RU2275893C2 - Medical antidecubital burn treatment bed - Google Patents

Abstract

FIELD: medical engineering.

SUBSTANCE: device has chamber, time relay, bottom plate, fixed external carcass, movable internal carcass having electromotor and protective movable carcass manufactured from plates and rubber-impregnated fabric manufactured as hood for covering patient. Quartz irradiator and tube are mounted on the bottom plate. Warm air is supplied via the tube. The fixed external carcass has frame, having cross-spanned flexible supports. The internal carcass has frame and perforated pins for fixing bearing flexible supports and guiding bushings to allow reciprocating motion to take place.

EFFECT: wide range of functional applications.

3 cl, 3 dwg

Description

The invention relates to medicine, namely to medical equipment, and is intended for the treatment of patients with burns and for the prevention of pressure sores. There are several types of devices for treating patients with burns and preventing pressure sores:

1. Anti-decubitus mattress made of rubberized fabric, in which the anti-decubitus effect is created by alternately inflated chambers using a compressor, which leads to alternating contact of the chamber walls with the body surface.

2. An air mattress (water mattress) helps to reduce pressure with the contacted surface due to the uniform distribution of pressure with the contacted surface (body surface).

3. Bed - a net, a bed of mesh fabric (fishing net, tulle, etc.), stretched on a "Balkan frame", with electric fans installed to dry the burn wound.

1. An anti-decubitus mattress with alternately inflated air chambers is made of rubberized fabric, which restricts air access to the skin and leads to its maceration, causing blotting of the wound with the development of infection and wound deepening;

- it is impossible to effectively warm the patient;

- there is no way to dry the burn surface, which means to get a dry formed scab on the burn surface.

2. Air and water mattresses are made of rubberized fabric, cellophane, oilcloths, etc., which absolutely prevents air from reaching the wounds, causing maceration of the skin, deepening of the wounds;

- does not exclude the formation of pressure sores.

3. Bed - mesh, despite good aeration, does not exclude the formation of pressure sores. As a prototype, we took a bed "Clinitron" (Medical equipment, Sat. Information materials, 1998).

KLINITRON - this installation, the anti-decubitus effect in which is created by "pseudo-fluid" under a stretched special sheet. A powerful air flow drives a huge number of microspheres in a closed chamber, which contributes to the effect of weightlessness or buoyancy with a marginal decrease in contact pressure with the patient’s body surface.

The disadvantages of the prototype include the following:

- limited availability of the installation due to its high cost;

- the need for a constant load;

- the complexity of maintenance of the installation and patient care;

- energy intensity;

- the high cost of consumables;

- the need for an adaptation period when transferring patients to an ordinary bed.

The aim of the invention is to improve the quality of treatment for patients with extensive superficial and deep burns, to prevent or significantly reduce the risk of serious consequences (deepening and infection of wounds, the occurrence of pressure sores, etc.), achieving savings by reducing hospital bed and intensive care.

The inventive KMP-O is a bed-chamber (figure 1, 2, 3), consisting of a fixed outer and movable inner frames, which is driven by an electric motor.

The outer frame (figure 2) consists of a fixed frame, stretched across the elastic stops (figure 2, item 7) with a cross section of 5-6 mm The internal movable frame (figure 2, position 1) consists of a frame, studs with holes for fixing the bearing elastic stops and guide bushings for vertical reciprocating motion. The stops are fixed laterally, parallel to each other every 20 mm.

The body (Fig. 2, pos. 6) is made in the form of a box of easily processed material, lined with plastic with holes for installing the control panel (Fig. 1, pos. 4), pipes for heat supply (Fig. 1, pos. 7.) And two doors (figure 1, pos. 3) for servicing the patient and sanitary treatment of the chamber cavity. The drive for driving the inner frame consists of a reversible electric motor (figure 2, position 9), a worm gear (figure 2, position 5), bevel (figure 2, position 4) and helical gears (figure 2 , item 3). Rotations from the electric motor are transmitted to and from the worm gear through the shaft (Fig. 2, pos. 8) to bevel gears and screw hoists fixed between the upper and lower frames. When you turn on the electric motor, the lifts move up and down the inner movable frame mounted on the guide bushings of the outer fixed frame, driving the bed from the woods (Fig. 1, item 5). Protective strips (figure 1, pos.6) are used to prevent the ingress of any objects on the moving parts of the KMP-O. Folding manipulation table (figure 1, item 9) serves to serve the patient.

Above the bed is closed by a frame (Fig. 1, pos. 2) made of rubberized fabric and in the form of a cap covers the patient to the neck. The cap frame is made of lightweight and strong enough (duroaluminium plate) material, easily reclines and is held in a vertical position by shock absorbers (Fig. 1, item 10). The frame protects the patient from the influence of environmental factors, retains heat, contributing to the formation of a scab on the burn surface, and creates an individual microclimate. Warm air from the ATU-3 installation is supplied to the KMP-O through a pipe (Fig. 1, item 7) with a diameter of 100 mm, with holes of 15 mm and a length of 200 cm, installed in the bed tray. The temperature of the supplied air is regulated by the sensors of the ATU-3 installation and is 37-38 ° С.

For disinfection and ultraviolet irradiation of the patient’s wounds, a quartz irradiator OBN-150 is installed in the bed tray (Fig. 1, pos. 8). Outside, at the head end of the bed, a folding manipulation table is installed (Fig. 1, item 9).

PRINCIPLE OF WORK OF AUTOMATION AND ELECTRIC DRIVE

The control panel (figure 3) provides automatic operation of the ILC-O. The electrical circuit of the KMP-O control panel is shown in Fig. 3a. The voltage is supplied to the control panel by turning on the GF circuit breaker (inside the box) and the SA key switch (on the control panel door). HLI lamp indicates the presence of voltage in the network.

The installation starts from one of the extreme positions, for this it is necessary to press the button up on the control panel (Fig. 3, pos. 3), if the movable frame is in the lower position, or the button down (Fig. 3, pos. 1), if the frame is in the upper position. From this moment, KMP-O operates in automatic mode, which is supported by an electronic unit with a time relay installed in it. The time relay controls the contact time of the stops with the surface of the patient's body and is set manually. The electronic circuit of the installation provides automatic blocking of starters in case of simultaneous (erroneous) pressing of both buttons.

KMP-O works as follows: turning on the key switch (Fig. 3, pos. 7) located on the control panel starts the time relay (Fig. 3, pos. 16) with a pre-set time that starts the starter (Fig. 3, Pos. 14). The inner frame with the frame and the bearing stops moves upward, taking the patient from the fixed frame onto himself. Thus, the patient is completely moved from the stops of the fixed frame to the stops of the moving frame and is on them as much time as installed on the timer. The most optimal time is 10-12 minutes, this is the time required to restore blood circulation in areas in contact with the stops of the frames. After a set time, the inner frame begins to move down, the patient's body moves to the stops of the fixed frame. Thus, there is a change in the contacting areas of the patient’s body, which contributes to the restoration of blood circulation in areas in contact with the stops, the most dangerous for the occurrence of pressure sores.

Disinfection of the bed KMP-O is carried out by conventional disinfectants with an additional inclusion of 2 quartz lamps of ultraviolet radiation (UV).

An example of using a medical decubitus burn bed

19 patients with extensive superficial and deep burns aged 16 to 72 years, including 7 women and 12 men, were treated at KMP-O.

EXAMPLE: 1. B. M., 21 years old, I. B. No. 41/0414, entered 04.12.02. Diagnosis: Thermal (flame) burn ZAB Art. 85% (20%) rep. body. Thermo-inhalation injury. Shock III Art.

Immediately after admission, the patient is placed on the ILC-O. After appropriate therapy, shock phenomena are eliminated after the second day. The burn surface was covered with a dry scab during the first day. On the 12th day, spontaneous healing of superficial burns under the scab was observed on an area of about 65% of the body surface. On day 15, the first autodermoplasty operation was performed. On day 20, without signs of inflammation of the wounds and pressure sores, he was transferred to the general ward. The second operation was performed on the same day. Autograft engraftment 100%, was discharged on day 37 with recovery.

Signs of the invention, distinctive from the prototype:

1. KMP-O differs from the prototype in that, for the prevention of pressure sores, elastic, parallelly located “bed of woods” stops are used, with alternately changing the place of contact with the body. In the prototype, there is constant contact with the surface of the body.

2. The contact time of the stops with the patient's body is regulated using a time relay.

3. To create an air flow of warm air, an aerotherapeutic unit (ATU-3) is used with filters that purify the air and with an air temperature control relay.

4. The device is equipped with built-in UV lamps for ultraviolet irradiation of wounds (extensive burn surfaces) and disinfection of the bed chamber.

5. There is a protective, movable frame.

6. KMP-O is equipped with a folding manipulating table and doors for patient care, disinfection treatment and care of the body cavity.

7. Protective movable frame helps to create an individual microclimate for the patient, protects the respiratory system and face from heated air flow and ultraviolet radiation.

The positive effect of using the invention.

The constant flow of warm purified air around the patient’s body helps to create an optimal microclimate, eliminates maceration of the skin, promotes the early formation of a dry scab, which prevents the loss of plasma, protects the wound from infection and contributes to the primary epithelization of superficial burns. The vertical reciprocating movement of the KMP-O stops prevents pressure sores due to the alternating change of pressure on the body. Treatment of extensive thermal lesions with an open non-dressing method saves dressings, medicines. When transferring patients from KMP-O to an ordinary bed, the patient adaptation period is not required.

Literature

Bed "Clinitron" (Medical equipment. Sat. Information materials, 1998). Prototype.

Claims (3)

1. Medical bed, decubitus, burn, containing a fixed outer frame and a movable inner frame associated with an electric motor, characterized in that it further has a protective, movable frame of plates and rubberized fabric, made in the form of a cap for covering the patient, camera, time switch , a pallet, a quartz irradiator placed in a pallet and a unit for supplying warm air through a pipe installed in the pallet, while the stationary outer frame consists of a frame with elastic stretched across stops, and the inner frame consists of a frame, studs with holes for fixing the bearing elastic stops and guide bushings for vertical reciprocating motion. 2. The bed according to claim 1, characterized in that between the upper and lower frames are fixed bevel gears and screw hoists, to which rotation is transmitted from the electric motor through the worm gear and the shaft. 3. The bed according to claim 1, characterized in that at the head end has a folding manipulation table.

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