WO2024010734A1

WO2024010734A1 - Patient support apparatus with patient support surfaces therefor

Info

Publication number: WO2024010734A1
Application number: PCT/US2023/026576
Authority: WO
Inventors: James K. Galer; Brian Cheadle; Nicholas D. KOCH; Iii David Scharich; Ryan Ariel Alvarez
Original assignee: Stryker Corporation
Priority date: 2022-07-08
Filing date: 2023-06-29
Publication date: 2024-01-11

Abstract

A patient support surface with a first and second layers. The first layer me be a cushioning layer, and the second layer may be a cooling layer. The cushioning layer may be sufficiently compressible to allow a patient lying thereon to compress the cushioning layer to a greater degree in localized areas, forming variable spacings between the patient and the cooled second layer to provide localized cooling of the patient at the localized areas.

Description

PATIENT SUPPORT APPARATUS WITH PATIENT SUPPORT SURFACES

THEREFOR

BACKGROUND

[0001] The present disclosure relates to patient support apparatuses, such as beds, cots, stretchers, recliners, or the like. More specifically, the present disclosure relates to patient support apparatuses that include a patient support surface, such as mattress or pad, that supports the patient thereon and in some cases can be used to move the patient, assist the patient, cool the patient, and /or provide a surface that transforms between states to apply treatment to the patient.

SUMMARY

[0002] In one form, a patient support surface includes a first layer and a second layer that is located underneath the first layer. The first layer comprises a cushioning layer, while the second layer provides a cooling layer. The cushioning layer is sufficiently compressible to allow the patient lying thereon to compress the cushioning layer to a greater degree in localized areas and, thus, form variable spacings between the patient and the cooled second layer to provide localized cooling of the patient at the localized areas.

[0003] For example, the second layer may be formed by tubing, which may be filled with a cooled liquid.

[0004] In one aspect, each layer has a first side and a second side. The first layer overlays the second layer, with the first side of the first layer forming a patient facing side of the patient support surface, and the second side of the first layer facing the first side of the second layer. The second side of the second layer is for facing and supporting the patient support surface and a patient supported thereon on a support, such as a second underlying cushioned patent support surface. The second layer includes one or more fluid passageways to allow fluid to be circulated through the second layer to provide cooling to the second layer and to thereby provide cooling to the patient supported on the first layer in the localized areas and notably with greater cooling at the higher pressure points where the compressible material is most compressed.

[0005] For example, the first layer may include a cushioning material in or inside the first layer. Further, the cushioning material is porous at least in the direction of compression to increase transmission of the cooling to the patient where it is most compressed, which typically correspond to the high pressure points on the patient’s body.

[0006] Further, the first layer may be formed from upper and lower sheets that envelope the cushioning material, which are joined together to form an enclosed space in which the cushioning material is located.

[0007] In a further aspect, the upper sheet of the first layer may be semi-permeable, namely gas permeable and moisture impermeable, for example, or may be permeable to allow gas and moisture to pass there through. The lower sheet of the first layer may be semi- permeable, namely gas permeable, but moisture impermeable to prevent moisture, or liquids, from passing though the first layer to the second layer or onto the support beneath the second layer.

[0008] One suitable cushioning material comprises a spacer or drop stitch fabric, which, in addition to being porous in the direction of compression, is also porous in directions normal to the direction of compression.

[0009] In one aspect, the fabric may be enclosed by the above referenced upper and lower sheets or instead can be coated on its opposed upper and lower sides, with either a semi- permeable or perforated coating on the upper side that faces the patient to at least allow gas to flow through from the first side of the first layer to cool the patient supported thereon and a semi-permeable, namely gas permeable but moisture impermeable, coating on the lower side.

[0010] In another aspect, the fabric layer may be coupled to an air supply to thereby form a low air loss first layer, which directs air flow through the first side or patient facing side of the first layer. [0011] In yet further aspects, the patient support surface may be formed with two or more zones, with at least two zones each being formed to provide independent cooling zones.

[0012] For example, each zone may be formed from the above first and second layers, with each second layer being coupled to a cooling fluid supply independently from the other second layer so that the at least two zones can be independently cooled. Alternately, the above referenced first and second layers may be joined together by seams that create the independent zones.

[0013] In a fiirther aspect, in any of the above, the patient support surface is coupled to a controller that controls the cooling fluid or fluids.

[0014] Additionally, the controller may be coupled to a display and configured to display a graphical representation of the patient support surface. Further, the controller may be configured to indicate at the graphical representation when the second layer or second layers are being cooled.

[0015] In the case of the patient support surface having two or more zones, the controller may be in communication with a user interface that is configured to allow a user to select the zone or zones to be cooled. Additionally, the controller may be configured to vary the temperature of the cooling fluid, with the user interface optionally configured to allow a caregiver to adjust the temperature of the cooling fluid. Other characteristics of the cooling process may also be adjusted or set — such as cooling treatment time and/or frequency.

[0016] In any of the above, the first and second layers maybe separate or joined together, including releasably connected together or integrally joined together.

[0017] In another embodiment, a patient support surface includes a first layer and a second layer that is located underneath the first layer. The first layer comprises a gas permeable sheet that allows gas through the sheet but prevents moisture or liquid intrusion there through into the second layer. The second layer has a patient facing side and an opposed side for facing a support, such as a mattress or cushion, and is formed from a cushioning layer, which is configured to allow air flow through the cushioning layer both laterally and transversely through the patient facing side of the second layer so that air directed into the cushioning layer will then be directed to flow to the first layer and then to a patient supported on the first layer. [0018] The cushioning layer may be enclosed between upper and lower sheets, which are joined and sealed together, with the upper sheet either being semi-permeable or perforate to allow air flow through the upper sheet, but with the lower sheet being impermeable and imperforate. The upper sheet may be formed with semi-permeable or perforate regions so that air is directed to specific regions through the upper sheet and hence through specific regions in the first layer.

[0019] In one aspect, the second layer includes a spacer or drop stitch fabric as the cushioning layer, which is either enclosed by the above described upper and lower sheets or instead is coated on its opposed sides, with a semi-permeable or perforated coating on the side that faces the first layer patient to at least allow gas to flow through to cool the patient supported thereon and an impermeable and imperforate coating on the other side to reduce or prevent liquid and/or moisture intrusion into the underlying mattress or cushion.

[0020] In another aspect, the fabric may be coupled to a cooling fluid supply to thereby form a low air loss patient support surface, which directs air flow through the patient facing side.

[0021] In a fiirther aspect, the patient support surface may also include an incontinence layer, such as a sheet or pad, on top of the cushioning layer, which may be separate or integrated with the cushioning layer.

[0022] In another embodiment, a patient support surface includes a cushioning layer that is permeable to allow air flow into and out of the cushioning layer and that is contained in a chamber formed by a flexible covering, such as impermeable and imperforate upper and lower sheets or impermeable and imperforate coatings, which seals the cushioning layer. The patient support surface also includes an inlet and an outlet through the covering to allow air flow into and out of the cushioning layer, which is in fluid communication with a pump to supply air to inflate the patient support surface or to draw air out of the cushioning layer to selectively make the patient support surface rigid.

[0023] For example, the cushioning layer may comprise a spacer or drop stitch fabric. Further, when enclosed by a sheet or sheets, the sheet or sheets are either stitched to the fabric or adhered to the opposed sides of the fabric so that when inflated the covering formed by the sheet or sheets does not balloon and separate when inflated and instead remains joined with the fabric so that the patient support surface may remain flat even when inflated. Similarly, when the layer is deflated, the layer will remain flat (so that is opposed sides will be generally parallel).

[0024] In one aspect, the patient support surface includes one or more handles so that patient support surface can be used to move the patient supported thereon. Therefore, the length patient support surface may be varied to support the entire length of the patient or just a portion of the patient. Further, the patient support surface may include a cushion to support a portion or portions of the patient, such as a patient’s head or bolsters. For example, the cushion may be inflatable so the degree of cushioning may be adjusted.

[0025] In yet another embodiment, a patient support surface includes a central support surface formed from a first cushioning material that supports a patient thereon and a perimeter support surface that is formed from a second cushioning material that is more firm than the cushioning material of the central support surface. The perimeter support surface form bolsters on opposed sides of the central support surface to help prevent a patient from rolling off the central support surface and help retain the patient on the central support surface. The perimeter support surface also includes one or more inserts that are formed from a firmer material that provides one or more firmer zones adjacent ingress/egress locations of the patient support surface. [0026] In one embodiment, the firmer material is formed by a bladder that is inflatable to a selected pressure to form the inserts. Further, the inserts may be adjustable so that they are selectively firmer. For example, the inserts may have the same firmness as the remainder of the perimeter support surface under one condition but then have greater firmness under another condition.

[0027] For example, the firmer material may be formed from a spacer or drop stitch fabric that is enclosed in an impermeable covering that forms the bladder. For example, the covering may be formed by an impermeable sheet or sheets or an impermeable coating. The sheet or sheets are either stitched to the spacer or drop stitch fabric or adhered to the opposed sides of the fabric so that when inflated the covering formed by the sheet or sheets does not balloon and separate and instead remains joined with the fabric so that the patient support surface may remain flat even when inflated.

[0028] The inserts may be located in discrete regions at the ingress or egress location or locations and extend through the full height of the perimeter support surface or extend partially into the perimeter support surface. Similarly, the inserts may extend through the full width of the perimeter support surface or extend partially across the perimeter support surface. [0029] In one aspect, the perimeter support surface is formed from a foam, with the inserts inserted into the foam or replacing sections of the foam.

[0030] Additionally, the foam may include recesses on the vertical side surfaces of the perimeter support surface on either side of the inserts to form hand holds to help the patient egress the patient support surface.

[0031] For example, when the inserts have selectively adjustable firmness, their firmness may be adjusted by air flow into or out of the inserts. In one aspect, the patient support’s control system may detect the lowering of the side rails, and in response, inflate the inserts to their firmest settings but return them to their normal settings when the side rails are raised. [0032] Before the various embodiments disclosed herein are explained in detail, it is to be understood that the claims are not to be limited to the details of operation or to the details of construction and the arrangement of the components set forth in the following description or illustrated in the drawings. The embodiments described herein are capable of being practiced or being carried out in alternative ways not expressly disclosed herein. Also, it is to be understood that the phraseology and terminology used herein are for the purpose of description and should not be regarded as limiting. The use of "including" and "comprising" and variations thereof is meant to encompass the items listed thereafter and equivalents thereof as well as additional items and equivalents thereof. Further, enumeration may be used in the description of various embodiments. Unless otherwise expressly stated, the use of enumeration should not be construed as limiting the claims to any specific order or number of components. Nor should the use of enumeration be construed as excluding from the scope of the claims any additional steps or components that might be combined with or into the enumerated steps or components.

BRIEF DESCRIPTION OF THE DRAWINGS

[0033] FIG. 1 is a perspective view of a patient support apparatus;

[0034] FIG. 2 is an enlarged plan elevation view of one embodiment of the patient support surface of FIG.1 ;

[0035] FIG. 3 A is a cross-section view of the patient support surface of FIG. 2;

[0036] FIG. 3B is a cross-section view similar to FIG. 3 A;

[0037] FIG. 4 is plan or elevation view of a display of the patient support illustrating the zones of the patient support surface of FIG. 2;

[0038] FIG. 5 is an enlarged plan elevation view of another embodiment of the patient support surface of FIG.1 that can be used to alter the state of the patient support for use during, for example, CPR;

[0039] FIG. 6 is a cross-section view of the patient support surface of FIG. 5;

[0040] FIG. 7 is a side view of the patient support surface of FIG. 5; [0041] FIG. 8 is a fragmentary perspective view of the patient support surface of FIG.

5;

[0042] FIG. 9 is an enlarged plan elevation view of another embodiment of a patient support surface configured as a low air loss device that can be used with any of the patient support surfaces of FIGS. 2 or 5 or other patient support surfaces;

[0043] FIG. 10 is a partial exploded perspective view of the patient support surface of FIG. 9;

[0044] FIG. 11 is a cross-section view of the patient support surface of FIG. 10;

[0045] FIG. 12 is a perspective view of another embodiment of a patient support surface configured as a transfer surface that can be used with any of the patient support surfaces of FIGS. 2 or 5 or other patient support surfaces;

[0046] FIG. 13 is a cross-section view of the patient support surface of FIG. 12;

[0047] FIG. 14 is an elevation view of a patient support surface in the form of a mattress;

[0048] FIG. 15 is a plan view the patient support surface of FIG. 14;

[0049] FIG. 16 is a side view the patient support surface of FIG. 15; and

[0050] FIG. 17 is an enlarged fragmentary view of an edge of the patient support surface of FIGS 14-16.

DETAILED DESCRIPTION

[0051] Referring to FIG. 1, the numeral 10 generally designates a patient support apparatus. Although the particular form of patient support apparatus 10 illustrated in FIG. 1 is a bed adapted for use in a hospital or other medical setting, it will be understood that patient support apparatus 10 may be a cot, a stretcher, a gurney, a recliner, an operating room table, or a residential bed or any other structure capable of supporting a patient, whether stationary or mobile and/or whether used in a medical or residential setting. [0052] In general, patient support apparatus 10 includes a patient support surface 12, for example a mattress, which is supported on a litter deck 14, which in turn is supported on a litter frame (not shown). The term “patient support surface” is used broadly herein and may refer to the whole mattress or cushion that supports a patient thereon or may refer to a portion of the mattress or cushion, such as a topper or an overlay, or to a separate device that can be used with a mattress or cushion, for example such as a pad to be placed on top of a mattress to provide treatment to a patient, such as low air loss, to move a patient, or to change the characteristic of the mattress or cushion, such as described below.

[0053] Litter deck 14 may have one or more articulatable deck sections, including a back deck section (“Fowler”), a seat deck section, and a thigh deck section, which together with the litter frame are supported on a wheeled base 16 by a lift assembly 18. Patient support apparatus 10 farther includes a footboard 20, a headboard 22, and a plurality of side rails 24. Side rails 24 are all shown in a lowered position in which ingress into, and egress out of, patient support apparatus 10 is not obstructed by the lowered side rails 24. Each side rail is configured so it can be individually moved to a raised position. Side rails 24 may be moved to one or more intermediate positions as well.

[0054] In some embodiments, patient support apparatus 10 may be modified from what is shown to include one or more components adapted to allow the user to extend the width of patient support deck 14, thereby allowing patient support apparatus 10 to accommodate patients of varying sizes. For example, the width of deck 14 may be adjusted, between a first width, a second or intermediate width, and a third or expanded width. The first width may be, for example, a 36 inch width, the second intermediate width may be, for example a 42 inch width, and the third expanded width may be, for example, a 48 inch width, although these widths may be varied.

[0055] As used herein, the term “longitudinal” refers to a direction parallel to a central axis between the head end 10a and the foot end 10b of patient support apparatus 10. The terms “transverse” or “lateral” refer to a direction perpendicular to the longitudinal direction and parallel to a surface on which the patient support apparatus 10 rests.

[0056] Referring to FIG. 2, patient support surface 12 comprises a top layer, sometimes referred to as a topper, of a mattress. Patient support surface 12 may be integrated into an underlying mattress (and hence form a part of the mattress) or be placed on the mattress. The mattress itself may include variety of different cushioning assemblies, e.g., an assembly or assemblies formed from foam, foam in combination with bladders, foam in combination with one or more gel layers, or foam in combination with bladders and one or more gel layers, and may include a control system incorporated into the patient support surface or underlying cushioning components and contained, for example, within the foot end of the patient support surface in a control housing, such as disclosed in U.S. Pat. Nos 5,542,136; 5,325,551; 8,910,334 (STR03A - P239A); 8,911,387 (STR03A - P257A); 7,406,736; 9,820,904 (STR03A - P376A), and 9,468,307 (STR03A P400A), which are commonly owned by Stryker Corporation of Kalamazoo, Michigan, and are incorporated by referenced in their entireties herein.

[0057] Another suitable bladder cushioning assembly and pneumatic control system is disclosed in commonly assigned U.S. patent applications serial numbers 61/696,819, which is the provisional application to U.S Non-Provisional Application No. 13/836,813 (STR03A P400A), now Patent No. 9,468,307, and 61/697,010, which is the provisional application to U.S Non-Provisional Application No. 14/019,353 (P-405E), now Patent No. 9,420,895, entitled INFLATABLE MATTRESS AND CONTROL METHODS and PATIENT SUPPORT, respectively, both of which were filed on September 5, 2012, which are hereby incorporated herein by reference in their entireties. Such inflatable bladders have their inflation pressure controllable by one or more controllers contained with the mattress. The patient support surface may fiirther comprise a plurality of sensors used for detecting information about the status of the patient support surface, such as, but not limited to, one or more depth sensors, fluid pressure sensors, temperature sensors, patient interface pressure sensors, and/or humidity sensors.

[0058] Referring again to FIG. 2, as will be more hilly described below, patient support surface 12 is configured to apply treatment, such as cooling, to a patient lying thereon and may be configured with multiple zones, e.g. 12a, 12b, 12c, 2d, 12e, 12f, 12g, and 12h, which may be each independently controlled or configured to provide different treatment or different levels of treatment to different portions of the patient’s body.

[0059] Referring now to FIGS. 3 A and 3B, patient support surface 12 includes a first layer 30 and a second layer 32 that is located underneath the first layer 30. The first layer 30 comprises a cushioning layer, while the second layer 32 provides a cooling layer. The cushioning layer is sufficiently compressible to allow the patient lying thereon to compress the cushioning layer to a greater degree in localized areas ( such as shown in FIG. 3B) and, thus, form variable spacing X between the top surface 30a of first layer 30, which supports the patient (not shown) thereon and the cooled second layer to provide localized cooling of the patient at the localized areas of varying spacing — with the greatest cooling occurring where X is at its minimum height. Although not shown, a separate sheet or cover may be interposed between the patient and the patient support surface.

[0060] For example, the first layer 30 may include the cushioning material 34 in or inside the first layer. Further, the cushioning material is porous at least in the direction of compression to increase circulation and transmission of cooling to the patient where it is most compressed (where X is reduced or at its minimum height), which typically correspond to the high pressure point(s) on the patient’s body, such as the sacrum area or feet of the patient.

[0061] Further, the first layer 30 may be formed from upper and lower sheets or coatings 36 and 38 that envelope the cushioning material, which are joined together to form an enclosed space in which the cushioning material is located. The upper sheet or upper coating 36 may be semi-permeable, namely gas permeable but moisture impermeable, for example, or may be permeable to allow gas and moisture to pass there through. The bottom sheet or coating 38 may also be semi-permeable, namely gas permeable but moisture impermeable and liquid impermeable to prevent moisture, or liquids, from passing through the first layer to the second layer or onto the mattress beneath the second layer. In this manner, the first layer may be breathable, but optionally prevents moisture or liquid intrusion.

[0062] One suitable cushioning material comprises a spacer or drop stitch fabric, or other porous cushioning materials, which, in addition to being porous in the direction of compression, is also porous in directions normal to the direction of compression. When formed from the fabric, as noted, the cushioning material may be coated on its opposed sides with either a semi-permeable or perforated coating on the side that faces the patient to at least allow gas to flow through from the first or upper side 30a of the first layer 30 to cool the patient supported thereon and semi-permeable but moisture impermeable and liquid impermeable coating on the other side to similarly prevent moisture, or liquids, from passing through the first layer to the second layer or onto the mattress beneath the second layer.

[0063] Optionally, the cushioning layer may include an internal air distribution conduit or conduits, including a conduit or conduits forming an air distribution manifold to further assist with air flow through the first layer (may need a sketch).

[0064] The second layer may be formed by one or more conduits, such as tubing or bladders that are configured into tube shaped bladders, which may be filled with and circulated with cooled liquid, and which are optionally integrated with the first layer, for example, by welds or adhesive. The conduit may extend across the full width and length of the first layer or extend only across a portion of the first layer to provide cooling to areas associated with high pressure when a person is lying on the patent support surface, in a supine or side position.

[0065] Alternately, the second layer may be formed from a bladder layer that has one or more fluid passageways formed therein to allow cooling fluid to be passed through the bladder layer to replenish the cooling fluid. For example, the bladder layer may be formed from two sheets of impermeable and imperforate material that are joined together by a weld or welds or an adhesive at their perimeters, with channels formed there between (to form the passageways) by intermediate seams, also formed by welding or gluing. The channels and passageways may be in fluid communication with each other or separated and may be arranged in parallel or convoluted (e.g., serpentine) pattern and nested and in communication with one or more inlets and outlets to supply fluid to and discharge fluid from the respective passageways. The inlet, for example, may be coupled to a supply of cooling fluid, such as a cooling liquid, via tubing and suitable valving and a pump 40 (FIG. 2). The inlets and outlets may be located on the same end of the bladder layer or located on different ends or sides.

[0066] Thus, the upper side of the first layer forms a patient facing side of the patient support surface, and the lower side faces and is optionally joined with the upper side of the second layer. As would be understood the size of the two layers may be the same or different. The lower side of the second layer is for facing and supporting the patient support surface (and a patient supported thereon) on a support, such as a mattress as noted above or may be integrated into a mattress.

[0067] Further, as described, the second layer thus includes one or more fluid passageways to allow fluid to be circulated through the second layer to provide cooling to the second layer and to thereby provide cooling to the patient supported on the first layer in the localized areas and notably with greater cooling at the higher pressure points where the compressible material is most compressed.

[0068] Optionally, the first layer (cushioning layer) may be coupled to an air supply via an inlet formed or provided in the covering (e.g. sheet or coating), which couples to a hose or tube that then couples to the air supply, such as a blower 42, to thereby form a low air loss layer, which directs air flow through the first side or patient facing side of patient support surface 12 to fiirther enhance the circulation of the cooling air and further removable of moisture. [0069] As noted above, the patient support surface may be formed with two or more zones, with at least two zones each being independent to provide independent cooling zones. For example, each zone may be formed from the above first and second layers, with each second layer being coupled to a cooling fluid supply independently from the other second layer so that the at least two zones can be independently cooled. Alternately, the above referenced first and second layers may be formed by three or more sheets, with an upper sheet and a middle sheet forming the first layer, and the middle sheet and a lower sheet forming the second layer. The separate, independent zones are then formed by internal seams (interior or inward of the outer perimeter) with each independent zone coupled to its own cooling fluid supply and its own optional air supply.

[0070] In a fiirther aspect, the cooling fluid supply circuit (pump 40 and any control valving) as well as the optional air supply circuit (blower 42 and any control valving) may be controlled by a controller 50 (FIG. 2), such as the patient support controller, which controls the flow of the cooling fluid or fluids and optional air flow to and from the patient support surface 12.

[0071] Additionally, referring again to FIG. 2, the controller 50 may be coupled to a display 52 and configured to display a graphical representation of the patient support surface, such as shown in FIG. 4. Further, the controller 50 may be configured to indicate at the graphical representation when the zone or zones are being cooled. In the case of the patient support surface having two or more zones, the controller 50 may be in communication with a user interface that is configured to allow a user to select the zone or zones to be cooled. For example, user interface 52 may include a touch screen 54 with a graphical user interface (GUI) with a graphical representation 56 of the patient support surface (12) and, fiirther, where the graphical representation is segmented into areas 58 in a manner to correspond to the zones of the patient support surface 12. Additionally, each of the segmented areas 58 of graphical representation 56 may be touch sensitive areas to allow a user to select the zones to be controlled and to be activated to operate in a cooling mode or deactivated. Further, the segmented areas 58 of graphical representation 56 may be configured to provide user feedback to indicate that a zone had been selected to operate in a cooling mode or when it is not activated. For example, the color of selected segmented areas may change to indicate they are in the cooling mode. Further, the color maybe varied to indicate the degree (e.g., temperature or high, medium, or low, or other indicator) of cooling.

[0072] Additionally, the controller may be configured to vary the temperature of the cooling fluid, with the user interface 52 and optionally configured to allow a caregiver to adjust the temperature of the cooling fluid. Other characteristics of the cooling process may also be adjusted or set — such as cooling treatment time and/or frequency.

[0073] As would be understood, although described in reference to cooling patient support surface 12 may also be configured to warm the patient by circulating warm fluid, such as warm liquid. Thus, user interface 52 may also indicate using an icon 60 and/or wording and/or temperature to indicate the state— that is warming or cooling-of patient support surface 12.

[0074] In any of the above, the first and second layers forming patient support surface 12 maybe separate or joined together, including releasably connected together or integrally joined together.

[0075] Referring to FIGS. 5-8, the numeral 112 designates a patient support surface that is suitable for locating under a patient’s chest and may be sized to extend only under the chest or maybe increased in size, for example to extend under the patient’s full torso or under the full length of the patient, as described below. Similar to patient support surface 12, patient support surface 112 may be used on or integrated into an underlying mattress or cushion and is configured, as will be more fully described below to change the characteristic of the underlying mattress and, namely, to provide a firm and optionally localized firm surface under the patient’s chest for administering treatment to the patient, such as CPR. [0076] Patient support surface 112 includes a cushioning layer 130 that is permeable to allow air flow into and out of and through the cushioning layer 130. Cushioning layer 130 is contained and sealed in a chamber 132 formed by a flexible covering 134, such as impermeable and imperforate upper and lower sheets or impermeable and imperforate coating(s), which seals the cushioning layer 130 in the chamber 132.

[0077] The patient support surface 112 also includes an inlet and an outlet 136 (e.g. a dual opening coupler) through the covering to allow air flow into and out of the cushioning layer via a dual lumen conduit, such as a dual lumen tubing), which is in fluid communication with a pump to supply air to inflate the patient support surface or to draw air out of the cushioning layer to compress the cushioning layer and selectively make the patient support surface rigid to thereby transform the characteristic of the underlying mattress or cushion so that it is suitable for applying treatment to a patient, such as CPR compressions. When not made rigid, the patient support surface can be restored to a flexible state so that it does not interfere with the immersion of the patient into the underlying patient support surface, such as a mattress.

[0078] For example, the cushioning material forming the cushioning layer 130 may comprise a spacer or drop stitch fabric or other porous cushioning material. Further, when enclosed by a sheet or sheets, the sheet or sheets are either welded to the fabric at spaced intervals or adhered to the opposed sides of the fabric so that when inflated the covering formed by the sheet or sheets does not balloon and separate when inflated and instead remains joined with the fabric so that the patient support surface may remain flat even when inflated.

[0079] Alternately, when formed as a separate component from the mattress and sized to extend the full length of the patient, as described below, the patient support surface may be used to move a patient on the mattress or cushion or from one patient support apparatus to another. [0080] Referring to FIGS. 9-11, the numeral 212 designates another patient support surface that is configured to provide a low air loss device, such as a low air loss pad, that can be used on a mattress or cushion. Patient support surface 212 includes a cushioning layer that is permeable to allow air flow into and out of the cushioning layer 230. Similar to the patient support surface 12, cushioning layer 230 is contained in a chamber formed by a flexible covering 232. Flexible covering 230 may be formed by an upper sheet or coating and lower sheet or coating. The upper sheet or coating is semi-permeable, namely gas permeable, but moisture impermeable to allow air to flow from the cushioning layer through the patient facing side 212a of the patient support surface 212. The lower sheet or coating, which forms the side that faces the mattress or cushion, is impermeable and imperforate so that neither air nor moisture will not pass through to the underlying mattress or cushion. Instead, all the air will be directed to the patient facing side of the patient support surface.

[0081] Optionally, the upper sheet or coating may be formed with semi-permeable or imperforate regions so that air is directed to specific regions through the upper sheet and hence through specific regions in the patient facing side 212a.

[0082] To assist in directing the flow of air, cushioning layer 230 is selected from materials that allow air flow both laterally and transversely through the cushioning layer so that it will flow through the patient facing side and then to a patient supported on the patient support surface.

[0083] When the cushioning material is a spacer or drop stitch fabric, the cushioning layer may be is coated on its opposed sides, with a semi-permeable or perforated coating on the side that faces the first layer patient to at least allow gas to flow through to cool the patient supported thereon and an impermeable and imperforate coating on the other side.

[0084] To direct air into the cushioning layer, patient support surface 212 also includes an inlet 236 through the covering to allow air flow into and out of the cushioning layer 230 via a hose or tube 238, which is in fluid communication with a blower or pump to supply air to the patient support surface. A suitable pump or blower may be a pump or blower designated for the patient support apparatus or the mattress pump or blower in the case of an inflatable mattress, which may then be configured to supply air to the patient support surface in addition to the mattress bladders.

[0085] As noted, a suitable cushioning layer may be formed from a spacer or drop stitch fabric. Further, when covered by a sheet or sheet, the sheet or sheets are either stitched to the fabric or adhered to the opposed sides of the fabric so that when inflated the covering formed by the sheet or sheets does not balloon and separate when inflated and instead remains joined with the fabric so that the patient support surface may remain flat even when inflated.

[0086] Optionally, the patient support surface 212 may also include an incontinence layer 240, such as a sheet or pad, on top of the cushioning layer, which may be separate or integrated with the cushioning layer.

[0087] Referring to FIGS. 12-13, patient support surface 312 is configured to assist moving a patient on a mattress or cushion or from one patient support apparatus to another. Patient support 312 is constructed in a similar manner to support surface 112 except that may not integrated into a mattress, and instead remains separate when in use, though it may be temporarily coupled to a mattress or cushion or a patient support apparatus when not being used to move a patient. For the general details of the construction of patient support surface 312 reference is made to patient support surface 112.

[0088] In the illustrated embodiment, patient support surface 312 is sized to extend under the full length of the patient so that the patient’s head, torso, legs and feet may all be support thereon. To transform the surface to a transfer device, the patient support surface 312 is inflated via an inlet 334, a hose 336, and a pump 342 to where the surface becomes rigid, and hence can be used to move or transfer a patient between two patient support apparatuses, e.g., a bed to a stretcher or cot of vice versa. To facilitate the transfer or movement, the lower sheet or coating may be formed from or additionally coated with a low friction material at least over portion of the lower side of the patient support surface. Alternately or in addition, the lower sheet or surface may be semi-permeable to allow a low air leakage to form an air film to facilitate transferring the patient across a surface.

[0089] Optionally, the patient support surface includes one or more handles 370 on one or both sides of the patient support surface, such as formed by straps welded or stitched the patient support surface, to facilitate moving patient support surface 312 and the patient supported thereon. It should be understood that the length patient support surface may be varied to support the entire length of the patient or just a portion of the patient, for example, when a patient is in a seated position. Further, the patient support surface may include an additional cushion 372 to support a portion or portions of the patient, such as a head rest to support a patient’s head or bolster to support the sides of the patient. For example, the cushion 372 may be adjusted so the degree of cushioning may be adjusted.

[0090] Referring to FIG. 14, the numeral 414 generally designates a patient support surface that is configured as a mattress and further that is configured to assist a patient when egressing the patient support apparatus by providing additional support along the edge of the mattress.

[0091] As best seen in FIG. 15, patient support surface 414 includes a central support surface 480 formed from a first cushioning component or components that support a patient thereon and a perimeter support surface 490 that is formed from a second cushioning component or components that are more firm than the central support surface. For example, central support surface 480 may formed from foam, bladders, and or gel structures. The perimeter support surface 490 may also be formed from bladders, gel, and or foam, but more typically is formed from foam members that are part of a foam crib that supports the central support surface.

[0092] The perimeter support surface 490 is configured to form bolsters on opposed sides of the central support surface 480 to help prevent a patient from rolling off the central support surface 480 and help retain the patient on the central support surface 480. As will be nor hilly described below, the perimeter support surface 490 also includes one or more inserts located on either side of one or more egress locations on opposed sides of the patient support surface 412 (typically between the side rails when lowered) that are formed from a firmer material or area configured to be firmer than the balance of the perimeter support surface and that provide additional support to assist a patient egressing the patient support apparatus.

[0093] For example, the inserts may be formed form a firmer material than, for example, foam. One suitable firmer material includes a drop stitch material. Optionally the drop stitch material may be enclosed in a covering 496. For example, the covering may be formed by an impermeable sheet or sheets or an impermeable coating.

[0094] Optionally, the covering 496 may seal the drop stitch material so as to form a chamber about and in the drop stitch material (e.g., in space between the fibers forming the drop stitch material) that can be inflated to select and/or adjust the firmness of the inserts. The sheet or sheets are either stitched to the spacer or drop stitch fabric or adhered to the opposed sides of the fabric so that when inflated the covering formed by the sheet or sheets does not balloon and separate and instead remains joined with the fabric so that the perimeter support surface may remain flat even when inflated. For example, the inserts 492 may have the same firmness as the remainder of the perimeter support surface 490 when inflated under one condition but then have greater firmness under another condition, such as when the patient is or about to exit the patient support apparatus.

[0095] In another example, the inserts 492 each may be formed by a bladder that is inflatable to a pressure so that the bladders are firmer than the rest of the perimeter support surface. Further, the bladders may be adjustable so that they are selectively firmer. Optionally, the bladders may be filled with foam so that if there is a loss of power, the bladders will still provide cushioning. [0096] In the case of inflatable or adjustable pressure inserts, the inserts may be delivered controlled air via a pneumatic system that is either provided in the patient support apparatus or provided in a separate pump box, such as disclosed in the above referenced applications. Further the pneumatic system may be similarly controlled by the patient support apparatus controller or by a separate controller in the pump box.

[0097] As noted, the inserts 492 may be located in discrete regions at the ingress or egress location or locations 498 of the patient support surface 412 and extend from the top surface of the perimeter support surface through to the lower surface so that the inserts extend through the full height of the perimeter support surface 490 or extend partially into the perimeter support surface. Similarly, the inserts may extend from the from surface of the perimeter support surface through to the back surface (adjacent the central support surface) so that the inserts extend through the full width of the perimeter support surface 490 or extend partially across the perimeter support surface.

[0098] As noted, the perimeter support surface 490 may be formed from a foam, with inserts 590 inserted into recesses formed in the foam or inserted to replace an entire section or sections of the foam.

[0099] Additionally, the perimeter support surface may include recesses 490a on the outwardly facing vertical side surfaces of the perimeter support surface 490 on either side of the inserts to form hand holds to further help the patient egress the patient support surface 412. [0100] As noted above, the firmness of inserts maybe adjusted, for example, by adjusting the air flow into or out of the inserts. In one aspect, the patient support apparatus control system or the pump box control system, which may be in communication with the patient support apparatus control system, may detect the lowering of the side rails, and in response, inflate the inserts to their firmest settings but return them to their normal settings when the side rails are raised. Alternately or in addition, the patient support apparatus may include a bed exit system, as noted below, which can detect when a patient is near the edge of the patient support surface or is trying to exit the bed, and therefore can also provide input to the control system to control air flow to and from the inserts. Thus, as noted, the inserts may have a first firmness under one or more conditions, e.g., the patient is remaining on the central support surface and/or the side rails are raised, and the inserts may have a second greater firmness under other conditions, e.g. the patient is moving toward or onto the perimeter support and/or the side rails are lowered.

[0101] As noted, the patient support apparatus 10 may also incorporate a bed exit detection function adapted to issue an alert when a patient exits from patient support apparatus 10, but also as input to control the patient support surface. Such an exit detection function may include any of the same features and/or functions as, and/or may be constructed in any of the same manners as, the exit detection systems disclosed in commonly assigned U.S. patent application 62/889,254 filed August 20, 2019, by inventors Sujay Sukumaran et al. and entitled PERSON SUPPORT APPARATUS WITH ADJUSTABLE EXIT DETECTION ZONES; U.S. patent application serial number 17/318,476 filed May 12, 2021, by inventors Sujay Sukumaran et al. and entitled PATIENT SUPPORT APPARATUS WITH AUTOMATIC EXIT DETECTION MODES OF OPERATION; and/or the exit detection system disclosed in commonly assigned U.S. patent 5,276,432 issued to Travis and entitled PATIENT EXIT DETECTION MECHANISM FOR HOSPITAL BED, the complete disclosures of all of which are incorporated herein by reference.

[0102] It will be understood by those skilled in the art that patient support apparatus 10 can be designed with other types of mechanical constructions, such as, but not limited to, that described in commonly assigned, U.S. Patent No. 10,130,536 to Roussy et al., entitled PATIENT SUPPORT USABLE WITH BARIATRIC PATIENTS, the complete disclosure of which is incorporated herein by reference. In another embodiment, the mechanical construction of patient support apparatus 10 may be the same as, or nearly the same as, the mechanical construction of the Model 3002 S3 bed manufactured and sold by Stryker Corporation of Kalamazoo, Michigan. This mechanical construction is described in greater detail in the Stryker Maintenance Manual for the MedSurg Bed, Model 3002 S3, published in 2010 by Stryker Corporation of Kalamazoo, Michigan, the complete disclosure of which is incorporated herein by reference. It will be understood by those skilled in the art that patient support apparatus 10 can be designed with still other types of mechanical constructions, such as, but not limited to, those described in commonly assigned, U.S. Pat. No. 7,690,059 issued to Lemire et al., and entitled HOSPITAL BED; and/or commonly assigned U.S. Pat. publication No. 2007/0163045 filed by Becker et al. and entitled PATIENT HANDLING DEVICE INCLUDING LOCAL STATUS INDICATION, ONE-TOUCH FOWLER ANGLE ADJUSTMENT, AND POWER-ON ALARM CONFIGURATION, the complete disclosures of both of which are also hereby incorporated herein by reference. The mechanical construction of patient support apparatus 10 may also take on still other forms different from what is disclosed in the aforementioned references.

[0103] Further details of one type of monitoring system that may be built into patient support apparatus 10 are disclosed in commonly assigned U.S. patent application serial number 62/864,638 filed June 21, 2019, by inventors Kurosh Nahavandi et al. and entitled PATIENT SUPPORT APPARATUS WITH CAREGIVER REMINDERS, as well as commonly assigned U.S. patent application serial number 16/721,133 filed December 19, 2019, by inventors Kurosh Nahavandi et al. and entitled PATIENT SUPPORT APPARATUSES WITH MOTION CUSTOMIZATION, the complete disclosures of both of which are incorporated herein by reference. Other types of monitoring systems may be included within patient support apparatus 10 for monitoring parameters of the patient support apparatus 10.

[0104] In some embodiments, patient support apparatus 10 may incorporate a scale system that may include any of the same features, components, and/or and fimctions as the scale systems disclosed in the following commonly assigned patent references: U.S. patent application serial number 62/889,254 filed August 20, 2019, by inventors Sujay Sukumaran et al. and entitled PERSON SUPPORT APPARATUS WITH ADJUSTABLE EXIT DETECTION ZONES; U.S. patent application serial number 63/255,211 filed October 13, 2021, by inventors Sujay Sukumaran et al. and entitled PATIENT SUPPORT APPPARATUS WITH AUTOMATIC SCALE FUNCTIONALITY; U.S. patent 10,357,185 issued to Marko Kostic et al. on July 23, 2019, and entitled PERSON SUPPORT APPARATUSES WITH MOTION MONITORING; U.S. patent 11,33,233 issued to Michael Hayes et al. on June 15, 2021, and entitled PATIENT SUPPORT APPARATUS WITH PATIENT INFORMATION SENSORS; U.S. patent application 16/992,515 filed August 13, 2020, by inventors Kurosh Nahavandi et al. and entitled PATIENT SUPPORT APPARATUS WITH EQUIPMENT WEIGHT LOG; and U.S. patent application serial number 63/255,223, filed October 13, 2021, by inventors Sujay Sukumaran et al. and entitled PATIENT SUPPORT APPARATUS WITH PATIENT WEIGHT MONITORING, the complete disclosures of all of which are incorporated herein by reference. The scale system may utilize the same force sensors that are utilized by the exit detection system, in some embodiments, or it may utilize one or more different sensors. [0105] Various additional alterations and changes beyond those already mentioned herein can be made to the above-described embodiments. This disclosure is presented for illustrative purposes and should not be interpreted as an exhaustive description of all embodiments or to limit the scope of the claims to the specific elements illustrated or described in connection with these embodiments. For example, and without limitation, any individual element(s) of the described embodiments may be replaced by alternative elements that provide substantially similar fimctionality or otherwise provide adequate operation. This includes, for example, presently known alternative elements, such as those that might be currently known to one skilled in the art, and alternative elements that may be developed in the fiiture, such as those that one skilled in the art might, upon development, recognize as an alternative. Any reference to claim elements in the singular, for example, using the articles “a,” “an,” “the” or

“said,” is not to be construed as limiting the element to the singular.

Claims

1. A patient support surface comprising: a first layer; and a second layer located underneath the first layer and configured to be in fluid communication with a cooling fluid, the first layer forming a cushioning layer, and the second layer forming a cooling layer.

2. The patient support surface according to claim 1, wherein the cushioning layer is sufficiently compressible to allow a patient lying thereon to compress the cushioning layer to a greater degree in localized areas and, thus, form variable spacing between the patient and the second layer to provide localized cooling of the patient at the localized areas.

3. The patient support surface according to claim 1, wherein the second layer is formed by tubing, the tubing configured to be in fluid communication with and to circulate a cooling liquid through the second layer.

4. The patient support surface according to claim 1 , wherein each layer has a first side and a second side, the first layer overlays the second layer, with the first side of the first layer forming a patient facing side of the patient support surface, and the second side of the first layer facing the first side of the second layer.

5. The patient support surface according to claim 4, wherein the second side of the second layer is for facing and supporting the patient support surface and a patient supported thereon on an underlying mattress or cushion.

6. The patient support surface according to claim 2, wherein the second layer includes one er more fluid passageways to allow cooling fluid to be circulated through the second layer to provide cooling to the second layer and to thereby provide cooling to the patient supported on the first layer in the localized areas and with greater cooling where compressible material of the second layer is most compressed.

7. The patient support surface according to claim 1, wherein the first layer includes a cushioning material in or inside the first layer, and the cushioning material is porous at least in a direction of compression to increase transmission of cooling to a patient where it is most compressed, which typically correspond to high pressure points on a body of the patient.

8. The patient support surface according to claim 7, wherein the first layer includes upper and lower sheets that envelope the cushioning material, the upper and lower sheets being joined together to form an enclosed space in which the cushioning material is located.

9. The patient support surface according to claim 8, wherein the upper sheet is gas permeable but moisture permeable to allow gas to pass there through.

10. The patient support surface according to claim 8, wherein the lower sheet is moisture and liquid impermeable to prevent moisture or liquids from passing though the first layer to the second layer or onto a support beneath the second layer.

11. The patient support surface according to claim 7, wherein the cushioning material comprises a spacer or drop stitch fabric.

12. The patient support surface according to claim 11, wherein the spacer or drop stitch fabric is coated on its opposed upper and lower sides with either a semi-permeable or perforated

- Ti coating on the upper side facing the patient supported thereon to at least allow gas to flow through from a first side of the first layer to cool the patient supported thereon and an impermeable and imperforate coating on the lower side.

13. The patient support surface according to claim 12, wherein the spacer or drop stitch fabric layer may be coupled to an air supply to thereby form a low air loss first layer, which directs air flow through the upper side.

14. The patient support surface according to claim 1 , wherein the patient support surface is formed with two or more zones, with at least two zones each being formed to provide independent cooling zones.

15. The patient support surface according to claim 14, wherein each zone is formed from first and second layers, with each second layer being configured to couple to a cooling fluid supply independently from the other second layer so that the at least two zones can be independently cooled.

16. The patient support surface according to claim 1, wherein the first and second layers are joined together by seams to create independent zones in the first and second layers.

17. The patient support surface according any of the above claims, the patient support surface is coupled to a controller that controls the cooling fluid.

18. The patient support surface according to claim 17, further comprising a display, the controller being coupled to the display and configured to display a graphical representation of the patient support surface.

19. The patient support surface according to claim 18, wherein the controller may be configured to indicate at the graphical representation when the second layer or second layers are being cooled.

20. A patient support surface comprising: a first layer; a second layer located underneath the first layer, the second layer having a patient facing side and an opposed side for facing a support, such as a mattress or cushion; the first layer comprising a gas permeable sheet that allows gas through the sheet but prevents liquid or moisture intrusion into the second layer; and the second layer being formed from a cushioning layer, the cushioning layer being configured to allow air flow through the cushioning layer both laterally and transversely through the patient facing side of the second layer so that air directed into the cushioning layer will then be directed to flow to the first layer and then to a patient supported on the first layer.

21. The patient support surface according to claim 20, wherein the cushioning layer is enclosed between upper and lower sheets joined and sealed together, with the upper sheet either being gas permeable to allow air flow through the upper sheet.

22. The patient support surface according to claim 21, wherein the lower sheet is impermeable.

23. The patient support surface according to claim 21, wherein the upper sheet is formed with gas permeable regions so that air is directed to specific regions through the upper sheet and hence through specific regions in the first layer.

24. The patient support surface according to any one of claims 20-23, wherein the cushioning layer includes a spacer or drop stitch fabric.

25. The patient support surface according to any one of claims 20-24, wherein the first layer comprises an incontinence layer, such as a sheet or pad.

26. A patient support surface comprising: a cushioning layer that is permeable to allow air flow into and out of the cushioning layer; a flexible covering forming a chamber and containing the cushioning layer therein, the flexible covering comprising impermeable and imperforate upper and lower sheets or impermeable and imperforate coatings, the impermeable and imperforate upper and lower sheets or impermeable and imperforate coatings sealing the cushioning layer therein; and an inlet and an outlet through the covering to allow air flow into and out of the cushioning layer, which is configured to be in fluid communication with a pump to supply air to inflate the patient support surface or to draw air out of the cushioning layer to selectively make the patient support rigid.

27. The patient support surface according to claim 26, further in combination with a pump, the pump operable to supply air or draw air from the cushioning layer through the inlet or outlet.

28. The patient support surface according to claim 26 or 27, wherein the cushioning layer comprises a spacer or drop stitch fabric.

29. The patient support surface according to claim 26, 27, or 28, farther comprising one or more handles so that patient support surface can be used to move a patient supported thereon.

30. The patient support surface according to any one of claims 26-29, farther comprising a cushion to support a portion or portions of a patient, such as a patient’s head.

31. A patient support surface comprising: a central support surface formed from a first cushioning material that supports a patient thereon; and a perimeter support surface formed from a second cushioning material that is more firm than the first cushioning material of the central support surface, the perimeter support surface forming bolsters on opposed sides of the central support surface to help prevent the patient from rolling off the central support surface and help retain the patient on the central support surface, and the perimeter support surface including one or more inserts each forming a firmer region than the second cushioning material to provide one or more firmer zones adjacent ingress/egress locations of the patient support surface.

32. The patient support surface of claim 31 , wherein the firmer region may be formed from drop stitch material.

33. The patient support surface of claim 31, wherein the firmer region comprises a firmer material enclosed in an impermeable covering.

34. The patient support surface of claim 31, wherein the firmer region comprises an inflatable bladder, and optionally adjustable inflatable bladder.

35. The patient support surface of any of claims 31-34, wherein the insert or inserts each have an adjustable firmness.