US2248199A - Method and means for preventing cross infection - Google Patents

Description

July 8, 19 41. 2.248.199

METHOD AND MEANS FOR PREVENTING (moss INFECTION J. A. REYNIERS Filed April .4, 1958 2 Sheets-Sheet l (@QZBLZW ATTORNEYS.

y 1941- J. A. REYNIERS 2,248,199

METHOD AND MEANS FOR PREVENTING CROSS INFECTION 2 Sheets-Sheet 2 Filed April 4, 1938 Z I Z INVENTOR. JAMES A. )Qf-YN/f-EJ Ma \{W j ATTORNEYS.

Patented July 8, 1941 3 DIETHOD AND MEANS FOR PREVENTING CROSS INFECTION J amcs A. Reyniers, South Bend, lnd.

Application April 4, 1938, Serial No. 200,053 (01. 128-4) 1 Claim.

This invention relates to a method and means for preventing cross infection, and particularly to a method and means of this character for use in hospitals in the care of babies, although the same may be applied to the treatment of all hospital patients.

Cross infection as here referred to relates to the spread. of infection within a limited population, as among the patients of a hospital. The infective unit or germ is spread from patient to patient by contact, or is borne by the air, as by droplets suspended in air or in dust. Infection by contact may take many forms or paths, as from attendant (doctor or nurse) to patient, from one patient to attendant to another patient, from food to patient, or from utensils to patient, or modifications or extensions of these paths. Air borne infection may result from breathing of infected outside air, from breathing air recirculated from other parts of a hospital, from air circulated between patients, or from breathing air circulated from attendants to patient as in coughing. The problem of cross infection has been found to be particularly important in connection with infant mortality, but careful study has proven that there are a great many cases of infection acquired in this way by patients of all ages during hospitalization.

It is, of course, possible to maintain a reasonable degree of isolation by the practice of aseptic techniques with respect to infection by contact, but the degree of asepsis varies from institution to institution and is Wholly dependent upon the human factor. To some extent, as by the use of masks, air borne infection may also be controlled, but obviously the degree of-possible control of this type of infection is much smaller than with respect to infection by contact.

It is, therefore, the primary object of this invention to prevent cross infection and at the same time to maintain a maximum of contact between attendant and patient.

A further object of this invention is to situate a patient so that all vectors to and from the patient will be known and direct.

A further object is to mechanizethe system of asepsis in the handling and maintenance of patients to eliminate uncontrollable vectors of cross infection.

A further object is to provide a double walled cubicle construction with an independent con-' trolled air supply for both the inner and outer cubicles;

A further object is to provide a cubicle construction having one cubicle within another,

wherein the outer cubicle contains independent asep-sis apparatus; and wherein the inner cubicle is open to the outer cubicle only during treatment and handling of the patient.

A further object is to provide a method wherein an attendant prepares for treatment of a patient within an area free from air borne infective units and in which items adapted tocontact or touch the patient are retained, and wherein the patient-may be treated after the asepsis is complete.

Other objects will be apparent from the description and the appended claim.

In the drawings: I

Fig. 1 is a perspective view of one cubicle arrangement with parts broken away.

Fig. 2 is a horizontal sectional view taken on line 2-2 of Fig. 3.

Fig. 3 is a vertical sectional view taken on line 3-3 of Fig. 2.

Fig. 4 is a fragmentary vertical detail sectional view of the door of the inner cubicle.

Fig. 5 is a fragmentary vertical detail sectional view of means for locking the door of the inner cubicle.

Fig. 6 isa vertical sectional view similar to Fig. 3 illustrating a modified embodiment of the invention. I

Referring to the drawings, and particularly to Figs. 1 to 5', which illustrate the preferred embodiment of the invention, the numeral 10 designates a cubicle in the nature of a small closed compartment. The size of the compartment may vary, but its height should permit an attendant to stand therein. One or more of these cubicles may be installed in a room or ward of a hospital with the back thereof adjacent a wall of the room. Each cubicle comprises a suitable metal frame" It mounting wall panels l2 with a substantially air-tight seal. At least t-h-e'front panel I3 is formed of glass to afford vision of the interior. A door 14 is mounted at the front to effect an air-tight seal when closed. Frame I l supports a ceiling 15 with an air-tight fit, and the cubicle preferably has an indivi-dual fioor IS. The construction is thus of independent character, air sealed throughout.

Within. the-cubicle i0, and preferably at the rear thereof, is provided a second cubicle i1 supported on a frame I8 and having a hinged door I9. This secondcubicle I1 is preferably provided with an air-tight'sealed construction at all joints which separate it from the cubicle lil. The door I9 is preferably transparent and comprises an upper portion 20 stationary with respect to the door frame, and a lower portion 2| adapted to slide vertically in the door frame. A foot pedal 22 i pivoted to frame I9 of the door to control a latch 23 which normally locks the lower door portion 2|. Any suitable arrangement for opening the lower door section 2| upon depression of pedal 22 may be employed. For purposes of illustration, the door portion 2| is here shown (Fig. 4) to be connected to a counterweight 24 in any suitable manner, the counterweight being sufiiciently heavy to raise the door section 2| between guides 25.

One of the upper members of frame I common to both the inner and outer cubicles carries an air duct 26 extending from a filter 21. The outer end of duct 26 is adapted for connection with a source of conditioned air extending in the wall of the building and under pressure slightly in excess of atmospheric pressure. Air duct 26 has an outlet 28 within the inner cubicle I1, and an outlet 29 communicating with cubicle In. One of the lower members of frame common to both the inner and outer cubicles carries an air duct 30 open at 3| to the outer cubicle and at 32 to the inner cubicle, and this duct 30 is adapted for connection with an air exhaust duct in the building wall. The slight pressure of the air supply insures a slight positive air pressure in the cubicles which may be regulated as .between the cubicles by means of dampers, etc., and prevents recirculation of air to and from the respective inner and outer cubicles of each unit, and also serves to minimize entrance of outer air into cubicle H! upon opening door l4.

Within the outer cubicle I is installed the necessary equipment for asepsis. Thus a lavatory 35 is mounted within the cubicle and has its service pipes 35 extending through the adjacent wall and extending to the rear of the unit for threaded connection at 31 with the building water and sewer services by means of 'a union. Adjacent to the lavatory is positioned an arm plunge 38 containing an antiseptic for sterilizing the hands and arms. Suitable hangers 39 are provided for gowns, masks and the like. In the form of construction illustrated for use in baby wards. a recess 4|) is formed at the rear of the outer cubicle adjacent the inner cubicle II. This recess 40 provide space for a combined sterilizing cabinet and table 4| which in preferably mounted on wheels 42.

Within the inner cubicle I1 is positioned the crib or bed 43 for the patient, said crib being mounted on wheels 44.

In use, the assembled double cubicle unitabove described is placed in the hospital building with its back portion adjacent a building wall having air intake and air exhaust lines, and water and sewer lines, all provided with outlets or connections for the duct 26 and 30, and for the lavatory service lines 36. Upon connection of these ducts and service lines the unit is in conditionfor use, with filtered air under a small positive pressure being continuously and separately supplied to both the inner and outer cubicles. The patient is placed within the crib or bed 43, and thu has a double protection against'possibility of air borne infection by reason of the double walled cubicle arrangement. At the same time, the transparent wall l3 and door|9 permit'clear vision of the patient by the attendant from outside the unit.

When the attendant treats the patient access is bad through the outer door I 4 to the interior of the outer cubicle. The positive air pressure within the cubicle minimizes entry of outside air through said door while the same is open, and the continuous circulation of air quickly carries off any air so admitted after said door is closed. The attendant first dons the usual gown and mask retained within the outer cubicle on rack 39. As soon as the mask is donned, the last possible element of air-borne infection is eliminated. The attendant then washes hands and arms at the lavatory and sterilizes them at the arm plunge, and is ready to contact the patient. Access to the patient is had by operating foot lever 22 to raise the lower section 2| of the door of the inner cubicle, for the first time opening said inner cubicle, and then only after asepsis is complete and air borne infective units have been expelled by the normal air circulation. For convenience in handling, the crib or bed 43 may be rolled out of the inner cubicle, and the table 4| may be rolled to a convenient position with relation to the crib. After the treatment of the patient is completed, the crib may be moved back within the inner cubicle and the latter closed. The utensils may then be cleaned and sterilized in cabinet 4|, and the gown and mask removed and replaced on rack 39. The usual aseptic handling of towels, food, etc. may be practiced as the same'are brought into the cubicle l0, and this together with the donning of the gown and mask in the outer cubicle and the cleaning and sterilizing of hands and arms within the outer cubicle, effectively eliminates possibility of cross infection by contact.

The hinged mounting of the door unit I9 as a whole facilitates cleaning of the inner cubicle.

A slightly modified embodiment of the invention is illustrated in Fig. 6 wherein the reference numerals employed in describing the preferred embodiment are used so far as the constructions are similar. In this embodiment the outer cubicle is constructed in the same manner, and is provided with the same accessories, such as lavatory, arm plunge, clothes rack, sterilizer cabinet (not shown) as in the preferred embodiment, and also has the same air ducts and water services. No inner cubicle, in the sense of a structural part of the unit, is provided. Instead, the crib is provided with an air sealed construction 5| having transparent walls and cover. An individual air filter 52 is carried by the crib. An outlet 53 is provided in the air intake duct 26 adapted for detachable connection with filter 52 by means of a detachable conduit 54. A detachable conduit 55 extends from the crib to a suitable fitting 56 in the air exhaust duct 30. The crib preferably mounts a suitable independent air supply or pump unit 51 which may be connected with filter 52. 4

It will be observed that by the use of this embodiment, the same positive control of all vectors of infection, of both the air borne and con tact type, is obtained as with the preferred construction by maintaining the seal of the crib until all infective factors are eliminated. This embodiment has an additional advantage for babies and infants in that the sealed crib may be moved outside of the cubicle I0 without exposing the baby to infective units by providing the necessary air supply through operation of the pump unit 51 properly connected with filter 52. This is especially desirable to permit the baby to be taken to and seen by its mother.

I claim:

A cabinet for preventing cross infection, said cabinet having a chamber therein sealed against outside atmosphere, an entrance closure to said cabinet, an auxiliary compartment Within the chamber of the cabinet for the reception of a patient, said auxiliary cabinet being normally sealed against atmospheric pressure in the chamber of the first mentioned cabinet, a closure for the auxiliary cabinet and within the chamber of the first mentioned cabinet, said closure being slidably mounted for movement in the plane thereof, whereby it will not create air currents between said first mentioned chamber and the chamber of the auxiliary cabinet when the closure is opened or closed, and means for circulating air through both cabinets.

JAMES A. REYNIERS.

Patent No. 2,248,199 Granted July 8, 1941 JAMES A. REYNIERS The above entitled patent was extended January 8, 1952, under the provisions of the act of June 30, 1950, for 2 years and 328 days from the expiration of the original term thereof.

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