FR2531241A1 - Apparatus for programming the distribution of a fluid in a hospital environment, and device for supplying an apparatus of this type. - Google Patents

Abstract

The invention relates to an apparatus for programming the distribution of a fluid. The starting or stopping the distribution of the fluid is controlled by a solenoid valve EV, which receives from at least one electronic flip-flop BM1, electrical current pulses, whose duration and repetition frequency can be selected independently with the aid of buttons t1a to t2e of a keyboard. This apparatus makes it possible, for example, to program the distribution of oxygen to a patient suffering from respiratory difficulties in a hospital environment.

Description

the present invention relates to an apparatus for programming the distribution of a fluid in a hospital environment, in particular the distribution of oxygen to a patient suffering from respiratory insufficiency,
In modern hospital installations, an oxygen supply pipe, for example under a pressure of 3 bars, leads to a wall valve, with manual control 9, arranged at the head of each bed, this valve making it possible to supply a probe. nasal, notably by means of a flow meter, making it possible to adjust the oxygen flow. However, only intensive care patients are subjected to continuous inhalation of oxygen; on the other hand 5 the doctors generally prescribe to the patients suffering from respiratory insufficiency, inhalations oxygen, periodic, and of predetermined durations, generally equal, the range of the prescriptions being very broad, and being able to go for example of an inhalation of 5 minutes every 15 minutes, half an hour every two hours; these prescriptions are obviously established according to the results of the analysis of the blood gases of the patient and other clinical parameters
Each prescribed inhalation requires the connection of the nasal probe, via a flexible hose, to a wall fitting, the opening of the manually operated valve -with-memorizing the opening time, the -closure of said valve when the prescribed duration of inhalation has elapsed, and finally the disconnection of the flexible hose i the nasal probe. Each of these successive operations can give rise to errors, some of which can be very serious, and including the frequency is all the greater in the hospital environment as these operations are most often entrusted to the patient himself due to the overload of staff; the latter is not immune to similar errors precisely because of his overload. For example, the patient may forget to start an inhalation at the prescribed time, for example because he is asleep; he can open the manually operated valve before the nasal probe is connected to the wall installation or, on the contrary, disconnect the nasal probe before having closed the valve; in both cases, oxygen spreads in the patient's environment; this results in losses of this comatose gas and very serious risks of fire or explosion; finally the patient can stop an inhalation before its prescribed duration has elapsed, which is not extremely serious, but, above all, he can continue the inhalation unduly, especially if he fell asleep under the effect inhaled oxygen, which can have fatal consequences.

 The main object of the present invention is to allow the production of an apparatus for programming the distribution of a fluid in a hospital environment, in particular the distribution of oxygen to a patient suffering from respiratory insufficiency, under conditions suitable for guaranteeing that this distribution will take place under the exact conditions prescribed by the doctor, and under conditions of perfect safety.

 In a large hospital center with a central computer, it could certainly be envisaged to have the said computer program the distribution of oxygen to all the patients for whom it is prescribed. your prescription and safety conditions would however be satisfied in this case only at the cost of very precise programming and constantly updated according to daily or multi-day medical prescriptions, which would obviously pose very many problems. Using a microprocessor to program oxygen delivery would require user personnel, usually nurses, special knowledge, which they are far from having today.

 The present invention, on the other hand, makes it possible to produce a programming device which can be mounted at the head of each item, and which can other used without any special convergence on the part of the nursing staff. the device according to the present invention is characterized in that it comprises an electrovalve controlling the start or 1 stop of the distribution 9.

an electronic circuit9 producing pulses of electric current, periodic and of mime durations, serving to supply the solenoid valve, and means for independently adjusting the duration and periodicity of these supply pulses0
Insofar as 1 t device according to the present invention can other equipped with at least one generator of electrical impulses, of known type, whose durations, equal between them, of the impulses, and their periodicity can be regulated independently, this device provides automatic control of the distribution of oxygen to the patient 9 by means of only two interventions by the nursing staff, one at the start of the program, to choose the duration and periodicity of the inhalations, and the other to interrupt the program, which , meanwhile, took place in a fully automatic manner and in strict accordance with the medical prescriptions for duration and periodicity of successive inhalations. your perfect safety thus obtained clearly results from the fact that any intervention by the patient himself is excluded and from the fact that the operations required of the nursing staff are few and very simple the apparatus according to the present invention thus eliminates all risks of errors at the start and end of each inhalation period, and in particular any risk of an untimely prolongation of the inhalation of the sleeping patient, and the fatal outcome which sometimes results therefrom; any risk of oxygen escaping into the patient's environment is also avoided, resulting in significant savings in oxygen and the elimination of any danger of fire or explosion.

 the device according to the present invention can obviously also be used to program the distribution of a fluid other than oxygen, in particular of a more or less harmful fluid, in particular in a hospital environment, for example in the implementation general anesthesia techniques.

 A preferred embodiment of the programming device according to the present invention comprises a first monostable rocker, capable of producing a first substantially rectangular pulse, serving for the supply of the solenoid valve, a second monostable rocker capable of producing a second substantially pulse rectangular, means for independently predetermining the respective durations of said first and second pulses, means for triggering at least one first pulse at the start of the program 9 as well as means for triggering a second pulse at the start or at the end of each first pulse, and to trigger at least one other first pulse at the end of each second pulse. This preferred embodiment is capable of a first variant, comprising means for simultaneously triggering a first and a second pulse at the start of the program, as well as means for triggering simultaneously, by the trailing edge of each second pulse, another first pulse and another second pulse, so that it is the difference between the respective durations of the first and second pulses which determines the interval between two successive inhalations. In another variant, on the other hand, it is the duration of the second pulses which determines the interval between two successive inhalations.

 Preferably, the programming device according to the present invention comprises an optical signaling device, which is actuated during the entire duration of each fluid dispensing and / or an acoustic signaling device, which is preferably actuated only during the start of each fluid distribution As the optical and / or acoustic signals corresponding to the oxygen distributions to the various patients of the same department can be centralized, for example in the wardroom, this arrangement according to the present invention ensures considerable simplification and reporting of the monitoring of the various oxygen inhalation treatments.

your present invention also relates to a device for supplying direct electric current to a device whose operation, in particular in a hospital environment, must not be interrupted, even very brief. , for example due to a power cut, followed by the quick, but not instantaneous, start-up of the hospital's generator set, the supply device according to the present invention is characterized in that it includes a rectifier circuit, known for producing from the alternative sector; a substantially continuous low voltage, for example U = 12 volts, a regulator and a battery charger-regulator, the inputs of which are connected in parallel to the output of said rectifier circuit, as well as a battery of nominal voltage
U, connected in parallel to the output of the regulator charger, through a polarized diode to avoid any return of current in said charger - regulator, the output of the device being connected in parallel to that of the regulator and to a pale of the battery, through respectively two diodes of the same polarity.

 Compared to known power supply devices, with battery - buffer, the power supply device according to the present invention offers the very important advantage that its battery is constantly charged at the nominal voltage of for example U = 12 volts, which, in the event of a mains failure, immediately ensures that 1 t is supplied to the corresponding device at its rated voltage, so that the continuity of operation of the said device is not likely to be temporarily disturbed by an interruption in its electrical supply , or even by a temporary drop in its supply voltage. These front ges make the supply device according to the present invention particularly well suited for supplying the programming device which has been previously defined, since any temporary interruption of its supply electric, or grandma any relatively large drop in its supply voltage could bring the rocker (s) that i l comprises and, consequently, to permanently disrupt the program in progress te feeding device according to the present invention can, however, also be advantageously used to power other devices, the operation of which, in particular in a hospital environment, must not undergo no in% erruption, very brief meAme.

 By way of example, an embodiment of the programming device according to the present invention has been described below and illustrated diagrammatically in the appended drawing.

 your Figure 1 is the block diagram of the various circuits of this embodiment of the invention.

 FIG. 2 is the detailed electrical diagram of an embodiment of a particular circuit of FIG. 1.

 FIG. 3 is the diagram of the electrical pulses produced by the two monostable flip-flops that includes the diagram of FIG. 1.

The programming device according to the present invention, the electrical diagram of which is
reproduced in FIG. 1, firstly comprises a device for supplying electrical energy, which itself includes a step-down transformer, TR, which is connected to the two terminals, a and b, of the alternating network, for example at 220 volts and 50 periods per second, via a fuse
F and dDun-switch off - on, COlo The secondary terminals of the transformer TR are connected respectively to the first diagonal of a rectifier bridge, Po, whose output, constituted by 1 7 other diagonal, has a terminal, c0, connected to the earth of the device, and an active terminal, O A filtering capacitor Cl is connected between the terminals cO and c, the latter also being connected in parallel to the inputs of the regulator dou Re of the rectified and filtered voltage, and of a charger regulator,
A battery B, whose nominal voltage is for example U = 12 volts, has for example its negative pole connected to ground and its positive pole connected to the output of the charger - regulator Ca, via a diode D19, the polarity of which is chosen to prevent the battery B from flowing into the output of the charger - regulator Ca, the output of the regulator Re and the positive pole of the battery B are connected in parallel to a point d, respectively through two diodes, D2 and D3, of the same polarity, chosen so that said diodes can be traversed by the direct current leaving the regulator Re and the battery B respectively.

A second filtering capacitor, C2, is inserted between the ground and the point do. Between this point d and another point e are mounted in series a temporary action switch, in particular a push button Sp, and to a manual switch d ~ stop Co20 When 9 the stop switch Co2 being closed, the push button Bp is actuated, the DC voltage of 2 volts which appears at point d is transmitted to point e, and, from there, applied to the RI coil of a first relay , whose automatic maintenance is ensured, on reopening of the push button Bp, by temporary closing, then bonding, of the working contact, s'l, the blade of which is itself connected to an intermediate point of the line which connects the switch co2 to the push button Bp. The voltage + U is at the same time applied, through a diode D4 of appropriate polarity, to a general supply line B1. As soon as the push button Bp is closed, the voltage + U, which reaches point e, is transmitted from there, through two diodes,
D5 and D6, of appropriate polarities, on the one hand at the reset and start input, c1'a clock circuit
H, and on the other hand to a trigger line L2, the royal of which will be explained later on the clock circuit H comprises in a manner known per se, an oscillator synchronized for example by a quartz crystal, followed by dividers of frequency, constituted in particular by integrated circuits of known type, all of these circuits being arranged so as to appear, from the moment when the reset and trigger input, eH, of the circuit clock H receives a voltage pulse through diode D5, on its first output sE19 of the first clock pulses, of period for example? 1 = 5 minutes, and on its second output sH2, of second clock pulses , period for example
T2 = 15 minutes; in the exemplary embodiment illustrated, the clock circuit H comprises an auxiliary output sH3, producing clock pulses of period t much less than T1, for example t = 1 second, the role of which will be specified later.

The apparatus illustrated in FIG. 1 further comprises two monostable flip-flops, BM1 and BM2, which are for example of the type each comprising an input for clock pulses, namely eBIa, connected to the output sH1 of the clock circuit H, and eB2a, connected to the output sH2 of said clock circuit H, a trigger input, eB4b or eB2b, connected respectively to line t2, several, in particular five inputs, eBlc or eB2c, for the cumulative selection of durations of the corresponding switching pulse, and finally a power supply input, eB1d or eB2d, connected to the line Li, each of the monostable flip-flops BM1 and BM2 is constituted for example by an integrated circuit of the known type XR2240, which, in the application considered, that is to say in particular in the case of the assembly of FIG. 1, operates in the following manner as soon as one of the two monostable rockers, for example
BM1, receives the DC voltage of 12 volts on its eB1d9 power input from the line
L1, and, almost simultaneously, a reset and trigger pulse on its input eB1b, coming from line L2, when the output sH1 of the clock circuit H transmits the first (in time) of the first pulses d clock at its eBla input, it appears on the output sB1 of said monostable flip-flop BN1l, the front flank of a substantially rectangular pulse, the duration of which will depend on that ts) of its selection inputs eB1c which receives or receives them- same a polarization voltage, by means which will be specified later,
In the embodiment considered, the five selection inputs eBlc are chosen such that if only one is polarized, the trailing edge of the first rectangular pulse, appearing on the output sB1, will itself only occur after a duration which is an integer multiple of the period of the first clock pulses, T1 = 5 minutes, and more particularly after a duration of 5, 10, 20, 40 or 80 minutes, depending on that of the selection inputs, eB1c, which is polarized, is for example the first, the second. the fifth from the left on the diagram in Figure 1 ;; in addition,
if for example two of the eBlc selection inputs are polarized simultaneously, for example the first and the third from the left, the duration of the first pulse produced on the output sB7 of the first monostable flip-flop Bi # 1 taken as example, will be equal to the sum of the durations corresponding, respectively, to the polarization of only one of the two polarized inputs, namely, in the example considered, 5 + 20 or 25 minutes; of course, more than two eBc selection inputs, and possibly all of said selection inputs can be simultaneously polarized, the maximum duration of the previously defined first pulse then reaching 155 minutes, that is to say 2 hours 35 minutes .

The operation of the second monostable rocker, BH2, is similar, the durations associated with its different selection inputs, eB2c, being however generally different from the preceding ones, and equal for example to 15 minutes, 30 minutes, 1 hour 2 hours, 4 hours , a maximum duration of 7 hours 45 minutes.

 In the embodiment considered, the polarization of the various selection inputs of the two monostable flip-flops, BMN and EM2, is obtained using a keyboard comprising a first and a second series of five keys, with mechanical engagement or with electronic memory , tîa à tie and t2a à t2e.

In the diagram in Figure 1, each of these keys, tîa to t2e, is materialized by a two-circuit inverter, one of which, when the corresponding key is actuated, applies the voltage of + 12 volts, possibly present on line L1, at the corresponding selection input of the monostable lever with which the key in question is associated, while the other circuit of the same key applies the same voltage to an optical signaling device, for example the one of the incandescent lamps, lîa à 12e, the other terminal of which is connected to ground (line Lo).

On the diagram of FIG. 3, the first and the second pulses are represented, one above the other, by rectan gles-hatched
I1a and I2a respectively, which appear on the respective outputs, sB1 and sB2s of the two monostable flip-flops BM1 and BM2, between the instant of triggering of the program by actuation of the push button # Bp # and respectively 91st instants N.T1 and n # T2 , N and n being two integers (in the numerical examples indicated above, the integers N and n are always powers of 2 or from sums of these powers) 0
When the rear flank of the second pulse 12a appears at time nOT2g on the output sB2 of the second monostable flip-flop BM2, a re-trigger pulse of the two monostable flip-flops is derived from this rear flank by appropriate means9 which, according to the diagrams of the Figures 1 and 2, can be made as follows e the output sB2 of the second monostable flip-flop BM2 is connected, through two ohmic resistors to an adaptation and rectification circuit, AI, which can further be constituted as illustrated on FIG. 2 s its input is connected to a branch in series, constituted by a capacitor C3 in parallel on an ohmic resistance, Ro1, these two elements being followed by a diode in series, D7, the two electrodes of which are connected to ground through two other ohmic resistors, Ro2 and Ro3 the capacitor C3 has the effect of transmitting the trailing edge of each second pulse and transforming it
in a very brief pulse, which is transmitted by the diode D7 at the output of circuit A1, this very brief pulse coinciding substantially with the trailing edge of
every second pulse 0 This very brief pulse
leaving the circuit A1 attacks the input of a shaping circuit, which in the example illustrated ---------- in FIG. 1, is a monostable rocker, essentially constituted by two logic circuits, NI1 and
NI2, in series with each other, with the interposition of a capacitor C49 a feedback line, L5 connecting the output of NI2 to one of the two inputs of
NI1 following a well-known arrangement. The short, but well-defined pulse which appears at the output of NI2, at an instant substantially coinciding with the trailing edge of the second pulse I2a (FIG. 3), is amplified by a stage transistor
Tr1, which then applies it, via an appropriate polarity diode D8, to line L2, itself connected to the trigger inputs eB1b and eB2b of the two monostable flip-flops, BM1, BM2.

The operation of the programming device which lives to be described is the following o from the appearance of the first pulse, I1a, on the output sB1 of the first flip-flop BM1, at the start of the program, this pulse is amplified by a transistor stage -Tr2, and it is used to supply current to one of the terminals of the coil R2 of a relay, the other terminal of which is connected to the line ti; this relay immediately closes its working contacts, r2a, which immediately applies the voltage of, 12 volts present on the line ti, to the control winding of an ETJ solenoid valve, and r2b, which also applies the voltage present on the line L1 to an optical signaling device for the supply of the electrovalve EV, for example an incandescent lamp 13; ; the EV solenoid valve, which is inserted in the oxygen distribution circuit, upstream of the nasal probe connection, is then kept open throughout the duration of excitation of relay R2, i.e. practically throughout the duration of the first pulse 11a, at the end of which the relay R2 releases, which has the effect of closing the electro-valve EV, which interrupts the distribution of oxygen, and turns off the signal lamp 13 As the second pulse I2a, which also started at the start of the program, has a duration which is always chosen to be greater than that of the first pulse 11a, there is a certain time interval between the end of the first period of inhalation and the rear flank of said second pulse I2ag at the instant when this rear flank appears on the output sB2 of the second monostable flip-flop BN2, the circuits previously described derive a trigger pulse which #, via the components TrI and D8 and from line 29 is simultaneously transmitted to the trigger inputs eB1b and eB2b of the two monostable flip-flops ENI and BN2 ;; it then appears practically without delay a new first pulse Ilb on the output sB1 of the flip-flop BM1 and a new second pulse
I2b on the output sB2 of the second flip-flop BM2B the new first pulse, Iîb, causes, as described above, the reopening of the solenoid valve EV, for the duration NTî ', which was selected, before the program, by pressing at least one of the first to the next keys of the first series.

The process which has just been described is repeated at the end of the new second pulse I2b, which causes the triggering of a third inhalation period, of the same duration N.Tî. Of course, the interval between two successive inhalations, which is equal to the difference between the respective durations of the first and second pulses, was predetermined, before the start of the program, by the actuation of at least one of the keys t2a to t2e of the second series of the keyboard. The end of the program can be further triggered at any time, and for any reason, by manual actuation of the stop switch Co2, which then stops connecting the point d to the contact rî blade of the RI relay.

The embodiment of the programming device according to the present invention, the diagram of which is illustrated in FIG. I, further comprises an acoustic signaling device, for example of the so-called "buzzer" type, which is actuated only during the start of each fluid distribution, that is to say at the start of each of the first pulses Ila, Ilb. In the embodiment considered, the supply circuit of the signaling device, Bu, is controlled by the output d '' a logical door
AND with three inputs, which is constituted as follows: its first input is connected directly to a manual switch Cof, which, when activated, transmits to the signaling device Bu the voltage possibly present on line B1; the second input is connected by a line L4 to a point f of the assembly, where pulses appear which are synchronous with the first pulses, produced by the first flip-flop BNI; in the embodiment considered, the polnt f from which the line L4 starts is inserted between the working contact r2b of the relay R2 on the one hand, and the signaling lamp 13 on the other hand. your line t4 therefore transmits substantially rectangular and synchronous pulses of the first pulses 11a, I1b .., at the input of an adaptation and rectification circuit, A2, which can, for example, be analogous to the circuit AI in FIG. 2, which was previously described; circuit A2, like circuit Ai, allows the leading edge of each rectangular impulse to pass; so that there appears on the output of said circuit A2 a trigger pulse substantially synchronous with the leading edge of each of the rectangular pulses transmitted by the line L4; this trigger pulse is transmitted to the input of a monostable flip-flop, BMr, comprising means for adjusting the duration of sound, switching pulse, for example between 2 and 10 seconds, this switching pulse attacking a transistor Tr3 Finally, the third input of the AND circuit, mentioned previously, namely the control electrode of a transistor Tr4 mounted, in series with the acoustic signaling device, Bu # and the transistor Tr3, between the extension of the line tu beyond the manual switch Co3 and ground, is directly connected to the auxiliary output sH3 of the clock circuit H, on which pulses of period appear much less than the shortest duration of the first pulses I1a, that is to say very less than 5 minutes, for example pulses of period 1 second0 It is understood that the acoustic signaling device Bu is only actuated when the manual switch Co3 is closed, for an adjustable duration, for example e between 2 and 10 seconds, after the start of each inhalation period, at a rate of one sound pulse per second
the device, the diagram of which is illustrated in FIG. I, furthermore comprises the following arrangement ;; # which makes it possible to obtain continuous inhalation by simultaneously actuating a particular key of the first series of the keyboard, in particular the sort key, and a key particular of its second series, in particular t2a, these two keys having been chosen, moreover in a somewhat arbitrary manner, so that they do not risk being actuated simultaneously in order to obtain a discontinuous programming of inhalations, since their actuation simultaneous would correspond to programming inhalations of one hour 20 minutes, every 15-minutes "9 For this purpose, the voltage of +12 volts possibly present on line L1 is transmitted by the first circuits of the keys ti and t2a, when they are actuated, at the two inputs of a NAND logic gate, the output of which then produces a DC voltage, which a line L5 transmits to the control electrode of a transistor Tr5, inserted at be the earth and the coil of relay R2; this relay R2 therefore remains permanently energized and the permanent closure of its working contact r2a maintains the solenoid valve
EV constantly open
When the alternating voltage applied to the mains terminals, a and b, has its nominal value, the regulator Re applies, at point d, through the diode D2, a voltage always equal to +12 volts; as soon as the mains voltage drops below its nominal value and as a result the voltage at point d falls below 12-volts, like the battery
B was previously charged exactly at 12 volts the diode. D) is polarized in the conducting direction, so that said battery B sends electric current to point d at the same time as the regulator.
Re. If on the other hand the mains voltage is canceled, from m8 As soon as the voltage at the output of the regulator Re, only the battery B supplies the rest of the assembly through the diode D3, and this without any delay, which avoids the interruption, even brief, of 1 supply to the programming device, which would occur, for example, if it was supplied by a usual circuit with buffer battery, during the short but not zero time interval which is necessary the start-up of the generator group of the lshopital.

 It is remarkable that the ten keys of the keyboard provided in the embodiment of FIG. 1 make it possible to select 31 different durations and 31 different frequencies for the successive periods of inhalation.

The present invention is not limited to the embodiment described above. She
includes all its variants. Be clock circuit H could be replaced by another time base circuit, of a known type, operating for example using one or more RC cells. The special power supply device, which has been designed to the programming apparatus according to the present invention, however, is optional; it could also be used for other devices requiring an electrical supply free of any interruption, particularly in hospitals. The acoustic signaling device is optional material; it is also susceptible to many known embodiments, different from that previously described
Instead of being constituted by the previously mentioned integrated circuits, the two monostable flip-flops, BM1 and BM2S could be constituted by other integrated circuits, or even by known circuits, with discrete components, with which components would be associated, in particular adjustable resistors, making it possible to adjust, continuously or discontinuously, respective durations of the tilting pulses of said flip-flops, one independently of the other.

 As already mentioned, the trailing edge of each first pulse could be used to trigger the second immediately following pulse, the trailing edge of which would itself be used to trigger the leading edge of the immediately following first pulse; in this case, the intervals between successive inhalations would be determined by the durations of the tilting pulses of the second stable mono flip-flop Finally, the apparatus according to the present invention could comprise a single astable flip-flop, and means for independently adjusting the duration and periodicity of the tilting pulses of said astable rocker.

Claims (6)

CLAIMS 10 Apparatus for programming the distribution of a fluid in a hospital environment, in particular the distribution of oxygen to a patient suffering from respiratory insufficiency, characterized in that it comprises an electrovalve (EV) controlling the departure or the distribution stop, an electronic circuit (BM1), producing periodic electric current pulses (il) and mimes durations, serving for the supply of the solenoid valve (EV)., and means for adjusting independently the duration and periodicity of these supply pulses (I1).  2. Apparatus according to claim 1, characterized in that it comprises a first monostable rocker (Bt # l), capable of producing a first pulse (il), substantially rectangular, serving for the supply of the solenoid valve (EV), a second monostable rocker (B # 2) - capable of producing a second pulse (12), substantially rectangular, means (t1a .. t2e) for independently predetermining the respective durations of said first and second pulses (I1 and 12), means ( 3p) to trigger at least a first pulse (lia) at the start of the program, as well as means (Ai, NI1, NI2) for triggering a second pulse (12) at the start or at the end of each first pulse (il), and to trigger at least one other first pulse (I1b) at the end of each second pulse (12).  3. Apparatus according to claim 2, characterized in that it comprises means (Bp, L2) for simultaneously triggering a first and a second pulse at the start of the program, as well as means (Ai, NI1, I2) for triggering simultaneously, by the trailing edge of each second pulse (I2), another first pulse (il) and another second pulse (12).  4. Apparatus according to claim 3, characterized in that each of the two monostable flip-flops (BMI, BM2) is of the type comprising an input (eB1a or eB2a) for clock pulses of period T, a trigger input (eB1b or eB2b) and several inputs (eBlc or eB2c), for the cumulative selection of durations of the tilting pulse, respectively equal to T and to integer multiples of T, for example 2n.T, n being an integer at least equal at 10  5 Apparatus according to any one of claims 3 and 4, characterized in that the output (sB2) of the second monostable flip-flop (BM2) is connected in parallel to the respective trigger inputs (eB1b and eB2b) of the first (BM1) and second (BM2) monostable flip-flops, via a circuit adapted to derive a trigger pulse, from the trailing edge of each second pulse (12)  60 Apparatus according to claim 5, characterized in that the mentioned circuit comprises in series a circuit (A1) for selecting the rear flank, and a shaping circuit, for example a monostable rocker (NI1-NI2) with logic gates of the type NI  7 Apparatus according to any one of claims 4 to 6, characterized in that it comprises a contact with temporary actuation '(Bp), connected so as to simultaneously trigger the circuit (H) producing the clock pulses as well as the two monostable scales CBM1 and BM2)  8. Apparatus according to any one of claims 4 to 7, characterized in that it comprises an optical signaling device (13) which is actuated throughout the duration of each fluid distribution, and / or an acoustic signaling device (Bu) which is preferably activated only during the start of each distribution of fluid.  9. Apparatus according to claim 8, characterized in that the supply circuit of the acoustic signaling device (Bu) is controlled by the output of an AND logic gate with three inputs, which are connected respectively, the first, directly, to a manual switch (Co3), the second, at a point (f) of the circuit9 where rectangular pulses -synchronous clock pulses appear intended for the first monostable flip-flop (BM1), through the middle of another monostable rocker of adjustable duration (ber) and of a circuit (A2) for deriving a trigger pulse from this stable mono (BMr), from the front flank 'of each rectangular pulse, and  the third input to a special output (sH3) of the circuit (H) producing the clock pulses, this special output (sH3) producing pulses of period t much less than TI, for example t I second.  10. Apparatus according to any one of claims 4 to 9, characterized in that it comprises a periodic pulse generator (H), synchronized for example by a quartz crystal, and producing, on a first and a second output (sHA and sH2), connected respectively to the corresponding inputs (eB1a and eB2a) of the first (bai) and the second (BM2) monostable flip-flop, first and second clock pulses, the respective periods of which are, for example equal to TI = 5 minutes and T2 = 15 minutes, as well as a keyboard comprising a first and a second series of latching or memory keys (t1a to t1e and t2a to t2e), adapted to respectively apply selection voltages, preferably equal, to the respective inputs (eB1c and eB2c) of the first and second flip-flops (BIS1 and BM2) for the cumulative selection of the durations of their tilting pulses, as well as possibly for applying supply voltages to optical signaling devices (lia to 12e), respectively associated with said keys (pulled at t2e)  Il Apparatus according to claim 10, characterized in that it comprises means for controlling the continuous supply of the solenoid valve (EV), for example by simultaneously actuating a key (sort) of the first series, corresponding to the selection of a duration ffi of distribution of the fluid, and a key (t2a) of the second series, corresponding to the selection of a periodicity of the distribution, n.T2 less than N # Ti, n and N being integers, and said control means comprising for example a logic gate (AND), the two inputs of which are connected respectively to said keys (ti and t2a) of the first and second series, while its output (L5) is connected to the control circuit (R2) of the solenoid valve (PV) 0  12 Device for supplying direct electrical current to a device the operation of which, in particular in a hospital environment, must not undergo # any interruption, even very brief, for example for supplying a device used to program the distribution of a fluid, device characterized in that it comprises a known rectifier circuit for producing, from the AC sector, a substantially continuous low voltage, for example U m 12 Volts, a regulator and a battery charger-regulator, the inputs of which are connected in parallel to the output of said rectifier circuit, as well as a battery of nominal voltage U, connected in parallel to the output of the charger-regulator, through a polarized diode to prevent any return of current in said charger-regulator, the output of the device being connected in parallel to that of the regulator and to a ptle of the battery, through respectively two diodes of the same polarity