GB2343620A

GB2343620A - Supine transfer board with inclinometer

Info

Publication number: GB2343620A
Application number: GB9821349A
Authority: GB
Inventors: Muhammad Rizwan-Ul Hasan
Original assignee: HASAN MUHAMMAD RIZWAN UL
Current assignee: HASAN MUHAMMAD RIZWAN UL
Priority date: 1998-10-01
Filing date: 1998-10-01
Publication date: 2000-05-17
Also published as: GB9821349D0

Abstract

A transfer board 5 for transferring a person from a first horizontal surface (eg a hospital bed) to a second horizontal surface (eg a hospital trolley) is fitted with an inclinometer 10 to measure the angle of the board. The inclinometer uses the principle of a 'spirit level' using two immiscible liquids, one brightly coloured (14,fig. 8) and the other colourless (13,fig. 8), the coloured liquid becoming visible through a gap (18,fig. 6) in a mask (17,fig. 6) covering the inclinometer when the angle of the transfer board is within an allowable range. Alternatively a light weight brightly coloured solid disc may be used in place of the second liquid. The geometry of the inclinometer internal surface is designed to keep coloured liquid fully visible in the gap when the transfer board is tilted in the allowable range.

Description

IMPROVEMENTS IN OR RELATING TO SUPINE TRANSFER BOARDS This specification relates to Supine Transfer Boards which are used to transfer patients , between beds, etc. in medical establishments, old peoples homes, etc.

In medical establishments, for example hospitals, it is frequently necessary to transfer patients between one bed and another. In this specification, the term'bed'may also refer to a trolley, the couch of an X-ray machine or an operating theatre table, etc.

Supine Transfer Boards (STB) are commonly used for such a transfer to bridge the gap between the two beds. The correct procedure is that the two beds should be at the same height or the receiving bed should be marginally lower. When there is a height difference, it should not exceed 1 inch (25 mm). If the height difference is greater than this, a conscious patient may have an unpleasant experience sliding down the STB An unconscious patient may be at risk of serious injury. Conversely if the receiving bed is higher, the patient has to be moved up an incline causing the medical staff to exert greater effort than would otherwise be required. Back injuries are very common among medical staff and any unnecessary exertion is to be avoided.

Though all hospital staff are trained in the correct use of STBs, medical emergencies frequently require procedures to be carried out as rapidly as possible. This is particularly so in, Accident and Emergency Departments, in Operating Theatres and when patients suffer catastrophic conditions, e. g. heart attacks etc. Under these circumstances, the natural desire to treat the patient as quickly as possible sometimes leads to procedures not being followed to the letter. There is thus a need for an easy, visual means of identifying whether an STB is at the right angle for patient transfer so that this can be checked in the minimum of time and at arm's length.

There is thus a requirement in the use of STBs to: make the transfer of patients easier without compromising safety; * reduce the risk of back injuries to the medical staff responsible for transferring patients; and * cause minimum discomfort to the patient.

According to the invention there is provided apparatus for transferring a person, in a lying position, from a first essentially, horizontal surface to an adjacent second essentially horizontal surface comprising a portable, essentially rigid flat member, able to bridge the gap between said first and second essentially horizontal surfaces, having an inclinometer to show when the angle of said portable, essentially rigid flat member is either safe for the person to be transferred or not safe for the transfer.

According to a first variation of the apparatus of the invention, the portable, essentially rigid flat member may be the said first essentially horizontal surface.

In a preferred use of the apparatus of the invention, either of the first and second surfaces may be a bed, a trolley or an operating table, etc. in a medical establishment.

The portable, essentially rigid, flat member may be a stiff flexible board designed to bridge the gap from one bed to another. The patient, usually lying in the supine position, may be slid from the first bed onto the portable, flat member and then, by virtue of the low coefficient of friction slid across the portable, flat member onto the second bed.

Accordingly to a second variation of the apparatus of the invention, the means of indicating the angle of the inclinometer is visual.

According to a third variation of the apparatus of the invention, the inclinometer is a form of multi-phase liquid device.

According to a fourth variation of the apparatus of the invention, the inclinometer is in the form of a liquid with a buoyant solid floating thereon.

According to a fifth variation of the apparatus of the invention, the visual indication of the angle of the inclinometer is provided by one of the multiple phases being brightly coloured with respect to the other phase.

According to a sixth variation of the apparatus of the invention, marking is provided so that, when it is safe for the person to be transferred, the coloured less dense liquid phase/buoyant solid is visible through said marking and when it is not safe to transfer the patient, no colour is visible.

\ According to a seventh variation of the apparatus of the invention, the marking may be transparent, opaque or a combination of both.

In a preferred design the less dense liquid is brightly coloured and the more dense liquid is colourless so that the contrast between the two liquids is strong. The two liquids may be arranged in a conventional"spirit level"arrangement, i. e. in a glass or perspex container with a conventionally curved upper surface. The marking may be a mask which is placed over the upper surface with an aperture (s) cut therein so that, when the portable, flat member is horizontal or the second surface is at a very slightly lower level than the first surface, the coloured second liquid will be visible through the apertures in the mask thus indicating that it is safe to transfer the patient, Ideally, the aperture will be in the form of an arrow showing in which direction it is safe to transfer the patient and the inclinometers will be at right angles to the longitudinal axis of the transfer surface. If the height difference between the first and second surfaces is too great, or if the patient would have to be transferred up an incline, the less dense coloured liquid would move to one side of the arrow aperture and no colour would be visible, thus indicating that it was not safe for the transfer to beattempted.

According to an eighth variation of the apparatus of the invention, the inclinometer is fast with said portable, essentially rigid flat member.

In preferred designs the inclinometer may be attached to the surface of the member by a suitable adhesive or inset into the surface of the member if said member is of sufficientthickness According to a ninth variation of the apparatus of the invention electronic apparatus may be associated with the inclinometer.

If the portable, flat member is of the thinner types used in hospitals, etc. the inclinometer may be attached to the surface by an adhesive element. This would bue . suitable both for new manufacture and for attaching to existing items of equipment.

Where the portable, flat member is of the thicker type, such as the boards used by rescue services etc. and which also acts as a stretcher, there may be sufficient thickness for the inclinometer to be set into the board and thus present a flush surface. With such thicker boards, there may also be sufficient depth to provide a space for the incorporation of electronic equipment, e. g. means to illuminate the inclinometer and/or provide audible warnings, etc., any of which may operate for a pre-determined time.

According to the invention there is provided a method of transferring a person in the supine position from a first essentially horizontal surface to an adjacent second essentially horizontal surface comprising the steps of providing first and second essentially horizontal surfaces with a person lying on the first surface; partly rolling the person in a direction away from the second surface ; inserting a portable, essentially rigid flat member between said first surface and the person so that the member bridges any gap between said first and second surfaces and rests on both surfaces; rolling the person in the opposite direction to that previously onto said flat member, checking the inclinometer (s) fast with said member to ascertain that the angle of said member is appropriate for the transfer; and, if the visual indication shows that the angle is within the appropriate limits, proceeding with the transfer; or, if there is no visual indication that the transfer may be safely accomplished, adjusting the relative heights of said first and second surfaces until the indication is present and then proceeding with the transfer For a clearer description of the invention and to show how it may be put into effect, reference will now be made, by way of example only, to the following drawings in which: Fig 1 shows a plan view of a patient being transferred from one bed to another using an STB ; Fig 2 is a sectional elevation of the transfer shown in Fig 1, along the line AA ; Fig 3 shows a sectional elevation of the STB bridging gap 4 between beds 2 and 3; Fig 4 shows the geometry of STB 5 bridging gap 4; Fig 5 shows a plan view of an STB with Tilt Detection Devices (TDD) 10 according to the invention; Fig 6 shows a plan view of a TDD according to the invention; Fig 7 shows a sectional elevation of the TDD shown in Fig 6 along the line DD; Fig 8 shows a sectional elevation of an alternative design of TDD; Fig 9 is a plan view of a TDD when the STB is inclined at an angle a to the horizontal; Fig 10 is a sectional elevation of the TDD shown in Fig 9 along the line BB ; Fig 11 is a plan view of a TDD inclined at an angle 0+ to the horizontal, Fig 12 is a sectional elevation through the TDD shown in Fig 11 along the line CC; Fig 13 is a sectional elevation of a TDD attached adhesively to a STB ; Fig 14 shows a sectional elevation of a TDD inset into the surface of a STB; and Fig 15 is a sectional elevation of an alternative design of TDD.

Fig 1 shows the operation of a STB. A patient 1 is lying on a first bed 2 and is to be transferred to a second bed (or trolley, etc.) 3. Patient 1 is rolled 6 in a anti-clockwise direction (Fig 2) and STB 5 slid partly underneath their back as shown by arrow 7. Fig 2 shows that bed 3 is lower than bed 2 by a vertical distance 8 and the two beds are separated by a gap 4. When STB 5 has been partly moved under patient 1, he/she is rolled backwards in a clockwise direction, i. in opposition to arrow 6, onto STB 5.

Patient 1 is then slid across to the right along STB 5 onto second bed 3. STBs have as low friction surface so that the patient may be slid across with minimum of effort. As shown in Fig 2, height difference 8 will minimise the effort required to move patient 1, who may be unconscious following an operation. However, if bed 3 was higher than bed 2, patient 1 would have to be moved uphill requiring extra effort from the medical staff and risk of injury to them, as well as possibly, exacerbating any injuries that the patient might already have. Similarly, if the transfer was downhill but the slope was too steep, patient 1 may also suffer further injury.

Fig 3 shows STB 5 in the position where a patient is actually being transferred. One side of STB 5 rests on bed 3 at point A and point C is where the STB rests on the edge of bed 2. C represents a point on the longitudinal mid-line of STB 5, as shown on Fig 5. Point B represents the height of bed 3 projected across onto bed 2 and is vertically below point C. The vertical distance BC is equivalent to height difference 8. Fig 4 shows the geometry of triangle of ABC. Height BC should be no more than 1 inch (25. 4 mm) and AC represents half the width of STB 5. The width of a typical STB is 560mm so that AC is 280mm. Angle 0 is given by : Sin'BC = 25. ie 0=52 AC 280 Thus, for safe use, the STB angle should lie between 0 , i. e. horizontal, and a downward slope of 5. 2 Fig 5 shows a plan view of an STB 5 with 4 TDDs located one near each corner Hand holes 9 are also shown Fig 6 shows a plan view of a TDD according to the invention and Fig 7 shows a sectional elevation along the line DD of Fig 6. TDD 10 uses the principal of the spirit level, commonly used in building operations, etc. In a conventional spirit, level an air bubble in a liquid is aligned between marks etched onto the glass container to show the horizontal position This is appropriate for building work where the craftsman is able to concentrate on getting the alignment exact. In a hospital, where a medical attendant is standing and looking at an STB at, or below, waist height, it would be difficult to see the position of a transparent air bubble in a relatively clear liquid.

S In the invention, the air bubble is replaced by a second liquid 14. Second liquid 14 would have a lower density than that of first liquid 13, be immiscible with it and would be brightly coloured. Thus second liquid 14 would'float'as a brightly coloured separate item on the top of first liquid 13. As the two liquids would be immiscible, no dissolution of one in the other would occur. Examples of the liquids could be water for the first 13 and an oil for the second 14. If the oil contained a hydrophobic dye, it would appear as a coloured item, floating freely on the water. Other immiscible pairs of liquids are equally possible. The surface tension properties between the two liquids will be selected to maintain second liquid 14 as a single'lens'shape.

TDD 10 would be constructed in a similar manner to that of a conventional spirit level having a curved upper surface 12. In this case, a flat lower surface 11 and parallel sides 16 are preferred and curved surface 12 is sealed to base 11 at ends 15. As shown in Fig 7, the angle that the end of surface 12 makes with base 11 is greater that 8 and is as denoted 0+. An alternative design is shown in Fig 8 in which upper surface 12 is formed of two angled end sections 12B and 12C and a flat centre section 12A. A ridge 27 is provided at the joint between flat surface 12A and angled surface 12C. Again the angle between surfaces 12B, 12C and base 11 is 0+.

Fig 6 shows in plan the appearance of the upper surface 12 of TDD 10. It is covered by an opaque member 17 with an arrow-shaped cut-out 18 in the centre. In the horizontal position, second liquid 14 is at the top of curve 12, as shown in Fig 7. The position of second liquid 14 is shown by the dashed ellipse on Fig 6 and lies directly underneath cut-out arrow 18 so that the colour shows through. This would be an easily visible indication to the medical staff that the STB was horizontal and the patient could be moved. The position of arrow 18 is shown in the middle of curved surface but dimensions 19 and 20 can be varied to provide particular features, as will be described hereinafter In ar ideal application, first liquid 13 would be colourless, second liquid 14 would be green and opaque and base 11 would be red Thus, in Fig 6, only the green'safe'colour would be visible in arrow 18.

Figs 9 and 10 show the position where there is a height difference between beds 2 and 3 and the STB is inclined at an angle a less than 9, (i e 0 < a'0) Here liquid 14 is moving to the left and the ellipse 14 shown in Fig 9 covers only the majority of arrow 18 As the majority of arrow 18 will be showing a green"safe to use"indication, the patient may be transferred. Figs 11 and 12 show the situation where the angle of STB is greater than 0, i. e. A+, and here the ellipse 14A has moved to the extreme side of the TDD and only red is visible through arrow hole 18 The green"safe to use"and red "unsafe to use"follow the accepted colour codings However, in Fig 9, both colours would be visible together and this could lead to confusion One alternative is to have only second liquid 14 coloured green, i. e. first liquid 13 and base 11 would be colourless In this case, the absence of colour means"not safe to use"until the relative heights of the beds 2 and 3 have been adjusted accordingly.

In Figs 11 and 12, second liquid 14 has been replaced by a coloured disc 14A which floats freely on the surface 13A of first liquid 13. As before, green is the preferred colour for disc 14A and base 11 may be red or colourless. There are a large number of light plastic based materials which could be used for this application. One parallel application is in electric kettles where a coloured indicator is used in an external sight tube to show the level of liquid inside.

As shown in Fig 5, TDDs would ideally be placed at each corner of STB 5. As shown, arrows 18 would be point outwardly and would show colour only to indicate the safe direction in which a patient might be transferred.

Fig 13 shows how the TDD would be used by attaching to board 5 via an adhesive element 22.

A more robust form of board 5A, known as a Spinal Board, is used by the rescue services for collecting patients from the scenes of accidents, etc. This type of board SA (Fig 14) is thicker as it also acts as a stretcher to which the patient can be secured to immobilise the spine and prevent further injury. Here, an important factor is to keep the patient as nearly horizontal as possible at the scene of the accident, into the, ambulance, on the journey to hospital, out of the ambulance and into the X-ray facility and until he/she has been examined by a physician and given the'all clear'. The TDD is ideally suited to this task and may either be provided in pairs arranged mutually at right angles to each other, or produced in the circular form as used on theodolites and other instruments which have to be levelled in both x and y planes. Once the'all clear' has been given, the TDD may be used to transfer the patient in the manner previously explained. Apart from being round, the method of construction and use are the same as those taught for rectangular TDDs.

As shown in Fig 14, TDDs could be inset into a recess 5B. In this case, a perspex member 23 would cover the curved upper surface 12, as shown, to give a flush surface to board 5A. The extra thickness of board SA would permit a compartment 24, accessible via a cap 26, to be provided for electronic equipment. This could be a simple battery compartment for illumination of TDD 10 via a connection 25 or more versatile electronics could be provided, e. g. a timer and/or alarm to warn the attendant to be aware of the situation.

One problem with the basic form of TDD is shown in Fig 9 and is that, when STB 5 is at an angle a between 0 and , not all the area of arrow 18 is coloured If staff become used to seeing only a small area of colour, there is a risk that they may try to use it incorrectly when no colour is present. Fig 8 shows the TDD in the horizontal (0 ) position with lens 14 contacting a flat central section 12A. The addition of a ridge 27 (Fig. 8) will retain liquid under flat surface 12A as the STB is tipped to the right (as in Figs. 9 & 10).

If the STB is tipped towards the right, i. e. in the"safe to use"direction (0 < a < 0), second liquid 14 will move to the left and butt up against the vertical edge of ridge member 27. Because ridge 27 stops liquid 14 from moving further to the left, arrow 18 will remain fully coloured. The shape of lens 14 may change, i. e. it may become thicker but it will still essentially remain in the same position. The volume of liquid 14, its surface tension properties and the height of ridge 27 will all be chosen to ensure that it will stay in the position shown up to an angle 6. Above this angle, liquid 14 will, 'spill over'ridge 27 and collect in end space 33. This will leave no colour showing in arrow 18 The flat underside of ridge 27 will allow liquid 14 to run back to flat surface 12A as soon as the angle reduces to less than 0.

While ridge 27 solves the problem shown in Fig 9 of only part of arrow 18 being coloured in the"safe to use"direction, arrow 18 could still show partly coloured if the STB was tipped to the right, i. e a was negative It would thus appear to indicate that a transfer was allowable, even thought the incline would be slightly uphill By altering the internal geometry of surface 12, this can be avoided. Fig 15 shown such internal geometry with the TDD in the horizontal (0 ) position and lens 14 contacting a flat central section 29 The position of arrow 18 relative to section 29 is shown by dashed lines 32.

If the STB is tipped towards the right, i. e. in the"safe to use"direction (0 < a < 0), second liquid 14 will move to the left and butt up against the vertical edge of ridge member 28 Because ridge 28 stops liquid 14 from moving further to the left, arrow 18 will remain fully coloured. The shape of lens 14 may change, i. e. it may become thicker, but it will stay essentially in the same position. The volume of liquid 14, its surface tension properties and the height of ridge 28 will all be chosen to ensure that it will stay in the position shown up to an angle 0 Above this angle, liquid 14 will'spill over'ridge 28 and collect in end space 33. This will leave no colour showing in arrow 18 Similarly, if STB 5 is tipped towards the left, i. e. a becomes effectively negative, liquid 14 would immediately move to the right, past point 30, to contact another flat section 31 which is angled slightly away from the horizontal. The effect of this is that, as soon as the STB is angled only very slightly towards the left, liquid 14 immediately moves out of the way 32 of arrow 18 and collects in end space 34, i. e. there is no scope for part of arrow 18 to remain coloured and give a wrong indication.

Claims

What I claim is:1. Apparatus for transferring a person, in a lying position, from a first essentially, horizontal surface to an adjacent second essentially horizontal surface comprising a portable essentially rigid, flat member, able to bridge the gap between said first and% second essentially horizontal surfaces, having an inclinometer to show when the angle of said portable, essentially rigid flat member was either safe for the person to be transferred or not safe for the transfer
2. Apparatus for transferring a person as claimed in claim 1, wherein either/both of the first and second essentially horizontal surfaces is/are a bed, a trolley, an operating table, etc.
3. Apparatus for transferring a person as claimed in claim 2, wherein the portable essentially rigid flat member is the first essentially horizontal surface.
4 Apparatus for transferring a person as claimed in claim 3, wherein said portable essentially rigid flat member has a smooth surface to allow patients to be slid thereacross.
5 Apparatus for transferring a person as claimed in any preceding claim, wherein the inclinometer provides a visual indication that the angle of the portable essentially rigid flat member is safe for patient transfer.
6. Apparatus for transferring a person as claimed in claim 5, wherein the inclinometer is in the form of a multi-phase liquid device
7. Apparatus for transferring a person as claimed in claim 5, wherein the inclinometer is in the form of a liquid with a buoyant solid floating thereon.
8. Apparatus for transferring a person as claimed in claims 6 or 7, wherein the visual indication of the angle of the inclinometer is provided by one phase being brightly coloured, or differently coloured, with respect to the other phase.
9. Apparatus for transferring a person as claimed in any preceding claim, wherein the visible surface of the inclinometer is provided with a mask.
10. Apparatus for transferring a person as claimed in claim 9, wherein an aperture (s) is provided within the mask so that the multiple phases in the inclinometer are visible through said aperture (s) when the angle is safe for patient transfer.
11. Apparatus for transferring a person as claimed in claim 10, wherein the upper surface of the inclinometer is in the form of a convex curve.
12. Apparatus for transferring a person as claimed in claim 10, wherein the upper surface of the inclinometer is in the form of multiple curves.
13. Apparatus for transferring a person as claimed in claim 10, wherein the upper surface of the inclinometer includes uncurved, flat sections.
14. Apparatus for transferring a person as claimed in claims 11-13, wherein ridges are provided on the underside of the upper surface of the inclinometer.
15. Apparatus for transferring a person as claimed in any preceding claim, wherein the inclinometer is attached to the surface of the portable essentially rigid flat member.
16. Apparatus for transferring a person as claimed in claim 15, wherein adhesive means are used to attach the inclinometer to said portable essentially rigid flat surface.
17. Apparatus for transferring a person as claimed in any preceding claim, wherein the inclinometer is inset into the fabric of the portable essentially rigid flat member to give a flush surface.
18 Apparatus for transferring a person as claimed in claim 17, wherein electronic apparatus is associated with the inclinometer.
19. Apparatus for transferring a person as claimed in any preceding claim wherein the inclinometer (s) is/are arranged to be able to maintain the portable essentially rigid, flat member in a horizontal, or near horizontal, attitude in either/both the transverse and/or lateral planes.
20. A method of transferring a person in a lying position from a first essentially horizontal surface to an adjacent second essentially horizontal surface comprising the steps oC- providing first and second essentially horizontal surfaces with a person lying on the first surface; partly rolling the person in a first direction away from the second surface ; inserting a portable, essentially rigid flat member between said first surface and the person so that the member bridges any gap between said first and second surfaces and rests on both surfaces; rolling the person in the opposite direction to that previously onto said flat member; checking the inclinometer (s) fast with said member to ascertain that the angle of said member is appropriate for the transfer; and, if the visual indication shows that the angle is within the appropriate limits, proceeding with the transfer ; or, if there is no visual indication that the transfer may be safely accomplished, adjusting the relative heights of said first and second surfaces until the indication is present and then proceeding with the transfer.
21. Apparatus and method for transferring a person in a lying position from a first essentially horizontal surface to an adjacent second essentially horizontal surface as described in and by the above description with reference to the accompanying drawings.