FR2481110A1 - Movable support for stretcher in ambulance - has lifting and tilting mechanisms mounted between stretcher base and false vehicle floor - Google Patents

Abstract

The stretcher support is mounted to move along C-shaped rails (17) fitted in two longitudinal guide slots (6) formed in the false floor (5) of the ambulance. The stretcher (9) is rigidly fixed to an upper rectangular block support (10) and a lower block (12a) is mounted rigidly on a wheeled chassis sliding along the rails. The upper and lower blocks are joined by articulated arms (12c) to form a parallelogram linkage. This linkage (12) constitutes the stretcher lifting mechanism. A pivotal mechanism may be mounted on the sliding chassis to permit the stretcher to be moved in an arc if required.

Description

Support and displacement device for stretcher for emergency vehicle, in particular for ambulance.

 The present invention relates to support devices and movement of stretcher for emergency vehicle, of the type comprising a support on which a stretcher can be removably fixed and which is integral with a sliding element mounted in guide means integral with the floor of the vehicle between a position in which the stretcher fixed on the support is entirely housed inside the vehicle and a position in which it is practically entirely located outside the vehicle.

 These devices allow the introduction of a stretcher into the vehicle entirely mechanically, although the control can be manual or motorized, thereby minimizing the tremors and consequently the inconveniences, often serious, which may result for the person. transported, sick or injured, in particular by keeping the stretcher perfectly horizontal, or possibly If necessary at perfectly constant inclination, during this introduction. This is done by placing the sliding element in the external position, so that the stretcher can be placed and fixed on the latter outside the vehicle. We then bring the sliding element back inside the vehicle, this movement bringing the subject and his stretcher into the desired position inside the vehicle, with a perfect conservation of his plate, which is extremely advantageous.

Indeed, the previous devices only allowed to support the stretcher, the support element not being designed to be moved outside the vehicle, a single movement being provided transversely inside the vehicle to allow storage the stretcher on a hill or to allow access to a second stretcher. This provision required that the two carriers climb inside the vehicle, which risked shaking or tilting detrimental to the state. of the person transported, and even sometimes, in certain cases, serious falls which could engage the responsibility of the carrier before the commonplace
The support and displacement devices considered here are therefore of great interest and can very advantageously be used in ambulances and fire engines, and this both for on-site treatments, for example resuscitation, cardiac massage or pulmonary puncture, as for emergency transport, for example in the case of bleeding, trauma, or heart attack.

 The stretcher is advantageously made in the form of a molded plastic shell carrying a mattress, support devices such as oxygen bottles or vials of blood which can possibly be housed either in this cor keel or in this mattress, which makes it possible to supply the patient permanently with the corresponding fluids.

 Once the vehicle has reached the hospital, the stretcher is removed from the vehicle by a reverse mechanical movement having the same advantages, after which it is separated by means of foldable wheels inside the space of this stretcher, which makes it possible to move the latter to an operating room or a room where the person transported is finally transferred to an operating table or a bed. The transformation into a trolley can also be used when taking care of the person, which allows for example a short trip on a road or in a street.

 These same devices may include means of rotation about a vertical axis, interposed between the stretcher support and the sliding element. For the positioning of the stretcher, once the sliding element is placed in the external position, the support is rotated relative to the latter by about 900, which allows the stretcher to be placed on this support transversely to the direction of introduction. We then rotate the support and its stretcher by 900 in the opposite direction, which brings this stretcher in the direction of introduction and it only remains to return the sliding element to the internal position. It is however also possible not to use this latitude of rotation and to place the stretcher on the support, already oriented in the longitudinal position, which allows its introduction directly into this position.

 There are also commonly provided means for raising the stretcher, already existing and in this case purely vertical in the support devices alone, and here interposed, in the support and displacement devices, between the stretcher support and the sliding element. . It is thus possible to adjust the level of the stretcher and in particular to place it in a suitable position allowing certain immediate treatments in the vehicle.

 These devices can also include longitudinal tilting or lateral tilting means interposed between the stretcher support and the sliding element, which makes it possible to raise the patient's head, for example to avoid suffocation by rising bile, on the contrary to raise the feet, for example in the event of weak heart, or to tilt the patient on the side without having to turn him over, for example to carry out a pulmonary puncture.

 However, it turns out that, in devices of this type already known, for example by French patent 77 10 778 publication number 2 386 305) of the applicant, the translation means (sliding element and guide means) and the lifting means are designed in the form of combined means, constituted by a fairly high base disposed on the floor of the vehicle and which carries a longitudinal slide inclined up and down towards the rear of the vehicle and in which slides an intermediate slide diaire inside which slides in turn a carriage which is part of the stretcher support. When the intermediate slide is placed so as to coincide, lengthwise, with the main slide, and that the carriage is placed at their common upper end, the stretcher is in the raised position inside the vehicle, at a level allowing any desired treatment.

When the intermediate slide has been slid on the rear in the front slide, cipal and the c: iarlct of the support in this intermediate slide also towards the rear, this support and its brans card are arranged outside the vehicle and approximately at the level of the floor thereof, which allows the support of this stretcher by the carriers.

 This combined translation and elevation arrangement however has the serious drawback of being extremely bulky, because when the stretcher is in position inside the vehicle, the assembly of the two slides protrudes at one end. beyond the stretcher and also the width of the base fixed on the floor is also very important. This congestion can constitute a considerable embarrassment for the specialist who must give emergency care to the patient, and sometimes operate on the spot, and this in the conditions of already limited space that offers inside a vehicle. , this known combined structure results in a concentration of efforts (which can be very significant, the weight of a stretcher carrying a patient of up to 140 kg) in a very precise and limited location of the floor and therefore of the chassis, which requires providing a special reinforcement of this chassis, this reinforcement also not always avoiding fatigue of the chassis which could lead to a final decommissioning of the vehicle.

 This is why the present invention aims to provide a device of the aforementioned type whose constituents located below the stretcher support offer space, and therefore discomfort, minimally, while also avoiding having to carry out a special reinforcement of the vehicle chassis.

 To this end, the invention relates to a device of the aforementioned type, characterized in that it comprises a false floor which is fixed to the floor of the vehicle and inside which are intended to be placed, in its longitudinal direction and horizontally, said guide means, while the sliding element, which cooperates with these guide means is also housed in this raised floor, and can also protrude beyond the rear end of the raised floor, a longitudinal passage being housed in the raised floor above these guide means and this sliding element to allow the passage of a part connecting this element to the stretcher support.

 Thanks to this arrangement, the horizontal sliding element, which receives all the forces applied to the device, distributes these over its entire length to transmit them to the floor, which prevents any reinforcement of the vehicle chassis, while also the part of the device which connects the sliding element to the stretcher support can have a minimum size and therefore not interfere.

 Preferably, the stretcher support is connected to the rear end of the sliding element and the length thereof, increased by that of the part which connects it to the support, is significantly greater than the half-length of a stretcher, which allows this sliding element to carry the support and the stretcher in cantilever with respect to the vehicle floor.

 In the case where means of rotation about a vertical axis are interposed between the stretcher support and the sliding element, it may advantageously be. provided that these means comprise a pivoting part secured to the sliding element, and pivotally mounted inside a housing of a part belonging to the connecting part with the stretcher support. As a result, these means of rotation use the minimum space required for the connection portion with the stretcher support and therefore do not increase this space.

 In the case where lifting means are interposed between the stretcher support and the sliding element, the connecting part between this support and the element can> advantageously include these lifting means and these may include a upper block secured to the stretcher support and a lower block secured to the sliding element, joined by an arm which is articulated on these two blocks. This structure allows, when the arm is straightened vertically, to work on a stretcher located at a level suitable for this purpose, and this with perfect clearance below this stretcher, which thus avoids any harmful discomfort. , when the arm is folded horizontally and backwards, the support and the stretcher are in the ready-to-extract position, this being effected by simple translation of the sliding element and horizontal arm assembly towards the back. Due to the extension that, in this position, the arm constitutes for the sliding element, the length of the latter necessary to allow the cantilever support of the support and the stretcher can be significantly reduced.

 It is preferably possible to provide that the articulated arm is double by a second element also articulated on the two blocks and constituting with it a parallelogram mechanism, which makes it possible to maintain a horizontality, or possibly if necessary a constant inclination of the support and therefore of the stretcher, whatever the position of the lifting arm.

 Since the lifting means considered have a vertical dimension which, even when folded down, could bring the support and the stretcher only to a height above the ground greater than that allowing a normal grip of the stretcher by the carriers, it is preferably provided that the lower block is mounted at the rear end of the sliding element, which makes it possible to tilt the articulated arm beyond the horizontal and therefore to bring the support, at a height allowing this normal grip.

 The planned arrangement, with an articulated lifting arm, simultaneously presents the great advantage of allowing very advantageous lateralization of the stretcher, that is to say a transverse displacement of that inside the vehicle, and this by maintaining it parallel to itself, which allows it to be placed against a side wall of the vehicle to clear the rest of the vehicle, and for example above a wheel arch or a side seat.

This parallel support is obtained by advantageously providing that, in the case where rotation means are interposed between the stretcher support and the sliding element, the lower block can be mounted to pivot about a vertical axis relative to this sliding element. , while the stretcher support is also mounted to pivot, about a vertical axis, on the upper block.

 In the case where tilting means are interposed between the stretcher support and the sliding element, it can advantageously be provided that this stretcher support. and the connecting part each comprise a tilting part in the form of a surface of revolution, these two tilting parts being able to slide one around the other and comprising means for maintaining contact with one another. , while there is also provided means for guiding the relative movement of these two parts in a circumferential direction, and means for immobilizing the two parts relative to each other in different positions. This arrangement makes it possible to ensure an inclination of the stretcher by a simple sliding movement which therefore avoids any collision, jerking or jerking which is likely to affect comfort in the condition of the person being transported.

 Preferably, in the case where the tilting means comprise longitudinal tilting means and lateral tilting means, the two tilting parts may each have the shape of a spherical surface and means are provided for guidance along two perpendicular vertical planes.

One of the spherical surfaces therefore advantageously constitutes a protective casing for the rest of the mechanism and, in addition, the pivoting parts being constantly in contact with each other, there remains no dangerous roughness during the maneuver.

Other characteristics and advantages of the invention will emerge from the description which follows, by way of nonlimiting example and with reference to the appended drawings on which
- Fig 1 shows an elevation and rear view of an ambulance provided with a device according to a particular embodiment according to the invention
- Fg. 2A and 2E represent. a sowing view from the left of the object of FIG. 1, taken along the line of section II -IX in this FIG. 1, and respectively illustrating the device in a lowered position and an elevated position inside the vehicle for FIG. 2A, and in an extended position outside the vehicle for FIG. 2B.

 - Fig. 3 shows a top view of the device of Figure 2A taken in section along line III-III of this figure.

 - Fig. 4 represents a schematic perspective view illustrating the device of FIGS. 1 to 3 in external and inclined position.

 - The Fia. 5 shows a scheatic and perspective view of the longitudinal and lateral tilting means of the device, only the one of the two spherical tilting parts which is part of the stretcher support being shown for reasons of clarity.

 - Fig. 6 shows a view in elevation and in diametral section of these same longitudinal and lateral tilting means.

 - Fig. 7 represents a detail view taken in section along the line VII-VII of FIG. 6 illustrating the means for immobilizing the stretcher support in position.

 - Figs. 8A and 8B are two detailed views in section of a variant of the immobilization means which can be fitted to the inclination means of the device, one in the free position and the other in the blocking position.

 - Fig. 9 shows a schematic perspective view of a stretcher, illustrating its locking on the stretcher support and its use in a rolling cart.

 As shown more particularly in FIGS. 1 and 2A, the device illustrated is intended to equip a rescue vehicle such as an ambulance, comprising, mounted on a chassis, not shown, but itself carried by wheels 1, a body comprising a floor 2 and walls 3, the rear doors of the vehicle being assumed to be removed, the width of the floor 2 being moreover limited, at least over part of its length by the interior wheel protection passages 4.

 The support and displacement device comprises first of all, as shown more precisely in FIG. 1, a raised floor 5, extending between the side walls of the vehicle and, where they exist, between the wheel arches, this box having an upper surface 5a entirely flat, as well as lower bearing surfaces 5b which are fixed, for example by bolting, to the floor 2 of the vehicle.

 In its central part, this raised floor has in its upper surface two longitudinal slots 5c which extend over the greater part of the length of the floor and open at its rear end, the raised floor resting on the floor 2 via four longitudinal members 6 fixed under this false floor, on either side of the two slots 5c. On the facing faces of the two outer longitudinal members 6 are fixed two C-shaped section rails 7 whose openings face the two internal longitudinal members and in which are mounted, with the interposition of series of balls, two elongated bars 8 so as to constitute two ball slides. These two slide bars 8 also forming together a single sliding element thanks to a connection constituted by an inverted U-shaped plate 8a whose core rests above the part of the raised floor separating the two slots. 5c, while its wings pass through these same slots 5c and are fixed on the opposite faces of the two slide bars 8.

The support and displacement device is intended to support a stretcher which has an elongated parallelepiped shape 9 and which is for example constituted by a molded plastic shell, shown here schematically. This stretcher 9 rests on
a support which in FIGS. 1 to 3 is shown diagrammatically by a plate 10 and
whose details will be given next to the Fio. 6.

Between this stretcher support 10 and the
sliding part 8 is arranged a connecting part 11 which com
takes, on the one hand, an elevation mechanism 12 and, on the other hand, a
rotation and tilt mechanism 13 arranged above this meca
elevation, this latter mechanism of rotation and tilt
being schematized by a block of trapezoidal shape overturns, on the
Fig. 1 to 3, while its detailed structure is given opposite
Fig. 6 and 7.

The elevation mechanism 12 allows de
place an intermediate support in height, and possibly laterally
horizontal diary 14 which is also shown diagrammatically in the form of a
plate in Figs. 1 to 3, the structure of which will be detailed in re
gard of FIG. 6.

As shown more particularly by
Fig. 2A, the elevation mechanism 12 comprises a lower block 12a
which is pivotally mounted around a vertical axis XX as will be
described below, with respect to the sliding element 8, this block com
bearing two vertical side faces on which project
two pairs of trunnions arranged along horizontal axes trans
versals A and B, with axis B arranged below and at the rear of
axis A.

The el9tion 12 mechanism cor ers by
elsewhere an upper block 12a which is arranged below the support
intermediate 14, and in which is engaged from above, for example in a bore, the lower end of a section of shaft 15 which is
aispose along a second vertical axis YY, and whose joining
with the rotation and tilt mechanism 13 will be described later.

Like the block 12a, this upper block 12b carries, on two faces
lateral, two pairs of trunnions arranged along horizontal axes
transverse zontals C and D, arranged in the same relative position
that axes A and B so as to constitute with them a disposition
tion in the form of a parallelogram.

The lifting mechanism is finally completed
ted by an articulated arm 12c constituted by a box with a C section,
the two wings of which are arranged in corresponding parallel planes
laying on the lateral faces of the two blocks 12a and 12b, the ends of
these wings being pivotally mounted on the journals of axes A and C, the core of the box, perpendicular to these two wings, serving to stiffen the assembly. This articulated arm is completed by two parallel rods 12d, the ends of which are mounted articulated on the trunnions of axes B and D, these rods 12d also being enclosed inside the box formed by the arm 12c. This arm 12c and these rods 12d therefore complete a parallelogram-shaped mechanism with the two lower 12a and upper 12b blocks.

 As indicated above, the lower block 12a is pivotally mounted relative to the sliding element 8 about the vertical axis XX, and this by means of an assembly similar to that of a motor vehicle wheel rocket. , that is to say comprising a section of shaft 16a of axis XX and fixed on the upper face of the connecting plate 8a and, on the other hand, a cylindrical housing 12b provided inside the block 12a and receiving this section of shaft 16a with the interposition of tapered bearings 16c, as shown in FIG. 1.

Apart from the tilting movements which will be described later, following the description of FIGS. 6 and 7 and taking into account the authorized rotational movement around the YY axis, which will also be specified with reference to the same Figures 6 and 7, the operation of the device as described so far is as follows
Assuming that the stretcher is in position 9a as shown in solid lines in FIG. 2A, the parallelogram elevation mechanism 12 is folded towards 1'PrnBre so as to be arranged along the longitudinal axis' dJ ver? ^ Cule, that is to say above the connecting plate 8a, so that this mechanism is found to occupy the minimum vertical size, the -two lower 12a and upper 12b blocks having substantially the same height. It follows that the stretcher 9a is located at the minimum level above the vehicle floor, for example about 0.5 m.

 The stretcher is mounted on the support 10 very approximately in the middle, and as also the length of the parallelogram mechanism 12 is approximately of the order of magnitude of one third of the length of the stretcher, the front end thereof is located very slightly in front of the lower block 12a. As also the length of the sliding element 8 is provided very approximately equal to half the length of the stretcher, and that the lower block 12a is fixed, by its pivoting mounting , on the rear end of this element 8, there remains a relatively large free location in front of the stretcher 9a and above the sliding element 8, even when the latter is engaged as far as possible at the bottom of the slide 7, up to the vicinity of the bottom wall 3a of the vehicle.

 From this position 9a of the stretcher, it is possible to place the assembly manually in a rearward translation movement, in which, as shown in FIGS.

 23 and 3, the sliding element is brought into a -position 8b in which it projects augdelb from the end of the slide-7 and the base 5, being cantilevered> the quantity of which it makes projection also being such that the stretcher, now located in a position gb, has its front end free of the volume of the vehicle, that is to say located at the rear of the rear wall 3b of the latter. Since the vehicle floor is approximately 0.5 m above the ground, it follows that in position 9b, the stretcher is approximately 1 m above the ground.

 However, given that the tilt and rotation mechanism 13 has a certain vertical bulk, there remains between the lower block 12a and the underside of the stretcher a free space of the same order of magnitude. Thanks to the arrangement of this same lower block 12a at the rear end of the couisseau 8, it is possible to fold the parallelogram mechanism 12 even further, so that the arm 12c and the rods 12b are slightly inclined towards the rear, and this until the underside of the stretcher comes approximately in the vicinity of the lower block 12a. The stretcher is then located in a new lower position than the position 9bs and which is not shown for reasons of clarity.

As shown in Fig. 3, given that the front of the stretcher is located outside the vehicle 9 it is possible to pivot on the one hand the parallelogram mechanism 12 around the lower block 12a (axis XX) and on the other hand to make pivot the stretcher relative to the intermediate support 149 around the YY axis, thanks to the rotation mechanism 13, this double rotation movement making it possible to bring the stretcher into the best suitable position to allow it to be grasped by the carriers, by example
in position 9c shown in FIG. 3, in which it is
roughly disposes transversely to the longitudinal axis
of the vehicle. Of course, a single rotation around the YY axis
can achieve the same result.

It should be noted that the movement of
translation allowing to move the assembly towards the outside of the
vehicle can be operated manually by pushing or pulling
the stretcher itself. However, it can be expected that this movement
or assist with the help of a group made up of. example by a motor
electric and a cable.

When planned, the translation
purely manual brings as advantages an extreme simplicity of
control, elimination of any engine failure, lowering of the
cost price and finally a weight gain. Another essential advantage
of this manual translation lies in the fact that it is not reali-
sand than with the device described here, given that is real
placed in a horizontal plane, which would not be the case with a mechanic
inclined slide nism.

Advantageously, the slots 5c of the raised floor or the connecting plate 8a can be fitted with the sliding element.
a dust cover (not shown), for example with lips, the latter
deny allowing to keep the translational movement all its
smoothness of operation, even when this is provided on order
purely manual.

The ball bearing 7-8 is of course
also equipped with locking means which make it possible to securely and effectively maintain the device in a determined position,
by authorizing the translation only if the operator neutralizes these means
blocking.

Thanks to the ball slide, the effort to
supplied by the operator by pushing or pulling the assembly, is very
weak, while this same movement would be impossible with a glis
inclined due to the effort required to climb as well as
lowering the stretcher, manual control is also dangerous
reuse in this case, since it would simultaneously require the use
a significant lock.

 This translational movement described above authorizes, of course, both the establishment of the stretcher on its support and on the contrary its extraction.

 Furthermore, starting again from the position 9a of the stretcher in which the lifting mechanism 12 is folded over the raised floor 5, it is possible, as shown more precisely in FIG. 2A, to rotate the parallelogram mechanism which constitutes these lifting means around axes A and B, so as to bring the upper block 12b practically vertically above the block 12a, so that the stretcher is is then located in a raised position 9d in which it is for example has more than a meter above the floor.

 Because of this relatively, the front part of the stretcher was found close to the front wall 3a of the vehicle.

On the other hand, the rear of the vehicle is cleared as much as shown in FIG. 2A, while, as also seen in FIG. 1, the staff also has relatively large clearances on either side of the stretcher. It is especially important to emphasize.

 that; thanks to the particular embodiment provided here of lifting means 12, independently of the sliding members 8, these lifting means are arranged practically vertically, below the stretcher, which thus releases almost completely the space located not only around, but also below the stretcher, thus not risking any inconvenience to the staff. This ivolutian freedom. résul.te of course also the fact that thanks to the provision of the raised floor 5, there is a perfectly flat surface on which the staff can move.

 It is quite obvious, that due to the efforts to be brought into play to control the elevation movement considered, this movement is assisted, either at the descent, or at the ascent, by auxiliary means (not shown) such that a hydraulic cylinder, or a screw-nut mechanism driven by an electric motor, the locking in position is also obtained by this same member.

 By tailors, due to the particular structure of this lifting mechanism, the load to be moved and oriented (stretcher loaded with an injured person and possibly additional accessories) always moves on the same side as the point of support on the ground .

which makes it possible to combine with this mechanism a compensating device which can function as an energy recuperator. It follows that the efforts to be provided are reduced accordingly.

 Apart from the essential advantage provided by the clearance on the ground, the mechanism considers, in its realization in the form of a parallelogram, of course makes it possible to maintain the horizontality, or possibly if necessary, the constant provided for the stretcher, and this regardless of the position of the lifting mechanism arm. There is therefore no incompatibility in the movements whatever the relative positions of the stretcher and this lifting mechanism, whereas this would not be the case, for example, with an inclined slide device.

 The raised arrangement 9d of the stretcher which has just been considered is for example used when it is a question of carrying out emergency treatment on the spot on the patient or the injured person carried by the stretcher.

 It is also possible to arrange the stretcher in a cleared arrangement on the sides of the vehicle, and this by a simple movement. Indeed, as shown in particular in FIG. 1 in phantom, it suffices to rotate the lower block 12a around the axis XX, so as to bring the parallelogram mechanism 12 above this block, but oriented transversely relative to the vehicle, a simultaneous rotational movement around the YY axis allowing the stretcher to be kept parallel to l: 'r-me.

It is then sufficient to partially fold the lifting mechanism 12 on one side of the vehicle so that it comes to adopt the position shown in solid lines, in which the stretcher is in position 9, for which it partially overhangs the wheel arch 4 in coming practically into contact with the side wall 3 of the vehicle, thus freeing up the interior space as much as possible for the movements or the operations of the personnel (or a second stretcher).

 Thanks to the structure provided here, it is possible to bring the stretcher into each of the corners of the vehicle, which offers a much greater latitude of movement than in the case of an inclined slide device, while in addition the personnel has a maximum possibility of access.

 As shown in Figs. 4 5 and 62 the orientation and rotation mechanism 13 which is interposed between the intermediate support 14 and the stretcher support itself 10 is constituted by two orientation parts of generally spherical shape and which are integral one of the intermediate support 14 and the other of the stretcher support 10.

 The first fixing part 17a cons ~ kills part of the support 10, ee last further comprising a part 10a for fixing on the stretcher. The orientation part 17a is constituted by a hollow piece of constant thickness in the form of a spherical ring, therefore delimit by two circles situated in parallel planes perpendicular to the vertical axis YY, the plane of the largest circle being very approximately at a distance of half a radius from the center of the spherical surface2 while the radius of the smallest circle has a radius sufficient to allow, relative to a central cylindrical bearing, a complementary movement of the main clearance which will be described later.

 Next to its largest circle, this ring.

spherical is extended by a horizontal outer flange of relatively small radial dimension and which constitutes the fixing part 10a on the stretcher.

 The intermediate support 14 is constituted by a box of general shape of revolution and which carries in its center a guide sleeve 18 which is pivotally mounted, free in rotation> but fixed in translation, and this thanks to two ball bearings 19 around of the upper part of the shaft section l5 which runs along that which has been described with regard to FIG. 2A and which is fixed in the upper block 12b. It should also be noted that in the practical embodiment of the device, this upper block 12b is made integral with the casing or intermediate support 142 so that the shaft section 15 can pivot relative to the casing face 14 and to the upper block 12b> therefore relative to the lifting arm 12.

 At its upper end2 the shaft section 15 projects beyond the sleeve 18 and successively has a cylindrical surface 15a and a flange 15b associated with a centering tip and on which is fixed at the end a plate 20 which carries9 fixed on it permanently9 in the direction of the center of the spherical ring, a longitudinal guide sector 21a constitutes by a relatively thin plate whose outline is very roughly that of a circular ring sector with the same center as the spherical ring.

 A second guide sector 21b or lateral guide sector is also provided which is arranged below the plane of the fixing flange 10a and which is made integral with the latter by means of spoke-shaped elements 22 , this sector 21b also being constituted by an element in the form of a plate of thickness similar to that of sector 21a and which has the general shape of a circular sector, that is to say with a lower contour in an arc of a circle, this lateral guide sector being disposed in a vertical plane also passing through the axis YY, as for the longitudinal sector 21a, but. perpendicular to the plane of the latter.The outside diameter of the sector 21b is substantially smaller than the inside diameter of the sector 21a, so that between these two sectors can be found has a guide block 23 consisting of a cubic-shaped piece which has two guide slots arranged in perpendicular planes, one 23a on its upper face so that the central part of the lateral guide sector 21b can be accommodated therein, and the other 23b on its lower face so that can also be accommodated therein the longitudinal guide sector 21a, as shown in more detail in FIG. 5.

 As the ria show. 5, 6 2t 72 ha cun of the two sectors 21a and 21b pressing, on a sector of an arc of a circle disposed symmetrically with respect to the vertical axis Y-Y, a series of notches 24, and this on each of. their two faces, the series of notches are. corresponding on the two faces of each guide and two of these corresponding notches receiving, as shown in FIG. 7 for the guide 21a, the projecting parts of two balls 25a or 25b respectively, which are held in position in the block 23. These balls 25a or 25b are however mounted movable in a short stroke, inside the block 23 and perpendicular to the sectors 21a and 21b respectively, in bores 26 which intersect two pairs of passengers 27 formed in the block 23 in parallel: respectively, with the guide 21a and the guide 21b, these passages 27 containing cylinders - pushers 28. subjected at one end to the action of springs 29 holding the cylindrical surface of the pusher at the level of the bore 26 to push the balls 25a or 25b into the notches 24a or 24b of the guide sectors, while at their other end these pushers protrude from the external surface of the block 23 so that they can be actuated by control means, not shown, which can push these pushers against the action of the springs 29, so as to a lead housings 30 formed in their outer surface, facing the bores 26, thus allowing the balls 25a or 25b to move back in these housings 30 when they are pushed back by the sides of the notches 24a or 24b under the action of a stress during a tilt command as will be specified later.

 The guide assembly constitutes by the sectors 21a and 21b, and the block 23, as well as the associated notches and balls carried by these different elements, therefore makes it possible, in action of course, to provide the desired control members of the pushers 28, to on the one hand to move the block 23 relative to the sector 21a in a first determined direction, and supposed to be the longitudinal direction of the vehicle, and on the other hand to place the sector 21b, therefore the support IOa and the stretcher which is fixed to it , with respect to this same block 23, and this in a second determined direction which is perpendicular to the previous one and which is assumed to be the lateral direction of the vehicle.

 It is clear that the them coisside guides can be implemented when the balls 25a or 25b have been released from the corresponding notches of the sectors 21a or 21b due to the actuation of the associated pushers 28. These latter pushers 28 and their control members therefore constitute a locking mechanism with respect to the two planned tilt movements. These two movements can be of a significant amplitude, the different notches of the series 24a and 24b being for example provided from 20 to 20, and this over overall angles of approximately 400, which therefore allows an inclination, either longitudinal or lateral, of approximately 20 on either side of the normal horizontal position.

 The entire tilt and rotation mechanism is completed by the second orientation part indicated above, orientation part 17b which is integral with the intermediate support 14, this solidarity of movement being considered with regard to the movement of inclination, but not the rotational movement. Indeed, this inclination part 17b is constituted by two parts in the form of spherical caps 17b and 17c which are arranged on either side of the inclination part 17a integral with the support 10a, so that this fixing part 17a can slide inside the annular space existing between the two spherical caps 17b and 17c, this sliding being guided by circular plastic pads 31 which are arranged following the circles of larger diameter of these two spherical caps, so as to come to bear on the spherical ring 17a on either side of it, ensuring minimal pinching allowing the g free smoothing of this spherical ring between these two spherical caps in one or the other of the two guide directions provided above.

 In their central part, the two spherical caps 17b and 17c which constitute the second fixing part have circular openings the diameter of which allows a certain clearance relative to the cylindrical bearing surface 15a of the shaft section 15, for example 150. According to these same inner circles, the two spherical caps are joined by a sleeve 32 which makes them integral to constitute the second fixing part.

 The free angular movement between, on the one hand, the outer edges of the spherical caps 17b and 17c and the fixing flange 10a, and between, on the other hand, the inner edge of the circular ring 17a and the sleeve 32 of the second fixing part, has the same value which is of the order of 200 on each side of the vertical axis, which therefore allows a sliding movement which can reach this amplitude between the two fixing parts, and this in any circumferential direction desired, therefore in particular along the two guide directions considered above and embodied by the guide assembly 21a-21b-23.

 Since the stretcher support 10a is made integral in rotation, by means of the guide assembly 21a-21b-23, of the plate 20 and of the shaft section 15, while the casing or intermediate support 14 is integral in rotation with the upper block 12b and the lifting arm 12, it follows that the support 10a can also be moved, manually, for example, relative to this casing 14 and therefore relative to the lifting arm 12.

 The rotation mechanism which is constituted and completed by a braking device constituted by a band brake comprising on the one hand a pulley 33 wedged on the intermediate part of the shaft section 15, below the casing 14, and on the other hand by a braking belt which is engaged in the groove of this pulley, not shown, this belt being normally kept under tension by means of organs applied to the two ends of this belt (the latter engaging about three-quarters of the pulley's perimeter) while unlocking means, for example constituted by levers, make it possible to extend this belt and consequently to release the pulley and to allow rotation of the 'together to a new position in which, by operating the levers in the opposite direction, the belt is again applied to the pulley so as to immobilize the assembly (like a bung brake). In order to allow guidance in this rotational movement, of the inclination assembly 17a-17b-17c, the plate 20 which is disposed slightly inside the spherical cap 17c is extended by a frustoconical edge which bears on its periphery a circular shoe 34 similar to .. shoe. 31, while the casing 14 carries on its outer wall and at its upper part a circular shoe 34b. The two shoes 34a and 34b come to bear on either side of the set of two spherical rings 17b and 17c, ensuring thus any desired rotational movement of these tilting elements and Jnc of the ensero-le- which is associated with the support 1U'ag relative to the casing 14 and to the lifting arm 12.

 As shown in the schematic figure in FIG. 5, the mechanism described above therefore allows on the one hand a rotational movement R of the stretcher support 10a around the shaft section 15 and on the other hand two inclination movements of this same support 10a, relative to this section shaft 15, a longitudinal tilting movement. L1 authorizes when the support 10 and the block 23 are moved relative to the sector 21a, that is to say a lateral tilting movement L2 when the support 10 and its guide sector 21b are moved relative to the block 23.

 As shown in Fig 4 on which the orientation mechanism is shown schematically by the spherical ring 17a secured to the stretcher support 10a, as well as by the intermediate support 14 shown in the form of a simple circular plate secured to the upper block 12b, it is possible to proceed with the two inclinations recalled above with reference to FIG. 5, so as to orient the stretcher 9, either in the longitudinal direction or in the lateral direction. The rotation mechanism also described above makes it possible to rotate the stretcher 9 by the same angle of rotation, but reverse, as the lower block 12a of the lifting mechanism, which allows lateralization of the stretcher by keeping it in a position parallel to the longitudinal axis of the vehicle.

 In the variant of Figs. 8a and 8b, the whole of the preceding device is modified by eliminating the locking elements constituted by the balls 25a and 25b as well as their actuating pushers, these elements being then replaced by two series of balls arranged in place of the pads 31 of the orientation pieces 17bet l7c, cylindrical housings 35 containing the different balls 35a and comprising on their bottom strips or springs 35b which apply the balls to the two faces of the fixing piece 17c, these same housings 35 also comprising on their lateral face, cylindrical plastic pads 36 which slightly protrude relative to the surfaces of the fixing parts 17b and 17c. In the normal position shown in FIG. 8a, the fixing parts 17a and 17b-17c are free to rotate relative to one another, the balls 35a ensuring the proper sliding of the two parts relative to each other. In the position of FIG. 8b, control mayens, not shown, ensuring a tightening of the peripheral parts of the two fixing parts 17b and 17c, ensuring a bringing together of these two peripheral parts relative to the fixing part 17a and in particular a blocking of this part of fixing 17a using the pads 36.This therefore allows the immobilization of the assembly in the tilted position, longitudinal or lateral, chosen, when actuating the considered clamping means, the balls 35a receding at the inside the housings 35 by crushing the spring lamellae 35b.

 As shown in Figs. 6 and 9, the underside of the stretcher 9 has an annular support part 37 projecting downwards, and coming to bear on the fixing flange 10a of the tilting mechanism, a flange 37a of this part 37 coming surround the flange and also carrying several locking members 38 disposed below this flange 10a. These locking members 38 are for example constituted by fingers arranged radially and which are capable of coming to engage under the flange 10a against the action of return springs 38a, while their outer end is held under the support of an eccentric 39a carried by a rod 39 which extends under the stretcher and which projects beyond the end of the latter. These rods 39 are for example two in number, one at each end of the stretcher and can actuate two or four of the locking members considered, these rods 39 being actuated by a rotational movement.

 As also shown in FIG. 9, there are also provided, also two in number and at the rate of one at each end of the stretcher, control rods 40 actuated in translation and making it possible to deploy wheel supports 41, which are normally folded only on the stretcher and at the interior of the latter.

Claims (5)

 10) - Support device and movement of stretcher for emergency vehicle, of the type comprising a support on which a stretcher can be removably fixed and which is integral with a sliding mounted element in guide means integral with the floor of the vehicle between a position in which the stretcher fixed on the support is entirely housed inside the vehicle and a position in which it is practically entirely located outside the vehicle, characterized in that it comprises a raised floor which is intended to be fixed on the vehicle floor and inside which are placed, in its longitudinal direction and horizontally said guide means, while the sliding element which cooperates with these guide means is also housed in this raised floor , and can also project beyond the rear end of the raised floor, a longitudinal passage being provided in the raised floor above these guide means ge and of this sliding element to allow the passage of a part connecting this element to the stretcher support.  2) - Device according to claim 1, characterized in that the stretcher support is connected to the rear end of the sliding element and the length thereof, increased by that of the part which connects it to the support, is significantly higher - half the length of a stretcher.  30) - Device according to any one of claims 1 and 2, characterized in that, in the case where means of rotation about a vertical axis are interposed between the stretcher support and the sliding element, these means comprise a pivoting part secured to the sliding element, and pivotally mounted inside a housing of a part belonging to the connection part with the stretcher support.  40) - Device according to any one of claims 1 to 3, characterized in that, in the case where lifting means are interposed between the stretcher support and the sliding element, the connecting part between this support and this element comprises these lifting means and these comprise an upper block secured to the stretcher support and a lower block secured to the sliding element, joined by an arm which is articulated on these two blocks.  50) - Dispositi-f according to claim 4, characterized in that the articulated arm is doubled by a second element also articulated on the two blocks and constituting with it a parallelogram mechanism.  6) - Device according to any one of claims 4 and 5, characterized in that the lower block is mounted at the rear end of the sliding element.  7) - Device according to any one of claims 4 to 6, characterized in that., In the case where rotation means are interposed between the stretcher support and the sliding element, the lower block is pivotally mounted around d 'a vertical axis relative to this sliding element, while the stretcher support is also pivotally mounted, about a vertical axis, on the upper block.  8) - Device according to claim 7-, characterized in that the means of rotation of the stretcher support on the upper block are provided with an immobilizing member of the band brake type.  9) - Device according to any one of claims 1 to 8, characterized in that, in the case oO tilting means are interposed between the stretcher support and the sliding element, this stretcher support and the connecting part com cnacun part of tilting in fohne surface of? é.volution, these two tilting parts being able to slide one on the other and comprising means of maintaining in contact of one on the other, while there is also provided means for guiding the relative movement of these two parts in a circumferential direction, and means for immobilizing the two parts relative to each other in different positions.  10) - Device according to: claim 9s characterized in that, in the case where the means dJinclxnaison comprise longitudinal tilting means and means dDin lateral clinching, the two tilting parts each have the shape of a spherical surface and it guidance means are provided along two perpendicular vertical planes.  11 ") - Device according to any one of claims 9 and 10, characterized in that the means for maintaining contact are constituted by the fact that one of the two tilting parts is doubled so as to determine an interval to inside which the other tilting part is slidably mounted.  120) - Device according to any one of claims 9 to 11, characterized in that the guide means in a circumferential direction comprise a disc sector secured to one of the tilting parts, and a block which is secured to the other tilting part and which has a slot oriented in said circumferential direction and in which the disc sector is slidably mounted.  13) - Device according to claim 12, characterized in that the immobilization means comprise a series of housings housings on at least one face of the disk sector and with which cooperate projecting elements carried by the split block and mounted movable on this perpendicular to the disc.  14 ") - Device according to claim 11, characterized in that the immobilization means comprise support members mounted on one of the tilting parts and coming into contact with the other part, and clamping members radial of one of the parts on the other.  15 ") - Device according to any wheel of claims 1 to 14, characterized in that the stretcher support comprises a fixing part comprising a bearing surface on which a stretcher can come to rest, the latter moreover comprising locking on this fixing part.