CA1111731A

CA1111731A - Urological drainage monitor

Info

Publication number: CA1111731A
Application number: CA290,140A
Authority: CA
Inventors: Robert C. Wingrove
Original assignee: MEDICAL DEVICES Inc
Current assignee: MEDICAL DEVICES Inc
Priority date: 1976-11-04
Filing date: 1977-11-03
Publication date: 1981-11-03
Also published as: FR2369831B1; DK489177A; AU3021377A; BR7707360A; JPS5358185A; DE2749140A1; GB1600510A; AU511672B2; IT1087974B; LU78445A1; IE45939L; GB1600509A; FR2369831A1; NL7712135A; BE860459A; IE45939B1

Abstract

ABSTRACT
A drainage monitor including a collector and a control unit. The collector has a lower, storage portion made up of elongated parallel chambers, a liquid manifold passage above the chambers with a plurality of taps aligned with the chambers, and collapsible conduits connecting the taps with with the chambers. The control unit includes an arrangement for supporting the collector, chamber valving apparatus aligned with the conduits and operable to compress them so as to pre-vent liquid flow, releasable solenoid-and-latch apparatus for preventing operation of the valving apparatus, and electri-cal timing circuitry for controlling the releasable apparatus in a predetermined sequence.

Description

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Background of the Invention This invention relates to the field o medicine, and particularly to apparatus whereby medical personnel may col].ect and keep convenient and reliable record of ~he liquid output of a patient and extract samples of the liquid without compromising the sterility of the apparatus. The equipment is especially de-signed for monitoring the volumetric urine output of the patient a-t regular hourly intervals for a total period longer than the usual work shift of hospital personnel.
The importance of knowledge of the patient's renal out-put is well-known in medicine. A knowledge of the volum~s of .
urine excreted by a patient over particular periods of time is extremely helpful in the management of fluid imbalances or elec~
trolyte abnormalities. In case~ where the patient has been in shock and the renal function is questionable, as in severe burn cases, urine output measurement is very important. Also, in vlrtually any serious illness or injury or operational pro cedure where a reduction in blood volume is anticipated, accurate .
measurement of small urinary volume output is either mandatory or highly desirable.
Accurate urine measurements are an aid in recognizing the onset of impending post-surgical shock. For this reason, the urine volumes of many post-surgical patients are measured hourly, particularly those who have undergone cardiac, thoracic, neurological, or genitol-urinaxy surgery.
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~ Summary of the Invention :~: Numerous structures are known for monitoring the renal :.
: output of the patient, from a simple graduated cylinder at the ~; ~ end of the indwelling catheter to a highIy mechanized arrangement ~:~. 30~
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such as that of Scott Patent 3,194,069, for example. My moni-toring arrangement has the advantages of completely automatic operation to collect in sequential chambers the excretions for ten successive hours, in a form resembling a bar graph for con-venient observation, with provisions for sampling the liquid in any chamber at any time, in a closed or sealed system adapted either for emptying and resterilizing or for disposable use, the manipulations at the end of the total collecting period to pre-pare for a second collection period being simple, convenient and sanitary. Provision is made for applying suction if this is ; desired, and the arrangement includes a control unit powered by a battery which is rechargable or long service.
Various advantages and features of novelty which characterize my invention are pointed out with particularity in the claims annexed hereto and forming a part hereof. However, for a better understanding of the invention, its advantages, and objects attained by its use, re-ference should be had to the drawing which forms a further part hereof, and to the accompany-ing descriptive matter, in which there is illustrated and de-scribed a preferred embodiment of the invention.

; Brief Description of_-the Drawing In the drawing, FIGURE 1 iS a view o my invention in perspective; FIGURE 2 is a showing in elevation of a portion of the invention; FIGURE 3 is a fragmentary sectional view taken along the line 3-3 of FIGUR~ 2, to a larger scale; FIGURE 4 is a vertical sectional view along the line 4-4 of FIGURE 1 to a larger scale; FIGURE 5 is a fragmentary view like FIGURE 4, showing a different position of parts of the invention; FIGURE

6 is a schematic diagram showiny the electrical portion of the ` invention; and FIGURE 7 is a fragmentary view of the inven-tion -~ in use.
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~, Description of the Preferred Embodiment _ As shown in the drawings, my monitor comprises a collector 10 and a control unit 11 which supports the collector and controls the flow of liquid thereto. As shown in FIGURE 2, collector 10 has an upper, mani~old s~ection 12 and a lower, storage section 13~ The collec-tor is formed of relatively rigid plastic such as a vinyl resin, and ~ay be constructed from two sheets of material sealed together around their edges and at other locations as necessary. Each of front sheet 14 and back sheet 1~ is preformed so that together they define the chambers and passages a~out to be descrîbed~ Preferably, fron-t sheet 14 is transparent and colorless, and carries volume gradu-ations 16, while back sheet 15 is translucent and white~
Storage section 13 comprises the plurality oE verti-cally elongated chambers 17 separated by spacing walls 20 and having indi~idual upwardly directed nipples ~1 at thelr upper endsO A common space 22 connects all the chambers near their upper ends, and a lateral opening 23 is formed in one end wall ~; of the collector.
- 20 Manifold section 12 co~prises an inlet connection in -the .
form of a drip chamber 24 extendin~ downward to a tap 25. A gen erall~ horizontal passage or header 26 slopes sl~ghtly downward away ;~
fro~ tap 25, to which`it is connected at a sharp downward angle at 27. ~ plurallty of further taps 30 extend downward from passage Z6 in line with the nipples o cham~ers 17, in a se~
quence counting to the right from tap 25, the final tap 30a being in act integral with thq nipple of thè ~inal cham~ex.
Taps 30 are not sLmple ri~ht angle connectionsr but are formed as at 31, so that liquid flo~ng to the right in the passage tends to flow into t~e taps rather than pa$s by them, as will he explain2d more~fully hel`ow-.
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Cutouts 32 are formed in the front and back sheets~be-tween nipples 21 and taps 25, 30, and supporting apertures 33 are provided in the sheets at each end and centrally of -the row of cutouts. A pluralit~ of collapsibIe kubes 34 are connected a~ their upper ends to taps 25, 30, and at their lowest ends to nipples 21r so that liquid may flow from passage 26 into any of the storage chambers 17. Drip chamber 24 is formed at its upper end 35 to receive the end of an in-dwelling catheter or other liquid source, not shown, and outlet 23 is similarly formed to receive an overflow or suction tube, also not shown, or a pledget of cotton to prevent contamination of the collector, which ac-cordingly acts in the closed or~sealed mode.
Some or all of the chambers may be provided near their bottoms with external self-sealing patches 36~ to permit an in-sertion of a sampling needle without subsequent leakage.
Control unit 11 comprises a metallic housing which en-closes the battery and electrical circuitry of ~he systemt and includes at its ~op a handle 37 by which the monitor can be con- `
veniently carried o~ supported,from a bed rail, for example.
Its front panel 40 carries a si~nal lamp 41, a battery control switch 39, and such other controls as may be desired for circuit refinements not pertinent to the overall invention here. The housing may also be provided wlth a connection for supplying ~; charging energy for the system battery, as is known in battery actuated equipment.
A plurality of support pins 42 project from the lower part of the front panel, spaced for engagement with apertures 33 in collecto~ 10, so that chambers 17 are below the unit, and a recess 43 may be provided in panel 40 to accommodate chamber 24, as suggested in FIGURE 4O
A bar 44 of rigid material is located outside collec-tor 10 in the area o-f cutouts 32 and tubes 34, and is carried : ~ ^ . ' ' ' ^3~

on pins 42: bar 44 may be separate and metallic, or may be molded as a portion of front sheet 14. In the'f.igure, a remov-able metal bar is provided with slots 45 which fit into grooves 46 in pins 42, whe`re it. is heId gravitationally by its own weight:
: alternative astening methods may be used as desired.
A row of chamber valving means 49 extends across the bottom of unit 11 for alig'nment with'tubes 34 of collector 10.
For each tube 34, there is an actuator 50 urged towards the tube by a spring 51 and having a finger 52 which e~tends through an opening 53 in panel 40 to engage the tube. The force of springs 51 is sufficient to cause fingers 52 to compress tubes 34 against bar 44 suficiently to prevent the flow of liquid through the tubes, as shown in FIGURE 5. A cushion 54 i5 also provided.
Each actuator 50 is normally retained in the position shown in FIGURE 4 by means including a latch 55 pivoted at 56 and having a notch 57 to receive the tip 60 of the actuator.
Movement of latch 55 is accomplished by a solenoid 61 mounted on ; a bracket 6Z and having an actuator 63 pivoted to latch 55 at 64.
,, A cushion 65 is provided here also. Actuator 63 is normally re- :
:~, 20 tained, by the resilient means not shownS in the position shown ; in FI5URE 4. Notch 57 is square-wallad, but the front top por-tion of latch 55 is curved downwardly at 6~o Momentary energi-zation of reIay 61 pivots latch 55 to release actuator 50, the parts ~hen taking the position shown in FIG~RE 5.
;' FIGURE 6 is a schematic showing of the circuitry con-tained in unit ll. Electrical energy for the various circuit ,~
elements is obtained ~rom a battery 70 arranged for recharging ~.

through a connection 71, and controlled by switch ~39.: A timing : circuit 72 of an~ suitable design supplies one pulse per hour -:

on a cable 73 to a decade counter 74 of the type which resets ~ ~:
, ': ~ itself to zero when de-energized. The zero count output of the ~; : counter 74 is not used: To each of the other outputs there are ,.

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connected a monstable muli.vi.brator 75 and a power amplifier 76 the la-tter bei.ng connec-ted -through a cable 77 to one o~ -the solenoids 61. The solenoids are connec-ted in sequence beginning with the one neares-t drip chamb~r 24. Alsc) connected to the nine count ou-tput of counter 75 is signal ]..amp 41.
It will be apparent -that -timing circuit 72 may perform fur-ther functions no-t i.nvolved in -the presen-t invention.

Operat_ons ~ To use my inven-tion, a control uni.t having an ade~uately 10 charged battery is carried to the site o~ use and secured by handle 37 to a suitable support, such as a bed rail. Bar 44 is removed, exposing openings 53, and actuators 50 are manually pressed inward until their tips depress latches 55 and are en-gaged by notches 57. A collector 10 is now supported on pins 42 by its apertures 33, and bar 44 is replaced in the grooves in ` pins 42. If desired, an overflow tube is inserted in opening 23 and an overflow vessel is provided therebelow, or a suction tube may be connected to opening 23 if the condition of use o the monitor warrants. The discharge end of an in-dwelling cathe-ter or othar liquid source is connected to the upper end 35 of drip chamher 24, and switch 42 is turned on, beginning operation of timing circuit 72. Liquid discharge drops through chamber 24 r tap 25, tube 34, and nipple 21, into the ~irst, le~thand cham-ber 17 o collector 10. Its quantity, color, and so forth can be visually observed~ and if sampling is desired, a needle may ; :be thrust into the chamber through patch 36 to extract li.quid from the chamber.
: At the e~ed o an hour, timing circuit 72 supplies a pulse to counter 74, which in turn supplies a signal on the first count lead to ~ulivibrator 75, which acts through power ampli-~ fier 76 to anergize soleno.id 61 associated with the chamber :

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valving of the lefthand chamber. Latch 55 is pivoted i.n a counter-clockwi.se dl.rection, releasing ac-tuator 50 to close off tube 34 by compression agai.ns-t bar 44. A-t the end o:E the muli vibrator pulse, solenold 61 i.s de-energized, but actuator 50 re-mains in its operated position. Liqui.d con-tinues to drip i.nto tap 25 until it fills with liquid, which then rises at 27 into passage 26 and flows into the first tap 30, whi.ch conducts the liqui.d through tube 34 and nipple 21 to dr:ip into the second chamber 17. At the end of the second hour, timing unit 72 sup-; 10 plies second signal to counter 74, which now supplies an outputon the second CQUnt. conductor to cause the solenoid of the sec-ond chamber valYing means to release its actuator, and thi.s pro-cess continues.
FIGURE 7 is a fragmentary view showing the appearance of the apparatus shortly after the end of the third hour. Li.-quid has been collected in the first three chambers, and the firs-t three tap~ also contain li.quid: newly excreted liquid now flows along passage 26 to drip into the fourth chamber. It will;
: of course, be understood, tha-t the graduations on each chamber take into account the liquid trapped in the preceeding tap 30.
It will be evident that the monitoring system presents very clearly to medical personnel, in bar graph form, and na-tu-ral color, the renal function of the pa~i.ent, that sampling is -~
availa~le at any time without disturbing the patient or the monito~ing e~uip~ent, and that liquid from the dri.p chamber ::~ cannot pas into a given collecting chamber until the taps lead- :.
: ~ ~ng to all preceeding chambers are closed and filled with liqui.d.
As show~ in khe drawing, collector 10 is provided with - te~ chambe~s 17, to allow for changing oollectors once during ~30 eac~ elght-hour shi. t for the nursing personnel~ To perform the ahange~ it is only necessary to turn off -~he switch 42, lit bar 44, di.sconnect the catheter tube at 35~ and remove the ~ ;:

: -7 :~ ' collector with its contents. After manually resetting the actu-ators 50,,a new collector is suspended on pins 42, bar 44 is re-placed, the catheter is re-connected at 35, and s~itch 42 is then turned on. This is a clean, convenient procedure, causing minimum annoyance to patients and medical personnel. If such a regular changing proced`ure'is followed, there is no need for an overflow tube or container. . .. .
Sometimes, however, emergencies arise which prev~nt the changing of the collector at eight-hour intervals. At the end of the eighth hour, flow of liquid i5 directed into the ninth chamber. At the end of the ninth hour, flow of li~uid is directed into the tenth chamber, and lamp 41 is illuminated to attract the attention of medical personnel. At the end of the '.
tenth hour, no further operation is possible from the valving apparatus, and the fluid continues to pass into the last chamber until it overflows at opening 23. This opening also functions to afford egress for liquid poured from the colleator at the end of its period of use. While it may be possible to clean and ster- ' , ilize these colIectors, it is more desirable simply to dispose of them in a suitable fashion~
From the foregoing, it will be evident that I have in- . .' vented a new and wholly automatic arrangement for convenient and sterile monitoring of liquid discharges, particularly discharges of urine, from patients in hospitals. My arrangement enables ready inspection and sampling of the liquid collected, and is ~' ' quickly and conveniently affixed to any hospital bed and easily used wikh a minimum of training by hospital personnel~
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~,. Numerous characteristlcs and advantages of my inven- .

ti~n have been set fort'h~in the foregoing description~ together with details of the structure and ~unction of the invention and :

the novel features thereof.are polnted out in the appended ~: claims. The disclosure, however, is illustrative only, and : ~ :
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changes may be made in detail, especially in matter~ of shape, size, and arrangement of parts, within the principle of the in-vention, to the full extent indicated by the broad general mean-ing of the terms in which the appended claims are expressed.

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Claims

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

1. In a drainage monitor for receiving and displaying the urinary output of a subject;
a unitary array of elongated parallel closed storage chambers in fixed, side-by-side relationship, said chambers having individual input nipples in first ends thereof;
a continuous header of greater than capillary dia-meter passing transversely with respect to said first ends of said chambers and having a plurality of taps spaced therealong;
collapsible conduit means connected to conduct liquid from said taps to said nipples;
means affording an inlet connection to said header at one end thereof;
support means for suspending said chambers and said header with said chambers extending vertically below said header;
and valving means external to said conduit means for enabling and preventing passage of liquid therethrough.

2. A structure according to claim 1 in which said header is configured to prevent flow of liquid in said header beyond the first chamber in sequence enabled to receive said liquid.

3. A structure according to claim 1 in which said valving means includes a timer.

4. A structure according to claim 1 including a manifold section which comprises said header and said inlet connection, said header extending from said inlet connection in a direction such that said taps become increasingly short and said taps being connected thereto in such a fashion that liquid does not flow into a tap from said inlet until all previous taps are full of liquid.

5. A structure according to claim 1 in which said cham-bers and said header are integral.

6. A structure according to claim 1, in which the valving means includes (a) actuator means normally operative to prevent passage of liquid through said conduit means, (b) releasable means for preventing operation of said actuator means, and (c) control means for releasing said releasable means to enable operation of said actuator means.

7. In a urinary drainage monitor: (1) a substantially flat liquid collector comprising (a) a storage section including a unitary array of elon-gated, parallel chambers in fixed side-by-side relation-ship, said chambers having individual input nipples in first ends thereof, (b) a continuous header of greater than capillary dia-meter passing transversely of said first ends of said chambers and having a plurality of taps spaced therealong in a predetermined sequence, and (c) collapsible conduit means connected to conduct liquid from said taps to said nipples; and (2) a control unit comprising (a) support means for suspending said collector for visual observation with said chambers extending vertically below said header, (b) chamber valving means positioned for alignment with said conduit means and including individual contact fingers resiliently operable into collapsing engagement therewith to thereby prevent passage of liquid there-through, (c) releasable means for preventing operation of said valving means, and (d) control means for releasing said releasable means in said predetermined sequence to enable operation of said valving means.

8. A structure according to claim 7 in which said valving means are arranged to collapse said conduit means against a portion of said support means.

9. A structure according to claim 7 in which said con-trol unit comprises a housing containing said valving means and said releasable means, and is provided with apertures through which the valving means engage said collapsible conduit means.

10. A structure according to claim 7, including rigid means engaging the sides of said conduit means remote from said control unit in alignment with said valving means.

11. In a drainage monitor; (1) a substantially flat liquid collector comprising (a) a storage section including a unitary array of elongated, parallel chambers in fixed side-by-side rela-tionship, said chambers having individual input nipples in first ends thereof;
(b) a continuous header of greater than capillary dia-meter passing transversely of said first ends of said chambers and having a plurality of taps spaced therealong in a predetermined sequence, and (c) collapsible conduit means connected to conduct liquid from said taps to said nipples; and (2) a control unit comprising (a) support means for suspending said collector with said chambers extending vertically below said header, (b) chamber valving means positioned for alignment with said conduit means and including individual contact fingers resiliently operable into collapsing engagement therewith to thereby prevent passage of liquid there-through;
(c) releasable means for preventing operation of said valving means, and (d) control means for releasing said releasable means in said predetermined sequence to enable operation of said valving means, (e) said support means including rigid means engaging the sides of said conduit means remote from said control unit in alignment with said valving means, in which said rigid means is integral with said chambers and said header.

12. A liquid collector comprising:
a storage section having a unitary array of elongated storage chambers in substantially flat side-by-side relation for separately receiving and displaying liquid, said chambers having individual inlet nipples in first ends thereof, a manifold section integral with said storage section and having an inlet for liquid, an elongated header connected to said inlet, and a plurality of liquid discharge openings positioned along said header;
discrete collapsible conduit means interposed between said discharge openings and said nipples for connecting said chambers severally to said openings to enable and prevent flow of liquid therebetween; and support means for suspending said collector with said chambers extending vertically below said header, and with said header sloping downwardly from said inlet.

13. A structure according to claim 12, including passage means and interconnecting said first ends of said chambers, said passage means being continued beyond the end of a chamber remote from said inlet, as an outlet from said storage section.

14. A structure according to claim 12 in which said storage chambers define front and rear surfaces and the front surface of said storage section being at least partly trans-parent, and the rear surface of said storage section being translucent and white so that different levels of visible fluids in said chambers give the visual appearance resembling a histogram.

15. A structure according to claim 14 in which said front of said storage section bears graduations correlated with the volumes of said chambers, measured from second ends thereof when the chambers are vertical, augmented by the volume of said header between said chamber.

16. A structure according to claim 12, in combination with a control unit comprising support means for suspending said liquid collector with said chambers extending vertically, and valving means positioned to engage said collapsible conduit means externally for enabling and preventing passage of liquid therethrough.

17. A structure according to claim 16 in which the valving means includes (a) actuator means normally operative to prevent passage of liquid through said conduit means, (b) releasable means for preventing operation of said actuator means, and (c) control means for releasing said releasable means to enable operation of said actuator means.