DE2800982A1 - Blood pressure measuring sleeve - has bellows with pair of hoses half-way between its ends - Google Patents

Abstract

The blood pressure measuring sleeve comprises an oblong flexible wrapping which can be stretched round a limb of an adult, and with an inflatable bellows inside extending in the lengthwise direction of the wrapping. The bellows has a pair of tubular hoses (24) halfway between its ends. Its length can be at least two-thirds that of the wrapping, one end being common with that of the latter, the length being at least 20 cm. Bellows dimensions can be 12-14 cm. x 22-26 cm, the hoses being equidistant from the mid-point of the bellows and approx. 3 cm apart.

Description

Blood pressure mansions

The invention relates generally to diagnostics, in particular to the creation of an improved bellows conservation for the sleeves of a Sphygmomanometer.

The cuffs of pressure gauges are known to be shaped of elongated, flat shells made of a suitable fabric and have devices to these sheaths around the limb (generally the left or right arm) of an individual in position to have their blood pressure measured shall be. In general, an inflatable bellows is arranged in the cuff, the is substantially the same width as that normally in the cuff provided bellows-receiving pocket. In particular, a typical bellows would generally be 1/4 up to 1/2 inch narrower than the pocket width of the usual elut pressure cuff of Hem to hem.

The bellows for blood pressure cuffs are wide in terms of their width and length measured differently. They are designed to cover a wide area of limb girths, namely of the arm of a newborn child up to the schetikel of an adult. In general, it should be noted that with a des Blood pressure the upper end of one arm or the other is the limb of choice is.

The pressure in the bellows in a routine blood pressure measurement is the pressure displayed on the sphygmomanometer, and with such a blood pressure measurement the bellows itself serves as the A'D binding force.

In the manufacture of blood pressure cuffs and bellows, certain know-how basic standards must be met. The basic requirement for the bellows (and consequently for the cuff) is that the width of the bellows is at least 20 must be larger than the diameter of the limb on which the bellows is placed will. The dimensions of the bellows are decisive for all dimensions of the sleeve or bellows size. For example, if the bellows is 12 cm wide and the total width the cuff is 14 cm and the distance across the bellows pocket from seam to If the seam is 3 cm, all dimensions would be 12 cm.

A second commonly accepted requirement, which is like this first based on recommendations from the American Heart Associat: ton is that the bellows should be long enough to go halfway around the limb, when carefully placed over the compressed artery ~ be casual mentioned that the American Heart Association has been in the English-speaking world 1939 sets the standards for the dimensioning of these diagnostic facilities, and it should also be mentioned that these standards are constantly being revised.

It has also been recognized in this regard that when applying the above standards mentioned a "bag (bellows) of 30 cm length, which almost or completely the The limb surrounds, avoiding any risk of misuse. The standardized bellows for Adults, as used in the US, Asia, and England, have a length between 22.8 and 24.8 cm.

Since the beginning of our century, authoritative doctors have been consistent take their view that the bellows are placed over the inside of the arm or over the artery to be ligated should be centered.

At this point, the anatomical position of the artery (usually arm artery) to be ligated. This artery begins in the patient's achaelic cavity, extends downward on the inside of the Arms and then cross the front of the arm to the opposite bend room immediately opposite the elbow. At this point the arm artery splits in a fork shape. The bifurcation is generally chosen by the user for attaching the stethoscope.

The binding force should therefore be effective over the inside of the arm be.

According to the state of the art, the bellows were designed so that that their ducts were very close to one end of the bellows clear distance from the longitudinal center of the bellows. The medical practice habitually consists of keeping the two feed lines near the fork to center the arm artery. This habit is in many cases due to the fact due to the fact that one of the pipe lines or one of the hoses is located extends towards the piston and valve in the user's hand while the other conduit extends to the mercury manometer outside the Body of the patient. In the case of a pocket aneroid instrument, there is the dial on the cuff in the user's direct line of sight.

Apart from the habitual practice described above and the need to arrange the aneroid dial in the direction of view of the User, is centering the lines in the opposite bend space opposite the In many cases, elbows are also necessary when the patient is lying on their back and cannot be moved.

Because of the off-center position of the guide lines with respect to the The length of the bellows corresponds to that described above, which is habitually practiced by doctors Practice improper placement of the bellows with respect to the arm artery if the blood pressure is measured in one arm. When the bellows according to the habitual practiced practice over-the other's arm artery Arms is arranged, then, on the contrary, it is correctly centered0 means correct "and" incorrect " here an arrangement in which the artery is not tied off with the first degree of efficiency which ensures maximum accuracy of the blood pressure measurement.

If one considers the other generally practiced medical practice of measuring blood pressure in only one or the other arm of a patient, then it can be seen that the Significantly increases the likelihood of an incompletely accurate blood pressure reading is.

The likelihood becomes even greater when you consider that the current manufacturers in the United States of America, Germany, Japan and many other parts of the world, the bellows end of the cuff is not standardized Use wise. In some cases this is located in an end region of the cuff Bellows end adjacent to the guide lines. In other cases the bellows layer is Reversed end by end, i.e. the guide lines are now more on the longitudinal center point the cuff closed. There is no obvious reason for this lack of standardization known. There have already been suspicions that the reason for this may well be May go back to a time when the left arm was the arm of choice for the occasional Blood pressure measurements were while present the right arm for occasional blood pressure records seems to be preferred. However, it is often advisable to check your blood pressure if possible measure in both arms.

It is thus found that the medical problem is due to the general, nowadays common bellows constriction currently consists of that this construction along with the usual habitual Practices by general practitioners is the inadvertent improper arrangement of one Blood pressure hlgs promotes, therefore an arrangement outside the setting relationship with reference on the artery to be compressed.

In terms of the prior art, it is also important to current manufacturing processes for blood pressure cuff bellows To be referred to The bellows or sacks are conventionally made by two methods has been manufactured. One process is called a trimming or vulcanizing process denotes in which a flat piece of rubber is folded into the shape of a sack and vulcanized at the locking points. This procedure is less costly in execution when the guide lines are near one of the edges of the resulting bellows.

The second process is a seamless immersion process in which a mold hanging from two rods is immersed in a latex bath in order to obtain the to build up the required wall thickness. The bellows is partially tied and between A small slit is formed between the two guide lines so that the bellows can be pulled over the short end can be stripped from the mold. It should be noted that after Once the mold has been removed, the long guide lines and the slot area can be drawn in reverse.

The requirement for the stripping procedure and the determination of the place, where the guiding lines are to be arranged is mainly one Function of the distance between the guide lines, the width of the bellows and other variables, the reason for the short length on one side of the bellows having The reference to its management lines is therefore on the stand. In the first, older one Vulcanization process is the reason for convenience and low cost. In the second Procedure there is a need to remove the inner mold from the half bonded rubber without deforming the resulting product.

It should be noted that the vast majority of 99% of all are in use The bellows are made of rubber. It should also be considered that Asian, British, Mexican, South American, North American converters Plants for bellows use the submerged sack. Some German and Eastern European Manufacturers take turns using the older vulcanized system. The vast majority on new systems and bellows supplied as spare parts originate from the immersion process.

Centered guide lines can be found on bellows in sizes fit "Newborns and" Children ". The bellows width for" Newborns "is 3 cm, and the width for "children" is 7 cm. These centered positions are only due to the very short ones Total length of the bellows on which the guide lines are provided is possible.

The total length of a "newborn" "or ~ children" bellows for a The blood pressure cuff is therefore very small. The result is that the above mentioned manufacturing problems with reference to the known (Erwacllsenen) bellows in the preparation of of bellows for children and newcomers not exist and therefore allow a centering of the guide lines and it really even make it difficult to locate the guide lines other than in a centered position to be arranged between the ends of the bellows. Even such a centering of the lines in the opposite flexion space does not ensure an accurate reading in both arms.

Briefly summarized, the invention consists in a blood pressure cuff, in which a sheath and a bellows, both of which are generally accepted medical and Correspond to manufacturing standards, are related to one another in such a way that when placing the blood pressure cuff on either the right or left arl. in the normal manner generally practiced by general practitioners and with centering of the guide lines over the bifurcation of the arm artery of the bellows in each case in the correct ligation relationship with respect to the arm artery of the selected arm lies.

The figures show: FIG. 1 a perspective illustration of a bellows, such as he himself in Abbindebezichung with reference to the arm artery of the right arm of a Represents the patient, with the patient's body and the sheath in phantom the blood pressure cuff is shown in dashed lines, Figs. 2 and 3 are schematic Representations of the known construction of a bellows and a blood pressure cuff when placed on the patient's right or linear arm and although when the arms are shown in cross section along the line 2-2 of FIG. 12, FIG. 4 and 5 representations similar to those of FIGS. 2 and 3, each illustrating the invention show schematically when arranged on the right or left arm of a patient, 6 is a view of the blood pressure cuff to show the outside of the same; with broken parts to better show the details of the bellows construction, and FIG. 7 shows a longitudinal section essentially along the line 7-7 of FIG exaggerated thicknesses.

Figures 2 and 3 show a conventional one, indicated generally at 10 Blood pressure cuff as used when placed on the right or left arm, RA and LA, a patient appears.

H denotes the humerus of the arm in each case, while the arm arteries of the right and left arms are labeled RBA and LBA, respectively.

At 12 the known blood pressure cuff sleeve is shown while 14 denotes a known bellows, in which the guide lines 16 in its one End region 17 are arranged.

It is common, or perhaps, in medical practice rather, a habit, the guide lines 16 above the To center the bifurcation of the right arm artery, i.e.

directly at the midpoint of the opposite bend space opposite the elbow of the arm, be it the right or the left arm. This is the location of the guide lines 16, in the illustrations of the booth shown schematically in FIGS. 2 and 3 the technology is shown.

When a general practitioner uses the known cuff designed according to FIG is used, then the routinely geiitote arrangement of the guide lines leads through him in the middle of the opposite bend space above the arm crotch so that the bellows for a complete ligation of the right arm artery RBA is not properly located. This can be traced back to the off-center arrangement of the guide lines.

If one now looks at the representation of the stand shown in FIG. 3 technique, then the same cuff guides when applied to the left arm and Pursue his well-established habit of arranging the guide lines the doctor now uses the fork to position the bellows in the correct position Ligation relationship with respect to the left arm artery LBA.

No improvement would be found in those blood pressure cuffs in which the bellows, while it still has eccentrically arranged guide lines, is reversed end by end within the cuff sleeve 12. In such a The correct arrangement of the bellows for ligating the artery in the trap would be right arm but not in the left arm occur when one this arrangement according to the state of 'Sechnlk with the arrangement according to the state of Technique compares, for example, particularly shown in Figures 2 and 3 is.

Also through the remedy of making the bellows longer than normal will an inaccurate display is not avoided. The arm circumference fluctuates, and the result is that the possibility of creating a gap between the ends of the bellows remains at the critical tie-off point.

The present invention is shown in Figures 1 and 4-7. It includes a blood pressure cuff, indicated generally at 18, and one Sheath 20 and a bellows 22, which is arranged within the sheath and with the guide lines 24 is provided.

In this case the pair of guide lines is halfway between placed at the opposite ends of the bellows 22, and the result is in that when the cuff is placed on the upper arm in the generally introduced and generally practiced manner most general practitioners use, the bellows is in the correct ligation relation to the arm artery, be it the artery of the left or optionally the right arm.

In the example shown, it is used for manufacturing reasons preferred to make the bellows in a length of about 30 cm as compared to the length of 23 to 24 cm, as they are currently used in the known bellows kolmnt. However is the fact that the bellows are preferably longer as the well-known bellows is, not the reason for its automatic arrangement in the correct bonding relationship to the artery.

The normal arrangement of those embodying the present invention Blood pressure cuff 18 is also shown in FIG. 1. Because the user is the arrangement of the guide lines 24 in a central position in the opposing bend space If you follow the practice, simply attach the guide lines to the desired one To arrange space and then to wrap the sleeve around the upper arm without exerting air pressure, the ends of the cuff wrap at any particular point on the arm circumference to arrange0 In other words, the entire relationship between the sheath and the arm arises (and with it the relation of the bellows to the arm artery) entirely out of habit Practice of locating the guide lines essentially in the opposite bend space.

According to the invention, the bellows lies in a shell in the arrangement which is best shown in Figures 6 and 7. The shell is fundamental of conventional construction, i.e., it is made from a single piece of fabric of a definite nature Length formed on a transverse fold line 26 along midway between its Ends folded back on itself int. This forms (see Fig. 7) an inside section 28 and an outside portion 30.

A circumferential stitch line 32 secures the side sections across theirs entire length permanently together, as well as across the end of the sleeve opposite the end bounded by the fold line 26.

Then the stitch line 34 is drawn across the entire width of the envelope guided, in one place a little more than a third of the distance from the end 35 of the envelope.

As a result, between the stitch line 34 and the other end 37 of the envelope a pocket 36 for the bellows 22 is formed. The bellows 22 extends essentially over the entire length of the bag and thus in the present one Example over almost two thirds of the total length of the envelope. The width of the bellows substantially overlaps the entire seam-to-seam spacing of the pocket 36.

Reference is now made to FIG. 6, in which a feed or a reinforced portion 38 on one longitudinal edge of the pocket midway between their opposite ends is formed and lines or hoses 24 in one piece are shaped with the bellows and through the fore shoe or reinforced section enter the bellows.

Means are provided on opposite sides of the cuff, to releasably overlap the cuff ends when the blood pressure cuff is in use as shown in Figures 1, 4 and 5. This facility is shown at 4o, 42 and is conventional in itself. This device may for example take the form disclosed in the same BrSinder's patent 3,699,945 dated October 24, 1972 is shown. In this patent, the devices 40, 42 are mated pads Ilaken elements and Schleifon made of flexible, elastic Material, These pads are previously known and are fully understood in U.S. Patent 3,009,235 and are disclosed under the trademark "Veloro" (a trademark of Velcro Corp., 681 Fifth Avenue, New York, New York).

As can be seen from Figures 1, 4 and 5, the invention makes it practically impossible to have a blood pressure cuff in normal in the whole world habitually practiced way to lay on one arm without losing the binding force of the bellows immediately above the center of the artery to be compressed, be it the right or the left arm artery.

This is solely due to the arrangement of the guide lines directly midway between the opposite ends of a bellows of conventional Length as determined by recognized mechanical authorities and standards in both the United States as well as prescribed anywhere in the world.

A bellows with this significant improvement can be found in each of the two recognized manufacturing processes already mentioned in this one Application have been described, manufacturev When manufacturing after the trimming or The vulcanization process arises in comparison to the use of this process in the manufacture of bellows with filling ducts near one of their end edges a comparatively small increase in the cost of production1 Nonetheless far outweighs the improvement in terms of taking more accurate measurements the relatively small increase in costs.

The same applies to those proceedings in which the Blag is made by the "dipping" process. In this case it is to be careful not to remove the bellows while stripping them from the inner The shape to which the liquid rubber material was applied as a coating is not deformed will. Here, too, there may be an increase in manufacturing costs, however, the increase in manufacturing cost is far outweighed by the benefits conferred on the final product, namely the ability to take accurate blood pressure readings, without the general practitioner from his usual and generally established manner of putting on a blood pressure cuff on the right or left arm , i.e. one continues to proceed in such a way that the guide lines are in a central position in the opposite bend room, be it the right or the left ltrm.

The abstract of this application is not intended to be a comprehensive discussion all principles, possible embodiments or types of application of the in this Document represent the invention disclosed and not for interpreting the scope of the serve the following claims.

Claims (8)

A p r u s e s: 1. Blood pressure cuff with an elongated one flexible sheath that can be stretched into a member of an adult can, and with an inflatable bladder of one to be enclosed within the envelope Length, the length of the bellows being larger in terms of the length of the envelope as the dimension of the bellows in the transverse direction of the envelope, characterized in that that the bellows has a pair of tubular conduits which are substantially in the are centered midway between its ends. 2. Blood pressure cuff according to claim 1, characterized gekemizeiciu # et, that the length of the bellows is at least two thirds that of the sleeve amounts to. 3. Blood pressure cuff according to claim 1, characterized in that that one end of the bellows is substantially common to the corresponding end of the Cuff ends. 4. Blood pressure cuff according to claim 1, characterized in that that the bellows has a length of at least 20 cm. 5. Blood pressure cuff according to claim 1, characterized in that the dimensions of the bellows on the order of 12 to 14 cm x 22 to 26 cm and the lines are equidistant from the longitudinal center of the bellows are about 3 cm apart. 6. The process for producing a blood pressure bellows, characterized by that a flat, elongated, generally rectangular solid shape with a pair from one long edge of the shape in the middle between its ends forte @ stracke @@ the rods were immersed in a bath of liquid rubber, the liquid used as a coating iui applied the rods around the mold, the liquid applied as a coating Time is given to set on the mold, then the set gum from the Rods and the form is stripped, the rods openings for receiving delimited by roll-shaped conduits, and finally a pair of flexible tubular ones Lines are tightly fastened in the openings. 7. Method of manufacturing an inflatable bladder for use in a blood pressure cuff cover, characterized in that a flat piece Rubber of a certain length on itself in the form of an elongated, general rectangular body folded, sealing the various edges of the folded body be connected to form a completely closed bag and a pair tubular lines on one longitudinal edge of the sack in connection with the inside @ the same is attached to a place centered between the ends of the sack. 8. Blood pressure cuff with an elongated sleeve that encircles the human Arm stretched around kaiui, a bellows to be placed in the shell, one contains inflatable elongated body characterized by conduit means, the are arranged on the body so that when centering the conduit means in the opposite bend space opposite the elbow of a human arm when extending of the body at least partially around the arm between the elbow and shoulder the body is in direct connection with the arm artery over the inside of the arm, be it the right or the left arm.