EP0195082A1

EP0195082A1 - Handling bed.

Info

Publication number: EP0195082A1
Application number: EP85905324A
Authority: EP
Inventors: Den Brandt Wilhelm Van
Original assignee: DEN BRANDT WILHELM VAN
Current assignee: HUBER, HELMUT
Priority date: 1984-09-27
Filing date: 1985-09-25
Publication date: 1986-09-24
Anticipated expiration: 2005-09-25
Also published as: EP0195082B1; AU4868385A; DE3585614D1; WO1986001999A1

Abstract

Le lit de traitement permettant de donner des soins aux personnes alitées, possède une surface de couchage réglable (1), un arrangement pour l'alimentation et l'évacuation des liquides, ladite surface de couchage (1) étant une surface pouvant être utilisée comme siège, douche, surface de toilette, de satisfaction des besoins et de traitement; la surface (1) peut être divisée en un certain nombre de sections mobiles (8) reliées les unes aux autres par des articulations, chaque section (8) pouvant être dotée d'une pluralité de zones (9) dont la forme peut être modifiée pour s'adapter à l'anatomie du sujet; le lit de traitement possède sur un de ses côtés une surface coulissante pivotante (54), pour le transport des personnes.The treatment bed for caring for bedridden persons has an adjustable lying surface (1), an arrangement for supplying and draining liquids, said lying surface (1) being a surface which can be used as a bed. seat, shower, toilet surface, needs satisfaction and treatment; the surface (1) can be divided into a number of movable sections (8) connected to each other by joints, each section (8) being able to be provided with a plurality of zones (9), the shape of which can be changed to adapt to the subject's anatomy; the treatment bed has on one of its sides a pivoting sliding surface (54) for transporting people.

Description

-1- Treatment couch

The present invention relates to a treatment couch for hygienic cleaning and care, satisfying needs and for diagnostic monitoring and therapeutic care of permanently or temporarily bedridden, motionless, restricted and / or disabled people, according to the preamble of claim 1.

This type of patient can be a person who is bedridden due to age or is bedridden as a result of an incurable disease leading to slow death (e.g. cancer or MS) or is permanently paralyzed, or else those who have to wait for their healing process to lie down (eg thigh fractures).

Common to this group of people is that they are no longer patients in the medical sense and. therefore cannot stay in a hospital, although they could only be optimally cared for there.

The invention has set itself the task of creating a treatment couch with which an optimal supply of this group of people in their apartments, i.e. is made possible in the family community of relatives or in nursing homes, so that the persons concerned are able to help themselves depending on their physical condition or the caregivers, i.e. Spouses, family members, neighborhood assistants, nursing staff, resident doctors etc. are taken away from the spatial and situation-related burdens that stand in the way of optimal care.

Starting from a treatment couch of the type specified in the introduction, this object is achieved with the features specified in the characterizing part of claim 1; advantageous embodiments are described in the subclaims. The treatment couch according to the invention takes into account the operational circumstances and environmental requirements as well as the existing psychological, personal, interpersonal, spatial, organizational and financial limitations to which bedridden and needing care outside a hospital are subject. The invention is based on the fact that the bedridden person concerned primarily wants to be in his bed only to sleep and wants all nursing care to be carried out outside the bed, ie on the treatment couch.

The same applies to the helping people, since it is much easier and more manageable to care for the person to be cared for outside of the bed.

A multitude of advantages are achieved with the treatment couch according to the invention; these are: nursing duties *. a low-force transport of the bedridden person from their bed to the treatment couch; the fulfillment of needs in a sedentary posture; the person sitting on a toilet-like arrangement; automatic and hygienic genital cleaning and drying; the disposal of excrement automatically and with little odor or manually without direct visual and touch contact; a whole body and genital shower cleaning for both sexes; a skin refreshing spray (e.g. rubbing alcohol); self-sufficiency of the people with regard to the daily activities such as brushing teeth, combing, shaving etc. the possibility of sitting, if necessary supported, eating, reading, writing; the automatic cleaning and disinfection spray of the -3- couch; the possibility of being connected to the existing house systems for the supply and disposal of water and electricity without structural changes and additional devices; the possibility of forming a receiving device on the treatment couch for those persons who, for therapeutic reasons, are subjected to a body immobilization in a couch and receive the same nursing, diagnostic and therapeutic needs from there; the possibility of transporting the person if necessary; low space requirements for storage and free access for the nursing staff.

Another advantage in terms of optimal care for these people is therapeutic care for maintaining or restoring or improving the physical vital functions. Such disorders are particularly addressed here, the origin of which can be found in the fact that people are bedridden, e.g. Bowel problems, blood pressure and circulatory problems, muscle weakness, circulatory disorders etc. and the consequent loss of life, depression etc.

Furthermore, such individually indicated medically prescribed forms of therapy can also be complied with, which are disease-related aftercare therapies, such as, for example, infusion therapy, inflammation and infection therapy, getting up and walking training, extremity movement therapy, Kneipp water therapy , the stimulation current therapy or the inhalation or 0 ₂ ~ therapy.

All of these therapy options are made possible by the treatment couch according to the invention either in direct or in direct form. Such therapies are also possible, for which additional equipment is required, for example for the administration of syringes, for -4- Blood sampling, for minor surgical wound care, for rinsing therapy or reviving emergency aid. Devices of known type for diagnosing and monitoring cardiac functions, such as, for example, EKG monitoring and diagnostic evaluation of external cardiac pacemakers, defibrillators, to name only a few, can also be used in the sense of the modular principle. Furthermore, bedridden people can also be held in such body positions as are required, for example, for a gynecological examination or rinsing therapy.

There is also the possibility of storing the diagnostic values or the data of the monitoring activity, so that they can be transmitted telemetrically to a corresponding retrieval system and can be retrieved from there at any time by the attending doctor. An emergency code can also be transmitted in this way.

From DE-PS 21 40 559 a device for internal human water therapy on a mobile frame is known with a device for supplying treatment liquid from a storage container via an outlet device to a patient with a seat and lying surface for a patient whose The inclination of the backrest and headrest parts can be adjusted and a treatment console with two inclined seat surfaces for the thighs with the knees drawn up is provided on the horizontal seat part adapted to the two seat halves, the console providing a device for guiding the patient away from the patient of the previously performed treatment liquid has excreted substances and with a device for collecting the excreted substances, which is connected to the device for guiding away.

However, the advantages given above are not achieved with this known device.

In the following the invention with reference to the drawing explained in which advantageous embodiments of a treatment couch according to the invention are shown.

FIG. 1A schematically shows a side view of a treatment couch, which consists of a collapsible couch surface 1, which is arranged on a console 2, in which the supply and disposal arrangement is accommodated. The console is mobile, since 3 wheels 4 are arranged on its underside via a plurality of holding arms.

As FIG. 1E shows, the holding arms 3 can be designed to be extendable in order to cope with different loads. In FIG. 1B, the treatment couch is shown schematically in the folded state of the couch surface.

Figure IC also shows schematically a side view of the console, which is provided on its upper side with an opening which ensures access to the supply and disposal arrangement. Separated from the supply and disposal arrangement, a multiplicity of electrical connections can be provided on the console.

The console can be equipped with an adjusting device for the lying surface 1 e.g. a hydraulic, pneumatic or electrical arrangement, which is schematically designated 6 in FIG. 1D. In the case of pressure cylinders 7 (FIG. 1F) these are e.g. Horseshoe-shaped attached to the top of the console so as to give the lying surface 1 any desired side, height and length adjustment.

FIG. 2b shows a reduced plan view of a lying surface which is divided into several sections 8, the individual segments being connected to one another in an articulated manner so as to fold the lying together.

Figure 2a shows an enlarged view of a plan view -6- on this lying surface, the individual sections 8 being provided with a large number of fields 9. The fields 9 can consist of inflatable hollow bodies, for example of rubber, or of a suitable plastic which is so elastic that it adapts to the anatomical shape of the body. The fields 9 can either be connected together or individually to an air pump, as indicated in FIG. 2d. As a result, each individual field 9 can be inflated at different pressures by means of an associated hose 15 from a pump 14 in order to take account of the circumstances of the person. Drainage grooves 17 are provided between the fields 9 and run to the lowest lying point of the lying surface 1, at which a preferably circular cutout 5 is provided, which is delimited by an edge 4. This section is directly connected to the supply and disposal arrangement in the console 2.

On the outer edge of the lying surface is e.g. inflatable side wall 10 is provided which, after it has been filled with a fluid, enables the lying surface 1 to be filled with liquid. Figure 2c shows a section through the lying surface 1 with the side wall 10 in an uninflated, i.e. at rest. In order to ensure the adjustability of the individual segments when the side wall 10 is inflated, concertina-shaped joints 12 are provided in the side wall at the articulation points, which enable the straight course of the side wall 10 to be bent. In order to further ensure an adaptation of the lying surface 1 to the body length of the person, extension pieces 11 are provided on the two end parts, which can also be designed in accordion-like fashion in order to ensure the length of the lying surface can be adjusted.

The side wall 10 can be designed in such a way that it has a stiffened outer skin and a stretchable inner skin, so that when part of the filling air is released, the inner skin contracts downwards and thus the upper -7- edge of the outer skin also pulls down.

The round cutout 5 arranged approximately in the middle of the lying surface can be closed, as indicated in FIG. 2e. This lockability is e.g. guaranteed by four elastic segments 16 which are inflatable and take the form of a quarter circle. They can be under the influence of a return spring 16 'which opens the cutout 5 when the pressure decreases; they can also be operated magnetically or electrically.

FIG. 2c also shows that a collecting tray 13 is provided below the section 5 and is connected to the disposal arrangement in the console.

The lying surface 1 can e.g. Via a central locking and unlocking arrangement shown in FIG. 2f, the console 2 and thus the supply and disposal arrangement can be released.

FIG. 3 schematically shows the structure of the supply arrangement, which in the selected example consists of a chamber system 19 which has a multiplicity of chambers 20 to 24, each chamber being provided with a level indicator. The first chamber 20 can contain soap, for example, the second chamber 21 an inlet liquid, the chamber 22 a gynecological liquid, the chamber 23 a special mixture and the chamber 24 a disinfectant. Each chamber is connected via an associated hose to a mixing valve 25, which is connected via a further hose to a pump 27, for example a roller pump, which in turn leads via a heat exchanger 28 to a two-way valve 29. An air line 30 is connected at a suitable point, for example between the pump 27 and the heat exchanger 28. Furthermore, a water line 32, for example connected to the house connection, with an associated decalcifier 33 is connected to the mixing valve 25. An electrical control circuit 31 controls the functions of the individual drain arrangements of the chamber system of the mixing valve of the pump and of the heat exchanger 28.

Arranged after the two-way valve 29 is a spray head, designated in its entirety by 34, and a shower device 35 for cleaning the entire body of the person via a longer flexible hose. The spray head 34 shown in more detail in Figure 4 is used to supply suitable liquid, e.g. for genital cleansing through section 5. For this purpose it has two opposing and radially extending limiting lips 40, 41 and an approximately centrally arranged spray nozzle 36 which is adjustable in the direction of its longitudinal axis, the limiting lips 40 and 41 serving as a stop when the nozzle 36 is inserted rectally.

The spray head 34 can consist of a plurality of perforated disks 42 arranged one above the other and rotatable about their longitudinal axis, one of which is shown in plan view in FIG. 4d. By rotating the individual perforated disks relative to one another (FIG. 4c), different spray jets can be generated, as is indicated in plan view in FIG. 4e.

By suitable actuation of the two-way valve, a corresponding liquid can either be supplied to the shower device 35 for whole body cleaning or the spray head 34, so that any jet, gushing or shower spraying can be carried out or heated air through the air connection 30.

As can be further seen Figure 4b ^'spray head is net angeord- in the rest position adjacent to and below .of the cutout 34 and 5 via an appropriate hinge 58 strands will at a Ge 38 which is pivotable about a fulcrum. 39 This ensures that the spray head 34 cannot get dirty and that its spray is only at the selected time. -9- takes up the cleaning position in the middle of the section 5. In the rest position of the spray head 34 shown in FIG. 4b, it can carry out disinfection cleaning of the entire disposal arrangement.

The linkage 38 can be pivoted both by the person on the lying surface and by an auxiliary person.

The disposal arrangement is shown schematically in FIG. With 13 again the collecting tray is designated, which is arranged below the cutout 5 and which tapers downwards into a funnel part 44. A stationary disposal can take place, as is indicated in FIG. 5a, when an excrement pan 43, which is arranged below the lying surface 1 and is provided with a corresponding inlet opening, is moved directly below the funnel web of the collecting tray 13. FIG. 5b further shows that a profiled rail arrangement 46 is provided below the collecting bowl, which has a retaining bolt (not shown in more detail) which, if the excrement pan 43 is pushed over the rails under the discharge funnel, simultaneously opens the lid of the pan. Via a gear-like arrangement, which is attached to the end of the rails 46 and which connects two wheels by means of a roller 47, paper bags 45 arranged on the roller can be pulled over the pan by pushing it in and with its opening under the outlet funnel come to rest. The weight of the falling excrement through the opening 47 now causes the bottom of the flat-supplied bag to move downward on the side walls due to its nature, and thus to ensure clean and hygienic disposal (FIG. 5c). A further relief is achieved in that, as shown in FIG. 5d, a side wall 48 of the pan 43 is designed to be pivotable.

The waste bags for disposal can be found on the edges of the -10- have a perforated strip at the top and be in the form of an endless belt, which can be separated from one another via a perforation arrangement.

As FIG. 5e shows, automatic disposal can also take place in that the collecting tray 13 is provided with a collecting container 51 via a shredding pump 50, to which a suction pump 52 is connected. In this case, a spring-loaded flap 49 can be provided in the funnel of the outlet tray 13, which closes the funnel in the unloaded state and is opened only by means of the weight of the solid excrement or large amounts of liquid which are obtained when showering.

A further possibility consists, as indicated in FIGS. 5f and 5g, of connecting the collecting tray 13 directly to a separable collecting container 51 or a device for pulverizing the excrement and the liquid between the collecting tray 13 and collecting container 51 - to be provided, e.g. by appropriate cooling and evaporation or by supplying energy, such as laser radiation or ultrasound waves and then pulverizing the particles thus obtained.

Figures 6a to 6h show different possibilities of positioning the lying surface e.g. by using the pneumatic, hydraulic or electrical adjusting device, as is indicated schematically in FIGS. 6c to 6f. 6a shows the lying surface in the form of a chair with a strongly inclined backrest, in FIG. 6b with at least one extended holding arm 3, etc.

As FIG. 7 also shows, a side wall of the treatment table is provided with a sliding surface 54 in order to transport the person from the lying surface 1 to another bed level, for example a sleeping bed 53. By means of recesses 55 incorporated in the sliding surface 54, the persons can also move independently over the sliding surface. The sliding surface -11-

54 itself can consist of a plurality of freely movable rollers or balls 56, which e.g. are arranged as a band. The sliding surface 54 can be arranged pivotably on the treatment table and can be locked on the treatment table at an angle to the horizontal. FIG. 7b shows a side view of the sliding surface 54 between the treatment couch and a sleeping bed 53. As FIG. 8c shows, the rollers or balls can also be arranged in such a way that they are adapted to the anatomical body shape.

The sliding surface 54 can also be connected to the treatment couch via a joint and can have a hollow profile that can be slipped over the frame of the sleeping bed on its opposite side; Furthermore, it can be provided with a liquid drain groove and with an outlet opening for warm air.

The lying surface 1 can e.g. be arranged on a frame, which is then also divided into articulated segments or consist of a suitable plastic that is stiff enough to bear the load of the person and is also divided into segments. The treatment couch can also be provided with a variety of accessories, e.g. with an infusion stand, with an insertable table with rotating mirror, with a gynecological leg holder, with a rectoscopic examination arrangement or also with a bicycle ergometer. Furthermore, an arrangement for storing medical data and values of the person being treated can have an arrangement for the telemetric transmission of these values. It can also have an electronic control system for the central actuation of all functions, which is operated by the person himself or an auxiliary person.

The treatment couch according to the invention is also particularly protected against explosions due to its special construction.

Claims

1. Treatment couch for hygienic cleaning and care, for satisfying needs and / or for diagnostic monitoring and therapeutic care of permanently or temporarily bedridden, motionless or restricted movement and / or disabled people, with an adjustable lying surface for the person, with an arrangement for ver and disposal of liquids, characterized in that the lying surface is a seating, showering, rinsing, satisfaction and treatment surface, that the lying surface can be divided into a number of movable, articulated sections, each Section can be provided with a large number of shape-changing fields which adapt to the anatomy and that the treatment couch is provided on one side with a pivotable sliding surface for the transport of people.

2. Treatment couch according to claim 1, characterized gekennzeich¬ net that the supply and disposal arrangement is detachably connected to the bed surface.

3. Treatment couch according to one of the preceding claims, characterized in that it has a system for supplying substances and / or with different liquids.

4. Treatment couch according to one of the preceding claims, characterized in that it has a separate device for collecting and removing solid excrement.

5. Treatment couch according to one of the preceding claims, characterized in that the bed surface is arranged on a console which is provided with wheels, the holding arms of which can be extendable.

6. Treatment couch according to one of the preceding claims, characterized in that it can be collapsible and that it can be height, side and length adjustable.

7. Treatment couch according to one of the preceding claims, characterized in that it has a device for storing medical data and values of the person being treated, and a device for the telemetric transmission of these values.

8. Treatment couch according to one of the preceding claims, characterized in that it has an electronic control system for the central actuation of all functions.

9. Treatment table according to one of the preceding claims, characterized in that the bed surface has side walls which can be set up so as to take the form of a tub and that the bed surface has an advantageously round cutout in approximately its center, which can be closed and is connected to the disposal arrangement.

10. Treatment couch according to claim 1, characterized gekennzeich¬ net that the fields of the individual sections of the lying surface consist of inflatable hollow bodies made of rubber or elastically deformable plastic.

11. Treatment couch according to claim 10, characterized in -14- that each field of the lying surface is assigned its own air supply arrangement.

12. Treatment couch according to claim 10, characterized in that the individual fields are arranged in such a way that there are drainage grooves between them, which of the

Side walls run radially to the round cutout, which is arranged lower than the side walls.

13. Treatment couch according to one of the preceding claims, characterized in that the side walls of the lying surface have a stiffened outer skin and a stretchable inner skin, so that when part of the filling air is released, the inner skin contracts downward and thus the upper edge of the outer skin pulls down.

14. Treatment couch according to one of the preceding claims, characterized in that the cutout in the lying surface can be closed.

15. Treatment couch according to one of the preceding claims, characterized in that a flat point made of solid material is arranged at its foot end for receiving devices for movement therapy.

16. Treatment couch according to one of the preceding claims, characterized in that the end parts of the couch surface can be pulled out.

17. Treatment couch according to claim 1, characterized gekennzeich¬ net that the lying surface is detachably connected by means of a centrally operable locking and unlocking arrangement with the supply and disposal arrangement.

18. Treatment couch according to claim 1, characterized gekennzeich¬ net that the device for supplying the liquids has a plurality of chambers which with a liquid Level indicators are provided and are connected to a mixing valve via outlet pipes in order to be able to carry out jet, surge, shower and / or disinfection sprayings.

19. Treatment couch according to claim 18, characterized gekennzeich¬ net that it has a control device for mixing pure water with treatment liquid.

20. Treatment couch according to claim 18, characterized gekennzeich¬ net that the liquids can be heated.

21. Treatment couch according to one of the preceding claims, characterized in that the supply arrangement has an air nozzle which is connected to a two-way valve in order to supply drying air to the person to be treated.

22. Treatment couch according to claim 1, characterized in that a genital cleaning device is provided below the cutout in the lying surface, which consists of a spray head which is connected to the supply arrangement.

23. Treatment couch according to claim 22, characterized in that, in addition to the spray head, a shower device connected to a flexible hose is provided for whole-body cleaning, which is also connected to the chamber system.

24. Treatment couch according to claim 22, characterized in that the spray head for supplying treatment liquids consists of a plurality of perforated disks which are arranged one above the other and can be rotated relative to one another and has at least two radially arranged limiting lips.

25. Treatment couch according to claim 22, characterized in that the uppermost perforated disk has a centrally arranged spray nozzle which is adjustable in the axial direction.

26. Treatment couch according to claim 22, characterized gekennzeich¬ net that the spray head is in the rest position next to the round cutout in the lying surface and can perform disinfection of the entire disposal arrangement in this position and that it is connected to a linkage so that it can be pivoted approximately into the central position below the cutout.

27. Treatment couch according to one of the preceding claims, characterized in that it connects to the cut-out in the lying surface with a funnel-shaped downwardly tapering collecting tray with the flushing ring on the inside and the retaining ring on the outside.

28. Treatment couch according to claim 27, characterized in that at the end of the funnel web of the drip tray there is a profiled rail arrangement with a retaining bolt for receiving the excrement pan and at the same time opening the lid provided on the pan.

29. Treatment couch according to claim 28, characterized in that a gear-like arrangement is provided at the end of the rail, which connects a roller and two wheels to one another, so that paper bags are located on the roller by inserting the pan over them be pulled and come to rest with their opening under the funnel of the drip tray.

30. Treatment couch according to claim 29, characterized gekennzeich¬ net that the paper bags have an opening in the middle of their top, that the side walls are folded and connected to each other by a bottom, -17- that the edges of the top have a perforated strip and two opposite sides and that the individual bags are connected to one another by perforated strips.

31. Treatment couch according to one of the preceding claims, characterized in that the excrement pan has a side which can be pivoted via an articulated rail and which can be pivoted via a pulling device.

32. Treatment couch according to one of the preceding claims, characterized in that a perforated sieve is provided at the beginning of the funnel web of the collecting tray, which opens into a collecting ring and serves to separate liquid and solid excrement and which is provided on the funnel web with a spring-loaded flap that closes the funnel web without load.

33. Treatment couch according to claim 32, characterized in that between the collecting tray and the collecting container for the liquids to be discharged a crushing pump e.g. a screw feed pump or a roller pump is provided.

34. Treatment couch according to claim 1, characterized gekennzeich¬ net that a pneumatic, hydraulic or electrical device for height, side and length adjustability may be present below the lying surface.

35. Treatment couch according to claim 1, characterized gekennzeich¬ net that the sliding surface for transferring the person between the treatment couch and e.g. a bed has freely movable rollers or balls, which are arranged individually or in a band and that it is provided with cutouts.

36. Treatment table according to claim 35, characterized in that the sliding surface can be locked at an angle to the horizontal on the treatment table.

37. Treatment couch according to claim 35, characterized gekennzeich¬ net that the sliding surface is connected via a hinge to the treatment couch and on the opposite side has a hollow profile that can be slipped over the frame of a bed.

38. Treatment couch according to claim 35, characterized gekennzeich¬ net that the sliding surface is adapted to the anatomical body shape.

39. Treatment couch according to claim 35, characterized gekennzeich¬ net that the sliding surface is provided with a liquid drainage groove and with an outlet opening for warm air.

40. Treatment couch according to one of the preceding claims, characterized in that the disposal arrangement comprises a device for pulverizing the excrement and / or the liquids, which e.g. can be evaporated by means of a laser or an ultrasound source after a suitable cooling.