ES2550810T3 - Hospital bed equipped with a proclive device, a declining device, and a mechanical emergency control system - Google Patents

Abstract

Hospital bed (1) equipped with a frame (2) and a bed base (3), this bed (1) being further equipped: - with a device for adjusting (4) the height of the bed base (3) in relation to the frame (2), this device (4) comprising a deformable crosshead (5) provided with a headboard bar (6) and a footboard bar (7), mutually articulated; - with a proclive device (18) comprising: - a compass (19) mounted articulated between the head bar (6) and the bed base (3), between a retracted position and an extended position, - an actuator (30 ) which controls the movement of the compass (19) through a coupling (31), this bed (1) being characterized in that the coupling (31) of the proclive device (18) is detachable and can adopt a clutch configuration in which the compass (19) is coupled with the actuator (30), and a disengaged position in which the compass (19) is disengaged from the actuator (30), and by which the bed (1) is further equipped: - with a device decline (35) comprising: - a connecting rod (36) mounted in an articulated manner between the foot bar (7) and the bed base (3) between a low position and a high position; - a brake (43) having a blocking position in which it blocks the rotation of the connecting rod (36) relative to the foot bar (7), and a release position in which it allows the rotation of the connecting rod ( 36) in relation to the foot bar (7), - with an emergency control system (46), comprising a control pedal (47) and a mechanical transmission (48) connecting the control pedal (47) with the declining device (35) and with the proclive device (18), the control pedal (47) being mounted mobilely between: - an inactive position in which the pedal (47) holds the brake (43) of the device decline (35) in its locked and engaged position (31) of the proclive device in its engaged position, - an active position in which the pedal (47) releases the brake (43) of the decline device (35) and places the coupling (31) of the proclive device (18) in its disengaged position.

Description

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DESCRIPTION

Hospital bed equipped with a proclive device, a declining device, and a mechanical emergency control system

The invention relates to the field of hospital beds, and more precisely to hospital beds that integrate a tilting function called proclive, which allows the bed base to be tilted so that the patient's head is more raised than the feet.

The proclive function particularly allows to control the circulation of the physiological fluids of the patient. In particular, this function allows to favor the circulation of pathological fluids (such as pus) that it retains, unlike a horizontal position, and reduce the risks of regurgitation for patients suffering from gastroesophageal reflux.

The proclive function is also appreciated by patients for reasons of comfort, when combined with a box spring joint allows the bed to be set up as an armchair, facilitating both current activities in a sitting position (food, reading, receiving visitors) as well as the step from standing position to sitting position (or vice versa).

The proclive function is generally associated with a function of adjusting the height of the bed base, allowing the accumulation of the two functions to the patient and the medical staff to cope with numerous situations dictated both by the patient's comfort and by his pathological state.

It is known from EP 2,210,577 (MEDICATLANTIC) a bed equipped with a proclive function, which comprises a mechanism interposed between the bed base and a crosshead designed to allow the adjustment of the height of the bed base.

This bed is satisfactory. However, it is not equipped with a safety function, called a decline, which allows the bed base to be tilted so that the patient's head is lower than his feet. This function is particularly required in case of urgency, when the vital prognosis is compromised and needs to irrigate the brain at the moment.

There are beds equipped with such a function, which can be added to the proclive function, see for example European patent EP 0 494 551 (SSI MEDICAL SERVICES). In this type of bed, the functions are hydraulically piloted, each function being controlled by a jack. The jack is fed with fluid from a pump driven by an electric motor. This bed is satisfactory as long as position adjustments do not have to be made in emergencies. However, this bed has a main drawback, due to the electrohydraulic control of the functions. For this reason, the decline is slow. As a result, there is a risk of aggravation of the condition (even of loss) of the patient during the declining position. This slowness is all the more problematic when it is necessary to move the bed from the proclive position directly to the declining position, since the angular displacement is then maximum.

A first objective is to maximize the survival expectations of patients in an emergency situation, where the vital prognosis is compromised.

A second objective is to propose a hospital bed that offers numerous adjustments (proclive, height) compatible with patient safety.

A third objective is to propose a hospital bed equipped with a proclive function and that offers a declining position that can be obtained in the blink of an eye.

In this regard, a hospital bed equipped with a frame and a box spring is proposed, with this bed also being equipped:

- with a device for adjusting the height of the bed base in relation to the frame, this device comprising a deformable crosshead provided with a headboard bar and a footboard bar, mutually articulated; -with a proclive device comprising:

-a compass mounted in an articulated manner between the headboard and the bed base, between a retracted position and an extended position,

- an actuator that controls the movement of the compass through a coupling.

In this bed, the coupling of the proclive device is detachable and can adopt a clutch configuration in which the compass is coupled with the actuator, and a disengaged position in which the compass is disengaged from the actuator, and the bed is further equipped:

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-with a declining device comprising:

-a connecting rod mounted in an articulated manner between the bar of the footrest and the bed base between a low position and a high position;

5 -a brake that has a blocking position in which it blocks the rotation of the connecting rod in relation to the foot bar, and a release position in which it allows the rotation of the rod in relation to the bar of the foot,

-With an emergency control system, which includes a control pedal and a mechanical transmission that connects the control pedal with the declining device and the proclive device, the control pedal being

10 mounted mobile between:

- an inactive position in which the pedal keeps the brake of the device declining in its locked position and the coupling of the device prone in its locked position,

An active position in which the pedal releases the brake of the declining device and places the coupling of the proclive device in its disengaged position.

15 Thanks to this emergency control system, the decline function can be activated mechanically (and consequently without electrical assistance) regardless of the initial orientation (horizontal or proclive) of the bed base. The disengagement of the proclive function allows the operation to be carried out quickly, for the benefit of the therapeutic safety of the patient.

Various additional features may be provided, alone or in combination:

The brake of the declining device is presented in the form of a jack comprising a piston slidably mounted on a cylinder, and a valve having two positions controlled by the pedal, namely a closed position corresponding to the locked position of the brake, in which the valve seals the cylinder, and an open position, corresponding to the release position, in which the valve puts the cylinder outdoors;

The actuator comprises a motor and the coupling comprises a movable rod interposed between the motor and the compass; -in the clutch position the rod is integral with the engine, while in the disengaged position the rod is freely movable relative to the engine; -according to a first embodiment, the transmission is direct from the pedal to the brake of the declining device, 30 but indirectly from the pedal with the coupling of the proclive device;

- in this case, the transmission comprises a set of cables that have a primary cable that connects the pedal with the brake of the declining device, and a secondary cable that connects the declining device with the coupling of the proclive device;

-the emergency control system comprises a lever coupled in rotation with the connecting rod, and the cable

The secondary lever connects the lever with the coupling of the proclive device, the mobile lever being between an inactive position in which it loosen the secondary cable, allowing the coupling to adopt its clutch configuration, and an active position in which it exerts traction on the secondary cable , placing the coupling in its disengaged configuration; -the lever is mounted in rotation around a supportive axis of the foot bar, a spring of

40 recoil requests the lever to its active position, and the connecting rod has a stop against which the lever is applied under the action of the return spring; -the declining device comprises a return organ that requests the connecting rod towards its elevated position; -according to a second embodiment, the transmission is direct from the pedal to the declining device, and from the pedal to the proclive device;

45 -in this case, the transmission comprises a set of cables with a primary cable that connects the pedal with the brake of the declining device and a secondary cable that joins the pedal with the coupling of the proclive device.

Other objects and advantages of the invention will appear in the light of the description of an embodiment, made below with reference to the accompanying drawings in which:

50 - Figure 1 is a perspective view of the top of a hospital bed equipped with a proclive device, with a declining device and with an emergency control system, according to a first embodiment;

Figure 2 is a side sectional view of the bed of Figure 1, shown horizontally in the bed base; 55 - Figure 3 is a view similar to Figure 2, showing the bed in a proclive position of the bed base; -Figure 4 is a detail view partially showing the emergency control system, according to the frame IV of Figure 3; -Figure 5 is a schematic view showing the activation of the emergency control system;

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Figure 6 is a view similar to Figure 2, which shows the bed in a declining position of the bed base;

Figure 7 is a view similar to Figure 4, according to frame VII of Figure 6;

-Figure 8 is a view similar to Figure 3, showing the bed in a prone position according to a second

embodiment;

Figure 9 is a view similar to Figure 5, for the emergency control of the bed illustrated in Figure 8.

In Figure 1 a hospital bed 1 is shown.

This bed 1 comprises a frame 2 provided with wheels, and a bed base 3 mounted on the frame 2 movably. Bed 1 is not symmetric. In fact, it has a headboard side (indicated by arrow T) and a footboard side (indicated by arrow P). The bed base 3 is adjustable both in height and in position in relation to the frame 2, that is to say that the bed base 3 can be inclined so that the headboard side is higher, or conversely lower than the side of the footboard.

In this regard, the bed 1 is firstly equipped with a device 4 for adjusting the height of the bed base 3 in relation to the frame 2. This device 4 comprises a deformable crosshead 5 provided with a head bar 6 and a bar Footrest 7 mutually articulated around a central axis 8. The foot bar 7 has a lower end 9 through which the foot bar 7 is articulated, relative to a beam 10 of the frame 2, by means of a pivot 11.

The head bar 6 also has a lower end 12 through which the head bar 6 is articulated, relative to the crossbar 10, by means of a pivot 13 that slides in the form of a roller mounted on the lower end of the bar 6 headboard and cooperating with a slide 14 integral with the crossbar 10.

As can be seen in the figures, the head bar 6 is long, while the foot bar 7 is short, being interrupted in the vicinity of the central axis 8 by the joint of the crosshead 5.

According to an illustrated embodiment, the height adjustment device 4 comprises a motorized jack 15 interposed between the frame 2 and the crosshead 5 to open it (thus raising the bed base 3) or closing it (thus lowering the bed base 3). In the illustrated example, the motorized jack 15 is rotatably mounted, by a lower end, on a lower crossbar 16 of the frame 2 located by the footboard side, and, by an upper end, on a medium crossbar 17 mounted on the upper end of bar 7 of the footboard.

On the side of the headboard, the bed 1 is equipped with a proclive device 18 comprising a compass 19 provided:

-of an arm 20, substantially rectilinear, mounted in rotation, by a lower pivot 21, with

in relation to an upper end of the head bar 6 and, by an upper pivot 22, in relation to the

box spring 3,

-of a fork 23 in Y that presents:

- an upright 24 at one end of which the fork 23 is articulated, relative to the bed base 3, by means of a pivot 25 that slides in the form of a roller mounted at a rear end of the upright 24 and cooperates with a slide 26 attached to the bed base 3, - an upper arm 27 by which the fork 23 is articulated relative to the arm 20 around a central pivot 28, and - a lower arm 29 forming a V with the upper arm 27.

The proclive device 18 further comprises an actuator 30 mounted on the bed base 3 and which controls the movement of the compass 19 by means of a detachable coupling 31 which can adopt a clutch configuration in which the compass 19 is coupled with the actuator 30, and a disengaged position in which compass 19 is uncoupled from actuator 30.

According to one embodiment, the actuator 30 comprises a motor 32 mounted in rotation relative to the bed base 3, at a front end thereof, and the coupling 31 comprises a moving rod 33 interposed between the motor 32 and the compass 19.

As in the illustrated example, the rod 33 can be mounted in translation in the manner of a jack provided with a piston mounted in a cylinder fed with fluid, or as a gear-coupled rack with a drive pinion. A free end of the rod is rotatably mounted relative to the lower arm 29 of the fork 23 by means of a pivot 34 located at one end of the lower arm 29. The passage to the disengaged position of the rod 33 can be particularly carried out by setting to the air of the cylinder (in the case of the jack) or by deolidarization of the motor pinion (in the case of the rack).

In variant, the actuator rod 30 is threaded and mounted in rotation, such a rod being for example helically coupled with a grooved gear mounted at the end of the lower arm 29. In

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In this case, the step to the disengaged position of the rod can be carried out by its freewheeling.

The compass 19 is articulated between a retracted position in which the arm 20 and the post 24 of the fork 23 are substantially collinear, the lower arm 29 protruding downward, and an unfolded position in which the arm 20 and the post 24 form an angle (being perpendicular for example, as illustrated).

In the clutch configuration, the rod 33 is integral with the motor 32, which thus drives the movement of the compass 19 between its retracted position and its extended position, while in the disengaged position the rod 33 is freely movable in relation to the motor 32, the measure 19 then adopt any position between the retracted position and the extended position under the external mechanical action, as will be explained below.

The bed 1 is also equipped, side footboard, with a declining device 35 comprising a connecting rod 36 articulated, on the one hand, relative to an upper end of the bar 7 of the footboard by means of a pivot 37, and by another part in relation to the bed base 3 by means of a pivot 38 that slides in the form of a connecting roller of the connecting rod 36 and cooperates with a slide 39 integral with the bed base 3, of the footboard side. The connecting rod 36 is thus articulated in relation to the foot bar 7 between a low position in which the connecting rod 36 substantially extends to the foot bar 7, and a high position in which the connecting rod 36 moves angularly in relation to the bar 7 of the footboard on the side of the headboard of the bed.

As illustrated, the connecting rod 36 may be provided with an angular end stop 40 which, in a low position, limits the angular movement of the connecting rod 36 which is applied against a bearing surface 41 formed by the upper end of the foot bar 7, or on a mounting plate 42 of the connecting rod 36, integral with the bar 7 of the foot.

The declining device 35 further comprises a brake 43 having a locking position in which it blocks the rotation of the connecting rod 36 relative to the bar 7 of the footboard (whatever its relative position), and a release position in which the brake 43 allows the free rotation of the connecting rod 36 relative to the bar 7 of the footboard under an external mechanical action.

According to a particular embodiment, the brake 43 is in the form of a jack comprising a piston 44 mounted in rotation relative to an upper end of the connecting rod 36 and sliding in a cylinder 45 mounted in rotation on the central cross member 17.

This jack 43 comprises, for example, an air intake valve having two positions, namely a closed position corresponding to the blocking position of the jack (i.e. the brake) 43, in which the valve seals the cylinder 45 and blocks thus the movement of the piston 44 in relation to the cylinder 45, and an open position, corresponding to the release position of the brake 43, in which the valve puts the cylinder 45 outdoors and thus allows free movement of the piston 44 in relation to to cylinder 45.

The bed 1 is on the other hand equipped with an emergency control system 46, comprising a control pedal 47 (in this case on each side of the bed 1, on the side of the footboard) and a mechanical transmission 48 that connects the control pedal 47 at the same time with the declining device 35 and with the proclive device 18.

In the drawings it can be seen that, in the illustrated example, the control pedal 47 is operable with the foot. The pedal 47 is movably mounted (in translation or, as in the example illustrated, in rotation) in relation to the frame 2 between:

- an inactive position in which the pedal 47 maintains the brake 43 of the declining device 35 in its locked position and the coupling 31 of the proclive device 18 in its engaged position, - an active position in which the pedal 47 releases the brake 43 of the decline device 35 and place the coupling 31 of the proclive device 18 in its disengaged position.

In an exemplary embodiment corresponding to the illustrations (see figures 5 and 9), the pedal 47 is mounted in rotation relative to the frame 2, about an axis 49, against a return spring 50 requesting the pedal 47 towards Your inactive position.

The term "pedal" does not exclude an embodiment in the form of a hand operable hand. In this case, such a hand can be mounted not on the frame 2, but directly on the bed base 3.

According to a first embodiment illustrated in Figures 1 to 7, the transmission 48 is direct from the pedal 47 to the brake 43 of the declining device 35, and indirectly from the pedal 47 to the coupling 31 of the proclive device 18, the transmission being made to the proclive device 18 by means of declining device 35.

In the illustrated example, the transmission 48 comprises a set of cables with a primary cable 51 that connects the pedal 47 with the brake 43 of the declining device 35, and a secondary cable 52 connecting the declining device 35 with the coupling 31 of the proclive device 18.

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More precisely, and as illustrated, the emergency control system 46 comprises, for example, a lever 53 rotatedly coupled with the connecting rod 36, and the secondary cable 52 connects this lever 53 with the coupling 31 of the proclive device 18.

The lever 53 is movably mounted relative to the connecting rod 36 between:

- an inactive position on the lever 53 loosens the secondary cable 52, allowing the coupling to adopt its clutch configuration, and - an active position in which the lever 53 exerts a traction on the secondary cable 52, which places the coupling 31 on its disengaged configuration.

In the illustrated example, the lever 53, which is presented in the form of a metal foil folded in the square at its ends, is mounted in rotation about a central axis 54 integral with the bar 7 of the footboard.

At an upper end 55, the lever 53 is slotted to allow the passage of the secondary cable 52, of which one end 56 provided with a projection is housed in the bend in the bracket square of the lever 53.

At a lower end 57, the lever 53 forms a hook on which a return spring 58 is fixed, which requests the lever 53 to its active position (Figure 4).

In addition, as illustrated, the connecting rod 36 has a stop 59 against which the lever 53 is applied under the action of the return spring 58.

In the absence of solicitation, the pedal 47 is in the inactive position (with solid line in figure 5) and does not exert any traction on the primary cable 51. The brake 43 is then in the locked position, the connecting rod 36, Under these conditions, it sets in rotation in relation to the footboard bar 7. Normally, the connecting rod 36 is in a low position, its angular end stop 40 being applied against the bearing surface 41. The coupling 31 is in its position in the clutched position, allowing the actuation (or the reverse of the folding) of the compass 19 by means of the actuator 30.

A support (particularly of the foot, with the help of a sanitary assistant) on the pedal 47 places it in active position (with broken lines in Figure 5). The pedal 47 then exerts a traction on the primary cable 51 and places the brake 43 (by opening the valve, in the example presented above) in the unlocked position.

The passage of the brake 43 to the unlocked position releases the rotation of the connecting rod 36 relative to the foot bar 7. However, given the presence of the angular end stop 40, only the rotation movement of the connecting rod 36 towards the high position is allowed.

Therefore, the operator can manually lift the bed base 3 from the side of the footboard. This movement pivots the connecting rod 36 in relation to the foot bar 7, which drives, under the action of the recoil spring 58, the lever 53 initially in an inactive position to its active position (Figure 7). The lever 53 then exerts a traction on the secondary cable 52, which disengages the coupling 31 from the beginning of the tilting of the connecting rod 36 and thus cancels the eventual proclive position, in the hypothesis that it was present when the operator had activated the pedal 47. In order to assist the operator, the declining device 35 may be provided with a return member 60 (such as a gas spring, as in the illustrated example), which requests the crank 36 towards its high position.

The passage of the coupling 31 to the disengaged position releases the compass 19 which, given the weight of the bed base 3 (and its occupant) tends to find its retracted position from its extended position.

In summary, it is enough for the operator to lift the bed base 3 on the side of the footboard to swing it to the declining position, in which the bed base 3 is lower on the side of the headboard than on the foot side. The cancellation of the proclive position is induced by the progressive lifting of the bed base 3 by the footboard side, and the concomitant tilting of the lever 53 towards its active position as explained above. This step operation to the fully mechanical decline position can be performed in a few seconds.

Once the declined position reached, the operator loosens the pedal 47. The brake 43 of the decline device 35 is then locked, while the coupling 31 of the proclive device 18 remains disengaged due to the position of the lever 53. The bed base 3 then maintains its position, and a pressing on the pedal 47 is necessary to cancel the declining position and return the bed base 3 to a normal use position where the proclive function will be operational again.

According to a second embodiment illustrated in Figures 8 and 9, the transmission 48 is direct not only of the pedal 47 with the declining device 35, but also of the pedal 47 with the proclive device 18. More precisely, according to an illustrated embodiment example , the transmission 48 includes a set of cables comprising:

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- a primary cable 51 connecting the pedal 47 with the brake 43 of the declining device 35, and

-a secondary cable 52 connecting the pedal 47 with the coupling 31 of the proclive device 18.

In the illustrated example, the primary cable 51 is fixed:

-by a lower end, to the pedal 47, for example by means of a projection integral with the lower end of the

primary cable 51 and housed in a slot provided in an upper portion of the pedal that forms a scale

around its axis 49,

-by an upper end, to brake 43, and more precisely, in the example mentioned above, to the valve

air intake

The secondary cable 52 is fixed in relation to it:

-by a lower end, to pedal 47 as a primary cable 51,

-by an upper end, to the coupling 31, and more precisely, in the example presented above,

to a push-button (not shown) that drives the passage of the rod 33 from its clutch position to its

disengaged position, and vice versa.

To simplify manufacturing, the transmission 48 per set of cables may include a junction box 61 in which the primary cables 51 and the secondary cable 52 are connected, and through which the cables 51, 52 are connected to the pedal 47 to allow simultaneous control of the brake 43 of the declining device 35 and of coupling 31 of the proclive device 18. This junction box 61 comprises for example a box 62 in which a magazine 63 is slidably mounted to which they are fixed on one side. the lower ends of the cables 51, 52, and on the other hand a section of cable 64 connected with the pedal 47.

In the absence of solicitation, the pedal 47, under the effect of its recoil spring 50, is in the inactive position and does not exert any traction on the cables 51, 52. The brake 43 is then in the locked position, with the connecting rod 36 Under these conditions, it sets in rotation in relation to the footboard bar 7. Normally, the connecting rod 36 is in a low position, its angular end stop 40 being applied against the bearing surface 41. The coupling 31 is in its position in the clutched position, allowing control, by means of the actuator 30, of the deployment (or vice versa of the folding) of the compass 19.

A support (particularly of the foot, with the help of a health worker) on the pedal 47 places it in an active position. The pedal 47 pivots around its axis 49 against its return spring 50 and then exerts a traction on the cables 51, 52 (Figure 9) by means of the section 64 and the lane 63, and places:

- by means of the primary cable 51, the brake 43 (by opening the valve, in the example presented above) in the unlocked position, - by means of the secondary cable 52, the coupling 31 in the disengaged position.

The passage of the brake 43 in the unlocked position releases the rotation of the connecting rod 36 relative to the foot bar 7. However, given the presence of the angular end stop 40, only the rotation movement of the connecting rod 36 towards the high position is allowed.

The passage of the coupling 31 in the disengaged position releases the compass 19, which, given the weight of the bed base 3 (and its occupant) tends to find its retracted position.

Thus, when the bed base 3 is initially in a proclive position (that is to say that the compass 19 is in the unfolded position), the activation of the pedal 47 allows the proclive function to be immediately canceled, tilting the bed base 3 towards a horizontal position, and it is enough to operator with lifting the bed base 3 by the footboard side to make it swing in a declining position, in which the bed base 3 is lower by the headboard side than by the footboard side. This operation can be performed in a few seconds.

Once the declining position is reached, the operator loosens the pedal 47. The brake 43 of the declining device 35 is then locked, and the coupling 31 of the proclive device 35 engaged. The bed base 3 then maintains its position, and a pressing on the pedal 47 is necessary to cancel the declining position and change the bed base 3 to a normal use position.

The bed 1 just described has several advantages.

First, thanks to the emergency control system 46, the bed base 3 can be tilted in the blink of an eye towards the declining position, in which the bed base 3 is lower on the side of the headboard than on the footboard side.

This operation can be performed manually, without electrical assistance and therefore even in case of power failure or depletion of the power batteries of the electrical systems.

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This results in a better therapeutic safety of the patient, whose survival expectations are maximized in an urgent situation when the vital prognosis is compromised.

The tilting towards the declining position that can be obtained regardless of the height of the bed base 3, and even when it is in a proclive position, it is understood that the decline function (and therefore the patient's safety) is compatible with the comfort of the patient, induced by other bed adjustments (height, proclive).

Claims (9)

1. Hospital bed (1) equipped with a frame (2) and a box spring (3), this bed (1) being also equipped: - with a device for adjusting (4) the height of the bed base (3) in relation to the frame (2), this device (4) comprising a deformable crosshead (5) provided with a head bar (6) and a bar ( 7) Footboard, 5 mutually articulated; -with a proclive device (18) comprising: -a compass (19) mounted articulated between the head bar (6) and the bed base (3), between a retracted position and an extended position, 10 - an actuator (30) that controls the movement of the compass (19) by means of a coupling (31), this bed (1) being characterized in that the coupling (31) of the proclive device (18) is detachable and can adopt a clutch configuration in which the compass (19) is coupled with the actuator (30), and a position disengaged in which the compass (19) is uncoupled from the actuator (30), and why the bed (1) is also equipped: 15 - with a declining device (35) comprising: -a connecting rod (36) mounted in an articulated manner between the foot bar (7) and the bed base (3) between a low position and a high position; -a brake (43) having a blocking position in which it blocks the rotation of the connecting rod (36) in relation to the 20 foot bar (7), and a release position in which it allows the rotation of the connecting rod (36) in relation to the foot bar (7), - with an emergency control system (46), comprising a control pedal (47) and a mechanical transmission (48) that connects the control pedal (47) with the declining device (35) and with the proclive device ( 18), the control pedal (47) being mounted mobilely between: 25 - an inactive position in which the pedal (47) holds the brake (43) of the declining device (35) in its locked and engaged position (31) of the proclive device in its clutch position, - an active position in which the pedal (47) releases the brake (43) of the decline device (35) and places the coupling (31) of the proclive device (18) in its disengaged position. 2. Bed (1) according to claim 1, characterized in that the brake (43) of the declining device (18) is presented 30 in the form of a jack comprising a plunger (44) slidably mounted on a cylinder (45), and a valve having two positions controlled by the pedal (47), namely a closed position corresponding to the locked position of the brake (43), in which the valve seals the cylinder (45), and an open position, corresponding to the brake release position (43), in which the valve puts the cylinder (45) outdoors. 3. Bed (1) according to claim 1 or claim 2, characterized in that the actuator (30) comprises a The engine (32) and the coupling (31) comprise a moving rod (33) interposed between the engine (32) and the compass (19), and because in the clutch position the rod (33) is integral with the engine (32) , while in the disengaged position the rod (33) is freely movable relative to the motor (32). 4. Bed (1) according to one of claims 1 to 3, characterized in that the transmission (48) is direct from the pedal (47) to the brake (43) of the declining device (35), and indirectly of the pedal (47) with the coupling (31) of the proclive device 40 (18).

5.

Bed (1) according to claim 4, characterized in that the transmission (48) comprises a set of cables (51, 52) having a primary cable (51) that joins the pedal (47) with the brake (43) of the device decline (35), and a secondary cable (52) that connects the decline device (35) with the coupling (31) of the proclive device (18).

6.

Bed (1) according to claim 5, characterized in that the control system (46) comprises a lever

45 (53) in rotation coupled with the connecting rod (36), and because the secondary cable (52) connects the lever (53) with the coupling (31) of the proclive device (18), the lever (53) being mobile between an inactive position in which it loosen the secondary cable (52), allowing the coupling (31) to adopt its clutch configuration, and an active position in which it exerts a tension on the secondary cable (52), placing the coupling (31) in its disengaged configuration. A bed (1) according to claim 6, characterized in that the lever (53) is mounted in rotation about an axis (54) integral with the foot bar (6), because a return spring (58) request the lever (53) towards its active position, and because the connecting rod (36) has a stop (59) against which the lever (53) is applied under the action of the 9 return spring (58).

8.

Bed (1) according to one of claims 4 to 6, characterized in that the declining device (35) comprises a return member (60) requesting the connecting rod (36) towards its raised position.

9.

Bed (1) according to one of claims 1 to 3, characterized in that the transmission (48) is direct from the pedal

(47) to the declining device (35), and from the pedal (47) to the proclive device (18). 10. Bed (1) according to claim 9, characterized in that the transmission (48) comprises a set of cables (51, 52) with a primary cable (51) connecting the pedal (47) with the brake (43) of the declining device (35) and a secondary cable (52) that connects the pedal (47) with the coupling (31) of the proclive device (18). 10