WO2013003964A1

WO2013003964A1 - Device for changing the properties of a support surface and method for preventing health hazards

Info

Publication number: WO2013003964A1
Application number: PCT/CH2012/000147
Authority: WO
Inventors: Andrin MAGGI; Michael Sauter
Original assignee: Compliant Concept Ag
Priority date: 2011-07-01
Filing date: 2012-06-29
Publication date: 2013-01-10
Also published as: CH705224A1

Abstract

The invention relates to a support surface (1) of a bearing device for persons, comprising at least one support element (12), the position or shape of which can be modified by an electronic control means (21) for the purpose of preventing health hazards by means of an actuator according to at least one first measured variable that can be influenced by the activity of a person supported or carried by the supporting surface.

Description

Device for modifying properties of a

Wing and method for

Health risk prevention

The invention relates to a device for

Modifying properties of a wing and a method for health hazard prophylaxis with this device according to the preamble of claims 1 and 10.

If a person is lying for a long time without moving, it may be due to the pressure points of the body

Pressure ulcers arise. The skin and underlying tissue are locally damaged. Such

Pressure ulcers are also called pressure ulcers, decubitus ulcers or wound beds ulcers.

In healthy people, the risk of decubitus is low because they often change their position even during sleep. at

however, the ability to self-reliant may be impaired or disturbed. As a rule, they must therefore be monitored by nursing staff and regularly relocated. The

Monitoring and rearrangement of endangered persons by caregivers is complex and expensive. The risk of decubitus is often not right estimated. In the case of overburdened and / or insufficiently trained caregivers, there is thus the danger that a person in need of care suffers a decubitus ulcer. This in turn leads to follow-up costs for the care of these persons, which would be avoidable if suitable precautionary measures were taken.

There are already known storage systems for patients in which a lying surface or areas of a lying surface comprise a plurality of individual movable bearing elements. CH-A2-700874 discloses such

Storage system, wherein each of the storage elements is adjustable by means of an actuator in height, and wherein each of these actuators comprises a sensor to detect the pressure exerted by the patient body pressure. The

Measurement data from the sensors are processed and graphically displayed so that caregivers can recognize critical stress points and relieve them in a targeted manner. The relief takes place by adjusting the altitude of one or more actuators e.g. is changed by pneumatic or hydraulic force application. The relief of

Pressure points can also be automatically taken over by a controller. On the basis of the measured variables of the sensors, areas or storage elements are detected in which the pressure load is too high. A processing system evaluates the measurements as a function of time and controls or regulates the height of the storage elements so that the contact pressure locally to an uncritical Mass is reduced.

Although such storage systems can detect local pressure points with too high and too long support pressures. But they include a variety of sensors and actuators and a complex control and are expensive accordingly. In particular, each actuator is individually equipped with a sensor so that the contact pressure at each of these

Actuators can be regulated. So that local pressure points can be detected and the contact pressure can be locally controlled or regulated, the patient must rest as directly as possible on the individual storage elements. An additional, several or all storage elements covering mattress or padding would the measurements of the sensors in the individual storage elements in an inadmissible manner

influence.

An object of the present invention is to provide a

To provide support surface in a storage device for a person, which is deformable with comparatively simple means by an actuator device. A further object of the invention is to automatically control the deformation of the support surface for decubitus prophylaxis in a person as a function of sensory measured quantities. These objects are achieved by a device for

Changing properties of a wing and through a Method for health hazard prophylaxis according to the features of patent claims 1 and 10.

The invention is based on the recognition that the.

Decubitus risk in a person lying in a bed significantly due to regular changes in position especially in the pelvic area of this person or due to changes in the position of the center of gravity of the buttocks or pelvic area acting on the mattress

Weight can be assessed. For effective decubitus prophylaxis accurate knowledge of local

Pressure points and a targeted local relief of such pressure points not mandatory. It is sufficient to detect and monitor changes in the position of a person, which cause a sufficient relief of vulnerable pressure points.

Even if no sufficient movement can be detected, it is not necessary to use the local

To identify places with too high pressure load and to relieve targeted. Rather, it is usually sufficient to stimulate the person to a movement of their own strength by the shape of the bed surface is changed or by the bed surface is moved. If the person does not move on their own, their position can be determined by a

Movement of the mattress can be changed sufficiently.

Such movements can be the simplest

Embodiment of the inventive device already be effected with only one actuator. In this case, an elongated support element of the lying surface on which, for example, a conventional mattress can rest, by a

Supporting element supported on an elongated bridge. The bridge itself is supported on two lateral longitudinal beams of the bed frame and aligned approximately in the pelvic area of a person lying across the bed. The

Support element has the shape of a e.g. height-adjustable bellows by means of compressed air and is supported on the one end of the bridge on this. The end regions of the bridge comprise differently high support bodies for the elongated support element. When the height-adjustable support member is in its lowest position, the support member rests on the two support bodies and is inclined relative to the horizontal position in a first tilt position. However, if the support element has assumed its highest position, then the support element rests only on the higher of the two support bodies and on the support element and is inclined with respect to the horizontal position in the other direction.

In preferred further embodiments, this is

Support member at least partially deformable and is supported by two or more height-adjustable support elements at different longitudinal positions on the bridge

supported. Preferably, such support elements are near their ends at other bearings in a fixed predetermined height with sufficient freedom of movement on the bridge stored. In this way, the shape of a lying on the mattress mattress between its two longitudinal sides can be modified in many ways.

In a particularly advantageous embodiment of the inventive device a plurality of such adjustable support elements are supported on a bridge and / or more of such bridges with adjustable support elements on the bed frame or generally on a support device. In a further alternative embodiment, the support surface may also be the lying surface of a mattress on which the person rests directly. For example, such a mattress may comprise a plurality of chambers whose volume can be increased by adding and removing a fluid medium such as e.g. Air can be changed by means of a pump as an actuator.

The actuator or actuators are controlled by a controller. The actuation of the actuators takes place

automatically depending on at least a first

Measurements indicating the position or position changes or

Movements of a person on the bed represent, and as a function of time as a second measure.

Preferably, only movements with a predeterminable minimum strength are detected as relevant movements. Additional criteria such as temporal behavior or accelerations can be taken into account. Corresponds to the frequency and intensity of the movements not certain in the control predetermined Comparison criteria, the controller changes the position or shape of the adjustable by means of the actuators

Supporting elements. In a memory of the controller, multiple sets of setting values for the actuators for setting different configurations of the

be stored adjustable support elements. Switching between each of these configurations results in a sufficiently strong rearrangement of the patient so that the risk of a health hazard from excessive pressure on the body can be minimized.

Preferably, the control for each person to be monitored depending on the state of health individual reference intervals can be specified.

If the duration between two consecutive relevant movements or after the last detected relevant movement in a person to be monitored exceeds the predetermined duration of such a reference interval, the control causes a change to another by setting the actuators accordingly

Configuration of adjustable support elements.

The required measuring device includes

at least one sensor whose measured variable allows conclusions about the position or about changes in position of a person lying on the bed. Preferably, the

Measuring device at least one weight or

Force sensor located in the power transmission path between the load supported by the bridge and the bridge supporting Carrying device is arranged, and the measured variable is variable by the load distribution of the supported load. In particular, it is advantageous to force sensors at the support points of the bridge in the support device

to arrange. In general, it is advantageous if the sensor or sensors in the pelvic area or above the

Pelvic area of the person to be supported are arranged. For several bridges with supporting elements, it is sufficient to provide a measuring device in at least one of these bridges.

If the person the location of their pelvis or the

Weight distribution in the pelvic area changes autonomously several times within a predetermined period of time, the pressure ulcer risk is low. For the timely detection of the risk of a pressure ulcer, it is therefore sufficient

Monitor movements or changes in position in the pelvic area of a person. This can be achieved by detecting the position of the center of gravity of the load borne by this middle region transversely to the longitudinal direction of the lying surface in a central region of the lying surface. The pelvic area of the person to be monitored is supported in this central area of the lying area.

If the person moves, the distribution of the weight load across the bed and thus also the position of the center of gravity in this middle area changes. To capture the center of gravity position across the bed is in a middle

Area of the lying area between the head area and Foot area a bridge structure arranged, which supports the mattress in the pelvic area of a person lying on it.

One or more sensors of a measuring device may e.g. be arranged together with one or more actuators on a bridge with one or more support elements. However, sensors can also be arranged separately or independently of actuators, for example on a pressure-sensitive mat which can be placed on the lying surface or on the mattress.

In the international patent application entitled "Measuring device for detecting changes in position of persons in beds", which the same day as the

The present patent and patent have been filed, various embodiments of bridges with measuring devices are described and illustrated. The entire content of this international patent application also applies by referential inclusion as the content of

existing property rights.

The inventive device can not only at

Beds are used. In general, any supportive surfaces that can be used to support or carry persons can be formed in this way, for example

Wheelchairs, dental chairs or airplane seats. In a preferred embodiment, the bridge comprises one or more resistive force or pressure sensors, in particular strain gauges, also called DMS for short, which change their electrical resistance depending on the respective compressive or tensile load. Alternatively, it is also possible to use sensors operating according to other physical principles whose measured variables change depending on the load distribution acting on the bridge, for example optical, capacitive or inductive

Sensors, which cause a deformation of the bridge in

Detect dependence of the weight load distribution. In principle, piezoelectric force sensors can also be used. However, these are usually only suitable for recording dynamic processes. For the detection of a static load distribution or the

Due to their drift, active piezoelectric transducers are rather unsuitable for transverse position to the bed. The

However, it is possible to record changes in the weight load distribution.

In one embodiment of the bridge with only one

This weight sensor is preferably arranged so that it detects as possible only the contact force of the transverse element on one side of the frame. Depending on the center of gravity in the pelvic area of the person lying on the bridge, the weight load distribution between the two lateral support areas on the frame changes with the bridge. The measured variable detected by the sensor thus changes when the center of gravity in the pelvic area of the person to be monitored changes. The sensor is connected to a controller for the acquisition and evaluation of the measured variable. Preferably, the controller is designed so that it can store the time profile of the sensor signals. Alternatively, information derived from the processing of the measured variable can also be stored. For example, the controller may include processing instructions that filter out of the measurand movements of the person necessary to prevent pressure ulcers in that person. Does not correspond to the frequency and intensity of the movements in the

Control predetermined comparison criteria, the controller outputs an alarm signal.

The controller can also be used to detect

Reference variables may be formed, which in the

Processing of the measured variables can be shared. Thus, for example, measured variables recorded by the sensor can be stored if the person lies in a defined position on the bed, in particular if the main load of the bridge takes place approximately in the middle of the bridge. Alternatively or additionally, the control of the body weight of the person to be monitored or other parameters can be specified. Together with these parameters and the measured value of the sensor, the control can not only control the

Decubitus prophylaxis required changes in position, but also monitor the position of the person in the transverse direction of the bed. Alternatively or additionally, the measured variable can for example also be filtered in different ways or further processed in different ways in order to obtain information about activities and / or

Gain bodily functions such as breathing or the pulse. In this way, for example, the breathing of a sleeping person can be monitored. If the breathing is irregular or completely suspended during a predetermined or predetermined reference time - as may occur, for example, in persons suffering from apnea - this condition can be remedied automatically by stimulating a rearrangement. In an analogous manner, the heart rate or the pulse of a person can be monitored. If this falls under one

Reference value, a normalization can be achieved by actively stimulating a rearrangement. Because the

Stimulation of an autonomous rearrangement of the person is gentle, the sleep of the person is not disturbed. The present invention is generally applicable to

Health prophylaxis and in particular be used for decubitus prophylaxis.

Depending on the embodiment, the bridge can be supported directly or indirectly by means of connecting means on the frame or otherwise mounted on the frame.

Based on some figures, the invention will be described in more detail below. Show Figure 1 shows a storage device with a

Lying surface, whose supporting elements are adjustable,

FIG. 2 shows a partial view of the storage device from FIG. 1 with two support elements adjustably mounted on a bridge,

FIG. 3 shows a partial view of the storage device from FIG. 2,

Figure 4 is a schematic representation of a

Arrangement with a support element, which can be adjusted by only one actuator, wherein the support element is aligned in a first position,

Figure 5 shows the arrangement of Figure 4, wherein the

Support element in a second position

is aligned,

6 shows the arrangement of Figure 4, wherein the

Support element in a third position

is aligned,

Figure 7 is a bridge with a in shape

changeable support element,

Figure 8 is a schematic representation of the bridge

7, wherein the support element has a first position or shape due to the manipulated values of the actuators,

FIG. 9 shows a further embodiment of a bridge with integrated sensors, FIG. 10 shows a schematic side view of the bridge from FIG. 9.

Figure 1 shows a storage device with a

Wing 1 or lying surface, as they are e.g. for beds in hospitals and nursing homes is used for laying a mattress. The support surface 1 comprises two parallel longitudinal members 3, between which a back part 5 and a leg and foot part, henceforth called foot part 7, are pivotally mounted. At the ends of the longitudinal members 3 are mounting plates 11 for attachment to a

Bed frame (not shown) - henceforth also short frame or generally called support device - formed. The longitudinal beams 3 may alternatively be associated with the support device. Between the back part 5 and the

Foot part 7, the support surface 1 comprises a central part 9, which in conventional beds, for example, a rigid

Sheet metal construction may be, which is usually firmly connected to the two longitudinal beams 3 and is not movable relative to it (not shown). The middle part 9 extends transversely to the bed approximately in the region of the pelvis of a person lying on the bed.

In at least one of the sections of the wing 1, an elongated bridge 10 is formed. FIG. 2 shows a detail of an arrangement in which only in the region of

Middle part 9, a bridge 10 is arranged. In the example shown in FIG. 1, in addition to the middle part 9, the back part 5 and the foot part also comprise such bridges 10, the end regions of which are supported directly on the longitudinal bars 3 or indirectly on the adjustable frame of the back part 5 or of the foot part 7. In the area of these bridges 10, the support surface 1 comprises at least one elongated support element 12. The support elements 12 in the example shown each comprise a rigid one

middle section and two flexible outer

Sections. In the region of their ends, the support elements 12 are mounted on bearings of the bridges 10 so that they can deform between these bearings, but maintained at the bearings their distance substantially. In the transitional areas between the rigid middle section and the adjacent flexible outer sections, each of the

Support elements 12 each by a height-adjustable

Support member 14 supported on the bridge 10. Between these support elements 14, the support elements 12 may be connected by means of guide elements 16 with the bridge 10. The guide elements 16 guide the movement of the rigid central portions in the deformation of the support members 12. The support members 14 are generally any actuator of an actuator device used to influence characteristics of the support surface 1 and controlled by an electronic controller 21. In particular, the support elements 14 may be e.g.

pneumatically or hydraulically adjustable bellows or electric drives include. In alternative Embodiments of the storage device may also only a part of the support elements 12 - in particular of the

Middle section 9 - be equipped with actuators. in the

Furthermore, there are a variety of possible variations with respect to the number of bridges 10 of the wing 1, the number of support members 12 in each bridge 10 and the number of height-adjustable support members 14 in each support member 12. Preferably, the support members 12 project beyond the

Support elements 14, so that of the actuators

influenceable area of the support surface 1 is increased and extends beyond the region of the support elements 14. In the bridge 10 of the middle part 9 are in the

Placed on the longitudinal bars 3 sensors 13

formed, whose measured variables in each case on the

Longitudinal beams 3 supported weight force correspond. The term sensor 13 is to be understood generally and includes e.g. any force sensors 13a, in particular resistive strain gauges or pressure sensors. This bridge 10 of the central part 9 is thus part of a measuring device with at least one sensor 13, the measured variable in

Dependence of the bridge 10 acting

Load distribution is changeable. The bridge 10 is designed as a force transmission means. As part of the wing 1, it carries the weight bearing on it and is in turn carried by the longitudinal bars 3 or the bed frame. FIG. 3 shows a detail of the arrangement Figure 2, but without support elements 12 and without

Support elements 14.

The sensor or sensors 13 can in principle

be arranged at different points of the power transmission path between the load carried by the bridge 10 and the support device or the longitudinal member 3, for example, on the bridge 10 itself, at one

Connecting means which the bridge 10 with the

Carrying device connects, on the carrier itself or somewhere in between.

The sensor (s) 13 or force sensors 13a are connected via one or more connecting lines (not shown) to the electronic controller 21, which evaluates the measured variables and generates control variables for the actuators or the supporting elements 14. The corresponding control lines are not shown.

Preferably, the sensor or sensors 13 are formed separately or independently of the actuator (s). Their measured variables contain information about the situation or about changes in position or movements of the supported person. The sensors 13 need not be located at the same locations as the actuators. The detectable by the sensors 13 areas do not have to be congruent with the influenceable by the actuators effective ranges. Basically, any measured variables can be detected, from which movements or changes in position of the person can be derived. For example, as an alternative appropriately trained motion detector or on

Structure-borne sound responsive to movements of the person

Sensors 13 are used to detect movements. As a criterion for judging sufficiently strong

Changes in position, for example, the signal strengths and / or the duration of the sensor signals or

Characteristic signal waveforms of the sensor signals with corresponding comparison variables in one

Processing device of the controller 21 are compared. After one found in this way

Sufficient change of position or movement of the person must be within a predetermined or predefinable

Delay time another such movement

can be determined. The duration of the delay time can optionally be adjusted automatically within predefined limits. For example, the time course of the detected movements can be saved.

If the controller 21 determines a sufficient number of autonomous movements of the person, it may e.g. increase the value of the delay time.

In addition, the controller 21 may also be used to influence an optical and / or acoustic

Alarm function are used. The controller 21 or parts of this controller 21 may, for example, also be arranged on the bridge 10 or on one or more of the sensors 13, 13a. In particular, the sensors 13, 13a For example, a control and / or evaluation such as an A / D converter include (not shown). A plurality of sensors 13, 13a may also include common electronics for driving and / or evaluating (not shown). Preferably, at least a part of the controller 21 is arranged in a housing which can be attached as needed at different locations of a bed, for example at the head or foot end of the bed frame. The controller 21 preferably comprises a display, an optical and / or acoustic

Warning device, buttons or other input means for influencing device functions and an interface, such as a connector for an Ethernet connection for communication with other devices (not shown).

In addition, the lying surface or the supporting surface 1 may be formed in different ways. It may be formed, for example, as in an embodiment according to Figure 1 for placing a mattress. In alternative embodiments, the support surface 1 may for example also be the lying surface of a mattress (not shown). A person can thus depending on

Embodiment directly or indirectly supported by the wing 1 or worn.

Figures 4, 5 and 6 show a schematic in the

Compared to the embodiment according to Figure 1 simplified wing, in which the inclination position of at least one elongated support member 12 each only by a single height-adjustable support member 14 is controllable. In the end regions of the bridge 10, support bodies 25a, 25b of different height are formed for the support element 12. In between, the support element 14 is supported on the bridge 10 in the vicinity of the lower support body 25b. In its lowest position, the support element 14 has a height Hl which is smaller than or equal to the height of the lower support body 25b. This situation is shown in FIG. The support member 12 rests on the two support bodies 25a, 25b and is inclined to the right below the horizontal by an inclination angle to the bottom right. In the situation according to FIG. 5, the support element 14 is in a medium height H2

extended, so that the support member 12 is horizontal

is aligned. In the situation according to Figure 6, the support member 14 in its maximum height H3 and the

Support member 12 is inclined to the horizontal by an inclination angle ß to the bottom left.

The actuators and the controller 21 are preferably for setting a plurality of predeterminable layers or in general

Configurations of the support members 12 is formed. In alternative embodiments, e.g. by

Interpolation can also be set values between these default configurations. FIG. 7 shows a further bridge 10 with a shape or shape through two support elements 14

pneumatic support actuators variable support member 12. The support members 14 are supported on a rigid base plate 31, wherein at the ends of this base plate 31 bracket 33 for attachment to the lateral longitudinal members of a bed frame (not shown) are formed. The lath-type support element 12 has in the middle section a zone with lower flexural elasticity than in the outer sections adjoining on both sides

Support elements 14 are arranged in the boundary region between these three sections. In between, the support element 12 is held with bands 35 on the base plate 31.

Figure 8 shows schematically the arrangement of Figure 7, wherein the left support member 14a extended to full height and the right support member 14b are in its lowest position. The bracket 33 are not shown in Figure 8. Accordingly, the support member 12 and deforms

optionally a mattress resting thereon (not shown).

Figure 9 shows a possible embodiment of a

Base plate 31 for supporting support elements 14. It comprises at least one rigid top

Plate section 37a, 37b, which is supported by support members 41 and spacers on a flexurally elastic lower plate 39. If the plate 37 comprises a plurality of sections 37a, 37b, these are preferably hinged or through flexurally elastic connecting means connected to each other (not shown). The two plates 37, 39 are preferably made of metal, for example made of stainless steel. The upper plate 37 and the upper one

Plate sections 37a, 37b comprise bevelled

Longitudinal edges and / or other structures or elements, e.g. glued longitudinal ribs 43 for increasing the

Bending stiffness. In the region of the support elements 41 sensors 13 for detecting the on these support elements 41st

supported load arranged.

Claims

claims

1. Device for changing properties of a

Supporting surface (1) of a storage device for health prophylaxis in a person supported or supported by this support surface (1), characterized in that the support surface (1) comprises at least a portion with a supporting or supporting support element (12), its position and / or shape is changeable by at least one actuator that a control variable for the

Actuator in response to at least a first measured variable is variable such that the risk for a health hazard in the worn or supported person due to the changing

Storage conditions is minimal, and that the first measure of an activity of the person

can be influenced. 2. Device according to claim 1, characterized in that the control variable is additionally variable as a function of a second measured variable, and that this second measured variable is a fixed predetermined or

variable delay time is, by a dependent of the first measurand control variable

is triggerable.

Device according to one of claims 1 or 2, wherein the support surface (1) is carried by a support device, characterized in that the portion with the support element (12) comprises an elongate bridge (10) whose end portions directly or indirectly on the

Supporting device are supported, that the support element (12) of the support surface (1) in the region of this bridge (10) and supported by at least one support member (14) on the bridge 10, and that the height of the support member (14) by the actuator is changeable.

4. Apparatus according to claim 3, characterized in that the inclination position of the support element (12) and / or the shape of the support element (12) by the support element (14) are adjustable with the actuator.

Device according to one of claims 2 to 4, characterized in that at least one sensor (13) of a measuring device for providing the first

Measured variable and an electronic control (21) for processing the first measured variable with the participation of the second measured variable to a control variable for the

Actuator are provided. 6. The device according to claim 5, wherein the supporting surface is the lying surface of a bed, and wherein a mattress rests on this lying surface in that the sensor or sensors (13) of the measuring device

a) on the mattress or

b) in or on the surface of the mattress or c) in the power transmission path between that of the

Lying surface supported load and the support device are arranged.

Apparatus according to claim 5, characterized in that the one or more sensors (13) on the bridge (10) or between the bridge (10) and the Tragvorrichtun are arranged.

Device according to one of claims 5 to 7, characterized in that the one or more sensors (13)

Force sensors (13a) are, and that the measuring device or the controller (21) comprises processing instructions for determining a center of gravity or the change of a center of gravity of the first measured variables of the force sensor or sensors (13a).

9. Device according to one of claims 5 to 8, characterized in that the at least one actuator and the at least one sensor (13) separately

trained and attachable to the storage device. A method for health hazard prophylaxis with a device according to one of claims 1 to 9, characterized in that due to the at least one first measured value, a risk potential is assessed in the supported or carried by the support person, and that at a thus identified risk potential by appropriate control of or the actuator, the position or shape of at least part of the wing is changed.

A method according to claim 10, characterized in that on the basis of the first measured variable, the position or a change in position or movement of the person supported or supported by the support person is determined that in cooperation with the second measurement insufficient positional changes are detected, and that when detected insufficient position changes by appropriate Actuation of the actuator or the position or shape of at least part of the support surface is changed.