (e.g., removable or permanent) bonding strength.
While this invention has been described with reference to exemplary embodiments, it will be understood by those skilled in the art that various changes can be made and different equivalents may be substituted for particular elements thereof, without departing from the spirit and scope of the invention. The invention is thus not limited to the particular examples that are disclosed, but can also be adapted to different problems and situations, and applied with different materials and techniques, without departing from the essential scope of embodiments encompassed by the appended claims.
This application is a continuation in part of U.S. patent application Ser. No. 13/626,457 by Ty A. White and Aaron J. Emerson, SYSTEM AND METHOD FOR TRANSFERRING PATIENTS, filed Sep. 25, 2012, issued Jul. 22, 2014 as U.S. Pat. No. 8,782,826, which claims the benefit under 35 U.S.C. §119(e) of prior U.S. Provisional Patent Application No. 61/624,527, filed Apr. 16, 2012, each of which is hereby incorporated by reference herein, in the entirety and for all purposes. This application is related to co-pending U.S. application Ser. No. 14/153,805 by Ty A. White and Aaron J. Emerson, SYSTEMS, METHODS AND TRANSFER SHEETS FOR TRANSFERRING PATIENTS, filed on even date herewith.
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Number | Date | Country | |
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Parent | 13626457 | Sep 2012 | US |
Child | 14153800 | US |