WO2014021518A1 - Appareil de maintien de position pour une assistance respiratoire - Google Patents

Appareil de maintien de position pour une assistance respiratoire Download PDF

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Publication number
WO2014021518A1
WO2014021518A1 PCT/KR2012/010887 KR2012010887W WO2014021518A1 WO 2014021518 A1 WO2014021518 A1 WO 2014021518A1 KR 2012010887 W KR2012010887 W KR 2012010887W WO 2014021518 A1 WO2014021518 A1 WO 2014021518A1
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WO
WIPO (PCT)
Prior art keywords
patient
segment
posture
head
airway
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Application number
PCT/KR2012/010887
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English (en)
Korean (ko)
Inventor
오영민
Original Assignee
가톨릭대학교 산학협력단
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 가톨릭대학교 산학협력단 filed Critical 가톨릭대학교 산학협력단
Publication of WO2014021518A1 publication Critical patent/WO2014021518A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0292—Stretching or bending or torsioning apparatus for exercising for the spinal column
    • A61H1/0296—Neck
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/10—Parts, details or accessories
    • A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
    • A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
    • A61G13/121—Head or neck
    • A61G13/1215—Head or neck with patient airway positioning devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G15/00—Operating chairs; Dental chairs; Accessories specially adapted therefor, e.g. work stands
    • A61G15/10—Parts, details or accessories
    • A61G15/12—Rests specially adapted therefor, e.g. for the head or feet
    • A61G15/125—Head-rests
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0048—Mouth-to-mouth respiration
    • A—HUMAN NECESSITIES
    • A47—FURNITURE; DOMESTIC ARTICLES OR APPLIANCES; COFFEE MILLS; SPICE MILLS; SUCTION CLEANERS IN GENERAL
    • A47G—HOUSEHOLD OR TABLE EQUIPMENT
    • A47G9/00—Bed-covers; Counterpanes; Travelling rugs; Sleeping rugs; Sleeping bags; Pillows
    • A47G9/10—Pillows
    • A47G9/1081—Pillows comprising a neck support, e.g. a neck roll
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G2200/00—Information related to the kind of patient or his position
    • A61G2200/30—Specific positions of the patient
    • A61G2200/32—Specific positions of the patient lying
    • A61G2200/327—Specific positions of the patient lying supine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G7/00—Beds specially adapted for nursing; Devices for lifting patients or disabled persons
    • A61G7/05—Parts, details or accessories of beds
    • A61G7/065—Rests specially adapted therefor
    • A61G7/07—Rests specially adapted therefor for the head or torso, e.g. special back-rests
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/01—Constructive details
    • A61H2201/0119—Support for the device
    • A61H2201/0138—Support for the device incorporated in furniture
    • A61H2201/0142—Beds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2203/00—Additional characteristics concerning the patient
    • A61H2203/04—Position of the patient
    • A61H2203/0443—Position of the patient substantially horizontal
    • A61H2203/0456—Supine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes

Definitions

  • the present invention relates to a posture maintenance device for securing an airway of an emergency patient, and more particularly, having a segmented portion at a position of the head, cervical spine, and thoracic vertebrae of the patient, and for managing the airway of the patient so that each segment is angulated.
  • a posture maintenance device for securing an airway of an emergency patient, and more particularly, having a segmented portion at a position of the head, cervical spine, and thoracic vertebrae of the patient, and for managing the airway of the patient so that each segment is angulated.
  • the patient's best posture for emergency intubation is a head-elevated laryngoscopy position (HELP), with a slight disagreement but usually a head-high and neck-down position.
  • HELP head-elevated laryngoscopy position
  • FIG. 1 shows the patient's posture appropriate for tracheal intubation, with OA representing the Oral Axis, PA representing the Pharyngeal Axis, and LA representing the Laryngeal Axis.
  • Figure 1 (a) shows that the angle between the oral axis, pharyngeal axis and larynx axis when the patient is lying on a flat floor is very large.
  • 1 (b) shows that the angle between the axis of the pharynx and larynx is reduced by raising the head using a cushion or the like on the patient's head.
  • Figure 1 (c) shows that by tilting the patient's head back in Figure 1 (b) can be quite close to the angle to the oral axis.
  • Figure 2 shows the optimal posture for the airway management of the patient, the angle between the chest and the jaw line of the patient's head is maintained at 35 degrees, the straight line of the patient's eyes and jaw line and the horizontal line passing through the patient's nose When the angle is maintained at 15 degrees, it is shown that the position for optimal airway management.
  • the laryngoscope is removed and the height is adjusted again with a bed sheet.
  • Increasing the number of laryngoscopes increases the likelihood of a 'failed airway' situation, especially obesity.
  • Patients with shorter safe apnea times, such as heart disease and respiratory disease, are at greater risk.
  • Figure 3 shows the incidence of complications in the city at the time of intubation more than three times for airway management, and the number of complications when the number of intubation attempts (based on how many times the laryngoscope is put in the mouth) is three times or more than two times or less It is showing an increase.
  • hospital beds can be divided into electric / manual methods, but the upper and lower body can be raised in common, and consists of three parts.
  • the operator and the assistant should make separate efforts to optimize the angle of the head and cervical spine of the patient by using a sheet or a pillow.
  • Some models of hospital beds support the backrest tilt and leg lift by electric, but there is no bed that can adjust head height and cervical spine angle required for emergency airway management.
  • the devices developed as positioning devices for the conventional airway management should be placed in the head part before the patient is placed on the bed, and since the power and operation are performed separately from the operation of the bed, intubation may be delayed in an emergency situation. There is a high likelihood problem (approximately 56 seconds to mount and position). Once the patient has been in bed and later the tracheal intubation is determined by changes in the patient's condition, the device is placed underneath the patient's upper body. It is not easy, especially in obese patients, the problem is very difficult or impossible.
  • an object of the present invention has a plurality of segments, and has a drive unit for driving the segment to be each angular for each head, cervical spine, thoracic vertebrae part of the patient, It is to provide a posture maintenance device for airway management having a control unit that can be controlled.
  • a pentaprism device and a display device to store the operator's field of vision, it is possible to check whether the patient is properly treated, and to manage the airway management to save image data for clinical practice education. It is to provide a posture maintenance device.
  • the present invention provides a posture maintenance device for maintaining a patient's posture that is optimal for emergency intubation, having a plurality of segments to segment the head, cervical spine, thoracic spine of the patient separately; A driving unit for individually moving the segment; It provides a posture maintenance device for airway management, including; a controller for adjusting the drive unit.
  • segment is characterized in that consisting of 3 to 10.
  • the apparatus may further include a shock absorber positioned at an upper portion of the segment and configured to prevent an impact of the patient due to the position adjustment of the segment.
  • the controller is located on the right side of the upper end of the bed, it characterized in that the controller to adjust the position of the segment by a joystick or a reduced model of the segment.
  • controller is characterized in that the operator to ensure the airway of the patient with both hands in the form of footswitch.
  • the driving unit is separately attached to the segment portion to move separately, characterized in that the hydraulic device.
  • the band portion for preventing the movement of the head of the patient when attempting to intubate the cervical spine in the state fixed to the segment located in the head portion of the patient of the segment further comprises a.
  • the apparatus may further include a storage device and a display device connected to the main frame and configured to store a patient's airway acquisition situation using a pentaprism device connected to the operator's head.
  • the patient bed according to the present invention makes a certain posture before intubation, and instead of the conventional method of changing the patient's posture during intubation, the angle can be adjusted by the operator's right hand while operating the laryngoscope with the left hand, while blowing the gate of the gate. It can be optimized in real time during the procedure. This angle adjustment allows the operator to secure an optimal field of view according to the patient's body shape and airway structure.
  • the posture maintenance device is determined to be particularly useful in emergency centers, intensive care units, recovery rooms, etc. where tracheal intubation is frequently performed, and in particular, in the operating room situation where numerous tracheal intubation is performed every day, it is easy to intubate various patients during anesthesia induction. It provides an easy posture, and can be easily and safely provided to switch back to the optimal posture during surgery, and to return to the optimal posture for airway maintenance at the time of recovery and extubation.
  • the posture maintenance device can easily and quickly provide an appropriate posture for intubation even when creating an environment suitable for intubation.
  • Figure 1 shows the position of the patient appropriate for tracheal intubation.
  • Figure 2 shows the optimal posture for airway management of the patient.
  • Figure 3 shows the incidence of complications in the city at the time of intubation three or more times for airway management.
  • Figure 4 shows the state before operation of the posture maintenance device in one embodiment according to the present invention.
  • Figure 5 shows the state after the operation of the posture maintenance device in one embodiment according to the present invention.
  • FIG. 6 is a plan view of the posture maintaining apparatus according to an embodiment according to the present invention.
  • Figure 7 is a schematic diagram of a posture maintenance device equipped with an apparatus for storing the operator's field of view and a display device in one embodiment according to the present invention.
  • FIG 4 shows the state before operation of the posture maintenance device in one embodiment according to the present invention.
  • the posture maintenance device for airway management has the following configuration.
  • the segment 10 the drive unit 20, the main frame 40, the controller 30 and the bed is composed of the basic components.
  • Segment part 10 is characterized in that the partial operation is possible to adjust the angle of the cervical spine and head.
  • the segment 10 may be composed of 3 to 10 columns, and is disposed between the head, cervical spine, and thoracic spine of the patient to induce an optimal 'HELP' posture.
  • the segment 10 is advantageously provided with a number of segments arranged between the head, cervical and thoracic vertebrae of the patient and angulated respectively.
  • the segment 10 may be moved up and down by the driving unit 20 disposed at the lower part.
  • the upper portion may be further provided with a shock absorbing portion 11 for preventing the impact.
  • the shock absorbing part 11 is for preventing the patient from directly receiving the shock generated by the movement of the segmental part 10 of the patient, and generally uses a shock absorbing material made of a soft material such as latex.
  • the driving unit 20 is a device that allows the segment 10 to move up and down individually, and maintains a curve while adjusting the curvature of the bed with a small force by using a hydraulic device.
  • the driving unit 20 is disposed according to the number of the segmentation units 10.
  • the main frame 40 supports the segment part 10 and the driving part 20, and has separate additional devices.
  • the controller 30 and the foot switch 31 are connected to the main frame 40.
  • the controller 30 is disposed on the right side of the posture maintaining apparatus 100, and has a form that can be easily operated by an operator or an assistant during laryngoscope intubation. By operating a joystick or a reduced model, such as an automobile seat adjuster, the angle and the degree of the segment 10 may be adjusted.
  • the foot switch 31 may be used by the operator to adjust the angle and the degree of the segment 10 by the foot.
  • both hands of the operator can be used freely has the advantage that the patient's airway can be secured more precisely.
  • the foot switch 31 is connected to the controller 30 through a cable.
  • Figure 5 shows the state after the operation of the posture maintenance device in one embodiment according to the present invention.
  • the driving unit 20 moves up and down, respectively, so that the segment 10 maintains the 'HELP' posture.
  • the drive unit 20 may use a well-known hydraulic device, or may use another device.
  • the posture maintenance device 100 allows the cervical spine segment 10 of the patient to be placed higher than the head segmental segment 10 of the patient, thereby making the posture of raising the head of the patient and tilting the neck backward easily. There is an advantage that it can.
  • the embodiment in which the number of the segment portions 10 is arranged is shown as seven, but as described above, the number may be three to ten.
  • the third segment 10 located from the top is the highest position, which is generally the part where the patient's head and the cervical spine meet. In this case, the above-described "HELP" posture can be easily made.
  • FIG. 6 is a plan view of the posture maintenance device to prevent the head of the patient from moving when the tracheal intubation is attempted while the cervical spine is fixed in the segment where the patient's head is located among the plurality of segmental portions 10.
  • An embodiment having a band unit 60 is shown.
  • the band part 60 When the patient's head is moved when the laryngoscope is inserted, it may be difficult to secure airways. Therefore, in order to prevent this, it is necessary to provide a band part 60 to fix the patient's head, and the band part 60 has various forms such as a velcro band.
  • the band of can be applied.
  • FIG. 7 is a schematic diagram of a posture maintenance device having a display device and a device for storing the operator's field of view as an embodiment of the present invention.
  • the pentaprism device 70 is attached to the operator's field of view so that the image of the operator securing the airway is separated. It may be stored in the storage device 80, so that it is displayed on the display device 90 to allow an assistant other than the operator to confirm whether the correct procedure is performed.
  • a clinical data base can be established for airway acquisition for various types of patients.
  • the operator drives the plurality of driving units 20 using the controller 30, and moves the segment 10 connected to the driving unit to obtain an optimal posture to secure the airways.
  • the surgeon can secure the airway and at the same time change the posture, making it easier to secure the airway compared to the way of rolling up the patient's head by using a conventional seat or using a separate device, which greatly reduces the number of intubation attempts. Can be.
  • Using the posture maintenance device 100 according to the present invention can reduce the number of emergency intubation, it is possible to obtain the effect of reducing the complications caused by emergency intubation.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
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  • Epidemiology (AREA)
  • Emergency Medicine (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Pulmonology (AREA)
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  • Orthopedic Medicine & Surgery (AREA)
  • Pain & Pain Management (AREA)
  • Hematology (AREA)
  • Anesthesiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Neurosurgery (AREA)
  • Otolaryngology (AREA)
  • Endoscopes (AREA)
  • Accommodation For Nursing Or Treatment Tables (AREA)

Abstract

La présente invention porte sur un appareil de maintien de position destiné à une assistance respiratoire d'un patient des services d'urgence et, plus particulièrement, sur un appareil de maintien de position destiné à une assistance respiratoire d'un patient, l'appareil de maintien de position comprenant des parties segment segmentées situées au niveau des partie tête, vertèbres cervicales et vertèbres thoraciques d'un patient, chacune des parties segment étant inclinée. L'objet de la présente invention est de pourvoir à un appareil de maintien de position destiné à une assistance respiratoire comprenant : une pluralité de parties segment ; une partie d'actionnement destinée à actionner les parties segment de sorte à permettre que chacune des parties segment soit inclinée au niveau des partie tête, vertèbres cervicales et vertèbres thoraciques d'un patient ; et une partie de commande permettant de commander la partie d'actionnement.
PCT/KR2012/010887 2012-07-30 2012-12-14 Appareil de maintien de position pour une assistance respiratoire WO2014021518A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR1020120082948A KR20140016465A (ko) 2012-07-30 2012-07-30 기도관리를 위한 자세유지 장치
KR10-2012-0082948 2012-07-30

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WO2014021518A1 true WO2014021518A1 (fr) 2014-02-06

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10888183B2 (en) 2018-11-20 2021-01-12 Popitz, LLC Method, system, and apparatus for facilitating positioning a person in supine sniff position

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050081866A1 (en) * 2001-10-11 2005-04-21 V. C. Saied Endotracheal intubation assistance device
US20060174895A1 (en) * 2005-02-04 2006-08-10 Sdgi Holdings Adjustable orthopedic positioning device and method of use
JP2009125256A (ja) * 2007-11-22 2009-06-11 Kandado:Kk 安眠枕
KR20090099042A (ko) * 2009-08-21 2009-09-21 정순철 욕창방지용 침대
KR20100102702A (ko) * 2008-01-17 2010-09-24 카디오프리시즌 리미티드 리트랙터
EP2392233A1 (fr) * 2010-06-07 2011-12-07 Han-Chung Hsu Dispositif de lit de santé pour supporter activement le cou et les épaules et procédé associé

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050081866A1 (en) * 2001-10-11 2005-04-21 V. C. Saied Endotracheal intubation assistance device
US20060174895A1 (en) * 2005-02-04 2006-08-10 Sdgi Holdings Adjustable orthopedic positioning device and method of use
JP2009125256A (ja) * 2007-11-22 2009-06-11 Kandado:Kk 安眠枕
KR20100102702A (ko) * 2008-01-17 2010-09-24 카디오프리시즌 리미티드 리트랙터
KR20090099042A (ko) * 2009-08-21 2009-09-21 정순철 욕창방지용 침대
EP2392233A1 (fr) * 2010-06-07 2011-12-07 Han-Chung Hsu Dispositif de lit de santé pour supporter activement le cou et les épaules et procédé associé

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10888183B2 (en) 2018-11-20 2021-01-12 Popitz, LLC Method, system, and apparatus for facilitating positioning a person in supine sniff position
US10898015B2 (en) 2018-11-20 2021-01-26 Popitz, LLC Method, system, and apparatus for facilitating positioning a person in lateral sniff position

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