 |
Description  |
|
|
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention is in the field of medical apparatus. More specifically, the
present invention is in the field of improved patient-transportation
apparatus having means for providing supportive treatment to a patient or
victim in the field, and forwarding record of that treatment to a
primary-care facility.
2. Description of the Prior Art
Apparatus for transporting patients to a care facility are well-known in
the art, including the emergency litter comprising two poles through the
sleeves of two or more shirts as described in the Scout Handbook and a
hands-free means for carrying a litter described by Sanders in U.S. Pat.
No. 3,486,671. Rogers describes a stretcher having wheels and
patient-restraint means in U.S. Pat. No. 5,179,746; a patient can be
strapped to a rigid back-board for immobilization, and the unit carrying
the patient then rolled on its wheels to either directly to a care
facility or to other transportation means for subsequent transfer to the
care facility. Neither the Sanders nor the Rogers apparatus have any
provision for treatment of a patient other than rudimentary first-aid
prior to arrival at the care facility.
Apparatus such as that described by Reinhold in U.S. Pat. No. 4,060,079 is
a self-contained portable unit having parts relatively movable with
respect to each other, such that the unit can be carried by one person to
a location of limited accessibility; upon reaching the patient, an
emergency crew can apply first aid, open the unit to accommodate the
patient, and then transport the litter to appropriate transportation
means, having the patient secured on the litter.
The '079 patent further describes the application of various treatments to
the patient during transportation to a primary-care or other facility.
This treatment includes a heart-lung resuscitator assembly, and has drug
and equipment compartments for supporting oxygen containers and ancillary
equipment for treatment of the patient. It has been found, however, that
the Reinhold device, while useful for limited emergency cardiac-related
treatment, is not suited for transporting a trauma victim while providing
multiple types of supportive treatment.
Bucur, in U.S. Pat. No. 3,896,797, illustrates a partial litter, the
purpose of which is to support the body of a victim undergoing cardiac
stimulation. While a sturdier apparatus than that of Reinhold, the Bucur
litter is not suitable for moving a victim undergoing emergency cardiac
treatment, except for very short distances.
Newman describes a patient-transfer apparatus in U.S. Pat. No. 5,271,110
for moving a patient from one bed to another, or to a stretcher, litter or
other transport means. The Newman apparatus, however, while useful for its
described function, has no utility for field work, and is effectively
limited to institutional functions in its application.
One problem which emergency-room (ER) workers have heretofore encountered
with respect to patients arriving therein after transportation from a
remote site, with attendant emergency treatment prior to or during such
transportation, has been a lack of dependable data regarding that
treatment, or the response of the patient to whatever treatment was
applied. Irrespective of significant levels of training in emergency
treatment, and highly competent personnel, the very fact of the
circumstances of the event can lend confusion to the situation; one
emergency medical-service (EMS) worker may be seeking a pulse or treating
a wound while another is moving debris, requesting bystanders to move, or
performing any of a number of other functions. And while time is generally
of the essence in a particular situation, that very fact can render it
difficult or impossible to take note of the exact times involved, the job
of keeping a patient alive or out of danger being the first priority.
On the arrival of the transport team at the ER, the recollections of the
team members, while individually accurate, can suffer from viewpoint, time
constraints and particular job function, requiring the physician then to
attempt to interpret and integrate that information in minimal time, in
order properly to decide on the nature and extent of immediate treatment.
A possible method of overcoming the problem of fragmentary, confused or
conflicting information would be to equip the transport device with
recorders such as, e.g., a strip chart, for each mode of treatment
protocol; thus, an oximeter could have a gauge for measurement of the
oxygen (O.sub.2) content of the patient's blood, a pulse monitor to
determine pulse rate, and other measuring devices as appropriate, whether
those devices be individual or integrated. However, this method still
requires the ER physician or other attendant to read and interpret the
strip chart or other recorded data to obtain necessary information upon
the arrival at the ER of the EMS team.
SUMMARY OF THE INVENTION
The present invention is a patient-transport device having means for
monitoring and responding to the condition of a patient under emergency
treatment, comprising in combination a litter, at least one
condition-monitoring means, recording means, and remote-transmission
means. One embodiment of the invention further comprises data-storage and
-retrieval means, sound-recording means, and sound-transmission means. The
litter is light enough to be portable.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a view in perspective of the apparatus of the present invention.
FIG. 2 is a sectional view taken along lines 2--2 of FIG. 1, showing
disposition of moleties of the invention.
FIG. 3 is a block diagram of the most-preferred embodiment of the
invention.
FIG. 4 is another view of the apparatus of the invention.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
The preferred embodiment of the present invention comprises apparatus for
the treatment and transportation of a patient generally from a remote site
to a primary-care facility, the apparatus having means for monitoring the
condition of the patient, comprising in combination a litter,
condition-monitoring means, treatment means, recording means, and means
for transmission of recorded data to a remote facility. A more-preferred
embodiment of the invention further comprises data-storage,
data-retrieval, sound-recording and sound-transmission means. A
most-preferred embodiment of this invention further comprises illumination
means, a real-time chronometer and means for voice dialog with personnel
at a remote facility.
The invention comprises patient-transport means, referred to herein as a
litter, having affixed thereto or connected therewith a plurality of
treatment devices, monitors to determine the extent of treatment or the
condition of the patient, display means to permit observation of such
monitoring, data-storage means, data-retrieval means, transmitting means,
and a timing device. The design and construction of the apparatus of this
invention are such that the apparatus is portable, wherein the term
"portable" is defined for the purposes of this specification as being
sufficiently light in weight to be carried by one member of an EMS team,
and to be carried by two members of the team when transporting a patient
disposed thereon.
The method of this invention also comprises providing emergency service to
a patient at a site remote from a primary-care facility, comprising
placing the patient on apparatus comprising a litter with a head end, a
foot end, upstanding walls and a floor, and affixing to the patient means
affixed to the litter for continuously monitoring and responding to the
patient's vital signs prior to and during transport, wherein the litter
has at least one power means connected with the monitoring and responding
means.
This invention further comprises condition-responsive means for monitoring
the vital signs of the patient, the condition-responsive means providing
input signals for treatment of the patient.
Turning now to the drawings, FIGS. 1 and 4 are perspective views from
opposite sides of the present invention, showing litter 10 with
illumination means 12 and removable defibrillator 86; FIG. 2 is a
sectional view of litter 10, taken along lines 2--2 of FIG. 1, and shows
the disposition of portions of the apparatus not visible in FIG. 1.
Restraint means 14 are shown in FIG. 1 as at least one strap 18 passing
over securement means shown as rods 20 rigidly affixed to wall 26 of
litter 10, straps 18 having adjustment means 16 and fastening means 22
shown in FIG. 1 as hook and loop-pile fabric. The function of restraint
means 14 is to keep the body of the victim from moving or falling off
litter 10, either by inadvertence during transportation or due to bodily
movement of the victim. Litter 10 has head end 80, foot end 82, floor 24,
upstanding walls 26, and base 28 within which a patient or victim is
disposed for treatment and transportation. Fastening means 62 provide a
method for affixing hooks, straps or other lifting means for the purpose
of air rescue, particularly by helicopter, or for moving litter 10
vertically where necessary; fastening means 62 are preferably provided at
the corners of litter 10.
Supplies and equipment for treatment or monitoring the condition of the
patient can be disposed within storage means 30, shown in FIG. 1 as at
least one compartment having closure means 68. The exact location of
compartments 30 is not critical, it being adequate for purposes of this
invention that they be easily accessible to EMS personnel. Flexible
container 32, shown here as a mesh bag, provides retention for loose
first-aid and other items such as, e.g., bandage strips, compresses,
saline solution, and the like.
Display means 56 provide visual information concerning the patient's
condition as reported by meters or monitors for, e.g., pulse rate 36,
blood pressure 38, blood O.sub.2 40, and body temperature 42.
At least one electronic data central processing unit (CPU) 34, shown in
FIG. 2, is located at any convenient location within litter 10, and is
interconnected with and receives input from and provides operating signals
to the various sensors, treatment means and communication means, and
display means 56 by any convenient connecting means, shown here as wires
48. Display means 56 are preferably set in at least one recess 52 in
litter 10, and can be disposed at any location convenient for observation
by EMS attendants; this location can be at head end 80 or wall 26 of
litter 10. Those skilled in the art will realize that display means 56 can
be multiple; thus, display means 56 can be at head end 80 and either side
26, or foot end 82, of litter 10, or at each location.
Microphone 44 is connected through signal-transmission means, shown here as
wires 48, to sound recorder 70, and data transmitter 72. Transmitter 72
preferably has multiple channels for the transmission of both voice and
data. Those skilled in the art are aware that wireless means can also be
used to transmit, among the instrumentation or other devices of the
present invention, any of the various signals generated thereby.
Monitors 36, 38, 40 and 42 are interconnected by signal-transmission means
48 with data-recording and -storage means 74, shown in FIG. 2 as a
recordable integrated-circuit chip. Those skilled in the art will realize
that other means for data recording and retrieval can also be used,
including, e.g., magnetic and optical media; it is sufficient that the
data be capable of storage and retrieval on command, substantially without
modification of the data so stored, i.e., without the introduction of
non-data noise. Data so stored can include, without limitation,
instrumental, sound, and visual data; the stored data can be transmitted
simultaneously with storage, or retained in storage subject to recall upon
command. The form of storage can be analog or digital.
The sensors, monitors, operating moieties and recording devices are
connected with CPU 34, which is interconnected with both data-recording
and -storage means 74 and transmitter 72. The arrangement of routine data
on the condition of the patient under treatment permits and provides rapid
response as necessary to the condition of the patient; transmission of
either or both data and voice to personnel at a remote primary-care
facility; and dialog with such personnel as necessary and appropriate.
As depicted in FIGS. 1, 2 and 4, litter 10 preferably has removably affixed
thereto and juxtaposed therewith at least the following items and devices:
breathing-assistance means 84; defibrillator means 86; monitors for pulse
rate 36, blood pressure 38, pO.sub.2 40, and body temperature 42;
hyperbaric sleeves 88, and routine first-aid materials in bag 32 as
discussed hereinabove. Tubing 76 provides flow for intravenous or other
liquid treatment by infusion pump 90, and tubing 78 provides drainage or
suction by suction means 94. Litter-support means 144 is shown here as a
strap affixed to the litter to enable EMS personnel to bear the weight of
litter 10 with a patient disposed thereon, while leaving their hands and
arms free for prehension in rough or sloped terrain. Litter-support means
144 is preferably flexible and adjustable, to permit it to be disposed in
the fashion most convenient for the person employing it.
The various removable monitoring and treatment means, such as
breathing-assistance means 84; defibrillator means 86; monitors for pulse
rate 36, blood pressure 38, pO.sub.2 40, and body temperature 42; are held
in place on or in litter 10 by means well known in the art, such as
quick-release or spring-loaded fittings. Where electrical connections are
required for power or data transmission, plug-and-socket connectors can be
used. Both the fittings and the connectors are well known in the art, and
form no part of this invention as such.
Supporting and ancillary equipment, affixed to or within the structure of
litter 10 in such fashion as to be removable or serviceable only by
qualified personnel, include illumination means 12,
pharmaceutical-infusion pump 90, suction means shown here as pump 94,
O.sub.2 supply 102 and air supply 104; power means such as, e.g., at least
one battery 106, recording means 70, CPU 34, data-transmission means 72,
and defibrillator-control means 92.
Litter 10 preferably has at least one auxiliary power source such as a
backup battery 128 or turbine-driven generator 138 powered from either or
both air cylinder 104 and external air. A solenoid valve 134 in hose 60 is
maintained in the closed position with respect to generator 138 through
hose 148 by current from battery 106 or 128; on failure of that current,
valve 134 opens, and air from tank 104 causes generator 138 to turn,
providing electrical energy to operate the systems until either battery
106 or 128 can be replaced.
If available, compressed air can replace or supplement air from tank 104 by
connection to an external source of compressed air through connector 64
integral with litter 10 and air hose 66. Hose 66 is connected to hose 60
through valve 154. Valve 154 is a one-way valve, permitting air flow only
into hose 60, in order to prevent inadvertent loss of air from tank 104.
Hose 58 serves to convey oxygen, and hose 60 serves to convey air, to
ventilation or breathing-assistance apparatus 84, depending on the
application. Hoses 58 and 60 are shown only partially, for clarity of
presentation in FIGS. 1 and 2. Details of the connection of hoses 58 and
60 are well known to those skilled in the art, and form no part of this
invention as such. Pressure-reduction valves 150 and 152 are placed in
lines 58 and 60 to provide air and O.sub.2 at pressures appropriate to
their respective uses.
In illustration of the utility of the invention, litter 10 is preferably
carried in an EMS vehicle, and draws standby and maintenance-charge power
therefrom by connection through connection means 100 to external power
such as a battery or household line circuit, well-known to those skilled
in the art, and forming no part of this invention as such. Upon removal of
the apparatus from its storage position, switch 110 is triggered, turning
on light 12 and causing elapsed-time meter 112 to start; elapsed-time
meter 112 is optionally integral with CPU 34. Each ancillary treatment
apparatus or function is connected with elapsed-time meter 112 to provide
a record of the clock time of operation and the duration of that
operation. Thus, if infusion pump 90 is used to provide, e.g., 0.1N sodium
bicarbonate solution to the patient, the times of that operation, any
non-treatment intervals, and the total duration are recorded in
data-storage means 74, and are thus available for review as necessary.
Connection means 100 can further be used to connect to auxiliary
electrical power in the field, as necessary.
Light 12 is preferably energized upon removal of litter 10 from its storage
position, as noted hereinabove. Switch 50 is provided to enable light 12
to be turned off if necessary or appropriate. Light 12 is preferably
juxtaposed within side handle 96 integral with the structure of litter 10,
and can be protected from breakage by transparent shield means 98. Shield
means 98 is preferably formed of translucent impact-resistant glass or
plastic such as, e.g., polycarbonate, polyethylene terephthalate and the
like. Light 12 can be multiple, and can be disposed at any one or more
locations on litter 10. Side handle 96 is preferably multiple, and so
situated as to provide convenience for lifting litter 10 by a plurality of
EMS personnel.
Sound-recording means 70 is preferably of the type which responds to, and
records, sounds above a pre-set level, thus avoiding the necessity of
reviewing long stretches of non-data recording. Any member of the EMS team
can effect the entry of relevant information by speaking above the pre-set
sound level, e.g., "High blood-CO.sub.2 level; starting oxygen at 0100
hours." In this fashion, the EMS attendants can continue rescue and aid
efforts without stopping to turn on a recorder to accept dictation.
Sound-recording means 70 can be equipped with an optional on-off switch
146, in order to enable recording on a full-time basis, or discontinue
recording entirely, if appropriate.
Radio-reception and -transmission means 156 can be included, with
microphone 44 and speaker 108 connected therewith, to permit dialog as
necessary between EMS and ER personnel relating to patient treatment in
the field. Data on the patient's condition and treatment can be
transmitted to ER personnel as an adjunct to the voice transmission.
Display means 56 provides information for those functions generally
required, such as, e.g., blood pressure, blood O.sub.2 or CO.sub.2, pulse
rate, and body temperature. The amount of O.sub.2 or CO.sub.2 in the
patient's blood serves as a lung-function measurement, and provides a
control parameter for metering O.sub.2 to the patient through ventilation
or breathing-assistance apparatus 84.
On operation of switch means 54, stored data can be displayed as required,
including, e.g., battery, air and O.sub.2 reserves, clock time, elapsed
time from the time litter 10 was removed from its storage location, and
the patient's vital signs.
In order properly to position a patient if necessary for breathing
assistance, optional backrest 114 and headrest 116, shown in FIG. 1, are
juxtaposed on floor 24 of litter 10. Backrest 114 is affixed to floor 24,
preferably by hinge means 120, and to headrest 116 by hinge means 122.
Floor 24 is provided with stop means 124 to permit proper positioning of
backrest 114.
Backrest 114 and headrest 116 are adjusted to conform to the patient's size
because of the necessity of maintaining the appropriate angular
relationship between the patient's torso and head to keep the tongue from
blocking the airway, and for other reasons necessary to proper treatment.
Backrest 114 is raised, and headrest 116 is set into the proper stop and
secured there against inadvertent movement by lock means 126. Cushion 118
is secured to headrest 116, and serves both to maintain the head of the
patient in optimal position and to avoid mechanical shock which might
otherwise be transmitted through the body of litter 10 to the patient's
head.
Both backrest 114 and headrest 116 have depressions 130 and 132 to
accommodate the shape of the patient's head, thus facilitating the
juxtaposition between the patient and floor 24 of litter 10. Restraint
means 136 serves to maintain the head of the patient in the proper
position for intubation, suction or any other reason. Preferred means
include, e.g., an elastic band or an adjustable strap.
All of the components which might be subject to induced abberant currents
or signals from strong electromagnetic-force fields including, e.g.,
lightning, radio broadcast signals, high-voltage and high-frequency
devices, are shielded and grounded to avoid the introduction of spurious
signals into such components. Thus, CPU 34 and wires 48 have shielding
means 140 juxtaposed thereabout; shielding means 140 are electrically
connected to ground-potential means 142. Shielding means 140 can further
comprise electrical shielding generally, and are well-known to those
skilled in the art, forming no part of this invention as such. It is
sufficient that stray currents, voltages and electromagnetic signals be
intercepted and negated without causing error in the data-gathering,
-storage and -transmission devices of this invention.
FIG. 3 presents a schematic representation of the operating mode of the
present invention. The various moieties discussed hereinabove are shown as
being connected with CPU 34, which is in turn connected with the display
panel 56. As data are provided from data-storage unit 74, the CPU provides
control of the various units as programmed. Data in storage unit 74 can be
preprogrammed, entered in the field, or can result from input from any of
the other moieties of the litter. Thus, e.g., input from blood-oxygen
monitor 40 may indicate a relatively low level of oxygen in the patient's
blood; the programming of CPU 34 then provides a command to increase the
oxygen flow through breathing apparatus 84. The term "status inputs" in
FIG. 3 is defined as the transmission of data to either or both
data-storage unit 74 or to CPU 34, wherein the data are generated from any
of the monitoring means, such as, e.g., blood-pressure monitor 38,
body-temperature monitor 42 and the like, and provide information
concerning the condition of the patient.
Modifications and improvements to the preferred forms of the invention
disclosed and described herein may occur to those skilled in the art who
come to understand the principles and precepts hereof. Accordingly, the
scope of the patent to be issued hereon should not be limited solely to
the embodiments of the invention set forth herein, but rather should be
limited only by the advance by which the invention has promoted the art.
* * * * *
|
|
 |
|
 |
Description |
|
