CA1048883A

CA1048883A - Gas pressure cuff

Info

Publication number: CA1048883A
Application number: CA75217836A
Authority: CA
Inventors: Hans Tillander
Original assignee: METEVE AB
Current assignee: METEVE AB
Priority date: 1974-01-14
Filing date: 1975-01-13
Publication date: 1979-02-20
Also published as: FR2257263A1; FI750082A; FI59334B; NO750084L; FI59334C; NO137744C; SE381986B; DK141352C; GB1481125A; DK141352B; FR2257263B1; SE7400412L; DE2500993A1; DK5575A; NO137744B

Abstract

ABSTRACT

A blood emptying device for pressing the blood from an extremity towards the heart of a patient prior to a surgical incision, said device comprising a number of sections arranged to be provided around the extremity and to be filled with a gaseous medium, a first section being filled until a predetermined pressure has been obtained before a second section is filled, the sections being connected to each other via valves, which are operated from an operation device forming part of the blood emptying device.

Description

16)48883 The present invention relates to a gas pressure cuff to be used for emptying blood from extremities prior to a surgical incision.
The object of the present invention is to obtain a blood emptying device by means of which a simple blood emptying of an extremity may take place ~- without using a large physical force and without risk of incurring further damages.
It is known, in the case of surgical incisions on extremities, as well as with accidental damages as at restorative incisions of various types, to empty the extremity of blood and by means of a cuff or tube pumped up with air, to prevent the blood from streaming back into the extremity. An incision :., ; during such conditions is said to be an incision in a blood-emptied area.

;; The blood emptying procedure has heretofor comprised tightly wrapping ., the extremity from the periphery towards the body by means of an elastic rubber roller a so called Esmarck's roller, and in such a way prevented the arterial blood from moving out into the extremity at the same time as venerial blood is ,:
pressed out from the extremity. Each revolution of the roller overlaps the -~ previous one by one third and the roller is stretched between each revolution.
This is a hard and troublesome task, especially when the bones of the extrem-; ity are broken, and requires great care and practice in order not to cause damage.
When the extremity has been wrapped so that only a decimeter is left of the proximal part a special kind of cuff is appliedl which is pumped up with air to a pressure which is well above the blood pressure of the patient.
The roller can then be removed, whereby the cuff prevents the blood from streaming back into the extremity.
; This troublesome and sometimes damaging method may now, surprisingly, be eliminated by using the present invention. Thus in accordance with the present invention, there is provided a gas pressure cuff for use in the emptying of extremities of blood before a surgical incision and comprising a -: . ... ..
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`~ -1~488~33 plurality of sections connected in series arranged to receive and retain a gaseous medium and a number of valves connecting said sections, characterized ' in that valves are arranged to allow a gaseous medium to pass from one section to another when a predetermined gas pressure has been obtained in a first sec-~
tion, a first section of the device being connected to an operating device via a filling tube, which operating device in one position is arranged to allow the gaseous medium to pass to the valves and into said sections and in a second - position is arranged to open the valves for emptying the sections.
According to one suitable embodiment of the invention an operation ' 10 tube is connected to the operation device for controlling the opening and the closing, respectively, of the valves.
, According to another embodiment of the invention the valves comprise !, ` ` .
a spring-biased ball-valve, the opening-pressure of which is arranged to be varied by means of a regulating device.
According to a further suitable embodiment of the invention the valves are provided with a pressure piston which, by means of a pressure medium in-troduced into the operation tube, is arranged to raise the ball-valve for em-pyting of the sections.
According to another suitable embodiment of the invention the valves are provided with a pressure piston which by means of a pressure medium in-troduced into the operation tube is arranged to keep the ball-valve in closed position, whereby upon removal of the pressure medium the ball-valve opens for emptying of the sections.
` The present invention will be described in the following with refer-ence to the attached drawing wherein Figure 1, shows one suitable preferred embodiment of the blood empty-ing device according to the invention, Figure 2 shows a valve construction of one suitable embodiment of e said blood device according to Figure 1, and

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1~48883 ':
Figures 3a and 3b show another preferred embodiment of the valve of the device of Figure 1.
An operation device 1 is connected to a cuff 8 formed from a piece of stable fabric or plastic material of soft but not elastic quality by means of a filling tube 2 and an operation tube 3. The main shape of the cuff is that of truncated isosceles triangle, i.e. it has the shape of a parallel trapezium, the two non-parallel sides having the same length. The two non-parallel sides 9a and 9b of the cuff 8 are provided with a divisible zip fastener 6, by means of which the cuff can be shaped to a slightly cone shaped cylinder.
On one side of the form of stable material a number of sections 4 are provided, which sections are elongated and arranged parallel to the par-allel sides of the parallel trapezium. The sections 4 are manufactured of an elastic, strong plastic material, rubber or other air impervious material.
The sections may also consist of balloons attached to a pocket in the cuff.
The sections 4 are further connected in series by means of special valves 5 connecting said sections, which valves are arranged to open first when a certain pressure has been obtained on its pressure side.
To the cuff 8 belongs also the above mentioned operation device 1.
The operation device contains a reducing valve and a reversal valve 20. The reducing valve reduces an inlet air pressure from a tube 7 to, for example, 350mm Hg. From the operation device leads the filling tube 2 and the operation tube 3, the former being relatively coarse and the latter being of a relatively fine caliber.
The valves 5 consist of a ball valve, where the ball 12 can be pressed against its seat by means of an adjusting force adjustable by an ad-justing screw. The walls of the sections 4 are, in Figure 2, marked as 4a and 4b whereby air can pass from the lower section, in the figure, via an opening 18 and the ball-valve to the upper section, in the figure, through an opening 19, as soon as the air pressure exceeds the pressure by means of which i .

, ' ' ' ' : '' , 104~883 the ball 12 presses against its seat.
The valve S is further provided with a certain operation cylinder 10 in which a piston 14 can move and with a pin 15 can raise the ball from its seat regardless of the air pressure in the sections. A return spring 16 is also arranged to move the piston 14 back to its original position. In the operation cylinder 10 a channel 17 ends which is connected to the operat-ion tube 3 of the operation device 1.
When the blood emptying cuff 8 is to be used it is placed under the extremity to be emptied and is closed around it by means of the zip fastener 6. The reversal valve 20 of the operation device 1 is put on T
taccording to Figure 1) whereby air can pass the reducing valve and the filling tube 2 to the first section, which thereby is filled with air. ~hen the pressure in this section has reached the preadjusted value of the ball-valve, suitably 300 mm Hg, the ball 12 raises and air streams to the next section. The air fills in this way section after section until the whole cuff has been filled with air. The blood has now been driven in the central direction, i.e. in the direction towards the heart. An ordinary pressure cuff is then arranged around the extremity above the blood emptying cuff and is pumped up to a suitable pressure.

The reversal valve of the operation device is now put on F (accord-ing to Figure 1), whereby the filling tube 2 is connected with the outer air at the same time as the pressure air with the pressure of 350 mm Hg is guided to the operation tube 3 and via this to all the valves 5.
Via the channels 17 and the pressure pistons 14 the balls are now raised from their seats and air can stream from the upper sections to the lower sections and out via the filling tube 2. The blood emptying cuff is ., then removed whereupon the operation can start.

During the whole blood emptying procedure the extremity has been absolutly quiet and the work has been done by the cuff, whereby troublesome physical work and not the least the risk for complications has been eliminated.

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It has been shown above that the valves 5 connect the sections 4 - by being placed in the intermediate walls of the sections, with one opening in each section; and in such a way connec~ing the sections. The sections can also be connected by means of tubes in which tubes the valves 5 are arranged.
The valves 5 have been shown above to open under pressure for emptying of the sections 4. The valves may, however, also be constrained against emptying by means of pressure, whereby when the pressure is released the sections are emptied.
; According to another preferred embodiment of the valve shown in Figures 3a and 3b and its arrangement to and in the cuff, the valves 21 are arranged in the filling tube 2 then running along the short ends of the sections 4. In the filling tube 2 the valves 21 are provided in such a way that they have each an inlet opening 22, an outlet opening 23 to the section 4, and an outlet opening 24 towards the next valve 21 arranged in the tube 2.
The function of these valves are as follows: when the gaseous medium via the operation device reaches the first valve 21 it enters the valve and the first section 4 through outlet 23, outlet 24 thereby being closed by a guid-ing piston 26. As soon as the predetermined pressure has been obtained in this section the outlet 24 opens as the pressure reached presses the piston 26 via a connecting channel 27 and a spring 28 biassed rubber membrane 29 to connect the inlet 22 with the outlet 24 via the piston bore 30 and gaseous medium passes to the next valve 21 and the next section 4. When the piston opens for the next section 4 the piston simultaneously closes an outlet .. . . .
opening 25, connecting the following section with room pressure. -When the device is to be emptied the tube 2 is connected to room pressure in the operation device, i.e. a negative operation pressure is applied. Thereby the air leaves the section, the pressure on the membrane falls, the piston moves to its first position, opens the outlet opening 25 whereby the next section is emptied therethrough, etc. All outlet-openings 25 can thus be connected to the openings of the sections substantially at T~

, the same time, as the pressure falls almost simultaneously, all sections thereby being emptied substantially at the same moment.
The advantage with this type of valve arrangement is that the pressure obtained in each section 4 providing for the emptying of blood in the underlying tissue is even more evenly distributed, and further that the valves 21 are easily reachable and thereby more readily served when needed, and that the air or other gaseous medium used leaves the sections at the same time and thereby faster which may be of interest if blood should be needed quickly in the extremity for one reason or another. Further a compensation for leakages is always made.

Claims

THE EMBODIMENTS OF THE INVENTION IN WHICH AN EXCLUSIVE
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:

1. A gas pressure cuff for use in the emptying of extremities of blood before a surgical incision and comprising a plurality of sections connected in series arranged to receive and retain a gaseous medium and a number of valves connecting said sections, characterized in that valves are arranged to allow a gaseous medium to pass from one section to another when a predetermined gas pressure has been obtained in a first section, a first section of the device being connected to an operating device via a filling tube, which operating device in one position is arranged to allow the gaseous medium to pass to the valves and into said sections and in a second position is arranged to open the valves for emptying the sections.

2. A device according to claim 1, characterized in that the valves comprise a spring-biassed ball-valve, the opening-pressure of which is arranged to be varied by means of a regulating device.

3. A device according to claim 1, characterized in that an operation tube is arranged to the operation device for controlling the opening and the closing, respectively, of the valves.

4. A device according to claim 2, characterized in that the valves are provided with a pressure piston which by means of a pressure medium introduced into the operation tube is arranged to raise the ball-valve for emptying of the sections.

5. A device according to claim 2, characterized in that the valves are provided with a pressure piston, which, by means of a pressure medium intro-duced into the operation tube, is arranged to keep the ball-valve in closed position, whereby at the removal of the pressure medium the valve opens for emptying of the sections.

6. A device according to claim 1, characterized in that the valves are arranged in the filling tube outside the respective section, the valves comprising an inlet opening, an outlet opening to the respective section, and a connecting opening to the next valve, the connecting opening being opened when the predetermined pressure has been obtained in a first section, and an emptying opening being arranged to let gaseous medium from the section out, the emptying taking place when an operation pressure is applied.