GB2389535A

GB2389535A - Infant incubator

Info

Publication number: GB2389535A
Application number: GB0310377A
Authority: GB
Inventors: Neil Tierney
Original assignee: Individual
Current assignee: Individual
Priority date: 2002-05-07
Filing date: 2003-05-07
Publication date: 2003-12-17
Anticipated expiration: 2023-05-07
Also published as: GB2389535B; GB0310377D0; GB0210360D0

Abstract

An enclosure (5 fig 1) for an infant incubator comprises two domed ends 15, 32 and a cylindrical body incorporating a rotatable access hood. The hood may comprise two movable panels 30, 31, sliding in channels in bulkheads 22a, 22b. The panels may include handles 34 and may be retracted into a facia to give an open position (fig 3), may be placed adjacent one another in a closed position (fig 5) or in a position in which one or more access openings or portholes 20 in one panel are exposed. At least one sealable access porthole (14 fig 3) may be formed in at least one end. The enclosure may be double walled and may include a sectionable bed (16 fig 3) with airflow apertures (33 fig 3) and a heating delivery pipe (26 fig 6). The incubator may be mounted via vibration damping means (7 fig 1) on a lightweight, carbon fibre monocoque, wheeled chassis or trolley (1 fig 1) including gas cylinder(s), heating means, a control power system and intensive care equipment.

Description

-1- 2389535

INCUBATOR

The present invention relates to an incubator of the type commonly used for infants and neonates. In particular, though not exclusively, the present invention relates to 5 transport incubators of the type used to transfer critically ill infants from one location to another, and more specifically to an improved transport incubator which is lightweight, has increased autonomy and is easier to transport and use than conventional incubators.

Transport incubators are used as mobile intensive care units by medical staff, when moving infants and neonates from one area to another The incubator provides a heated microclimate to protect the patient from ambient weather 15 conditions and provides a platform to mount the necessary life sustaining care equipment.

Incubators were first developed in France in the early 1930's and exhibited at the Chicago World Fair in 1933 to 20 1934. Their design was revolutionary at the time, and had a huge impact on the care of critically ill infants. However, whist improving technology has resulted in these incubators becoming more efficient over the years, their design has changed very little. Today, most incubators still comprise 25 a housing to carry the infant, which is accessed by an access panel, and a mobile steel trolley upon which the housing sits. Typically the access panel is rectangular in design and is hinged such that it opens out and away from the housing. The access panel may also include a number of 30 portholes. These are useful as they allow access to the infant without needing to open the housing. However the inclusion of portholes may result in loss of air from the interior of the enclosure which may affect the microclimate or may produce draughts.

-2- A broad cross-sectiOn of the health service encounters and uses transport incubators. On average, 1000 babies per year are moved between hospitals in Scotland alone. Nearly 100% 5 of these babies require a transport incubator for safe transport. However, current designs of transport incubators are very heavy, cumbersome and difficult to manage. The need for improvement was noted several years ago in the chapter entitled "No commercially available transport 10 incubator fulfils the criteria of requirements" in The Manual of Neonatal Intensive Care.

Transport incubators are commonly used to transfer critically ill babies between wards or from one hospital to 15 another. Often it is necessary to transfer critically ill infants from rural or general hospitals to specialized pediatric hospitals, which may be several miles away or even in another part of the country. The incubator must therefore be suitable for transportation through hospital 20 corridors, up and down steps and in and out of various vehicles that may travel at high speed in the air or on land. The design of current transport incubators make these 25 complex transfers extremely difficult. It will be appreciated that where a seriously ill infant is being moved it is important to minimise the length of time the transfer takes as any delays may be detrimental to the infant's chances of survival. In particular, conventional transport 30 incubators are extremely heavy, often being more than 225kg in manual handling weight. As a result, the conventional incubators are cumbersome, and are liable to exert forces on the ambulance vehicle during emergency breaking. In

-3- addition, transportation of these heavy and cumbersome incubators can be difficult Transfers of critically ill infants are usually completed by 5 road and air. However, in October 2001 the Scottish Air Transport Service declared that they will stop carrying existing transport incubators because they weigh over 225kg.

The Scottish Ambulance Service is set to follow suit, as it is recognised that ambulances should not need to, or be 10 expected to transport any apparatus over 90kg. In addition, there are impending EU Regulations to reduce the manual handling weight of incubators to less than 90kg. These Regulations will render most commercially available current transport incubator designs obsolete.

Transport incubators require constant lifting and strenuous handling with many current designs exceeding a weight of 225kg they are therefore difficult to move and carry. This is a particular disadvantage in current incubators, given 20 the fact that one of their main functions is to support an infant during transport. It would be desirable to provide an incubator which also has improved safety for the medical, nursing, and ambulance staff who use it. Lifting and handling in the healthcare service accounts for 55% of all 25 reported injuries. In particular, ambulance staff have a very much higher incidence of patient handling injuries than any other staff. Therefore, it would be desirable to provide a lightweight incubator which minimizes strenuous handling. Also, conventional incubators may often be sensitive to vibrations which can result in inaccurate monitoring of the baby in the incubator. They also often suffer from poor

-4 soundproofing, which is problematic as excess noise can be detrimental to the infant A yet further disadvantage of conventional incubators lies S in the design of the infant housing. Obviously it is necessary for medical and nursing staff to have access to the infant. However, conventional incubators utilise an access panel/door, which is hingeably mounted and can be opened out and away from the housing. However, this design 10 is not ideal, as the opened panel/door impedes access to the baby, and can prevent both staff and equipment from getting close to the infant.

An additional disadvantage in current incubators results 15 from the manner in which they operate. Typically they comprise an air compressor which uses a battery source for power. The compressor drains the battery source relatively quickly and as a consequence most current designs of incubators have low autonomy, in other words they are only 20 capable to providing somewhere in the region of 2 to 2.5 hours of autonomous operation. This has significant consequences for the portability of the incubator.

The need for a new lightweight, reliable, ergonomic and 25 efficient transport incubator design is therefore urgently required. It is an object of the present invention to provide a transport incubator which has a lightweight design, 30 preferably below 90kOs, and which facilitates manual handling transportation of an infant.

-5- It is a further object of the present invention to provide an incubator which allows medical and nursing staff improved access to the neonate than conventional incubators.

5 A yet further object of the present invention is to provide a transport incubator which has an increased level of autonomy and portability, which can support a critically ill neonate for a greater period of time than conventional incubators. A yet further object of the present invention is to provide an incubator with improved soundproofing.

According to a first aspect of the present invention there 15 is provided an infant enclosure comprising first and second stationary ends and a rotatable access hood. The infant enclosure may be for use in a transport incubator, or may be for installation in a permanent or semi-permanent location in a hospital or other treatment centre.

Preferably, the infant enclosure includes a cylindrical body disposed between the first and second stationary ends, wherein the cylindrical body incorporates said rotatable access hood.

Preferably the first and second stationary ends are each dome-shaped. The rotatable access hood may, for example, be of a one 30 piece, two-piece or multi-piece design. For example, the rotatable access hood may comprise one or more rotatable access panels.

-6- In one embodiment the rotatable access hood comprises two rotatable access panels.

Preferably the one or more movable access panels run on 5 channels located in bulkheads. Typically the one or more access panels can be rotatably slid in the channels. The bulkheads may be linked by box section beams.

Preferably the one or more access panels have handles.

Advantageously, the rotatable access hood is formed and arranged so as to be disposable in at least one open position in which an access opening in the infant enclosure is open, and at least one closed position in which said 15 access opening in the infant enclosure is closed.

In the embodiment where the rotatable access hood comprises two rotatable access panels, when the rotatable access hood is in at least one said open position, preferably at least 20 one of the access panels is retracted into a facie of the infant enclosure.

In one embodiment the access panels can be run on the bulk heads between a first position, where the access panels are 25 retracted into a facie on the infant enclosure, a second position where the access panels are adjacent to each other and remote from the facie and a third position where the access panels are adjacent to each other and rest on a facie on the infant enclosure.

At least one of the first and second access panels may contain one or more portholes which allow access to the interior of the infant incubator.

Preferably, at least one access porthole is provided in one of the access panels and the access panels are rotatable between a first open position in which the two access panels are retracted into a facie of the infant enclosure, whereby 5 an access opening is provided in the infant enclosure, a closed position in which the access panels are adjacent one another and the access panel containing at least one porthole is retracted behind a facie of the infant enclosure such that the access opening is closed and the access 10 portholes are hidden behind the facie, and a second open position in which the access panels are disposed adjacent one another and remote from the facie such that the access portholes are exposed.

15 Preferably the infant enclosure also has a sealable porthole which can be used to access the infant's head. Typically the sealable porthole will be located in one of the first and second stationary ends.

20 Typically the infant enclosure is pod shaped.

Preferably the infant enclosure is double-walled. The infant enclosure may, for example, be manufactured from acrylic double glazed panels. Alternatively the infant 25 enclosure may be manufactured from any suitable plastic or reinforced glass material.

Preferably the infant enclosure further includes a sectionable bed. The sectionable bed typically has a 30 plurality of apertures which permit airflow through the bed.

Preferably the infant enclosure further includes a delivery pipe provided therein and containing heating means for delivering heat to the interior of the enclosure.

-8- Preferably, the delivery pipe is disposed below the sectionable bed. An electric DC fan may also be contained within a delivery pipe provided in the infant enclosure.

5 According to a second aspect of the invention there is provided a transport incubator comprising an infant enclosure according to the first aspect of the invention, and a wheeled chassis on which the infant enclosure is mounted. The chassis is preferably configured to house at 10 least one gas cylinder therein. For example, a housing for the gas cylinder(s) may be integrally provided in a body of the chassis. The chassis is preferably made of a lightweight material, such as carbon fibre. The incubator may be provided with one or more gas cylinders manufactured from 15 carbon fibre. Preferably the transport incubator has a weight below 90kgs. Most preferably the weight of the transport incubator is below 80kg.

The infant enclosure is preferably mounted to the chassis 20 via vibration damping means The chassis may include a vibration damped platform on which intensive care equipment may be mounted.

The chassis is preferably also adapted to allow mounting of 25 intensive care equipment. This may include ECG monitors, IV pumps, gas cylinders, nitric oxide delivery systems, oscillating ventilators and suction pumps.

Preferably the chassis also contains a cable management 30 system. This may comprise a housing which is adapted to retract and hold external cables.

According to a third aspect of the present invention there is provided a wheeled chassis for use as a patient

- 9 - transportatlon trolley, wherein the chassis includes a housing for at least one gas cylinder. Preferably the housing is integrally provided in a body of the chassis.

Preferably the chassis is manufactured from carbon fibre 5 monocoque. The chassis may be adapted to hold and transport the infant enclosure of the first aspect of the invention, or may be designed for adult transportation.

10 An example embodiment of the present invention will now be described with reference to the following figures, in which: Fig 1 is a perspective view of the f Font of the transport incubator of the present invention; 15 Fig. 2 is a perspective view of the rear of the transport incubator; Fig. 3 illustrates the baby enclosure/pod of the transport incubator with access panels fully open; Fig. 4 illustrates the baby enclosure/pod of the transport 20 incubator with access panels at a mid-position; Fig. 5 illustrates the baby enclosure fully sealed; and Fig. 6 illustrates the baby enclosure in section view.

Referring firstly to Fig. 1, the transport incubator of the 25 present invention comprises a chassis 1 and infant enclosure 5. The chassis 1 is supported by four caster wheels 2 and has grated anchorage points 3 to attach a winch system. The chassis 1 is manufactured from a lightweight material such as carbon fibre monocoque with a paper core material. This 30 lightweight construction greatly facilitates the ease with the incubator can be moved. The infant enclosure 5 is pod-

shaped and mounted on top of the chassis 1 as shown. The infant enclosure is smooth surfaced and easy to clean and in a preferred embodiment is manufactured from acrylic double

-10 glazed panels. Alternatively any suitable plastic may be used to manufacture the enclosure.

In the depicted embodiment the infant enclosure comprises a S cylindrical body having domed ends 15, 32 and has a respective aluminium bulkhead 22a, 22b disposed between the cylindrical body and each of the domed ends. The domed ends are particularly advantageous in attenuating sound. It is known that flat surfaces tend to resonate sound whereas 10 curved surfaces tend to attenuate sound. The pod shape of the infant enclosure, all its walls being of curved shape, is therefore particularly suited for insulating the enclosed infant from excessive noise.

15 The infant enclosure can be detachably removed from the chassis, if desirable. Intensive care equipment 6 can be mounted onto a vibration damped platform 7 provided on the chassis. For example, this may equipment may include ECG monitors, IV pumps, gas cylinders, nitric oxide delivery 20 systems, output printers, oscillating ventilators and suction pumps.

As the platform 7 is vibration dampened it therefore acts to minimise vibrations and dampen noise in order to prevent 25 damage to the infant inside the enclosure 5. An aperture 8 is also included in the chassis 1 to provide access to storage room underneath the enclosure 5.

The chassis 1 also integrally comprises a housing portion 30 la, which is configured for carrying two large gas cylinders (not shown). These are mounted on struts 9 provided therefor in the chassis. The cylinders are manufactured from carbon fibre and are therefore lightweight. The inclusion of these bespoke carbon fibre cylinders, provides

-11- the incubator with improved autonomy and reduced weight, compared with conventional incubators which rely on a heavy air compressor which runs on a battery source. Typically current incubators are capable of only around 2 to 2 5 hours 5 of autonomous operation. However the incubator of the present application is capable of approximately 4 to 5 hours autonomous operation before a back up power solution would be required (such back up power would need to be obtained from the ambulance, helicopter or other vehicle in which the 10 incubator is being transported).

The incubator is controlled by a power system comprising a battery 40, battery charger lO and an inverter ll, all housed within another housing portion lb provided therefor 15 in the chassis l, as can be seen in Fig. 2. A fibre-optic light box illuminator 12 feeds side emitting fibre-optic cable to light the baby enclosure (this fibre-optic cable runs from the illuminator to the interior of the infant enclosure). The external cables are routed through and can 20 be retractable housed in a housing 13 provided in the same housing portion lb of the chassis as the battery and charger. As the chassis is manufactured from a carbon fibre monocoque construction with a paper core material it is very lightweight and stiff, and thus is easy to transport.

The infant enclosure 5 is of a double-walled construction and is accessed via a rotating access hood forming part of the cylindrical body of the pod, generally depicted at 28, which allows easy access to the baby as illustrated in Figs. 30 3 to 5. The rotating access hood in this embodiment has a two-piece construction comprising first and second access panels 30, 31. Bulkheads 22a, 22b are provided with channels for the access panels to run on. In Fig. 3 the infant enclosure is open, in other words the rotating cylindrical

-12 hood is in a first position with the access panels 30 and 31 retracted such that there is unlimited access to the infant.

The first access panel 31 is retracted into a facie 21 forming part of the cylindrical body of the enclosure 5.

5 Additionally the second access panel 30 may be retracted into a similar facie (not shown) on the rear side of the incubator in Fig. 3. This is advantageous over conventional incubators where access is permitted by a panel or door which opens out and away from the incubator, impeding access 10 to the infant and making it difficult for equipment to be placed near the incubator. (In addition, this traditional design takes up a considerable amount of space when open, which is particularly inconvenient in ambulances or air ambulances where space is at a minimum). In the embodiment 15 of Figs. 3 to 5, this fully open position will typically be used when the infant is being inserted into, or removed from the incubator, and also in cases where access via portholes (accessible when the infant enclosure is in a mid position, as described below) is insufficient.

When the access panels of the baby enclosure are in a mid position, as shown in Fig. 4, access is achieved to the baby using portholes 20 provided in the first access panel 31.

In the mid position the access panels 30 and 31 are (from 25 their position in Fig. 3) both rotated towards one another until they are adjacent and abut each other. Handles 34 are included on the access panels to facilitate rotation. The mid position may be used when access to the infant is required by medical/nursing staff but it is not necessary to 30 open the entire incubator. Fig. 5 illustrates the infant enclosure fully sealed. In this state, the first access panel 31 is in its retracted position (as in Fig. 3) but the second access panel is rotated towards the first access panel so the two panels are adjacent and abut one another.

-13 When fully sealed, portholes 20 are closed (i.e. fully hidden behind the facie of the pod) and therefore air is not lost into the outer environment. This allows the inner conditions of the infant enclosure, for example the 5 temperature and microclimate to be maintained at a steady level. Access to the baby's head is achieved through a sealable porthole 14 located in left dome 15. It will be appreciated 10 that the design shown in the example figures may be reversed such that the porthole is located in the right dome 32. The infant lies on a sectionable bed 16 having a plurality of apertures or holes 33 which allow free airflow through.

Cables from the intensive care equipment are restrained and 15 managed by the porthole 17 located in the right dome 32.

The infant enclosure is height adjustable and vibration dampened, relative to the chassis, by means of four flange bearings 18 and air bladder actuator/isolator 19 arrangement. The enclosure is slidable up and down on rods 20 (not shown) which protrude through the flange bearings 18, under upward or downward force provided by the bladder actuator/isolator arrangement lg mounted between the chassis and the cylindrical body of the pod.

25 A sectional view of the baby enclosure is shown in Fig. 6, from which the manner in which the rotating cylindrical access hood acts can be seen. Each bulkhead 22a, 22b has left and right sections joined by a mechanical fastener 23, whilst a channel 24 provided in the bulkhead allows the 30 access panels 30, 31 to open and close. The two bulkheads are linked by two box section beams 27. The enclosure is heated by an electric DC fan heating element contained within a delivery pipe 26 running along the inside of the enclosure.

-14 The transport incubator is designed to be used in conjunction with certain existing intensive care peripheral outputs. Typically when the incubator is fully configured, S together with all peripheral equipment its weight is below 90kgs. In one embodiment the weight of the incubator is below 80kgs.

Typically the incubator has maximum dimensions of length 10 below 1, 300rnrn, width below 500rrun and height less than 1,200mm. The incubator can comfortably accommodate a neonate of less than 6kgs, and in the preferred embodiment is able to accommodate up to a long child.

15 A particular advantage of the present invention lies in the fact that the incubator has increased autonomy having a power supply which is capable of providing 4 to 5 hours autonomous operation, together with onboard compressed air cylinders. This is greatly increased autonomy as compared 20 with prior art incubators which utilise an air compressor

powered from a battery source. As afore-mentioned, such conventional incubators typically have an autonomy of 2 to 2.5 hours.

25 The incubator of the present invention is also capable of dampening noise to below 50 decibels and maintains a microclimate to a maximum of 37 C. The incubator provides quiet operation and can interface with ambulance and airioxygen and electrical system as well as ambulance and 30 aircraft stretcher restraint systems. The apparatus is also capable of withstanding a worse case scenario of a crash when in transport and has 20g forward and 10g side impact loads.

-15- A further advantage of the present invention lies in the fact that the chassis is lightweight in design, typically the whole transport incubator as a whole being below 90kgs in weight, and is thus easier to transport and reduces the 5 risk of injury to medical and ambulance staff during transportation. In particular the incubator of the present invention allows easy loading and unloading of an infant into all transport modes, including ambulance, helicopter and fixed wing aircrafts. The incubator has a single easy 10 to-use and understand control interface and feedback display. In addition the inclusion of a the cable management system allows the incubator and peripheral equipment cables to be organized. The chassis is designed to dampen vibration and noise and peripheral intensive care Is equipment can easily be mounted on the platform of the chassis. Yet further the incubator described in the present invention has utility support systems such as power and compressed air Which increases the autonomy of the incubator. It is recognized that whilst the chassis described in the present invention is particularly suitable for use with a baby enclosure/infant housing, it may be adapted as a trolley design for hospitals, to be used in transporting 25 adult patients.

Further modifications and improvements may be incorporated without departing from the scope of the invention herein intended.

Claims

-16 CLAIMS

1. An infant enclosure comprising first and second stationary ends and a rotatable access hood.

s

2. An infant enclosure according to claim l, for use in a transport incubator.

3. An infant enclosure according to claim l or claim 2, 10 including a cylindrical body disposed between the first and second stationary ends, wherein the cylindrical body incorporates said rotatable access hood.

4. An infant enclosure according to any preceding claim, 15 wherein said first and second stationary ends are each dome-

shaped.

5. An infant enclosure according to any preceding claim, wherein the rotatable access hood comprises two movable 20 access panels.

6. An infant enclosure according to claim 5, further including first and second bulkheads disposed between the cylindrical body and the first and second stationary ends 25 respectively, and wherein each said bulkhead includes a channel in which the rotatable access panels slide.

7. An infant enclosure according to any preceding claim wherein the rotatable access hood is provided with at least 30 one handle.

8. An infant enclosure according to claim 5 or claim 6, wherein each rotatable panel is provided with at least one handle.

-17

9. An infant enclosure according to any preceding claim, wherein the rotatable access hood is formed and arranged so as to be disposable in at least one open position in which 5 an access opening in the infant enclosure is open, and at least one closed position in which said access opening in the infant enclosure is closed.

10. An infant enclosure according to any preceding claim, 10 wherein at least one access porthole is provided in the rotatable access hood.

11. An infant enclosure according to any preceding claim, wherein the rotatable access hood comprises two rotatable 15 access panels and, when the rotatable access hood is in at least one said open position, at least one of the access panels is retracted into a facie of the infant enclosure.

12. An infant enclosure according to any of claims 5,6,8 and 20 11, wherein at least one access porthole is provided in one of the access panels and the access panels are rotatable between a first open position in which the two access panels are retracted into a facie of the infant enclosure, whereby an access opening is provided in the infant enclosure, a 25 closed position in which the access panels are adjacent one another and the access panel containing at least one porthole is retracted behind a facie of the infant enclosure such that the access opening is closed and the access portholes are hidden behind the facie, and a second open 30 position in which the access panels are disposed adjacent one another and remote from the facie such that the access portholes are exposed.

-18-

13. An infant enclosure according to claim 6, wherein the access panels run on the bulkheads between a first position in which both access panels are retracted into a facie on the infant enclosure, a second position in which the access 5 panels are adjacent one another and remote from the facie, and a third position in which the access panels are adjacent one another and rest on a facie on the infant enclosure.

14. An infant enclosure according to any preceding claim, 10 wherein at least one sealable porthole is provided in at least one of the first and second stationary ends of the infant enclosure, for accessing the head of an infant, in use of the enclosure.

15 15. An infant enclosure according to any preceding claim, wherein the walls of the infant enclosure are all of curved shape.

16. An infant enclosure according to any preceding claim, 20 wherein the infant enclosure is pod-shaped.

17. An infant enclosure according to any preceding claim, wherein the infant enclosure is double-walled.

25

18. An infant enclosure according to any preceding claim, further including a sectionable bed.

19. An infant enclosure according to claim 18, wherein the bed has a plurality of apertures provided therein for 30 permitting airflow through the bed.

20. An infant enclosure according to claim 18 or claim 19, further including a delivery pipe containing heating means

-19 for delivering heat to the interior of the enclosure, the delivery pipe being disposed below the sectionable bed.

21. A transport incubator comprising an infant enclosure 5 according to any preceding claim, and a wheeled chassis on which the infant enclosure is mounted.

22. A transport incubator according to claim 21, wherein the chassis is configured to house at least one gas cylinder.

23. A transport incubator according to claim 21 or claim 22, further including heating means.

24. A transport incubator according to claim 21, wherein the 15 infant enclosure is mounted to the chassis via vibration damping means.

25. A transport incubator according to any of claims 20 to 24, wherein the chassis is manufactured from carbon fibre 20 monocoque.

26. A transport incubator according to any of claims 20 to 25, wherein the chassis includes a vibration damped platform which is configured for mounting intensive care equipment 25 thereon.

27. A transport incubator according to claim 26, including a single user interface for controlling intensive care equipment mounted on the chassis.

28. A transport incubator according to any of claim 20 to 27, further including a control power system housed within the chassis

-20

29. A transport incubator according to any of claims 20 to 28, further including cable management means mounted in the chassis. 5

30. A transport incubator according to any preceding claim, having a total weight of less than 90kg.

31. A wheeled chassis suitable fox use as a patient transportation trolley, wherein the chassis includes a 10 housing for at least one gas cylinder.

32. A chassis according to claim 31, wherein the chassis is manufactured from carbon fibre monocoque.

15

33. An infant enclosure substantially as described herein and as shown in Figs. 3 to 6.

34. A transport incubator substantially as described herein and with reference to Figs.1 and 2.