EP0025540B1 - Holding device for medical implements, hingedly fixed to the ceiling of the interior of the body of an ambulance - Google Patents

Description

The invention relates to a lid-like holding device for medical devices for emergency care, which is pivotally fastened to the ceiling of the interior of the body of an operating ambulance and which rests against the ceiling when pivoted upwards, the devices being freely accessible from the vehicle interior when the holding device is pivoted down.

A corresponding holding device is known from DE-B-1 251 910 and consists of a press plate having a U-profile, which is welded to an essentially flat cover plate on the open side of its U-profile. The holding device is arranged as a hinged lid on a recess formed on the ceiling of the interior. Hook and securing elements are attached to the pressed sheet with the U-profile forming the inside of the lid, which allow the attachment of an infusion bottle when the holding device is folded down. After the infusion has been carried out, the infusion bottle is removed from the holding device, which is then pivoted upward, so that the hook and fastening elements are accommodated in the recess, which is now covered by the holding device. In this folded-up position, the holding device should not and cannot serve to hold an infusion bottle or the like.

Although this known holding device makes it possible to hold an infusion bottle or the like filled with blood supplies or blood substitute solutions, which is connected to a patient's vein by tubing and cannula for transfusion or infusion, in such a way that it does not interfere when not in use, but on the other hand always at hand is not swinging even if the vehicle is shaken and the cannula does not tear out of the patient's vein. Nevertheless, this holding device is unsuitable for the permanent storage of an infusion bottle intended for future emergency use, since the same cannot be accommodated with adequate protection.

As a result, unnecessarily valuable time is wasted attaching an infusion bottle stored elsewhere in the vehicle to the holding device and connecting it to the infusion set during an emergency operation.

To make matters worse, in conventional rescue and emergency vehicles, the infusion bottles u. Like. As well as the infusion set often have to be searched from different places in the vehicle. Overall, the preparations take a certain amount of time and can also contribute to a considerable and undesirable hectic of medical personnel.

The case of oxygen supply is similar. Here, too, not everything is always within reach as it should be. Decisive seconds are often lost again. The same applies to the connection of the ECG electrodes.

It is already known from US-A-4 154 237 to arrange breathing masks over the seats of large passenger aircraft which are accommodated in fixed containers arranged on the ceiling with lids which can be folded down. When this cover is opened, the breathing masks automatically fall downwards, with a portion of the breathing masks being simultaneously moved sideways by means of a corresponding linkage in order to reach the range of passengers sitting further to the side.

However, this known arrangement is able for u. Like to give no suggestion, since the problem is completely different. In the event of damage to the aircraft, in particular if the pressure in the passenger cabin drops, the breathing masks in the aircraft cabin should be brought into the range of the actively movable passengers, who can and should help themselves. However, this case lies in emergency operations of surgical ambulances. The like. Not before. As a rule, the patient is helpless and in particular is unable to easily recognize and / or carry out the care necessary for him. Therefore, the breathing masks u. The like. For the medical personnel - as freely as possible - to be accessible, but not for the patient. An arrangement in which the respiratory masks may fall out of a container attached to the ceiling and get close to the patient is therefore in surgical vehicles. Like. not useful.

The object of the invention is to provide a holding device for an operating ambulance which enables protected and nevertheless easily accessible accommodation of the medical devices in emergency use without any time delay and does not restrict the space available for the care personnel.

This object is achieved in that the holding device is designed as a trough-like container in which the medical devices are protected both in the up and in the swung-down state and are ready for use in an emergency or fully connected.

According to the invention, otherwise unused space above a treatment table within the surgical ambulance for medical devices and infusion containers and the like. The like. Are provided so that the devices and infusion containers for emergency use are kept ready in a central location in the immediate vicinity of the patient for immediate use or application.

If infusion agents are contained in one of the containers, they must be at a temperature of at least 20 ° C when infusing in order to avoid damage to health, in particular shock conditions, for the emergency patients, who as a rule already have a heat deficit, so that the infusions are too cold would mean a significant additional burden.

A certain increase in the temperatures of the infusion agents does not harm the patient, however the shelf life of the solutions is generally reduced. Therefore the temperature should not exceed 35 ° C.

A temperature range of 25 ° C to 35 ° C can be regarded as optimal. To maintain this temperature range, it is expedient that a thermostatically controlled heater is arranged in the container, which prevents the infusions from cooling down inadmissible and thus avoids long warm-up times, which would otherwise be necessary, since infusions are only gentle, i.e. with moderate heat, may be heated.

In temperate climates, there is no risk of excessive heating of the interior of the container even on hot days. However, in order to prevent overheating of the infusion solutions even in tropical climates, a thermostat-controlled heat exchanger can be arranged in the space enclosed by the container, which heat exchanger can be connected to a vehicle's own cooling or air conditioning system for cooling this space.

This heat exchanger can preferably be connected to the evaporator or the condenser of the cooling or air conditioning system via a line carrying a heat transport medium, the heat exchanger serving to cool the room in the former case and to heat it in the latter case. The stored blood and infusion solutions are therefore protected against both hypothermia and overheating.

In particular, if a cooling option for the stored blood and infusion solutions is not required, as in the temperate climates, i.e. if only a drop in temperature has to be prevented, the required heating of the container can be designed as an electrical resistance heater with one or more resistance lines, which are placed on an insulating layer, e.g. a plastic film, applied and covered by a cover, e.g. also made of plastic, are protected against damage. The heating lines can be produced by methods known from the manufacture of printed electrical circuits, such as screen printing methods.

In order to keep the necessary heating output and possibly also the necessary cooling output low, it is advantageous if the container walls and the area of the interior ceiling covering the container in the folded-up state or the part connected to it are designed to be heat-insulating. For this purpose, the container walls and the interior ceiling or the covering part above the container can have a heat-insulating coating, e.g. Made of a solid plastic foam that also acts as a cushion and protects the personnel of the emergency surgery vehicle from injuries. If necessary, the container can also consist at least partially of a heat-insulating rigid foam.

Preferred exemplary embodiments of the invention are explained below with reference to the figures.

• Fig. 1 eine Draufsicht auf einen erfindungsgemäss vorgesehenen Behälter mit Infusionsgeräten,
• Fig. 2 einen Schnitt durch den Behälter in hängender Lage desselben,
• Fig. 3 einen gleichen Schnitt wie Fig. 2, jedoch in gegen die Fahrzeugdecke hochgeklappter Lage,
• Fig. 4 eine Draufsicht auf einen erfindungsgemäss vorgesehenen Behälter mit Atemgeräten,
• Fig. 5 den Grundriss einer erfindungsgemäss ausgestatteten Karosserie und
• Fig. 6 einen Schnitt durch dieselbe,
• Fig. 7 eine Draufsicht auf eine elektrische Widerstandsheizung für einen in den Fig. 2 und 3 dargestellten Behälter und
• Fig. 8 das Zusammenwirken eines sowohl zur Kühlung als auch zur Heizung geeigneten Wärmeaustauschers mit einer Wärmepumpe.

Show:

• 1 is a plan view of a container provided according to the invention with infusion devices,
• 2 shows a section through the container in a hanging position thereof,
• 3 shows the same section as FIG. 2, but in a position folded up against the vehicle ceiling,
• 4 shows a plan view of a container with breathing apparatus provided according to the invention,
• Fig. 5 shows the plan of a body equipped according to the invention and
• 6 shows a section through the same,
• Fig. 7 is a plan view of an electrical resistance heater for a container and shown in Figs. 2 and 3
• Fig. 8 shows the interaction of a heat exchanger suitable for both cooling and heating with a heat pump.

6, one or two containers 11 and 12 are mounted on the ceiling 10 of the vehicle, which according to FIGS. 2 and 3 are arranged around a hinge device 13, e.g. a sliding joint or pair of sliding joints can be folded down into the room.

The articulation device lies within a bulge 28 of the vehicle ceiling 10, which is closed off at the bottom by the container 11 or 12 and has a slide 13a which is articulated on the ceiling 10 and can be pushed in a guide 13b on the container 11 (or 12) is guided and its pivoting movements are damped by a correspondingly designed pair of links 13c or the end positions thereof can be locked by the same.

The containers 11 and 12 are trough-shaped, their interior 19 together with the open bulge 28 in the folded-up position forming a space 40 which is sufficient for the attachment of the medical devices. The tub space 19 is preferably larger than the space of the bulge 28. Leather or rubber bands or the like can be provided in the containers 11 and 12 for additional fixing of the devices.

The trough-like containers 11 and 12 can have a foamed and padded layer 14 on the outside in order to avoid injuries to the container or to persons.

This layer 14 can be used together with a corresponding layer 14 ', which is arranged on the bulge 28, for heat insulation of the room 40.

In the container 11, which is shown in FIGS. 1 to 3, a completely connected blood container 15 and an infusion bag 16 are mounted on hooks 17 with an infusion set (not shown).

In order to be able to keep the temperature inside the room 40 above 20 ° C, preferably above 25 ° C, an electric heater 41 is provided, which is powered by the vehicle electrical system and is operated by means of a thermostat 42, e.g. a thermostat-controlled switch is turned on or off. This switch can switch on the heating if the temperature in room 40 drops below 27 ° C and switch off again if a value of 30 ° C is exceeded.

As shown, the heater 41 is preferably arranged within the bulge 28, so that no movable electrical lines are required are such. Optionally, however, a corresponding heater can alternatively or additionally be arranged on the inside of the container 11. The same applies to the thermostat 42.

• Auf einer wärmefesten, elektrisch isolierenden Folie 43 sind zwei jeweils mit Anschlusskabeln 44 versehene Leiterstreifen 45 im Abstand voneinander angeordnet, die durch Widerstandsheizleitungen 46, die ebenfalls auf der Folie 43 angeordnet sind, miteinander verbunden sind. Die Leiterstreifen 45 sowie die Widerstandsheizleitungen 46 besitzen zum Schutze vor Beschädigungen eine Abdeckung 47, welche aus einer auf die Folie 43 aufgeklebten wärmefesten weiteren Folie bestehen kann. Eine derartige Heizung kann ohne weiteres auf der Innenseite der Ausbuchtung 28 aufgeklebt werden.

The electric heater 41 can be constructed according to FIG. 7:

• On a heat-resistant, electrically insulating film 43, two conductor strips 45, each provided with connecting cables 44, are arranged at a distance from one another, which are connected to one another by resistance heating lines 46, which are likewise arranged on the film 43. The conductor strips 45 and the resistance heating lines 46 have a cover 47 to protect them from damage, which cover can consist of a heat-resistant further film glued onto the film 43. Such a heater can easily be glued to the inside of the bulge 28.

In order to also be able to cool the room 40, a heat exchanger 50 can be arranged, preferably likewise inside the bulge 28, which cools the room 40 above a temperature of approximately 33 ° C. based on a signal generated by the thermostat 42 for cooling the room 40 - or air conditioning of the vehicle can be connected. As soon as the temperature in the room 40 falls below a value of 30 ° C. again, for example, the heat exchanger 50 is uncoupled from the cooling or air conditioning system.

If necessary, the heat exchanger 50 can be used both for heating the room 19 and for cooling it, as will be explained with reference to FIG. 8. The heat exchanger 50 is optionally connected to a heat exchanger 54 or a heat exchanger 55 via lines 51, 52 carrying a heat transfer medium and a valve 53 controlled by the thermostat 42. In the position of the valve 53 shown, the heat transfer medium is conveyed by means of a pump 56 from the heat exchanger 54 to the heat exchanger 50 and from there back to the heat exchanger 54.

If the slide 53 'of the valve 53 is moved to its left-shifted position upon a corresponding command from the thermostat 42, the heat transfer medium circulates between the heat exchanger 50 and the heat exchanger 55.

An in-vehicle air conditioning or cooling system has a heat pump 57 in which a heat pump medium is compressed in a known manner by means of a compressor 58, then passed through a condenser 59 and then expanded through a reducing valve 60 and into a vaporizer with reduced pressure and correspondingly reduced temperature 61 arrives, from where it is again taken up by the compressor 58. The condenser 59 has a temperature that is higher than the ambient temperature, the evaporator 61 has a temperature that is lower than the ambient temperature.

Due to the thermally conductive connection of the evaporator 61 to the heat exchanger 54, the latter can be cooled accordingly, while the heat exchanger 55 can be heated accordingly due to its thermally conductive connection to the condenser 59. Through the respective switching of the valve 53, the heat exchanger 50 can thus be kept at a temperature below the ambient temperature or at a temperature above the ambient temperature, so that cooling or heating of the space 40 by means of the heat exchanger 50 is possible. As long as the space 40 has a temperature within the desired range, the slide 53 'can assume a central position and the pump 56 can be switched off, so that the heat exchanger 50 is decoupled from the heat pump 57 and has neither a cooling nor a heating effect.

According to FIG. 4, the container 12 contains a breathing mask 22, a breathing mask 23 with a breathing bag, a children's breathing mask 24 and an automatic breathing apparatus 25 (as it is on the market, for example, under the trademark “Medumat”). The oxygen supply takes place via a hose-like line 26, which leads to the breathing machine 25 and is laid through openings in the vehicle ceiling or behind the paneling of the vehicle and emerges from the ceiling within the fold-down container. The bottle that supplies the oxygen is located at another suitable location in the vehicle. The hose-like line 27 is used for suction via the breathing machine 25.

When the containers 11 or 12 are not in use, they are folded onto the ceiling 10 and do not, or at most only slightly, hinder the attending doctor or medic. When the container is folded down, the devices housed in it are immediately fully accessible to the attending physician.

Preferably the containers in the vehicle, e.g. an ambulance, on both sides of a handrail provided there. If necessary, the holding rod can be interrupted at the point of use of only one container. The hinges of the containers are advantageously located on their rear side, so that when installed, the internals (devices) can be operated from the front, ie from the supervisor's seat.

Of course, if desired or expedient, the distribution of the devices to the containers can also be provided in a different way.

5 and 6 show an example of an arrangement of the containers 11 and 12 on the vehicle ceiling, the containers in FIG. 6 being assumed to be folded down. With 29 a cable from the EKG device 30 to the electrode 21 is designated. 31 are oxygen bottles for supplying the hose-like line 26.

Each container advantageously has a handle.

Claims (15)

1. Cover-like holding apparatus for medical equipment (15, 16, 22, 25) for emergency care, the holding apparatus being pivotally secured to the roof (10) of the interior compartment of the body work of an operational ambulance and contacting the roof in the upwardly pivoted state, wherein the equipment (15, 16, 22, 25) is freely accessible from the interior compartment of the ambulance when the holding apparatus is pivoted downwardly, characterised in that the holding apparatus is constructed as a trough-like container (11, 12) in which the medical equipment (15,16, 20 to 25) is housed in a protected state and ready for, and/or already connected for, emergency use both in the upwardly and downwardly pivoted states.

2. Holding apparatus in accordance with claim 1 and characterised in that at least two containers (11, 12) are arranged within the ambulance (Figs. 5,

6) of which the one (11) contains infusion flasks or in-fusion bags (15, 16) and the other respiratory apparatus (22 to 25) with a respiration mask and accessories.

3. Holding apparatus in accordance with one of the claims 1 and 2 and characterised in thatthe hoses (26, 27), cables or the like necessary for the equipment (22, 25) are led through the roof (10) of the ambulance - which is preferably double-walled - to the equipment within the container or containers (12) .

4. Holding apparatus in accordance with one of the claims 1 to 3 and characterised in that the container (11, 12) is provided with a foamed or upholstered layer (14) on its outer side.

5. Holding apparatus in accordance with one of the claims 1 to 4 and characterised in that the pivot hinge (13) or the particular container (11, 12) is constructed as a sliding hinge with a slider (13a), which is guided for limited displacement within a guide part (13b) secured to the container (11, 12), in such a way that the container (11, 12) can execute a displacement approximately parallel to its extent with respect to the hinge (13), in particular when pivoting it upwardly from its hanging position into its approximately horizontal position at the roof of the ambulance.

6. Holding apparatus in accordance with one of the claims 1 to 5 and characterised in that a recess (28) associated with the respecitve container (11, 12) is provided in the roof (10) of the interior compartment of the ambulance, with the trough-like interior (19) of the container (11, 12) jointly forming a space (40) with the recess (28) for housing and securing the medical equipment (15, 16, 20 to 25) arranged in the container (11, 12).

7. Holding apparatus in accordance with claim 6 and characterised in that the depth of the trough-like container (11, 12) is greater than the depth of the recess (28) at the roof (10) of the ambulance.

8. Holding apparatus in accordance with one of the claims 1 to 7 and characterised in that a heater (41, 50) controlled by a thermostat (42) is arranged inside the chamber (40) enclosed by the container (11) in the upwardly pivoted state, in order to keep the infusion containers (15, 16) warm.

9. Holding apparatus in accordance with claim 8 and characterised in that a thermostat controlled heat exchanger (50) which can be connected to an air conditioning or cooling installation belonging to the ambulance (heat pump 57), is arranged in the chamber (40) enclosed by the container (11) in order to cool this chamber (40).

10. Holding apparatus in accordance with claim 9 and characterised in that the heat exchanger (50) is selectively connectable with the vaporiser (61) or the condenser (59) of the cooling or air conditioning installation (heat pump 57) via conduits (51, 59) carrying a heat transport medium.

11. Holding apparatus in accordance with one of the claims 8 to 10 and characterised in that an electrical resistance heater (41 ) is arranged inside the chamber (40) enclosed by the container (11) in its upwardly pivoted state.

12. Holding apparatus in accordance with claim 11 and characterised in that the resistive heating lines (46) of the electrical heater (41) are applied to an electrically insulating layer (43) and have a cover (47) against mechanical damage.

13. Holding apparatus in accordance with one of claims 8 to 12 and characterised in that the walls of the container (11), and of the region of the ambulance roof (recess 28) which covers the container (11) in the upwardly pivoted state, have a heat- insulating coating (14, 14'), for example of a synthetic foam.

14. Holding apparatus in accordance with one of claims 8 to 13 and characterised in that the container (11) consists at least partially of a thermally insulating hard foam.

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