GB2057864A

GB2057864A - Baths for the infirm etc.

Info

Publication number: GB2057864A
Application number: GB7924940A
Authority: GB
Original assignee: Tweedy of Burnley Ltd
Current assignee: Tweedy of Burnley Ltd
Priority date: 1979-07-17
Filing date: 1979-07-17
Publication date: 1981-04-08
Also published as: GB2057864B

Abstract

A bed has a bath portion 10, fig. 2, having a cavity 12 capable of receiving the body of a patient 13. The bath can be filled with water which is circulated through a thermostatically controlled unit 17. The bath may be used as a bed for a seriously ill patient, for example in an intensive care unit, by fitting over the bath a flexible sheet impermeable to water. The patients body will effectively float in the water in the bath but will be gently supported by the flexible sheet and hence kept dry. A box or canopy 32, fig. 8, is mounted over the bed and houses lighting and other services, including life support apparatus which can be attached to the patient without restricting access to the side of the bed. The patient may be lifted using a plurality of slings 34. A shower attachment may be fitted to a pipe 20 of the unit 17. Alternatively an incontinent patient may be supported solely by bags, fig. 4 (not shown) of polystyrene beads within the bath. <IMAGE>

Description

SPECIFICATION Beds The invention relates to beds, and particularly to beds for use in hospitals, for example in intensive care units.

According to one aspect ofthe invention a bed comprises a bath for fluid and an impermeable membrame extending over the bath such that a patient lying on the membrane can be supported by fluid within the bath. The bed according to this aspectofthe invention enables a patientto be supported with a substantially uniform pressure applied to all parts of the patient in contact with the membrane, thus reducing the risk of pressure sores developing. The fluid-supported membrane shapes itself to match the contours of the patient's body.

The bath may be shaped to conform generally to the shape ofthe human body.

Preferably the bath has a drain through which the fluid can be rapidly removed so that the membrane collapses to leave the patient supported on a substantially rigid base of the bath, for example for the application of heart massage.

The membrane is preferably removable so that the patient can then be bathed in the bath.

The membrane may comprise a plastics sheet attached to the rim of the bath e.g. by press-studs or a clip device.

The drain may incorporate a water trap device, e.g.

a U or S-shaped trap, so that the drain can be used not only to drain away washing fluid, but also the patient's body waste.

The entry to the drain from the bath is therefore preferably arranged in the region of the base of the bath which will underlie the buttocks of a patient lying in the bath.

Means may be provided for maintaining fluid in the bath at a controlled temperature e.g. to heat or cool the patient's body as desired.

Preferably that part of the bath which, in use, will underlie the patient's head and chest region is such that an image intensifier can be positioned underthe bath for the purpose oftaking X-rays.

The bath may, for example, be mounted on a support pedestal, the said part of the bath extending outwardly from the support pedestal in the manner of a cantilever.

The bed may include a support surface which may be used to cover the bath so that the bed can also be used to support a patient in a more conventional manner. The support surface may be adjustable so thatthe patient can be supported with his body in an inclined position, or with part of his body, e.g. his feed and/or his head, raised.

According to a second aspect of the invention an overhead canopy is provided for a hospital bed, various life support and/or monitoring devices being suspended from the canopy for attachment to a patient lying on the bed, so that hospital staff can move round the bed and gain maximum access to the patient without being obstructed by the devices when they are attached to the patient.

The canopy may also house lighting (e.g. of adjustable intensity) for the bed and connections to electricity, air, water or like services.

According to a third aspect of the invention a device is provided for lifting a patient from a hospital bed, the device comprising a plurality of slings for attachment to various parts of the patient's body, and means for raising the slings in unison to lift the patient's body.

The slings may also be adjustable with respect to one another so that the attitude of the body of a lifted patient may be varied.

The lifting device may incorporate means, e.g.

load cells, to weigh the body of a lifted patient.

The bed, canopy and lifting device according to the invention may be used singly or in any combination. The canopy according to the second aspect of the invention may for example be positioned over the bed according to the first aspect of the invention and the lifting device according to the third aspect of the invention may for example be supported by the canopy according to the second aspect of the invention. Alternatively however the lifting device may be supported by a frame and the frame may be movable.

By way of example, a specific embodiment of the invention will now be described, with reference to the accompanying drawings, in which: Figure 1 is a plan view showing a patient lying on an embodiment of bed according to the invention; Figure 2 is a vertical cross-section through the bed of Figure 1; Figure 3 is a view of part of the bed corresponding to Figure 2 showing how a patient may be bathed in the bed; Figure 4 is a view similar to Figure 3 showing an alternative means of supporting a patient in the bed; Figures 5,6 and 7 show further means of supporting a patient in the bed; Figure 8 is a side elevation of the bed showing the bed in use in combination with a canopy and lifting device according to the invention; and Figure 9 is an end elevation of the arrangement shown in Figure 8.

The bed shown in the Figures has two main parts, an upper, bath portion 10 and a lower supporting pedestal 11. As best shown in Figure 2, the bath 10 is shaped to provide a cavity 12 of a size to comfortably receive the body of a patient 13. As can be seen from Figure 1 the recess 12 is narrower in the region of the head and feet of the patient, and as can be seen in Figure 2, the recess is shallower in the region of the head and feet. There is a drain well 14 in the region of the buttocks of the patient and this drain well communicates with an outlet drain 15 which passes through the pedestal 11, via a water trap 16.

The bath can be filled with water through a thermostatically controlled temperature control unit 17.

Hot and cold pipes 18 and 19 are plumbed into the control unit 17 through the pedestal 11 and the con trol unit 17 is operable to mix the hot and cold water to achieve a preset temperature and feed water at this temperature into the bath through an inlet 20.

The control unit 17 includes a pump which with draws water from the well 14through a pipe 21, monitors the temperature of this water, and replaces the water through the pipe 20, adjusting the temperature of the water if necessary.

The bath may be used as a bed for a seriously ill patient, for example in an intensive care unit, by fitting over the bath a flexible plastics sheet which is impermeable to water. The sheet can be releasably secured to the rim of the bath by press-studs or some other releasable clip device so that while the patient is effectively allowed to float in the water in the bath the patient's body is gently supported by the plastics sheet and is kept dry. Since the sheet is only supported by the water the sheet shapes itself to conform to the contours of the patient's body so that support pressure is evenly applied to the patient's body and the risk of pressure sores developing is substantially reduced.

To prevent any water from spilling overthe sides of the bath two overflow holes 22 are provided which communicate with the drain via pipes 23.

Thus when a patient is lying in the bed the surface of the water is at the level indicated by reference numeral 24.

By effectively suspending a diaphragm from the rim of a rigid reservoir for fluid it is possible to achieve a greater approximation to true floatation, and hence more gentle support with less localised high pressure regions, than in a conventional water-bed, which is in effect merely a water-filled bag.

Furthermore, since the bed is intended to be used as shown in Figures 1 and 2 with seriously ill patients, who will therefore normally be lying in the prone position, it is unlikely that the patient's body will bottom on the base 25 ofthe cavity 12, as might happen if the patient were to sit up for example. This means that the clearance between the patient's body and the bottom 25 may be kept small and consequently the quantity of water required to support a patient is also small. If therefore it becomes necessark to provide the patient with a rigid support at short notice, for example to administer heart massage, the water can be rapidly drained out of the bath through the drain 15, leaving the patient supported on the rigid base 25. To ensure rapid removal of water the drain 15 can be of relatively large crosssection.The drain can be controlled by a solenoid operated valve which can be opened very quickly to maximum aperture by pressing an emergency button. It is impossible to administer effective heart massage to a patient lying on a conventional waterbed.

The portions 10 and 11 ofthe bath are manufactured from GRP mouldings, and afterthe mouldings have been secured together and the necessary plumbing and wiring has been installed inside the mouldings, the remaining space is filled with a hard setting plastics foam to provide a lightweight firm construction without the expense of steelwork.

Furthermore the bed can be easily cleaned, a vital consideration in hospitals. The cavity 12 can be filled with disinfectant which is then used to flush out the drains and the smooth outer surfaces of the bed can readily be hosed or washed down.

It might be thought difficult for the bed shown in the Figures to accommodate both underweight and overweight patients. However overweight patients are usually overweight because of excess body fat.

This reduces body density and improves floatation so that overweight patients are supported in the bed by floatation just as well, or even better, than patients of normal weight or patients who are underweight. The overflow holes 22 ensure that the water is maintained at the constant level 24 and in fact by always filling the bath to a predetermined amount, then placing the patient in the bath, and then measuring the water displaced through the overflow holes 22, one can obtain a measure of the patient's density or body weight.

The control unit 17 may if desired be controlled by a rectal thermometer, for example so that if the patient's temperature rises above safe levels the patient can be cooled by lowering the temperature of the water. Cooling patients with high temperatures in an ordinary bed can be difficult.

It will be seen from Figure 2thatthe portion of the bed which supports the patient's head and chest region projects from the pedestal 11 in the manner of a cantilever, leaving a clear space between the underside of the bath and the floor 26. This enables an X-ray image intensifierto be positioned under the head and chest region, to facilitate the taking of X-rays. This is also facilitated by the fact that the bath itself, being of GRP, is translucent to X-rays.

While the bed is intended to support the patient in a dry condition, the bed can also serve as a more conventional bath, by removing the plastics sheet so that the patient actually lies in the water in the bath.

As shown in Figure 3, a shower attachment 27 is provided which can be plugged into the water pipe 20 of the control unit 17 to facilitate washing of the patient. Intensive care patients are frequently incontinent, but because the drain 15 is provided with the watertrap 16, the drain can be used not only to remove washing water but also to remove body waste.

The bath may also be provided with a liquid soap dispenser (not shown).

With a very incontinent patient, who can only be nursed with difficulty when lying on the plastics sheet, both the plastics sheet and the water can be removed, the patient being supported in the bath on bags 28 filled with polystyrene beads, as shown in Figure 4. The bags support the body of the patient except in the region of the buttocks, which are positioned over the well 14. This well can be continually or periodically flushed by feeding a stream of water into the bath.

Certain medical procedures require a patient's body to be tilted. Furthermore, a gradually recovering patient may eventually wish to sit up. Thus arrangements are made to convertthe bed into a more conventional bed. The bed is provided with side frames 29 and 30 formed as channel members with the mouths ofthe channels facing one another.

A roller blind 31 constructed of slats hinged together is normally housed rolled up in a cavity at the foot of the bed. However the blind can be unrolled, the ends ofthe slats sliding along the channel members to be supported thereby, and in the unrolled position the blind provides a substantially rigid top as in a conventional bed. This top may be used to support a patient as shown in Figure 5, using bead bags 28 lying on the blind. Furthermore the members 29 and 30 can be tilted for example as shown in Figure 6, to support the patient's body in an inclined position.

The members 29 and 30 may also be provided with hinges so that they can be arranged in the position shown in Figure 7 to support a patient in a sitting up position. The members 29 and 30 may be removable for cleaning.

The slats of the roller blind are preferably of plastics material so that X-rays can still be conveniently taken even when the blind is in the position shown in Figure 5.

While the bed shown in the Figures has useful applications when used merely to replace existing beds, the bed is particularly useful as part of a total patient care system, for example as shown in Figures 8 and 9.

In conventional intensive care units, the bed is usually arranged with its head against a wall and connections to the patient from various life support systems and monitoring apparatus extend from the wall to the patient. However this prevents or restricts free movement of hospital staff around the bed and it is often particularly difficult to gain access to the head and cheat region of the patient in spite of the fact that access to these areas is usually most important in the case of a sudden emergency.

In the system shown in Figures 8 and 9, a box or canopy 32 is mounted overthe bed, suspended from the ceiling. The canopy is almost as long as the bed and slightly wider, housing six fluorescent lighting tubes. This gives a bright diffused shadowless light suitable for performing minor operations such as tracheostomy. When the light is not in use the canopy itself shades the patient's eyes from the general room lighting. The tubes can be switched on and off in pairs to provide different levels of lighting.

When in use, the light, being at a height of only six feet from floor level does not disturb patients in adjacent beds. In addition to the lighting tubes the box carries eight 13 amp mains outlets. Monitoring sockets for an electrocardiograph and similar apparatus are also provided, an amplifier being mounted in the canopy above the foot end of the bed, the signal then being sent to a main desk and from there back to large multi-channel electroscopes which can be placed at strategic points around the unit. Pipes for oxygen, vacuum and compressed air are mounted at the end of the canopy which overlies the head of the patient on the patient's right and flow meters, suction bottles and similar apparatus are placed alongside.

The canopy enables the various connections leading to a patient to extend vertically downwardly to the patient. This leaves both sides and both ends of the bed completely unobstructed so that hospital staffcan move right around the patient when necessary and gain unobstructed access to any desired part of the patient's body. An additional advantage of having overhead suction and oxygen is that the weight of the tubing is supported by the canopy and if the tubes are dropped they do not trail on the floor where they may get dirty. Hooks may be arranged around the canopy to provide suspension for drip bottles, thereby reducing the need for mobile stands.

The canopy also incorporates electronically controlled ventilators at the head end, and a balloon pump is built into the foot end. Not only is this a convenient position for the balloon pump, but it is also possible to reduce noise by plumbing the pump into the piped gas supply instead of using a portable compresser and suction pump.

The canopy may be made in sheet metal but it is preferred that GRP is used.

It will be appreciated from the foregoing description that the patient occasionally needs to be removed from the bed, for example to position or remove the plastics sheet or unroll the roller blind 31. The total patient care system shown in Figures 8 and 9therefore incorporates a plurality of slings 34 suspended from the canopy 32. When it is desired to lift a patient the individual slings 34 can be fitted under parts of the patient's body more conveniently than a fabric stretcher but once fitted, the slings can be lifted in unison to raise the patient as shown in Figures 8 and 9. If desired the slings may be adjusted independently of one anotherto vary the attitude of the patient's body.Furthermore, by arranging the slings asymmetrically, or by raising one end of each sling while lowering the other end, it may be possible to use the slings to rotate the patient's body, thus requiring much less effort on the part of the nurses.

The invention is not restricted to the details of the foregoing embodiments. For example pockets or other recesses may be moulded or cut into the plastics surfaces ofthe bed to house items such as suction catheters, used razor blades and the like.

The slings 24, instead of being suspended from the canopy 32, may be suspended from a mobile frame.

The bed may be used in a geriatric unit instead of in an intensive care unit, in which case the canopy 32 need not be used. It would only be necessary to provide a conventional hoist, or a set of the slings 34 mounted on a mobile frame, for use in lifting patients.

The lifting device incorporating the slings 34 may incorporate means such as load cells to enable a patient to be weighed.

The versatility provided by the lifting device shown in Figures 8 and 9 means that it may be useful in its own right, mounted on a suitable frame, and it does not need to be used in connection with the bed and canopy shown.

The canopy itself may be useful in any emergency area such as an accident and emergency department, or a recovery room.

Claims

1. A bed comprising a bath for fluid and an impermeable membrane extending over the bath such that a patient lying on the membrane can be supported by fluid within the bath.

2. A bed as claimed in Claim 1, in which the bath is shaped to conform generally to the shape of the human body.

3. A bed as claimed in Claim 1 or Claim 2, in which the bath has a drain through which the fluid can be rapidly removed so that the membrane collapses to leave the patient supported on a sunstantially rigid base of the bath, for example for the application of heart massage.

4. A bed as claimed in Claim 3, in which the drain incorporates a water trap device such that the drain may be used to drain away not only washing fluid, but also the patient's body waste.

5. A bed as claimed in Claim 4, in which the entry to the drain from the bath is arranged in tht -gion of the base of the bath which will underlie the buttocks of a patient lying in the bath.

6. A bed as claimed in any one of the preceding claims, in which the membrane is removable so that the patient can then be bathed in the bath.

7. A bed as claimed in Claim 6, in which the membrane comprises a plastics sheet attached to the rim of the bath.

8. A bed as claimed in Claim 7, in which the plastics sheet is attached by press-studs.

9. A bed as claimed in Claim 7, in which the plastics sheet is attached by a clip device.

10. A bed as claimed in any one of the preceding claims, having means for maintaining fluid in the bath at a controlled temperature e.g. to heat or cool the patient's body as desired.

11. A bed as claimed in any one of the preceding claims, in which that part of the bath which, in use, will underlie the patient's head and chest region is such that an image intensifier can be positioned under the bath for the purpose of taking X-rays.

12. A bed as claimed in Claim 11, in which the bath has a support pedestal, the said part of the bath extending outwardly from the support pedestal in the manner of a cantilever.

13. A bed as claimed in any one of the preceding claims, including a support surface which may be used to cover the bath so that the bed can be used also to support a patient in a more conventional manner.

14. A bed as claimed in Claim 13, in which the support surface is adjustable so that the patient can be supported with his body in an inclined position or with part of his body raised.

15. A bed constructed and arranged substantially as herein described with reference to the accompanying drawings.

16. An overhead canopy for a hospital bed, life support and/or monitoring devices being suspended from the canopy for attachment to a patient lying on the bed, so that hospital staff can move round the bed and gain maximum access to the patient without being obstructed by the devices when they are attached to the patient.

17. A canopy as claimed in Claim 16, housing lighting for the bed.

18. A canopy as claimed in Claim 16 or Claim 17, housing connections to electricity, air, water or like services.

19. An overhead canopy constructed and arranged substantially as hereinbefore described with reference to the accompanying drawings.

20. An overhead canopy as claimed in any one of Claims 16to 19, in combination with a bed as claimed in any one of Claims 1 to 15.

21. A device for lifting a patient from a hospital bed, the device comprising a plurality of slings for attachment to various parts of the patient's body, and means for raising the slings in unison to lift the patient's body.

22. A device as claimed in Claim 21, in which the slings are adjustable with respect to one another so that the attitude of the body of a lifted patient may be varied.

23. A device as claimed in Claim 21 or Claim 22, incorporating means to weigh the body of a lifted patient.

24. A device as claimed in Claim 23, incorporating load cells.

25. A lifting device constructed and arranged substantially as herein described with reference to the accompanying drawings.

26. A lifting device as claimed in any one of Claims 21 to 25, in combination with an overhead canopy as claimed in any one of Claims 16 to 19, and/or in combination with a bed as claimed in any one of Claims 1 to 15.