CA1073300A

CA1073300A - Limb restraint

Info

Publication number: CA1073300A
Application number: CA243,816A
Authority: CA
Inventors: Jerry L. Aslanian
Original assignee: MASTER MEDICAL CORP
Current assignee: MASTER MEDICAL CORP
Priority date: 1975-01-20
Filing date: 1976-01-20
Publication date: 1980-03-11
Also published as: AU501604B2; FR2297605B3; DE2601739A1; FR2297605A1; GB1522862A; BR7600317A; JPS5197291A; DE2601739C2; AU1024876A; ZA76229B

Abstract

ABSTRACT OF THE DISCLOSURE

Novel anatomical limb restraints are provided. Such limb restraint or arm support structure includes a rigid elongate member for receiving the patient's arm in either of two positions during administra-tion of I.V.'s. The device is generally concavo-convex in cross-section.
The one side (top) of the support is convex at its forward end to receive the palm portion of the patient's hand and has a concave, tapered section rearward of the convex portion. This configuration supports the patient's arm in a substantially horizontal palm-down position. The opposite side (bottom) of the support is generally transversely concave to receive the patient's arm in a generally horizontal, palm-up position. The opposite lower edges of the second side (bottom) are coplanar so that the arm support is stable when this side is resting on a flat surface. A plura-lity of spaced-apart projections extend along opposite longitudinal edges of the support so that conventional medical tape can be wrapped about the support on the patient's arm at various selected locations to restrain and stabilize the arm support. Recesses or notches at the forward end of the support receive the fingers of the patient in a curled position when the limb is in the volar position and the upper ends of the fingers and knuckles when the limb is in a supine position. The support can also be used with an absorbent envelope or cover. This limb restraint is there-fore suitable for use in intravenous treatment and provides for patient comfort and fulfills medical needs.

Description

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This invention relates to medical equipment and supplies.
In particular, the invention concerns anatomical limb restraints. More particularly, the invention concerns apparatus for immobilizing the forearm, wrist and hand of a patient during intravenous treatment.
Intravenous treatment, including bLood transfusions and intravenous feeding, is a frequent and familiar surgical procedure.
Basically, the routine consists of immobllizing the patient's lower limb, forearm, wrist and hand and making a venipuncture near the wrist.
The needle is generally taped in place and may remain for a pe~iod of a couple of hours to a few weeks. For the duration of the treatment, it is imperative that the limb remain immobilized to prevent dislodge-ment of the needle wlth possible serious consequences.
The prior art is replete with various limb restraints for use during intravenous treatment. The original device has been obscured by antiquity. Presumably, it was a wooden splint to which the limb was found. The earliest attempts to improve upon the limb restraint were obviously the result oE concern for a patient's comfort.
These efforts results in simply bonding a layer of cushiony m~terial to a flat elongate board.
; 20 Initially, the layer of cushiony material was specified as sponge rubber. With the development of synthetic ` ~ q 3 3~ 0 materials, the cushiony layer was subsequently changed to foamed plastic.
A moisture impervious covering encasing the porous cushiony layer pre-vented the absorption of body fluids. Bind:ing the patient's arm to the support was accomplished either by adhesive tape or buckle-fitted straps.
More recently, the cushiony layer has been discarded in favor of a contoured board. One type of contoured arrangement provided an elongate, rigid member having upturned sides to receive the patientls lower limb which was secured therein by snap-fastened straps. A future trend was established by an elongate rectangular board having on the upper surface thereof a large depression extending inwardly from one end thereof to re-ceive the forearm and a series of smaller impressions extending inwardly from the other end thereof to accommodate the three middle fingers. The board, being symmetrical from side to side, received either the right or left lower arm in the palm down position. The board had a substantially flat undersurface to rest upon a table or similar surface. In a subsequent development, a slightly flexible ball was provided for flexing the Eingers and hand to overcome tension and boredom.
The rigid contoured member evolved to the present-day molded plastic device which is contoured to receive the hand, including the thumb and all fingers thereof, the wrist and the fo~earm. The device accommodates either arm which is received in the palm down position~ The lower limb is secured by interlocking straps which are integral with the molded plastic unit. The patient's lower limb is wrapped in an irregularly shaped disposable liner.

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1~733C~0 Several criteria are paramount for effic$ent and effective immobilization of the patient~s lower limb. While retaining the arm ln the medically desired position, the method must be expedient and prosaic to insure that treatment can be commenced quickly in an emergency and that the manual manipulations are in accordance with established medical routine. Also, since most persons become nervous and fidgety during the tenure of the needle, the devices used should be as comfortable as possible.
The recently developed contoured arm supports, especially the molded plastic type, provide obvious advantages over the prior art.
However, such devices have not gained widespread medical acceptance, nor / commercial success, since such devices only partially fill the estab-lished requirements.
It would be highly advantageous, therefore, to provide a limb restraint for use in intravenous treatment which provides for patient comfort and fulfills medical needs.
Accordingly, it is an object of a principal aspect of the present invention to provide an improved limb restraint for securing a patient's lower limb, including hand, wrist and forearm, in a predeter-mined position for use during intravenous treatment.
An object of another aspect of the present invention is to provide a limb restraint which will receive either the right or left lower limb.
An object of still another aspect oE the present invention is the provision of a limb restraint which will contouredly accommodate a limb in the palm down or volar position, or in the palm ~p or supine position.
An object of still another aspect of the present invention is to provide a limb restraint in which the arm is secured thereto by adhesive tape in accordance with accepted medical practice.
~ n object of yet still another aspect of the present invention is to provide a limb restraint which retains the patient's arm and hand , - . i:

~i~733t~o in a more natural position to reduce restlessness and discomfort.
An object of a furtiler aspect of the present invention is the provision of an arm restraint in combination with a readily usable, disposable, absorbent cover.
An object of a still further aspect of the present invention is the provision of a limb restraint which is sufficiently durable for sterilization and reuse and yet inexpensively manufactured to provide a disposable unit at the discretion of the user.
By one broad aspect of this invention, a limb restraint is provided for immobilizing the forearm, wrist and hand of a patient and maintaining the limb in a cornfortable predetermined position during intravenous treatment and for contouredly receiving the palm side or back side of either the patient's right or left lower arm, the restraint comprising a rigid elongate member for receiving an arm of a patient in either of two positions during administration of intravenous feeding, the elongate member being generally concavo-convex in cross-section and including. (a) a substantially convex surface at its forward end and a concave tapered section rearward of the convex Fortion, the convex sur-face being generally contoured to receive the normal palm side of the ! 20 lower forearm, wrist and palm of the patient thereover and adapted to h old the hand in a generally horizontal position; (b) a substantially concave generally transverse surface generally contoured to receive the normal back side of the lower forearm, wrist and palm of the patient therein, the opposite lower edges thereof being coplanar; and (c) a plurality of spaced-apart projections extending along opposite longitu-dinal edges of the support; the convex surface and the concave surface extending along opposite sides of the elongate member; the convex sur-face and the concave surface having the contours thereof in general complementary alignment whereby the elongate member is substantially concaveo-convex in cross-section.

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In accordance with a preferred embodiment thereof, a rigid elongate member is provided which is substantially concavo~convex in cross-section. The convex surface is generally contoured to receive the lower forearm, wrist and palm of a human limb thereover in the volar position. The patient's limb in the supine position is received in the contoured concave surface. Each contoured surface is arranged to accommodate either the right or left limb. The patient's fingers rest in recesses spaced along one end of the elongate member. Adhesive tape, or other suitable medical binding, encircling the limb and the limb 10 restraint is received between projections spaced along either edge of the elongate member. Optionally, the elongate member is encased in a resili-ent, absorbent, disposable envelope.
By a variant of an aspect of this invention, the restraint includes means defining a plurality of recesses extending between the convex surface and the concave surface at the forward end of the limb restraint and extending rearwardly therefrom along a forward portion of the limb restraint for positionally receiving the fingers of the immobilized limb when the limb is placed against either the convex sur-face or the concave surface.
By another variant of an aspect of this invention, the restraint is provided in combination with a resilient, absorbent, disposable envel-ope sized and shaped removably to receive the elongate member therein and having a length substantially equal to the length of the elongate member.
In the accompanying drawings, Figure 1 is a perspective view of a limb restraint constructed in accordance with the teachings of an aspect of the present invention, particularly illustrated with the concave surface upwardly;
Figure 2 is a perspective view of the device of Figure 1 showing the convex side thereof;
Figure 3 is a plan view of the device as it appears in Figure 2;

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Figure 4 is a vertical cross-section taken along the line 4-4 of Flgure l;

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10733~0 Figure 5 is a vertlcal cross-section taken ~long the line 5-5 of ~'igure l;
Figure 6 is a perspective view o~ a disposable cover for use in connection with the device of an aspect of the present invention;
Figure 7 is a perspective view of the limb restraint of an aspect of the present invention as lt would appear when supporting a human limb in the volar position and having the venipuncture on the back side of the wrist; and Figure 8 i9 a perspective view of the llmb restraint of an aspect of the present i~vention as i~ would appear when supporting a human limb in the supine position and having the venipuncture on the underside of the wrist.
Turning now to the drawings, in which the same reference numerals indicate corresponding elements throughout the several views, attention is first directed to Figure 1, which shows an elongate member generally designated by the reEerence character 10, having a substan-tially concave surface 11 which is generally contoured to receive a patient's lower arm ir the supine position in accordance with the limb restraint of an aspect of the present invention. A first section 12 of concave surface 11 extending from the rear edge 13 of elongated member 10 to approximately the position indicated by the dashed line A
is shaped to receive the back side of the lower foresrm. A second section 14 generally lying between the dashed lines A and B is narrowed and curves upwardly from first section 12 generally to conform to the patient's wrist.

A third section 17, wider and deeper than the second section 14, extending generally from dashed line B to forward edge 18 of elongate member 10 is contoured to receive the bac~ of the patient's hand.
The generally convex surface 19 on the opposite side of elongate member 10 from concave surface 11 is illustrated in Fig. 2. Convex surface 19 is generally contoured to receive the patient~s lower arm in the volar position. First section 20 of surface 19 slopes upward from rear edge 13 to approximately the position designated by dashed line C to rest the lower forearm and wrist thereon. Second section 21 approximately between dashed lines C and D is hollowed to receive the heel of the hand and the face of the thumb. Third section 22, commencing at approximately dashed line D and ending at the forward edge 18, is best described as spheroid to receive the normally curved palm thereover in a natural position. Four recesses 23 are spaced along forward edge 18. Each recess 23 becomes shallow and even-tually fades as -lt i5 traced rearwardly, upwardly upon the generally spher-oid third section 22. Recesses 23 accommodate a patient's fingers, exclud-ing the thumb, as will be described hereinafter~
The general shape of elongate member 10 in plan view is best illustrated in Fig. 3. Elongate member 10 is symmetrical about the longi-tudinal axis thereof to provide a limb restraint which will accommodateeither the left or right lower arm. A plurality of projections 24 along each longitudinal edge 27 and substantially extending between :. . . : . ..
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~.0~3300 concave surface 11 and convex surface 19 are spaced to receive adhesive tape therebetween.
Fig~ 4 complements Flgs. 1 and 2 for a clearer illustration of the contours of concave surface 11 and convex surface 19. As further seen in Fig. 5, concave surface 11 and convex surface 19 are arranged to have the contours thereof in gen~ral complementary aligm~ent, whereby the elongate member 11 is substantially concavo-convex in cross-section.
The limb restraint of an aspect of the present invention, as ~
above described, is preferably fabricatèd from a lightweight, rigid, in-expensive, molded plastic such as, for example, polyethylene. This pro-vides a very lightweight device, yet having inherent strength and rigidity to be thoroughly reliable for the intended purpose. The material employed can be prepared for reuse by conventional gaseous sterilization, yet the substantially low cost of a mass-produced molded polyethylene structure suggests a disposable item.
Fig. 6 shows a pre-formed envelope 28 having a closed end 29 and an open end 30 which is sized and shaped to receive elongate member 10 therein. The envelope is pre-formed of a resilient, absorbent material such as, for example, embossed or multi-ply paper which is sealed along all edges thereof except for the open end 30. The purpose of the envelope is to cover elongate member 10 and absorb body fluids such as, for example, perspiration and blood which would otherwise soak into the somewli~t porous structure of the polyethylene.

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, Being pre-formed, the envelope is immediately available for use and can be readily exchanged during an extended treatment for keeping the treatment area clean and dry.
Figs. 7 and ~ graphically illustrate the arm support of an aspect of the present invention during the intended use thereof for immobili~ing the lower portion of a human arm during intravenous treatment. Fig. 7 shows the lower portion of the limb in the volar position against convex surface 19 of elongate member 10, while Fig. 8 depicts the lower limb re-ceived in the concave surface 11. In each case, the venipuncture is re-presented by surgical tube 31 which transmits the intravenous fluid there-through to a needle properly inserted into a vein and secured with adhesive tape 32.
The lower human arm, when unencumbered, assumes a natural position in which the hand and wrlst are generally stralght to the forearm with the fingers curled in a semi-grasping or clenched position. The natural curl of the fingers is somewhat less in the supine position than in the volar position. An object placed in the palm of the hand, especially in the volar position, tends to cause the fingers to curl thereabout in a normal position in which the tip of the thumb is generally perpendicular to the fingertips. Since intravenous treatment tends to cause nervousness or restlessness among most patients, being able to grasp and squee~e something is of considerable benefit to the patient.
As particularly noted in Fig. 7, the patient's forearm and heel are received upon sections 20 and 21, ~733Q~

respectively, with the hand grasped over spheroid section 22. The fingers are extended downwardly, lying in recesses 23 and curled over the end 18 of elongate member 10. The thumb, beginning in recessed portion 21, ex-tends forwardly outward and is curled over the edge of section 22. In this position, the entire lower limb i5 supported with the hand, including fingers and thumb, in the natural free position. ConventLonal medical ad-hesive tape strips 33, generally cut from the same roll thereof as adhesive tape piece 32, encircle the patient's lower arm to immobilize the forearm, wrist and hand~ Adhesive tape strips 33 pass between projections 27 to prevent longitudinal slippage between elongate member 10 and the patient~s lower limb.
The patient's lower limb in the supine position is received with-in the concave surface 11 of elongate member lO, as depicted in Fig. 8. The forearm and wrist are received in sections 12 and 14, respectively. The back of the hand, with the fingers curled in the natural position, is re-ceived in section 17. As explained in connection with Fig. 7, adhesive tape strips 33 secured the lower limb to the elongate member. It is par-ticularly noted in the illustrations of Figs. 7 and 8 that envelope 23 nor-mally used to enclose elongate member 10 has been partially cut away for purposes of clarity.
From the foregoing de'tailed description of an embodiment of an aspect of the present invention, it will be immediately apparent to those skilled in the art that the limb restraint disclosed therein as a single .
unit is readily available to immobilize either the right or left lower limb _ 11 --.

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1~73300 in either the volar or suplne position. The limb is secured to the re-straint in accordance with the accepted medical practice at the specific medical facility in which it is used. General:Ly, medical personnel prefer to use adhesive tape, although other types of bindings such as various straps and ties, are readily usable with aspects of the instant invention.

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Claims

The embodiments of the invention in which an exclusive prop-erty or privilege is claimed are defined as follows:

1. A limb restraint for immobilizing the forearm, wrist and hand of a patient and maintaining said limb in a comfortable predeter-mined position during intravenous treatment and for contouredly receiving the palm side or back side of either the patient's right or left lower arm, said restraint comprising a rigid elongate member for receiving an arm of a patient in either of two positions during administration of intravenous feeding, said elongate member being generally concavo-convex in cross-section and including:
(a) a substantially convex surface at its forward end and a concave tapered section rearward of said convex portion, said convex surface being generally contoured to receive the normal palm side of the lower forearm, wrist and palm of said patient thereover and adapted to hold said hand in a generally horizontal position;
(b) a substantially concave generally transverse sur-face generally contoured to receive the normal back side of the lower forearm, wrist and palm of said patient therein, the opposite lower edges thereof being coplanar;
and (c) a plurality of spaced-apart projections extending along opposite longitudinal edges of the support;
said convex surface and said concave surface extending along opposite sides of said elongate member;
said convex surface and said concave surface having the contours thereof in general complementary alignment whereby said elongate member is substantially concavo-convex in cross-section.

2. The limb restraint of claim 1, further including means defining a plurality of recesses extending between said convex surface and said concave surface at the forward end of said limb restraint and extending rearwardly therefrom along a forward portion of said limb restraint for positionally receiving the fingers of the immobilized limb when said limb is placed against either said convex surface or said con-cave surface.

3. The limb restraint of claim 1, in combination with a resilient 9 absorbent, disposable envelope sizes and shaped removably to receive said elongate member therein, and having a length substantially equal to the length of said elongate member.