WO1997017930A1

WO1997017930A1 - Anti-decubitus medical bed

Info

Publication number: WO1997017930A1
Application number: PCT/US1996/017570
Authority: WO
Inventors: Jalal Ghazal; Bassam Baroudi
Original assignee: Jalal Ghazal; Bassam Baroudi
Priority date: 1995-11-14
Filing date: 1996-11-06
Publication date: 1997-05-22

Abstract

An Anti-Decubitus Medical Bed apparatus (100) supports a recumbent individual alternately on one of two translating arrays (102, 104) of support tubes (110, 112). The two arrays of tubes are connected to one of two separated frames (106, 108) which translate relative to one another as first one, then the other array supports the individual. The support tubes of each array are interposed between the tubes of the other array. The ends (114) of the tubes may be provided with apertures (160) and channels (132) to conduct cleansing or medicating fluids to the adjacent surface of the individual. At least some of the tubes (110, 112) of one array (102, 104) are provided with fluid channels (132) for spraying medicating or cleansing fluids, e.g. water, or dispensing a soothing vapor onto the individual when the respective tube array (110, 112) is not in contact with the individual's body. A fluid impermeable cabinet and cover (166) enclose the apparatus so that cleansing or medicating fluids do not escape into the surroundings. A drainage system (168) is provided to remove the waste fluids. Air conditioning equipment may be included with the apparatus (100) to warm or cool the individual within the cabinet. An optional fluid heating or cooling device may be included with the apparatus (100) to heat or cool the fluids from channels (132). A pump may be connected from a fluid reservoir to supply cleansing or medicating fluids to the channeled tubes (110, 112).

Description

S P E C I F I C A T I O N

ANTI-DECUBITUS MEDICAL BED

Inventor: Jalal Ghazal Background of the Invention:

Field of the Invention:

The invention relates generally to new and useful improvements in an intensive care medical bed to support physically incapacitated individuals. The invention relates more specifically to an intensive care bed having at least two pluralities of support members having alternating intervals of full supporting contact followed by intervals of complete non-contact for alleviating the onset of decubitus ulcers. Previous Art:

In the medical care of seriously debilitated or incapacitated persons, prior medical beds have been provided with separate hinged portions for raising, lowering or tilting the separated portions to a limited degree. Such beds generally have two or at most three sections hinged laterally across the bed axis. For example, the bed may have a hinged top portion and hinged leg portion that can be tilted up or down to provide a more comfortable position for one lying on the bed. There may also be some therapeutic value in positioning the head or legs above or below the heart.

Patients in intensive care or protracted convalescent care generally are provided with ordinary medical beds with no distinguishing characteristics. Previous medical beds are generally covered with conventional bed coverings made from common fabrics: i.e. , sheets, blankets and the like. Medical or patient care team members are often faced with the difficult task of moving a seriously incapacitated patient to change bed coverings; either regularly, or when some situation requires that the bed coverings be washed; e.g. , bleeding, defecation, urination and the like. Not withstanding the extra labor and cost of changing and washing bed coverings, moving a seriously ill patient may be iatrogenic. In long term convalescent care, a serious medical problem may occur due to the development of decubitus ulcers (bed sores) in patients lying in bed for extended periods.

Bed sores are caused by excessively long contact between portions of the patient's body and the bed coverings thereunder. Bed sores can be serious, even fatal, if proper prevention and treatment are not provided. Repositioning the patient on the bed, i.e. , rolling the patient from one side to the other, or changing from lying to sitting or standing may be possible in some situations. In cases where this is not possible due to the nature of the disability or injury, the patient's health can be seriously compromised. It would be a great advantage to provide a means for drastically reducing the long term, uninterrupted contact between portions of the patient's body, the bed coverings and the structure providing the support.

The literature has many examples of medical beds proposed to relieve the problem of bed sores. Ferrand, in U.S. patent number 5,345,629, provides an excellent review of references. Air flotation beds of various types have been described which provide air or fluid inflated cushions that support a patient's body. Inflation and deflation of a plurality of segmented cushions are used in an attempt to position the patient by rolling and/or elevating and lowering different portions of the patient's body.

McClelland, in U.S. Patent 5,408,711, describes a matrix of rigid horizontal and vertical tubes which distribute air to the upper surface of an air mattress. Ambient air from the bottom of the plurality of vertical tubes is delivered to a plurality of tufted recesses at the top end of the vertical tubes in the air mattress. A peripheral mattress portion abutably receives the air mattress. Both mattresses are supported by like sized frame members. Multi-layered mattress pads to reduce the development of bed sores are described in

U.S. Patent 5,303,436 by Dinsmoor, III, et al. A cover contains interior strata of a plastic film layer atop a fluid bladder layer supported on an underlying layer of foam. Techniques to reduce and control normal pressures and forces on the patient such as modifying the configuration, filling, size and spring characteristics of support columns in the underlying foam layer are described.

It is generally believed that gentle variations of pressure, i.e. , massage, can greatly reduce the onset of bedsores caused by the long term contact described above. It would also be an advantage to provide such gentle massage of the body portions being supported in order to eliminate or reduce the onset of such bedsores. SUMMARY OF THE INVENTION

The present invention provides relief from situations potentially leading to the onset of decubitus ulcers (bedsores) for patients suffering from serious and debilitating injuries or long term disability. The invention also provides reduced effort and labor by staff members providing long term care for immobile or seriously debilitated patients. One advantage of the present invention is the alternating freedom from pressure on every portion of a recumbent patient's lower body surface provided by cyclic contact and release action of adjacent supporting tube members. Another advantage of one embodiment of the invention is the application of cleansing or medicating vapors or fluids by fluid conducting channels within some of the supporting mbe members. A temperamre controller and heating/cooling apparatus may be supplied with the apparatus to provide heated or cooled fluids or to heat or cool the interior of the enclosing cabinet.

Yet another advantage of one embodiment of the invention is a drainage system for removing waste fluids and matter without having to remove the patient from the intensive care bed and replace clean bed coverings. A particular advantage of the invention is provided by the absence of a mattress or cushioning pad with the attendant lower cost, and improved cleanliness aspects.

Still, another advantage of one embodiment of the present invention is a substantially impermeable enclosure for limiting the escape of cleansing or medicating fluids or vapors.

The alternating contact of the two sets of adjacent supporting tubes of the present invention may be particularly advantageous for persons having back injuries, such as the condition known as slipped disk. The displacement and rate of movement of the two sets of supporting mbes may be arranged to create a slight movement of the vertebrae of the spine. This may aid in preventing fusing of the disks when a person is lying immobile for a long time. The tips of the support mbes may be made removable so that the parts of the bed in direct contact with the body of a patient may be cleaned, sterilized or replaced.

Optional embodiments of the invention may include apparatus for heating or cooling the air, vapor and/or liquids sprayed or discharged from the support tubes. Additional heating and cooling devices for controlling the temperamre of the patient's body within the enclosure of the bed apparatus may be provided. This can be especially advantageous for burn victims, where a lower than normal body temperature may be therapeutic.

The cyclic support feamre of the present invention may also be used to advantage in a physical therapy, health club or sport club environment where the benefits of a gentle whole body massage may be desirable. An intensive care bed apparams 100 of the present invention includes a first mbe array 102 comprising a first set of spaced apart first support mbes 1 10. In a first frame position 128 the first set of support mbes 102 have respective proximal support tube upper ends 114 configured to receive a recumbent individual resting thereon. A first support frame 106 connects to the first mbe array 102 and is spaced distally away from the support mbe upper ends 1 14 of the first mbe array 102.

A second mbe array 104 is formed with a second set of spaced apart second support tubes 112. The second set of support tubes 112 are slidably interposed between respective members of the first set 110. A second support frame 108 is connected to the second set of support tubes 112 and spaced distally away from the first tube array 102 and the first frame 106. In a second frame position 130 relative to the first frame, the second set of support mbes 112 have respective proximal support tube upper ends 1 14 configured to receive the recumbent individual resting thereon. An actuating mechanism 1 18, 120 is connected between the two frames 106, 108 for translating the frames with respect to one another. The frames 106 and 108 are translated between the first position 128 and the second frame position 130, in which the individual is supported entirely by one set of support mbes 110 in the first position, and supported entirely by the second set of support tubes 1 12 in the second position. In a medial frame position 126, both sets of tubes 110 and 112 of the respective arrays 102 and

104 provide support to the patient's body.

The intensive care bed apparams may have the first tube array 102 and second tube array 104 configured to support only a portion of the recumbent individual's body in the respective first and second position. Alternatively, the first tube array 102 and second tube array 104 may be configured individually to support the entire patient's body in the respective supporting positions.

A portion of the support tubes 110, 112 of one set may be provided with channels 132 for conducting fluids to flow proximally to or be directed onto the individual. Such fluids may be water, water vapor, steam, and/or medicating vapors or fluids. A cover 166 may be provided to sealably enclose a portion or all of the individual's body to prevent fluids or vapor directed from the support mbes, toward the individual recumbent on the bed, from dispersing into the surroundings. Hinges and clamps (not shown) for securing and removing the cover 166 may also be provided to more readily place the individual in and remove the individual from the apparams 100. At least a substantial fraction of either or both sets of support tubes 110, 1 12 may be solid. The support mbes 1 10, 1 12 may comprise materials resistant to water, moisture, staining and rusting such as rubber, some types of wood, stainless steel, aluminum, plastic, brass and glass.

A drainage system 168 for collecting and disposing of waste fluids through a waste outlet 170 may be configured as part of the bed apparams.

The frames 106, 108 may be translated relative to one another by an actuating mechanism 118, 120 powered by manual actuation, hydraulic actuation, steam, petrochemical engine or electrical motor actuation. Fluid pumps may be connected between one or more fluid reservoirs and the fluid channels to provide a source of cleansing or medicating fluids.

BRIEF DESCRIPTION OF THE DRAWINGS For a further understanding of the objects and advantages of the present invention, reference should be had to the following detailed description, taken with the accompanying drawings, in which like parts are given like reference numerals and wherein;

Figure 1 A shows a partially cut away oblique view of one embodiment of the Anti- Decubitus Medical Bed 100 of this invention.

Fig. 1 B illustrates a magnified partial oblique elevation view of the support tubes of one embodiment of an Anti-Decubitus Medical Bed in accordance with this invention taken along the line IB-IB.

Figure 2 is an oblique exploded view of a portion of the dual frame and support tube structure of one embodiment of the present invention.

Figures 3 a, b, and c are schematic elevation views of the frame and support tube structure of one embodiment of the present invention in three positions. Figure 4 is an oblique view of the dual frame and support tube structure of this invention with a portion cut away.

DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT OF THF

INVENTION With reference to Figs. IA, IB and Fig. 2, there is shown a first embodiment of an Anti-Decubitus Medical Bed 100 in accordance with the present invention. The intensive care bed 100 includes a plurality of spaced apart body support tubes 110, 1 12 arranged in a first mbe array 102 and a respective second tube array 104. The support tubes 1 10, 1 12 are oriented such that they are directed along the vertical or Z direction and arrayed along X, Y axes, as indicated by the X, Y, Z axes shown in Fig. 2.

The support mbes 110, 112 each have respective spaced apart upper support ends 1 14, 1 15 and lower supports end 116, 117. The support mbe's lower ends 116, 1 17 of each support tube 110, 112 are respectively connected to one of two support frames 102, 104.

The first mbe array 102 is connected to a first support frame 106, and the second tube array 104 is connected to a second support frame 108. The second support frame 108 and first support frame 106 are spaced apart vertically (along the Z axis) and arranged to be movable with respect to each other in the Z direction by means of an actuating unit 1 18, and articulating arm 120 connected therebetween. The support mbe upper ends 114, 115 of each mbe 110, 112 are configured to comfortably support a respective small area of the lower portion of a patient's body (122). Details of the actuating unit 1 18 and arm 120 are not considered part of this invention. Providing suitable mechanisms for moving the frames 106, 108 with respect to each other is within the capability of a skilled mechanical engineer.

With reference to Fig. 2, there is shown an exploded oblique view of the first support frame 106 and second support frame 108 of one embodiment of the present invention. The support mbes 110 of the first mbe array 102 are arranged in spaced apart relationship with respect to each other and to the support tubes 112 of the second tube array 106, so that the support mbes 110 of the first tube array 102 may freely move along the Z-axis, by way of apertures 124 provided in the second mbe array 104.

The support mbes 110 of the first mbe array 102 are separated from each other in the X and Y direction by distances SI and S2 as are the support tubes 112 of the second mbe array 104. The through-hole apertures 124 are offset between the support tubes 1 12 of the second tube array 108 by spacing S3 and S4 in the X and Y direction. The apertures

124 are arranged to slidably receive the support tubes 1 10 of the first array 102.

The support mbes 110, 112 are preferably made of sufficiently rigid material to support the weight of the individual lying thereon without excessive distortion, i.e., without bending or compressing to touch or bind with adjacent mbes of the same or other array. Suitable rigid or semi-rigid materials contemplated are semi-rigid rubber, wood, steel, aluminum, plastic, brass and glass. Preferably the mbe materials are essentially impermeable to water, moisture and cleansing and medicating fluids. With reference to Fig. IB, the tubes 110, 112 may be solid or composites of several materials to optimize characteristics, e.g. , a solid inner rod 111 to provide mechanical strength, covered by a more flexible moisture impermeable sheath 113 to provide more comfort.

With reference to Fig. 3 A, B, and C there are shown three positions of the first support frame 106 and second support frame 108 with respect to each other and the patient's lower body surface 122. With respect to Fig. 3 C the support tubes 1 10, 112 are configured and connected to the respective first support frame 106 and second support frame 108 so that, at an upper frame position (UFP) 130 of the first support frame 106 with respect to the second support frame 108, the support tube upper ends 114 are disposed generally to conform to the patient's lower body surface 122. With respect to Fig. 3 B, a medial frame position (MFP) 126 of the first support frame 106 with respect to the second support frame 108 is shown in which the support tube upper ends 114, 1 15 of each support mbe 110, 112 is in contact with the patient's lower body surface 122. The support tube upper end 114, 115 are disposed with respect to the frames 106, 108 such that the support tube upper ends 114 of the first mbe array 102 and the support tube upper ends 1 15 of the second mbe array 104 provide a desired contour.

For example, at the MFP 126, the support tube upper ends 114, 115 may be disposed in a plane, similar to that of an ordinary bed. Alternatively, at the medial position 126, the support mbe upper ends 114, 115 may be disposed to form a contour (not shown) which conforms generally to the profile of a recumbent person lying prone (face down), supine (face up) or on one side or the other. This may be important for cases where individuals being treated must be constrained in a single position for extended periods, where movement would be detrimental, or even fatal.

Fig. 3 A shows a lower position (LFP) 128 of the first support frame 106 in which the support mbe upper ends 114 of the first support frame 106 are fully disengaged from the patient's lower body surface 122, and the support tube upper ends 115 of the second support frame 108 are fully supporting the patient's lower body surface 122. Fig. 3 C shows an upper frame position (UFP) 130 of the first support frame 106 relative to the second support frame 108, in which the support mbe upper ends 1 14 of the first support frame 106 are fully supporting the patient's lower body surface 122. In the UFP 130 the support tube upper ends 115 of the second support frame 108 are fully disengaged from supporting the patient's lower body surface 122.

The alternating contact of the support mbe upper ends 1 14 of first the support tubes 110 of the first support frame 106 and then the support tube upper ends 115 of support mbes 112 of the second support frame 108 provides support continuously to the patient, but at alternating contact points. This alternating contact also avoids the continuous contact provided by a conventional bed or by previous inflatable and deflatable air cushion mattresses in the absence of moving the patient's body, i.e. by sliding, rolling or lifting. The alternating contact allows blood to flow more freely in the tissue near the surface of the patient's Iower body surface 122 during the intermittent, and alternating times of non¬ contact. At least some time during each cycle of alternating contact there is no pressure applied to any portion of the patient's lower body surface 122 by a bed covering or by the support strucmre of this invention. The vertical (Z-direction) displacement of the first tube array 102 and second tube array 104 relative to each other may be arranged to be variable or a fixed amount by properly configuring the articulating unit 118 and articulating arm 120. A suitable articulating unit 118 for providing desired Z-direction movement between an upper frame position 130 and a lower frame position 128 may be configured from hydraulic actuators, compressed air or steam actuators and mechanical linkages, or electric motors and suitable gear trains or the like which are well known in the mechanical arts. The Z-displacement of the first tube array 102 can be easily arranged so that the support tubes 1 10 of the first tube array 102 completely separates from the patient's lower body surface 122 for a substantial fraction of the time. In addition, the Z-displacement of the first mbe array 102 can be arranged so the support mbes 1 12 of the second support frame 108 also completely separates from the patient's lower body surface 122 for a similar substantial fraction of time.

The displacement, time of transition from one position to another (rate) and the dwell time at each position may be controlled by a conventional timer, motor driven cam driver or an electronic controller such as a microprocessor control board, or the like.

Controllers for regulating the mechanical displacement from the lower frame position 128, medial frame position 126 to the upper frame position 130 of this invention may be designed by a knowledgeable practitioner in the electromechanical arts from a description of the desired rates, displacements and dwell times. Referring now to Figs. 1 and 4, there are shown further details of additional embodiments of the support mbes 1 10, 112 of the present invention. The support tubes 110, 112 of the embodiment of Fig. 4 may be of several different types. The support mbes 1 12 of the second mbe array 104 may be solid support tube 1 12 members having smoothly rounded support mbe upper ends 114. The support tubes 110 of the first tube array 102 may be of at least three different types. A first type of channeled support tube 152 includes a first channel 132 for conducting a fluid, e.g. , water, from a reservoir (not shown) through a fluid manifold 138 to exit at a first tube upper support end 136 and is directed toward the patient's lower body surface 122.

Referring again to Fig. 1 B, a second support mbe 134 includes a multiplicity of channels 140 for conducting other fluids, e.g., medications, salves and the like from a second fluid manifold 142 into proximity with the patient's lower body surface 122. A third multi-channeled support mbe 144 having alternative lateral channels 146 may be configured with a support mbe upper end 148 having lateral apertures 150 proximal thereto for introducing steam or other vapor 172 from a third manifold 154 into the space surrounding the patient.

A portion of the mbes 110, 112 of the tube upper ends 114, 115 may be made removable for cleaning or sterilization separate from the balance of the apparatus 100. For more complete cleanliness, the tube upper ends 114 may be disposable, so that no possibility exists for transfer of contamination from one patient to another.

The presence of a vapor supplied by the second support tube 144 along with the alternating pressure applied to the supported areas of the patient's lower body surface 122 by the cyclic Z-axis motion may be therapeutically advantageous. The support tubes 110 of one array 102 connected to one frame 106, and the adjacent mbes 1 12 of the other array

104 connected to the second frame 108, alternately contact, then completely separate from every respective portion of the patient's lower body surface 122 for a substantial fraction of the time the patient is lying in the Anti-Decubitus Medical Bed 100. The alternating contact and separation of the adjacent support tubes 1 10, 112 and channeled support tubes 132, 144, 152, 158 provides an optimum compromise for supporting the patient's body without excessive uninterrupted contact, i.e., pressure applied to the patient's lower body surface 122.

While the third support mbe 144 is disengaged from the patient's lower body surface 122, a medicating vapor or fluid (not shown) may be applied to the surface of the patient's skin from the third support mbe 144. The medicating vapor or fluid may be supplied from the fluid manifold 138 connected through fluid apertures 160 provided in the third support mbe 144. With regard to Fig. 4, the through-hole apertures 124 may be configured with sufficient space or gap 139 between the second support frame 108 and the individual support tubes 110 of the first tube array 102 to allow for passage of fluids and vapors between the cabinet interior 162 and a drainage channel 168. The drainage channel 168 may be gently sloped at an angle, θ, to allow waste materials to drain to a waste outlet 170 for removal. This provides a much improved method for maintaining a high degree of cleanliness for an incontinent or severely disabled patient. Urine or feces may be removed by simply translating the first support frame 106 and second support frame 108 through a contact and separation cycle and spraying water or other cleansing fluids through the appropriate support mbe. This also reduces the effort and time required for the staff personnel charged with the responsibility of cleaning the patient and the Anti-Decubims Medical Bed 100 apparams.

Pumps and storage vessels (not shown) with appropriate controls and associated delivery conduits (not shown) for supplying the fluids, water or steam to the respective support tubes, may be provided along with the Anti-Decubims Medical Bed 100, or may be separately connected through supply lines (not shown) from external sources.

Referring again to Fig. 1 , steam or water vapor 172 may be contained by a cabinet cover 166 sealed around the periphery (not shown) of the Anti-Decubitus Medical Bed 100. A flexible curtain 174 or drape may be provided to seal the cabinet cover 166 around the neck of the patient retaining the steam, moisture or other vapor within the cabinet interior 162. The cover 166 is substantially impermeable to the escape of the vapors or fluids being used to clean or medicate the individual thereunder.

While the foregoing detailed description has described the embodiments of the Anti- Decubitus Medical Bed 100 in accordance with this invention, it is to be understood that the above description is illustrative only and not limiting of the disclosed invention. The drawings shown here illustrate an integrated frame, mbe support and manifold structure. Other embodiments may be made with separate frame supports, or with removable support mbes and manifolds. It will be appreciated that it would be possible to modify the size, shape and appearance and methods of manufacmre of the tubes, frames, manifolds and various elements of the invention or to include or exclude various elements within the scope and spirit of this invention. Thus the invention is to be limited only by the claims as set forth below.

Claims

What is claimed is:

1. An Anti-Decubims Medical Bed apparams, comprising: a first tube array 102 comprising a first plurality of spaced apart first support tubes 110, the first plurality of support mbes 110 having respective proximal support tube upper ends 114 configured to receive a substantial portion of a recumbent individual resting thereon; a first support frame 106 connected to the first tube array 102, spaced distally away from the first tube array 102 support tube upper ends 1 14; a second tube array 104 comprising a second plurality of spaced apart second support mbes 1 12, the second plurality of support mbes 1 12 slidably inteφosed between respective members of the first plurality 110, the second plurality of support tubes 112 having respective proximal support mbe upper ends 1 14 configured to receive the substantial portion of the recumbent individual resting thereon; a second support frame 108 connected to the second tube array 104, spaced distally away from the first mbe array 102 and the first support frame 106; an actuating mechanism 118, 120 connected between the two frames 106, 108 for translating the frames with respect to one another between a first position 128 and a second position 130, in which the individual is supported entirely by one plurality of support tubes 1 10 in the first position 128, and supported entirely by the second plurality of support mbes 112 in the second position 130.

2. The Anti-Decubims Medical Bed apparams of claim 1 , in which the first tube array 102 and second mbe array 104 are configured to support the full weight of the recumbent individual's body in the respective first and second position.

3. The Anti-Decubims Medical Bed apparams of claim 1 , in which the first tube array 102 and second tube array 104 are configured to support the entire body of the recumbent individual in the respective first and second position.

4. The Anti-Decubims Medical Bed apparams of claim 2, in which in which at least a substantial portion of one array of the support mbes 110, 112 are sufficiently rigid to support the entire body of the recumbent individual without deforming such that adjacent mbes of the two arrays bind.

5. The Anti-Decubims Medical Bed apparams of claim 1 , in which at least a portion of the support mbes 110, 112 of one array 106, 108 are provided with channels 132 for conducting fluids to flow proximally to the individual.

6. The Anti-Decubitus Medical Bed apparatus of claim 1 , in which a cover 166 sealably encloses a portion of the individual's body.

7. The Anti-Decubims Medical Bed apparams of claim 5, in which a cover 166 sealably encloses a portion of the individual's body and a portion of the support mbes 110, 112, said portion provided with channels 132 for conducting fluids to flow proximally to the individual.

8. The Anti-Decubitus Medical Bed apparatus of claim 5, in which the fluids are selected from the group of water, water vapor, steam, and medicating vapors.

9. The Anti-Decubitus Medical Bed apparams of claim 1 in which at least a substantial fraction of the mbes selected from the group of the pluralities of support mbes 1 10, 112 are solid.

10. The Anti-Decubitus Medical Bed apparatus of claim 1 , in which the support tubes 1 10, 112 comprise a material selected from the group of rubber, wood, steel, aluminum, plastic, brass and glass.

1 1. The Anti-Decubitus Medical Bed apparams of claim 6, in which the sealed cover 166 is substantially impermeable to the escape of fluids introduced proximally to the individual.

12. The Anti-Decubitus Medical Bed apparams of claim 1 , further comprising a drainage system for collecting and disposing of waste fluids.

13. The Anti-Decubitus Medical Bed apparatus of claim 1 , in which the actuating mechanism is powered by means selected from the group of manual actuation, hydraulic actuation, steam, petrochemical engine and electrical motor actuation.

14. The Anti-Decubims Medical Bed apparams of claim 5, further comprising a fluid pump connecting between a fluid reservoir and at least one fluid channel.

15. The Anti-Decubims Medical Bed apparams of claim 5 further comprising a device for controlling the temperature of the fluids flowing from channels 132.

16. The Anti-Decubims Medical Bed apparams of claim 6 further comprising a air conditioning device for controlling ambient air temperamre proximal to the sealably enclosed portion of the individual's body.

17. The Anti-Decubitus Medical Bed apparatus of claim 1 , in which the upper ends 114 of a least a portion of the mbes 110, 112 are removable.