US1995583A - Resuscitation apparatus - Google Patents

Description

March 26, 1935.

E. L. SANDERSON RESUSC ITAT ION APPARATUS Filed Feb. 21. 1933 3 Sheets -Sheet l March 26, 1935. E. ANDERSON 1,995,583

\ RESUSCITATION APPARATUS Filed Feb. 21, 1953 3 Sheets-Sheet 2 March 26, 1935. I E. L. SANDERSON 1,995,583

RESUSCITATION APPARATUS Filed Feb. 21, 1933 5 Sheets-Sheet 3 MM dtto: e1

Patented Mar. 26, 1935 1,995,5*se I 18 Claims.

Thisinvention relates to certain improvements in. resuscitation, apparatus; and the natureand objectsof, the invention will be readily recognized and. understood by those skilled in the arts to which it pertains. in the light of;- the following explanation anddetailed; description of, the preferred methodand the stepsthereof from among equivalent or: other steps within, the scope of my invention, and from. the detailed, description of the; accompanying drawings illustrating what, I at present consideritorbe the preferred embodiments or mechanicalexpressions of, apparatus of myIinvention for carrying out'the method, from among. various other forms, arrangements, combinations andconstructions of which such apparatusis capable within thespirit andscope or" the invention.

My invention is primarily directed to' that branch of the art of resuscitation in which. a person whose normal and natural respiration functioning has ceased or is impaired through any of a variety of causes, such as suffocation, strangulation, asphyxiationand such like, is sub: J'ected to those. forms of artificial respiration utilizing the principle of:' the alternate application of. increased and decreased air. pressure, or

plus and minusatmospheric pressure, externally to the chest or body to cause they respiratory organs tofunction in. simulation of; thenatural and normal breathing acts. Experience with such forms of artificialrespiration. and the apparatus for carrying them. out, in which the body of the patientis in a recumbent position at rest, has demonstrated the fact that in manycases in order to obtain or induce the breathing acts, it is necessary to apply pressures. of sufiicient mag: nitude as to cause danger of injury to the lungs of the patient with resulting possibility ofher'norrhages.

- One of the-main objects of my invention is the provision of a method of-resuscitation by artificial respiration in which the breathing acts canbe induced in a patient by theapplication of td fll i e %5 d.9. i' Pl t XIQ- r Q Pies ur s, nd e ea d. or. m n s a mo rherici r sr suresonthe exterior of the chest or bodyofthe patient, but of relatively small magnitude and within a pressure. range such that, the possibility of, any injury to therpatient. or hisrespiratory organs is substantially eliminated, through the. utilization of movements. of, the. body. o fthe patient. in synchronization with the pressure applications, so as to, aidthe artificial functioning he'lun y s h beermo ements-antenna of relatively low pressure applications externally togproduce the breathing acts.

The method; of my invention in attainingthe foregoin general object and results, is essentially haract ize y i tineot r cking movement. of

thebody of thepatient while in a recumbent position, either; on its back or on its. stomach, to alternately raiseandlower the head so as. to alternately cause the abdominal organs to slide or move in the body from and toward. the dia. phragm and lungs. and thus compress and expand the lungs asthe decreasedor, minus-pressures and increased or pins; pressures, respectiyel are. applied externallyto the body-otthe pat entr V 7 Another general object of the invention is the provision of apparatus for use in carrying out and practicing the method'of resuscitation by artificial: respiration of my invention, which apparatus generally characterized by a hori-. zontally disposed andvertically rockable or tilt: able. body receiving compartment, which the patient is placed with; his head on the exteriorof the compartmentand in which the air pres-,- sureon, the body increased-and decreased. as thecompartmentisroeked or tilted to lower and raise, respectively, theheadend thereoi, to thereby synchronize the abdominal organmovements toward and from, the lungs. with, the pressures variati n A further object of, the; invention residespinthe provisionofsuch apparatus in whichthe means for. increasing and decreasing the air. pressures within theloody receiving compartment actuatedandcontrolled-by rocking ortilting, the com: partrnent; and further in so arranging andds signing; such means that theproper and required pressures arev automatically insured by thearocle ing, of the compartment.

An e ject and characteristic ofthe invention is ,found in. the provision for manual I rocking, operation of;- the body receivinggchame ber tcraise andflower. the headend thereof ata rateto resultqin the required rate or" breathing being induced in the. patient" by the artificial. r s ir tion; and further; in the provision: of: a pe. a haracterof chamberr pressure varyin m ansb Wh cht ui ed ndrop r t o tilting is clearlyindicated; to the operator.

eny nt n o ds: ur her Object-th r s on,- Q u e usc tat a ppara us hi h mocha. c s x uohumps.- o -i1 re sore;- ad; p ra n -me han sms can; e limi ated-i nd, an; xce d slw. truc u n simnla ffie snt n rqublepr -;.annaran duced, through the provision of a design and arrangement in which the body receiving compartment is formed in a casing or container that in cludes and carries a body of liquid and a system of air chambers and passages by which movement of the liquid body as the casing is rocked or tilted results in alternately exhausting or sucking air from the compartment to reduce the pressure therein, and forcing air thereinto to increase the compartment pressure. 7

' A further feature and characteristic of my invention resides in the arrangement of liquid and air passages by which the movement of the liquid and air in the operation of the apparatus is definitely controlled as to rate and resulting positive and negative pressures produced in the body re-:

ceiving compartment, so that the resulting breathing rate of the artificial respiration induced in the patient is thereby definitely automatically determined without relying upon the skill or judgment of the operator. 7

Another object and feature of the invention resides inthe design and arrangement by which the liquid means is utilized as a medium for main- .taining the desired temperature in the body receiving compartment; and further where water is employed as the liquid in the arrangement by which the air drawn from and forced into the body receiving compartment is warmed and humidified by the body of water in the operation of the apparatus. I

A further feature of the invention is presented by the design and arrangement of the body supporting tray or pallet by which the body is placed in and removed from the pressure compartment, and in the arrangement of the removable end closure and the manner of sealing and locking the same in compartment closing position.

Another object of the invention is to provide an efficient sealing diaphragm for the compartment end closure through which the neck of the patient extends and which diaphragmis so constructed as to form an efiicient' seal around the patients neck without discomfort or tendency to strangle or choke the patient; and further to provide an eflicient and readily operated arrangement for removably sealing the diaphragm on and across the end closure head opening.

" andresults in view, as well as certainlothers which will be readily apparent from the following explanation, the invention consists in certain novel steps and their equivalent of the method, and in certain novel features in construction and in combination and arrangements of elements making up the apparatus, all as will be more fully explained and specified hereinafter.

Referring to the accompanying'drawings:

Fig. 1 is a perspective view of one form of resuscitating apparatus embodying features of the invention and for carrying out my method of resuscitation, showing the patient receiving compartment forming container or body structure in position for tilting the patients body with head. lowered and feet elevated.

' Fig. 2 is a view in side elevation of the resusciating apparatus of Fig. 1, but showing the body receiving container rocked to position the patients body with head elevated and feet lowered.

Fig. 3is a plan view of a form of rubber sealing diaphragm for fitting over the head of and sealing around the patients neck, and for sealing the head end opening of the bodyreceiving compartment. v

Fig. 4-. is a transverse section taken on the line 4-4, of Fig. 3.

Fig. 5 is aplan view of the reverse side of the diaphraginfront that is shown in Fig. 3.

r Fig. 6 is a vertical longitudinal section through the body receiving container of the apparatus of Fig. 2 in head lowered position, and more or less diagrammatically showing a patient in position therein held against displacement and with the neck sealing diaphragm in its operative secured position sealed around the neck of the patient.

Fig. 7 is a view similar to Fig. 6, but with the body container and body therein rocked to head raising and feet lowering position.'

Fig. 8 is a vertical longitudinal view of the head end of the body-receiving container with the patient supporting tray or pallet and removable end closure and head rest carried thereby, in position partially removedfrom the body-receiving compartment of the container.

Fig. 9 is a perspective view taken from the rear of the removable body supporting pallet and container end closure unit, completely removed from the container body-receiving compartment, and showing the flexible holders for the patients body in their detached shoulder receiving position. r

Fig. 10 is a vertical'transverse section, taken as on' the linelo-lo, of Fig. 6; with the liquid removed from the liquid and air chambers, but with the approximate liquid level with the container inits maximum tilted positions in'relation to the pressure relief ports'in the chamber dividing wall indicated by legend.

Fig. 11 is a view in side elevation of a modified form of tilting or rocking mounting for the body receiving container, and of a modified form of liquid transfer and air sealing passage between the liquid and air chambers of the container, por tions of the walls thereof being broken away to clearly disclose the arrangement.

Fig. 12 is a View in side elevation of the tilting or rocking mounting of Fig. 11 with the radii of curvature-of therockers changed to compensate for the added weight at'the head end of the apparatus. 1 V I have presented herewith purely by way of example and not in every respect by way of limitation, embodiments of apparatus of my invention for efficiently practicing and applying the method of resuscitation by artificial respiration in accordance with the methodof my invention. The novel method disclosed maybe carried out and practiced by other forms and embodiments of apparatus within the spirit and scope of my invention, and such other forms and embodiments are contemplated by and included within the range of equivalents and the scope to which the broad features and principles of my invention, in both apparatus and method as disclosed herein, are'legally entitled.

One form and embodiment of apparatus incorporating the principles and certain features of the invention, and capable of carrying out the method of re uscitation of; my inve ion, s is..- closed in Figs. 1 and 2, in connection withcentain other figures-of the accompanying drawings, to which, reference will, be made inz'detaili herein.- after. This illustrated form of resuscitating ap; paratus is now -being successfully used'in' practice ing the: method, particularly in the resuscitation of new-bornbabies-in cases of strangulationsuffocationand the like, but itis to-be clearly under;

stood that. the'invention, as to either method or apparatus, is in no sense limiteclor restricted to such cases, and is generally applicable, as'is con temple-ted andintended; for the resuscitation of patients of any age, children as well as adults. The form of the apparatus asillustrated in Figs. 1 tolG, is designed primarily-forusein:practicing the method on new-bornor young babies, al-

though equally adaptedto children and adults,

andsuc-h use has been here selected for purposes of explanation primarily because the dangers of patient injury from the-conditionsoifhigh body pressures encounteredwith; known resuscitating methods and apparatus, are greatly; increased-in the case of a. new-born or-young'baby';

Referring now to Figs; l and2. of'thedrawings in particular, a resuseitating apparatus of the invention there shown happens to include a! supporting frame structureor stand-A, on which'is suitably mounted and supported-for vertical rockingor tilting, the-patient-receiving' and holding container B. For instance, the container-supporting structure or stand A, can, as in the example hereof, comprisethe spaced and opposite pairs oflegs lOconverged andconnectedat their upper ends, and formed ofv stripor band metal with the lower, diverged-- ends rolled or curved upwardly to provide the supporting feet: 11;

Suitable cross braces lz connect and maintain the V opposite pairs-of legs in. fixed-relation, such braces being located-intermediate the upper and.- lower ends of the legs. Preferably each pair of legs 10 is provided with an inter-brace or cross bar to strengthen and: give rigidity to the supporting structure.

Each ofthe cross. braces-12 is provided, in=the example hereof, with a suitable bumper, pref.- erably ofa yielding and sound deadeningmata rial, positioned thereon to be engaged by the adjacent end of container-B thereabove,-when such. end-is rocked downwardly; The bumpers 14, thus form stops limiting and determiningthe extent of downward movement of the adjacent ends, respectively, of container 13; andhence define themaximum: degree of tilt or inclination that can be given the-patient container;

Theupper ends of eachpair ofsupporting legs are converged and connectedby a suitable spacing member 1-6 horizontally disposed there between and below i the extreme upper ends .of 1 the legs. 7 A- space is thus formed between theupper ends of each pair of'supporting legsto removably receive the opposite side container pivots 21 by which the container Bis rockably'supported, on stand A, the members 16 'formingbearing supports for. such pivots, as will be clear byreference to Figs. 2, and 100i. the drawingsin particular.

While the supporting standA- as above described, prov-idesarelatively simple and enicient portable supporting. structureiior the particular. form, of. apparatus of the, present example, the invention isin no senselimitedthereto, or to anyparticular form, arrangementorconstruction of-the structure ormeans for rockably supporting the. patient body supporting and receiving container ,B, as any suitable or, desired. supporting: arrangement can be .providedto meet the exigencies .or. prefer;-

encesof anyrform ofrmy resuscitating apparatus, ,7

or oflthe-for'mof the .instanttexample;

Thecontainer B. for receiving and; supporting the patientis body in carrying: out. subjecting I;

the patientto, themethod of: resuscitationofi'my invention-,- in the particular example hereof: isv of general cylindrical. form externally; although. not soliinited; and. is providedwith. the: diametrically opposite, horizontally disposed andiaxially alined pivots or outwardly projecting stub :shaitszlgl-by which the container. is pivotally mountediior yer! tical rocking vortilting on, andbetween the up:

per ends of. the, opposite, spaced pairs. of- .legs 10; or other suporting means. In theexarnplehere given,- the pivots2-l are located centrally off-the length, andof-the Widthor diameterofzthe'con- 1 tainer, and removably seat on; the. members 16 betweent-he upper'ends of the 'spaoed p'airs of; legs 10, respectively, to removably support the con";- tainer-B- for free vertical tilting .on the pivots 21 as anaxisto alternately raise and lowerstheope pcsite ends of and alternatelytilt-or inclinethe container longitudinally in opposite directions. If desired, the pivots for the'containenBmay b located to secure a more perfect balance and com pensate for weight variations along the length or longitudinal axi's of the-container. j

The container, B, in this instance; includesthe outer cylindrical wall-20, withparticular refer encehere to Figs. 6, '7; and 10 of the drawings, having one end thereof closed. by. the end closure wall 22,- forming the foot end ofrthecontainer, and the oppposite end normally.closedby the're movable end closure or coverl'23, forming. the head end of the container. 'A patient. body-receiving compartment'P, is formed. within and longitudinally of the: container from end to end thereof and accessible throughithe headend normally closed by cover, 23, by anwinner; wall structure formedand .fixed within the con-v lspace-isthus formed-between. the outer wall 20 andthe inner walls 24-25, completely around and surrounding the body receiving compartmentP;

In'order to permanently closewthe headiend of the space between the inner and'youter. spaced walls of. containerxEan end'wall 26, referring particularly to Figs; 6, 7, and 8,-is secured in po= sition between and across the ends of the outer wall 20 and inner walls 24-25, around the end For example, such inner. wall; structure opening of the body receiving;compartment i such end wall 26 conforming in shape to the cross; sectional shape or" the space between the inner and outer container,wallsias will. be readily apparent. Thus, the space between the inner and outer walls of thecontainer is, closed atf'the foot end thereof bythe .end,wall.22, andlatthe head endbythewall26.-

A. relatively narrow, widthdepending well formedby adownward extension of the-space between the innerand-outerwallsof container B, is provided bya-wel-lforming-or trough-struoe ture 27, which depends or extends downwardly from the lower or under side of the outer wall 20, and is disposed longitudinally and centrally of the under side of the container B. 'Such trough structure 2 7 can be formed, as in' the example hereof, of the spaced, depending side walls 27a,

' and the longitudinal edge or end walls 27b, sloping 20 into, and forms a downward extension of the space between the inner and outer container walls, but of relatively narrow width with respect to the diameter of the container (see Fig. 10), and extending longitudinally and centrally thereof for 'a substantial portion of the length of the container B. (See Fig. 6.) v

A pet cook or suitable drain valve 28, shown in Figs. '1 and'2 of the drawings, is provided in the specific example hereof, in one of the side walls 27a adjacent the head end of the container and in proximity to the outer wall 20, that is, in the upper portion of wall 270, and opening into the shallow head end of the well formed .by the trough structure 27. The purpose-of such valve 28 and of the hereinbefore described well formed by the structure 27 will be described and explained hereinafter;

The space within the container formed between the outer wall 20 and the inner wall structure 2425, is formed and divided-into two chambers, a. forward chamber F, and a rear chamber R, by a dividing wall or partition 30 which is secured therebetween and connecting outer wall 20.. and inner walls. 24 -25, centrally of the length andintermediate the head and foot ends of the container, as clearly shown by Figs.

- 6 and '7 of the drawings; The wall or partition 30 conforms, of course, to the cross sectional shape of the space between the inner and outer walls of the container surrounding the compartment P, and extends completely across and between the floor wall 24 of the body receiving compartment P, and the opposite lower side portion of the outer cylindrical Wall 20, as will be clear, by reference to Fig. 10 of the drawings in particular.

The wall or partition 30 is also extended down into. and centrally of the length of, the well formed by the trough structure 27, a depending extension wall or partition 31 (see Figs. 6, 7,. and 10) from wall 30 being provided for this purpose. This well dividing wall 31 is in downward continuation of the wall or partition 30 thereabove, and extends between and connects the side walls 27a of structure 27, so as to di vide the well formed by such trough structure, into a forward chamber F and a rear chamber R in continuation of and communicating at their upper ends with chambers F and R, respectively, of thecontainer B. (See Figs. 6 and '7.) The lower end of the wall 31, is however, formed with, or to provide, a port or passage 32, referring to Figs. 6, '7, and 10, therethrough placing the chambersF' and R in communication at, in the specific example hereof, the deepest pointof the well, although the invention is not so limited as will be explained hereinafter. This port or passage 32 provides for restricted and controlled fluid or liquid flow between the chambersF' and R.

The wall or partition 30 is, in this instance, provided with the ports or openings 33 (see particularly Fig. 1c) therethrough at oppositesides of the inner wall 25,andin the specific example hereof, spaced a distance above the level of the patient supporting floor 24' of compartment P.

These ports 33 provide'for displacement of air and liquid between the chambers F and R in the operation of the apparatus, and their. area and relative positioning i in partition 30 controls certain factors, and is dependent upon certain others, in the operation and functioning of the apparatus, as will be later referred to herein.

The forward and rear chambers are placed in and R, are also placed in communication with' the exterior of the container B by the port or opening 35 formed throughthe upper side of outer wall 20 and opening into the rear chamber R adjacent the partition wall 30, in the partioular example hereof. This outer wall port 35 also provides a filling opening through which the chambers F-F and RR' are charged with the required quantity of liquid, such as the body of water W shown inFigs. 6 and '7, necessary to the proper operation and functioning of the apparatus. 1

The removable head end closure in the form of the slip-cover 23, includes the peripheral flange 40, referring particularly to Fig. 8 of the drawings, which removably fits over and around'the exterior of outer wall 20 of container B at the head end thereof, and the central aperture or opening therethrough defined by the outwardly extending neck flange ilsurrounding such opening; the neck flangev 41 being preferably formed to provide an external groove therearound. The cover 23 is fitted over and against the head end of container B,-with its neck opening in communication with and opening into the open end of'the patient compartment P, and is removably locked and secured in position by the draw bolts 42, or other suitable locking and securing means, carried on the exterior of container B and operatively engaging and cooperating with suitable lugs or projection 42a fixed on cover flange 10. (See Figs. 1 and 2.) A sealing gasket 43 (see Figsffi and 8), which is preferably as in the example hereof, in the form of a rubber or the like material tube, is secured around the inner side of cover 23 adjacent flange 4.0,for sealing engagement with the container end wall 26 when the cover is in secured position on the head end of the container, to prevent leakage or passage of air from the compartment P to the exterior of the container.

The apparatus includes a patient receiving tray or pallet 44 (see Fig. 9 in particular), which is secured to and forms a'unit with cover 2 3, and by which the patient to be treated is placed in and removed from compartment P, as well as being supported and maintainedin position in compartment P thereby, during treatment. For instance, such tray or pallet can, as in the form hereof, include the bottom wall 45, the vertical,

. cook or drain valve 28 (see Fig. 2) .isthen opened,

andrwith the'container held in such tilted'position', water, preferably warmed to a desirable temperature, is poured intothe container through theopening 35 until there is a flow fromthe open cook 28; whereupon the cock is closed. The desiredbody of water Wis thus placed in chambers F-F and RYR', surrounding compartment P,

and to a level such as, indicated in Fig. 7. In

such tilted position of the container B, the level of the body of water W is below the ports or openings 33 in the partition Wall 30 between chambers F and R, the distance below being non-essential and depending upon other factors, such as size of chambers, positioning of such ports and the quantity of liquid used.

1 The cover and tray unit 23 44 being removed from container B, the patient to be treated is placed in a recumbent position flat on his back or on his stomach (depending upon the type of case -to betreated) in the tray with his head resting on support 50 and cushion 52 and the diaphragm D forming asealing fit around the patients neck. The flexible members 61 are thensecured extending beneath the patients arm pits and theupper end hooks 62 are removably secured over rod 63. This position of apatient is clearly shown in FigS.6 and 7. Thecover and tray unit with the patient thereon is slid into the compartment P of container B, and the cover 23 is then locked in position by the draw bolts or the like 42. The body of the patient is thus disposed in compartment P, which compartment issealed by cover 23;and diaphragm D, around the patients' neck from the atmosphere except through ports 35, 34, and 33,while the patients head-is disposed at the exterior of the containerB. a

'The operator then starts functioning-of the apparatus to apply the method of the invention in resuscitating. the patient. Assume the container B in the head lowered position of Fig. 6-with the patients feet elevated. In such position the body of water W, is in the position indicated substantially occupying the forward chambers F and F. v The patients body is in a position to have caused'the body to compress toward the lungs and the abdominal organs have slid toward the diaphragm and tended to: compress the lungs to cause exhalation or expulsionof the air therefrom in simulation of such normal breathing act of the lungs. During the movement of the container B, in rocking from the opposite, head ele vated position, the shift in the body of water-W has caused the establishment of plus orintionof Fig. 7; The abdominal organs with the body in suchposition slide downwardly toward the: feet pulling'the diaphragmof the patient from the lungscreatinga suction; or reduced container from the head lowered position of Fig. 5.

6 to the head elevated position of Fig. '7, the body of liquid W, moves and is displaced from chambers F-Ff, at the head end of container 13, toward and intothe chambers R-.R at the foot end. This displacement forces air outwardly from chamber B through port '35 and results in an expansion or suction in chamber Fwith resulting suction and withdrawal of I air from. compartment P to change the pressure condition therein from a plus to a minus or reduced pressure acting on the patients body therein. The minus reduced pressure of the compartment P acting on the chest and abdomen of the patient, together with the action on the lungs by the elongating movement of the body and the movement of, the abdominal organs and diaphragm, produces or causes the lungs to expand and fill with air in simulation of the inhalation act of the breathing function.

The water or liquid body is of course, retarded and must accomplish its displacement through port 32 at the lower end of wall 31 in the well formed by trough 27, and by bubbling and flowing through ports 33 during any period in which the evel is aboveports 33. After the displacement of I through, and hence the compartment P pressure. is brought to normal or atmospheric pressure. :2.

Thecontainer B is then tilted back into the reverse position by the operator, with the water displacement causing compression'of air in chamber F and in compartment P to establish increased or plus pressure acting on the body. in cooperation with its head down, inclined position, to induce the act of exhalation by the patients respiratory organs. The operator then continues the rocking of container B to alternately tilt the patients body to raise and lower the head and induce the artificial respiration for the period of time which may be necessary to resuscitate the patient. The apparatus of the example hereof is featured bythe fact that the water in displacing from one position to the other in the container, together with the air bubbling through ports 33 is audible, which serves as a clear signal and indication to the operator when to rock the con tainer to the reverse direction, because such audible noises cease when the atmospheric pres'. sure condition is reestablished in compartment P and displacement of the liquid body has been consummated, following either a plus pressure (exhalation) or a minus pressure (inhalation) condition in such compartment. Thus, the area of ports 32 and 33 determines the period of time for liquid displacement and normal pressure re turn, so that, in accordance with the invention, the ports 32 and 33 are designed of such an area that the normal breathing rate, for examples. rate of 12 to 15 tim s per minute, is induced in the patient by rocking container B to the reverse position immediately after the cessation of the noise of liquid displacement following a r cking movement from one body tilted position to the reverse body tilted position. In the present example the area of port 32 is greater than the areas of ports 33 to allow a relatively quicker transferv of liquid to accumulate an air pressure in 'compartmentPdue to the relatively slower transfer rate through 'the smaller Iarea ports 33. In this manner the'rate of rocking required "for inducing the desired rate of artificial respiration is determined and the operatoris not called upon'to exercise any particular skill or judgment, but merely follows the rate audibly indicated.

:It 'is'v also to be .noted that the combined'area I of the'ports 33 can be provided by a single .port in wall 30, or can be-divided into a greater number of 'ports than the twohere shown.

3 secured by the air bubbling, through .the water in its flow to and from chambers F and R, through ports 33. Thus, a desired humid condition-can be maintained in the body receiving compartment P, together with a desired air tem- 3 perature therein.

The formation and arrangement of the trough structure 2'? to provide the liquid'well, together with the partition or wall .31 dividing the same into the chambers F and R in communication throughport 32, provides in effect a liquid seal or trap to prevent leakage or escape of" the air from and between chambers F and R during operation of the apparatus. For instance, in either of the positions shown in Figs. 6 and 7, a sufiicient body of liquidis maintained between the chambers to prevent passage of air therethrough and through port 32 from one chamber to the other. If the .port 32 is raised a sufiicient distance in the wall 31,;air will bubble back through the water and release the pressure condition which it is desired to establish for the required period of time in compartment P. The-apparatus or" this example here given is-so designed that the port 32 is just low enough to prevent such back bubbling of air and obtain the full .value of the difference inwater level pressure, whileallowing the pressures established in compartment P to be" gradually. released by air bubbling through the. 'small ports 33 in the chamber partition wall 30.

Themethod of resuscitation by inducing artificial respiration in the patient, in accordance with my invention, thus'inc'ludes the alternate tilting or rockingof the patient while maintaining the patients body in a flat, unbending position onhis back, or stomach so'as to cause the abdominal organs to move in the body to force be diaphragm'toward the lungs to compress them from below when the head is'lowerediexhalation) and when the head is raised and the feet lowered to cause the abdominalorgans to pull the diaphragm from the lungs and causing a suction or lowered pressure in the chest (inhalation). And, simultaneously and in synchronization with the alternate'tilting of the body the method provides the application of' pressure externally to the chest and abdomen of the patients, positive pressure when the body is tilted to' head lowered'position and negative or reduced pressures when the body is tilted to head elevated position. In this manner, by utilizing the action of the abdominal organs under gravityresponse, and of the tendency of the body to elongate and compress, a material aid to the compressing (exhalation) and expanding (inhalation) functioning of the lungs in performing the breathing arrangement of liquid seal act is obtained, and it is then only necessary to employ relatively low or light pressure applications externally to induce the natural breathing acts by the respiratory organs. With this method employing light pressure, the possibility organs of the of injury to the lungs and other patient is practically eliminated.

The forrn of apparatus as disclosed in Figs. l to l0 oftheaccompan-ying' drawings, is designed primarily tor the smaller types of the apparatus particularly intended for treating new-born or young babies, but the apparatus can be built in larger sizesjfor adults orfohildren and -of equally emciem operation andresults. However, in Fig. ll of the drawin s I have disclosed a form of mounting for the rockable or tiltable patient body receiving container B, which is en and efficiently adapted for the larger or adult sizes of the apparatus.

Reier-ring'to-Fig. 11 such form of mountingincludes a pair of spaced longitudinally disposed rockers -70, of which only one is shown here as they are identical secured to the lower ends of-a pair, of spaced depending legs or" struts; 71 which are fiiied' at their upper ends-adjacent" the opposite ends,=respectively, of container The container B is thus-rockably 'supported on rockers -?0,'and each of the rockers is so designed andformedas to presen'tthe intermediate curved portion termi nating at opposite ends in the substantially straight upwardly inclined portions 72, which" determine the degree to which the container can be tilted ineither direction in operation of the apparatus. 7 A further feature of thismounting is the formation ofthe curved intermediate in design and mounting, each portions-oi the rockers to have a radius ofcu'rvature, or varying radii of curvature, and to b61180 located along the rocker length with respect to container B, as weight/of the apparatus at the head end thereof With'a' patient in "the container, By such arrangement of the rockers, or by a positioning thereof under the container with respect to the center of gravity of .tl'ieapparatus the operator can smoothly and easily rock and alternately tilt the'container B as V I functioning as hereinbefore explained.

In Fig. 11, I have also presented a modified or trap between the chambers F-F, and R-"R,, ploy'ed in'place-o'i the wellforming trough struc to compensate for the greater required to obtain its 7 which can be ernture 27, hereinbefore described. For instance,*

the trough-structure and well are eliminated and a U-pipe or trap 73' is mounted depending from the underside of outer wall 20-withuone legopening into the container at the forward side oi partition 30, and the other leg opening into the'centainer' at the rear side of partition 36. The pa'r'tition '30 extends downwardly to the lower side of wall-20, and liquid thus fills U-pipe '73 and forms a liquid seal for the purpose new,

iii-before described.

-"What I ,claim is:- V

1. In apparatus for resuscitation by artificial "respiration, in combination, meansfcr' support-v ing a patient-in a recumbent position and for alternately bodily rocking the patient to head lowered'and feet raised and to head raised and feet lowered positions, and means for increasing the external pressure on the patients chest during rocking 'to head lowered position and for decreasing the exterhal chest pressureduring rocking of the 'patients body to headraised position. 7 2. 1m apparatus for resuscitation by artificial raised and feet lowered, and means controlled and actuated by operation of said first mentioned means for increasing the external pressure on the patients chest during tilting of the body to head lowered position and for decreasing the external pressure on the chest during tilting of the body to'head raised position. 7

3. In apparatus for resuscitation by artificial respiration, in combination, means for alternately bodilytilting a patient to an inclined body position with head lowered and feet raised and to an inclined body position with head raised and feet lowered, means limiting the degree of alternate tilting of the body by said means, and means for increasing the externalpressure on thepatients chest during tilting to head lowcred positionrand for decreasing the external chest pressure during tilting of the patients body tohead raised position. i,

4. In apparatus for resuscitation by artificial respiration, in combination, means providing a compartment for receiving and enclosing the body of a patient with his head at the exterior of said compartment, said means operative to alternately bodily tilt the patient to an inclined bodyposition with head lowered and feet raised, and to an inclinedbody position with head raised and feet lowered, and means for increasing the 'air pressure acting on the body. in said compartment during tilting of the body to head lowcred. position and for decreasing the pressure in the compartment during tilting of the body to head raised position.

5. In apparatus for resuscitation by artificial respiration, in combination, means providing a compartment for receiving and enclosing the body of a patient with his head at the exterior of the compartment, said means operative to alternately bodily tilt the patient to an inclined body position with head lowered and feet raised and to an inclined body position with head raised and feet lowered, and meansactuated and controlled by the operation of said first mentioned means to increase the pressure in said compartment during tilting of the body to head lowered position and for decreasing the pressure in the compartment during tilting of the body to head raised position. v c v V 6. In apparatus for resuscitation by artificial respiration, in combination, a container structure providing a compartment tlierewithin' for receiving and enclosing the body ofa patient in a recumbent position with the patients head at the exterior of said compartment, means removably sealing the head end of the compartmentand providing a sealingfit around the'neck of the patient, the said container structure mounted for alternately longitudinally. bodily tilting the patient to an inclined body position with the head lowered and feet raised and an inclined body position with the head raised and feet lowered,

and means for increasing the normal air pressure in said container during tilting of the patients body to head lowered position and for decreasing the normal compartment pressure during tilting of the body to head raised position.

'7. In apparatus for resuscitation by artificial respiration, in combination, acontainer structure having double walls providing an inner compartment longitudinally thereof and a closed lowered and feet raised and to an inclined body position with head raised and feet lowered, a body of liquid in the lower portion of the space around said compartment displaceable therein by the alternate tilting of the container structure, and the container structure formed with ports therein placing said space in communication with the compartment and with atmosphere whereby tilting of the container to patient head lowered position displaces the liquid body to cause increase in air pressure in the compartment and tilting of the container to head raised position displaces the liquid to cause decrease in the air pressure in the compartment.

8. In apparatus for resuscitation by artificial respiration, a container structure providing a compartment longitudinally thereof for receiving the body of a patient in a recumbent position with the patients head at the exterior of the container, means sealing the head end of the com partment from the atmosphere, said container structure including chambers at the outer side of said compartment having ports placing such chambers in communication with the compartment and with the atmosphere, a body of liquid in. the lower portion of said chambers and displaceable between the chambers'said container structure mounted for alternately longitudinally bodily tilting the patient to an inclined body position with head lowered and feet raised and to an inclined body position with head raised and feet lowered, said liquid body displaced by said container tilting to cause increase in pressure in the compartment during tilting to head lowered position and decrease in the compartment pressure during tilting to head raised position.

7 9. In apparatus for resuscitation by artificial respiration, in combination, a container structure providing a compartment for receiving the body of a patient in recumbent position with the head of the patient at the exterior of the container, means for sealing the head end of the compartment around the neck of the patient, said container structure rockable to bodily longitudinally alternately tilt the patient to an inclined body position with head lowered and feet raised and to an inclined body position with head raised and feet lowered, and means carried by and rockable with said container structure, including air chambers in communication with said compartment and a body of liquid in said chambers displaceable therein by rocking of the container to cause increase in the normal chamber pressure the patient, said container structure rockable to bodily longitudinally tilt the patient to an inclined body position with head lowered and feet raised 7 head end of the compartment around the neck of "for decreasing the normal air pressure in the compartment during tilting to head raised position and said pressure varying means providing for pressure relief and return to normal pressure,

in the compartment upon termination of body tilting and prior to rocking of the container structure to the opposite tilted position.

11. In apparatus for resuscitation by artificial respiration, in combination, a container structure providing a compartment for receiving the body of a patient with the head of the patient at the exterior of the container, means for sealing the head end of the compartment around the neck of the patient, said container structure'rockable to bodily longitudinally tilt the patient to an inclined body position with head lowered and feet raised and to an inclined body position with head raised and feet lowered, means carried by and rockable with said container structure, including air chambers separated by a partition wall and in communication with said compartment, and a body of liquid in said chambers displaceable through said wall as the container is rocked to cause increase in the normal compartment pressure during tilting to head lowered position and to cause decrease in normal compartment pressure during tilting to head raised position, and the said chamber partition wall including pressure relief ports whereby the pressure condition established by displacement of said liquid re-- turns to normal upon termination of the tilting movement in one direction.

12. In apparatus for resuscitation by artificial respiration, a container structure providing a compartment for receiving the bodyof a patient with the patients head on the exterior of the compartment, an end closure for the headend' of said compartment having an aperture for fitting over the patients head and through which the neck of the patient extends, said closure having an outwardly extended flange defining said aperture, a flexible sheet material diaphragm formed with a relatively thin central portion of reduced thickness with respect to the surrounding material of the diaphragm and having a central aperture expanded around and in sealing engagement with the neck of the patient, said diaphragm extended over andaround said cover flange, and a yielding ring member removably stretched over and engaged around said flange and diaphragm thereon to secure the diaphragm in attached position.

13. In resuscitating. apparatus, a container structure providing a compartment for receiving the body of a patient, said container structure mounted on rocker members for rocking movement to alternately bodily tilt the patients body to inclined position with head down and feet raised and to inclined position with head raised and feet lowered, stop means limiting the degree r of inclination to which the body can be rocked in either direction, and'the said rocker means formed and mounted to compensate for the increased weight of the body at the head end thereof to normally maintain the container structure balanced in substantially horizontal position.

14. In apparatus for resuscitation by artificial respiration,in combination, means for bodily tilting a patient while in a recumbent position alternately to inclined body positions with the.

head lowered and feet raised and with the head raised and feet lowered, means for holding the body of the patient in recumbent position against bodily displacement during tilting but with the body free to compress and elongate under its own weight as alternately tilted, and means for 7 decreasing the external pressure on the chest of the patient during bodily tilting to head raised position.

15. In apparatus for resuscitation by artificial respiration, in combination, means for bodily tilting a patient while in a recumbent position alternately to zinclined, body positions with the head lowered and with the head raised, and means for decreasing the-external pressure on the chest of the patientin bodily tilted and head raised position. a V v 16.fIn apparatus for producing artificial respiration, in combination, means for alternately bodily tilting a patientwhile in a recumbent po-' sition to inclined body positions with the head raised and with the head lowered, and means synchronized with the tilting of the body. by said the chest ofthe patient.

first means for varyingthe external pressure on 17. In apparatus for producing artificial respiration, in combination, means for alternately bodily moving a patient while in a recumbent position to inclined body positions with the head lowered and with the head raised, and means controlled by such alternate body movements to increase the external pressure on the patients chest for the head lowered position and to decrease such external pressure for the head raised position.

18. In apparatus for producing artificial respiration, a structure providing a compartment for receiving the body of a patient in a recumbent position, rocker members on which said structure is mounted for rocking movement to alternately bodily tilt the patients body to inclined positions with head lowered and with head raised, means'synchronized with the tilting of the body for varying the external pressure on a patient in said compartment and stop means limiting the degree of inclination to which the body can be rocked in either direction.

. EDGAR L. SANDER/SON.

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