US3545739A - Immobilization device - Google Patents

Description

g the positional United States Patent Marc B. DAvlgnon 1,051,349 1/1913 Neitro........ 75 Columbus St Manchester, Conn. 2,751,268 5/1956 Creelman...... 06040 Primary Examiner-Andrew R. Juhasz [21] 3 31 Assistant Examiner-Leon Gilden Dec 1970 Attorney eterL Costas Drawing Figs ABSTRACT: There is disclosed a device for containin [52] 11.8. 269/328, body of a patient to immobilize him and to m 128/373; 250/54 control of his body, which comprises a shell and retaining 8 l3/00 means associated therewith. The shell has an interior cell for the body of the patient and a peripheral-cross section of [72] Inventor [22] Filed [45] Patented [54] IMMOBILIZATION DEVICE polygonal configuration defining a multiplicity of planes extending longitudinally thereof about its periphery. The patient, secured in the cell by the retaining means, can be placed in a multiplicity of prone or recumbent positions by turning the device about its longitudinal axis to positions of support on a relatively planar surface.

269/322, 323, 328, 8/134, 373; 27/(lnquired); 5/82; 250/54 [56] References Cited UNITED STATES PATENTS 2,845,314 7/1958 PATENTED nEc 8l970 3545739 INVENTOR. MARC B. D'AVIG NON ATTORNEY IMMoBIL zA'TIoN DEVICE BACKGROUND OF THE INVENTION In many medical and, paramedical situations, a significant need existsfor immobilizing and positioning patients so that certain operations can be performed on them, and this need is most apparent when the patient is a child or an adult who is uncooperative due to shock, feebleness, hostility or other causes. In the field of radiography, the problem is particularly acute because it isessential that the patient be maintained in a relatively immobile condition since even slight movement will blur the radiograph and usually render it worthless, necessitating repeated exposures. Moreover, in radiography a number of exposures from various angles is frequently necessary for a complete and accurate diagnosis of the patients condition. Such angular positionsareoften difficult to achieve and maintain even with cooperative patients, but with uncooperative or immature persons achieving and maintaining these positions are sometimesvirtually impossible. The necessity for effectively immobilizing a pat'ient ina number of positions has in the past required that attendants personally restrain or position him, often requiring-the attention of at least two people for a single patient. This imposes significant demands upon the radiological staff and subjects the patient and the staff to excessive radiation due to' frequent and often extended exposures thereto.

Accordingly, it is an object of the present invention to provide a device for immobilizing-a patient and which also aids in achieving a multiplicity of angular positions relative to a reference point. x

It is also an object to facilitate posure of the patient and the staff toradiation by reducing both the number of personnel and also the number of X-ray exposures required.

J Another objectis to provide 'suchi'immobilizing devices which may be fabricated simply and relatively economically and which permit facile placement of the patient therein.

SUMMARY OF 'i'I-IE INVENTION radiography and minimize ex-- secured in the cell by the retaining means, can be placed in a multiplicity of prone positions byturning the device about its longitudinal axis to supported positions under the several planes defined by the polygonal configuration.

In one embodiment a body member having a cavity therein provides the interior cell, and. one, or more collars extending about the periphery of the body member provide the shell and the polygonal peripheral cross section thereof. Alternatively, the body member may have a multiplicity of projections extending outwardly from the periphery thereof to provide the peripheral cross section of the shell, in which case the planes are imaginary-and extend between the projections about the shell periphery. In anothere mbodiment the shell is a tubular member, the exterior configuration of which-has a multiplicity of faces providing the planes, and its aperture provides the interior cell.

The device may be comprised of a number of shells spaced along the length of the body of the patient or a single elongated shell may be used. The shell may beseparable into two or morelongitudinally extending sections, i.e., sections divided along planes parallel to itslongitudinal axis, and the sections may be hingedly joined. The retaining means may be a single support member or a plurality thereof spaced along the ble into elements which may be secured to the interior of the sections. v I A BRIEF DESCRIPTION OF THE DRAWING I FIG. 1 is a perspective view of a device embodying the present invention, supported upon a generally planar. surface and containing a major portion of the body of a patient, both shown in phantom line;

FIG. 2 is a section view of the device along line 2-2 of FIG. 1, to an enlarged scale andshowing-the' two sections prior to assembly thereof;

FIG. 3 is a fragmentary endview to a greatly enlarged scale showing the interengaging means along abutting edges of two shell sections;

FIG. 4 is a perspective view of anotherembodiment of the.

present device with a support surface and inflation tube shown in phantom line; and I i z 1 FIG. 5 is a fragmentary end view similar to FIG. illustrating the shell sections hingedly joined together.

DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMEN S.

Referring now in detail to FIGS..1--3' of the appended drawing, an immobilizationand control device, generally designated by the numeral 2, isdepicted upon a generally planar surface 4 with a film holder 6 disposed therebeneath, both the planar surface 4 and the film holder 6 being shown in phantom line. Also shown in phantom line is an X-ray unit 8 positioned above the device 2, and a patient 10 contained therewithin. It is apparent that in the relationship shown the patient 10 is positioned between the X-ray unit 8 and the film in the holder 6 so that upon exposure of the film the desired portion of thebody of the patient 1 0 is recorded thereon.

The device 2-includesa't ubularshell 12 with an extending portion 13 at one end thereof.- It is'of polygonal (octagonal) but also support the device'2 in an upright position and lend structural strength thereto.

As is best seen in FIG.' 2, the shell 12 is in two sections; namely, a top section and a bottom section l2b,-the end closure 20 being attached to the bottom section 12b and the endclosure 18, not visible'in this FI G., being attached to the top section 12a. Assembly of the top section 120 with the bottom section 12b provides an'aperture or interior cell 22 in which a major portion of the body of the patient 10 is contained. 1 p

Retaining means comprised of an upper support element 24 and a lower support element 26 are attached respectively to the upper shell section 12a and the lower shell section 12b, the support elements 24, 26 having semicircular recesses 28 which are alignable when the shell sections 12a, 12b are brought together to define apertures for confining the legs of the patient 10, as is seen in FIG. 1. Additional retaining means comprised of an upper support element 27 is also employed to engage a portion of the patients body nearer to his head, and such additionalretaining means may desirably be provided by a pair of support elementsattached to the shell sections 12a, 12b and provided -with suitably dimensioned and configured apertures. 1

As is best seen in FIG. 3, tongues 3,0 are provided on the edges of the upper section 12a which abut with the edges of the lower section l2b,which edges are provided with cooperating grooves 32. In the illustrated embodiment, utilizing resiliently deformable material for the shell section 12b enables the tongues 30 to snap into the grooves 32 and thus provide interengaging means for holding the sections of the shell 12 together.

The device 2 depicted in FIGS. 1-3 is utilized by placing the lower shell section 12b on a suitable planar support such as 4 and then laying the patient in a prone position within this section with his legs extending through the semicircular recesses 28 in the lower support element 26 and his body positioned in any other support element provided therein. The upper shell section 12a is then aligned and forced downwardly over the lower shell section 12b to cause the tongues 30 to engage in the grooves 32 and hold the two sections together with the legs of the patient securely held in the apertures defined by cooperation of the recesses 28 and his torso restrained by upper support element 27. The top section also brings upper support element 27 into position to restrain his torso and in rendering him immobile and properly positioning him. As shown in FIG. 5, the adjacent upper and lower sections 12a, 12b respectively may be joined by a suitable hinge 29 so that the shell 12 can be opened and closed by relative pivotal movement of the sections thereof. In such a case, the opposite edges are desirably provided with interengaging means (such as the tongue and groove arrangement shown in FIG. 3) to maintain the shell in closed position.

A second embodiment of the invention is illustrated in FIG. 4 wherein the immobilization device generally designated by the numeral 36, has a cylindrical body member generally designated by thenumeral 38. The body member 38 is composed of two sections, upper body section 38a and lower body section 38b, which in assembly define a cavity 39 providing an interior c'ell. Resiliently deformable material 40 is secured to the interior surfaces of the body sections 38a, 38b in the cavity -39 and provides the retaining means, the passageway 42 therethrough being somewhat smaller than the dimensions of the corresponding portion of the body of the patient to be placed therein to ensure that he is held securely. I

Spaced along the length of the cylindrical body member 38 and disengagably seated thereon are two collars 44 having a polygonal peripheral cross section to provide the shell configuration. The body member 38 extends through the axial passageways 46 so that the collars 44 extend about the periphery thereof, and the collars 44 each have six faces 48 which provide a hexagonal peripheral shell cross section. Alignment of the faces 48 on the respective collars 44 thus defines six planes for the shell extending longitudinally of the body member 38 for stable seating upon a relatively planar surface 50 depicted in phantom line.

In utilizing the device illustrated in FIG. 4, a patient is placed upon the resiliently deformable material 40 in the lower body section 3812, and the upper body section 38a is then placed over him so that the deformable material 40 thereof presses against and deforms about his body. The collars 44 are thereafter seated about the periphery of the assembled body sections 38a, 38b to provide the shell faces 48 in longitudinally extending planes and to secure the two sections in assembly. Although the resiliently deformable material 40 is desirably provided by a resilient foam or the like, as illustrated by the full line representation, a desirable alternative embodiment utilizes one or more inflatable bladders, as is suggested by the presence of inflation tube 41shown in phantom line on the material 40 in the lower body section 48b. Among the advantages in using such a bladder is the fact that it may be entirely transparent while providing excellent support, and it will be appreciated that in the illustrated embodiment the deformable material 40 in the upper body section 38a would be a similar bladder, although no inflation tube therefore is shown.

An essential feature of the invention is that a multiplicity of planes extending longitudinally ofthe device be provided about its periphery, and for this purpose a shell having a peripheral cross section of polygonal configuration is employed. The planes are necessary so that the device can be supported in a number of stable and relatively precise angular positions with respect to a reference point, and so that the patient is maintained in one of a number of desired positions without the necessity of having significant assistance from a staff member.

Although the number of planes which are defined may vary somewhat, the area of each must be sufficiently large to provide the desired degree of stability in each position, and consequently the number of such planes will not normally exceed about 10. A structure having-as few as three planes-may be useful, but since the number thereof should be adequate to provide views of the patientfrom'as many angles as necessary, generally six or eight planes will be preferred. Most usually the configuration is that of a regular polygon so that all faces and included angles are equal.

In one particularly convenient and economical embodiment of the invention, the shell is a tubular member having an exterior configuration with a multiplicity of faceswhic'h provide the planes for seating thedevice, and the aperture of such a member provides the interior cell. In a preferred embodiment such a tubular member is ,used having eight exterior faces, which is a particularly suitable configuration for use in fluoroscopy since normally eight views about the patients body are taken of the digestive organs. By .forming this member in two sections, one of which has three faces and the other of which has five faces, the five-face section may be used to receive the patients body initially, with the three-face section being placed over him as a cover to complete the structure. I g

In another embodiment, the device may be comprised of a body member having a cavity therein providing the interior cell and at least one collar extending about the periphery of the body member to provide the shell with the required polygonal. peripheral cross section. The collar may be integrally formed with the bodymember or it may be d i sengageably seated thereon. Since the'collar defines the shell configuration and the planes for seating, the, device, the-body member may be fabricated in substantially any shapealtliou'gh cylindrical body members or those having oval cros's'sections are most easily fabricated. Since the co'llarin this embodiment provides the seating plane for the, device, it is desirable to maximize the area of the faces thereof, so that preferably at least two collars are utilized which, by alignment of the respective faces thereof, define planes of relatively large areas.

Generally, the collars have an axial passageway to accommodate the body member and a coaxial equilateral polygonal exterior configuration providing the several planes. Although the collars are most easily fabricated in a single piece and slid over the body member, they may also be comprised of two or more sections joined together by any suitable means. A variety of interchangeable collars having different exterior configurations may be provided for use with a single body member so that the number of positions obtainable can be greatly increased by substituting various collars. It should be noted that in this embodiment the.body itself may have a polygonal cross section and may be used with or without collars, whereby the number of possible angular positions is even further increased. An additional beneficial aspect attendant to the use of such collars is that a body member in two or more sections can be utilized with the collars serving to hold the sections together by slipping them thereover subsequent to assembly. It is desirable to provide a key or rib extending longitudinally on either the body or the collars with a corresponding slot or channel on the other member, or an alignment rod between the adjacent collars, so that alignment of the faces of the plurality of collars is ensured.

A further illustrative embodiment of the invention utilizes a body member having a cell therein and multiplicity of projections or ribs extending outwardly about the periphery thereof. In this embodiment the ends of the projections define the shell peripheral cross section with the planes being imaginary and extending between the ends of adjacent projections about the shell periphery. It is especially desirable that the projections 5. be in the'form' of ribs on the body member extending longitudinally over a substantial portion of the'length thereof, and preferably the ribs are broader at the .base adjacent the body member than at the outermostedge to maximize stability of the device.v

The term "shell" as used herein includes any member which provides the necessary peripheral cross section of polygonal configurationjdefining a multiplicity of planes extending longitudinally thereof about its periphery. The shell may be tubular providing'both the polygonal cross section and the cell is forthe patients body, or it'may be comprised of one or more collars of polygonal peripheralcross section; or it may be defined by the ends of a. multiplicity of projections about a body member which provides the cell. Although in the preferred embodiments thetubular shell or the body member is elongated and dimensioned to receive a major portion of the body. of the patient, these structures may be considerably shorter than the patients body and a plurality spaced along the length thereof. If aplurality of such structures is employed, to ensure that the patient is rendered sufficiently immobile and to ensure that the desired precise angular relation ships are achieved, the structures should be tied together, either permanently or disengageably, by longitudinally extending means, such as tie rods and the like.

The-planes or faces of the shell, collar or projecting members on the body are' angularly disposed relative to one another, and when nonimaginary planes are present they are either permanently or disengageably joined at adjacent edges to provide a structure having a closed cross-sectional configuration. lt is also possibleto join-adjacent planes by relatively curved sections rather than sharp angles, and this may facilitate fabrication of the shell and alteration of the seated positions thereof, albeit'with' some sacrifice of stability. In the most preferred and ctrmmonforrjn, the shell has planes of a single width with equal angles included therebetween to provide a structure having an equilateral cross section which is also symmetrical.

Although the drawing illustrates devices of the invention which are separable into two longitudinally extending sections, it is equally feasible toform the device in either a single section or a multiplicity of sections; From the standpoint of access to the cell of the device,'it is generally preferable to utilize at least two sections which can be assembled after the patient is placed therein. From the standpoint of ease of fabrication it may be desirable to form the shell or body member as a structure having a regular and continuous cross section, since extrusion of a suitable material may then be a convenient fabrication technique. if a plurality of longitudinally extending sections comprises the shell or body member, interengaging means should be provided so that these sections can be readily aligned and securely assembled. This means can be in the form of the tongue and groove structure illustrated or it may simply be relatively offset shoulders on the respective sections which facilitate alignment and engagement thereof. In addition, the sections can be held in assembly by using other means such as clamp locks, and the like, which may be integrally formed with the sections, or separate straps, belts, and the like, may be used. it should be appreciated that the means that is employed 'to maintain the sections in assembly should not project beyond the planes defined by the peripheral configuration of the shell since at least some degree of stability is sacrificed by the presence of such an extension.

Whether or not the shell for" body member is a unitary member or a plurality of sections, it is very convenient to provide a hinge to allow relative movement of parts thereof. A unitary structure may be formed with a number of parts having integral hinges therebetween by use of certain orientable thermoplastic resins such as'polypropylene, which is capable of forming an excellent hinge by working the material at a temperature below its crystalline melting point. ,When a hinge is provided with any type of shell or body member, it will normally be positioned along edges which abut in a plane parallel to the longitudinal axis of the structure, although not necessarily at the intersection of two faces thereof.

portion thereof. v

The cell which is provided toreceivethe body of the subject may have numerous configurations and a volume which varies within wide limits. As has been indicated, the cell will not normally be sufiiciently large to contain the entire body. of the, patient, and in some instances it will contain less thanthe'major Although the retaining means may be designed for'positioning relative to the body of the patient'prior to placement thereof in the cell, preferably it is secured directly to the inside surfaces defining the cell. The means used for retaining the body may be a support member havingat least one aperture dimensioned and configured to receive and closely conform to a portion of the body of a patient. Most generallysuch a member has a peripheral configuration conforming to the cross section of the cell so that the patient is held relatively immobile relative to the shell or body member in the aperture of the support member when it is ass'embled in the cell, as is illustrated in FIGS. 1-3 of the drawing. Preferably a plurality of support members spaced along the length of an elongated shell or body member will be used, and when the shell or body member is separable into a plurality of sections the support member is most desirably separable into a pluralityof elements, one of which is attached to each of the sections. in such a case, the aperture in the support member is defined by cooperating recesses in the elements so that, upon assembly of the sections with the patient therein, part of his body is confined in the aperture.

ln another embodiment, the retaining means is provided by resiliently deformable material on the interior surface defining the cell, with the deformable material defining a passageway of at least somewhat smaller dimensions than the dimensions of the corresponding portionof the patients body to be received therein. In this mannenthe patient can be substantially surrounded by relatively deformable material, which will both cushion his body and also render it relatively immobile.

The relatively resilient material may be added separately to defining the cell also may.- be-configured to closely conform to the shape of the patients body, in which case this surface will provide the retaining means as well as define the cell. Most desirably, however, the retaining means is provided by separate elements which will facilitate use of one device for persons having different body characteristics.

In this regard the devices of the invention may be provided in a number of sizes to accommodate persons of different ages or levels of physical development, but preferably the devices" are adjustable so that a single unit can be employed for a wide variety of patients. One manner of ache achieving adjustability is by properly selecting the, retaining means used with the shell, and a movable bottom surface or closure at the foot of v the shell or body member perpendicular to the longitudinal axis thereof may also be used for size variation. Such a closure may slide within the shell or body member and be releasably engageable in a number of positions to provide support for individuals of different heights. The foot of the device should be configured to support thepatient in a stable upright position since, for example, X-rays of the patients chest are normally taken in this manner. It may be also advantageous to provide auxiliary support means extending perpendicularly to the axis of the shell or body member at the. foot thereof to provide a broad base and greater stability, and the previously mentioned collars advantageously provide such means if one of them is positioned adjacent the foot of the device.

vThe device of the present invention can be fabricated out of any of numerous materials, thesignificant criteria for the choice of material being structural strength, durability and ease of fabrication. When the device is used for radiography, transparency to X-rays is also important, although a small amount of opacity is tolerable as long as it is uniform throughout the material. Use of a material impregnated with certain metals known in the art may be desirable in radiographic applications since undesirable secondary and soft radiation is reduced thereby. It is particularly advantageous to utilize a visually transparent material for the device since this will allow observation of the patient therein. In view of the foregoing criteria it will be apparent that synthetic plastics will generally be most suitable for'use in fabricating the present devices, although it is entirely feasible to substitute other structural materials for any ofthe parts thereof.

Although not illustrated, the device can have suitable reinforcing means such as ribs or corrugations, particularly in the shell or body members, making it feasible to fabricate the device from relatively thin sections. Auxiliary devices may also be employed with the immobilization devices of the invention, and they may be attached directly thereto, such as bottles for barium sulfate mixtures used during fluoroscopy and film holders. A bracket having an arm extending outwardly from the foot of the immobilization device and pivotable thereabout, and having an axially extending post for slidably mounting a film holder is particularly advantageous for supporting such' an a'uxilia'ry device in virtually any position relative to the patients body.

Thus it can be seen that the present invention provides a device for immobilizing the body of a patient which aids in achieving desired angular positions with respect to a given point of reference. The devices of the invention are particularly suitable for use in radiography since they achieve immobilization and allow positional control while minimizing exposure of both the patient and also the staff personnel to harmful doses of radiation. The immobilizing devices may be fabricated simply and relatively economically, and utilize various specific structures to permit facile placement of the patient therein. Although reference has heretofor been limited to use of the present devices for human patients, the invention is not so limited, and the device is equally suitable for use with animals if properly designed to accommodate them.

lclaim:

1. A device for the immobilization and positional control of a patient comprising a shell having a peripheral cross section of polygonal configuration and defining a multiplicity of planes extending longitudinally thereof about its periphery for stable seating upon a relatively planar surface in a multiplicity of positions rotated about the longitudinal axis thereof, said device having a cell defined internally of said shell and in a fixed position with respect thereto, said cell being dimensioned and configured to receive a portion of the body of a patient therein; and retaining means internally of said shell and fixed against rotation relative thereto for maintaining the body of the patient fixed at all times in said cell against rotation relative to said shell, whereby said device may'be supported on a relatively planar surface in a multiplicity of stable positions upon said planes when rotated about its longitudinal axis, and the body of the patient can be placed in a multiplicity of prone positions corresponding thereto by turning said device about said axis.

2. The device ofclaim I wherein said shell is elongated and dimensioned to receive a major portion of the body of the patient.

3. The device of claim 1 wherein all of said planes have substantially the same width and the angles included between adjacent planes are substantially equal, providing a structure having an equilateral and symmetrical cross sectional configuration.

4. The device of claim 3, wherein said shell is of octagonal cross section.

5. The device of claim 1 wherein said cell and shell are provided, respectively, by a body member having a cavity therein providing said cell and at least one collar extending about the periphery of said body member to provide said shell with said polygonal peripheral cross section.

6. The device of claim 5 wherein said collar is disengageably seated on said body member.

7. The device of claim 5 wherein said body member has a plurality of collars spaced along the length of said body member.

8. The device of claim 1 whereinsaid device has a body member having said cell therein and a multiplicity of projections extending outwardly therefrom about the periphery thereof to provide said shell of polygonal peripheral cross sec- I tion with the planes being imaginary and extending between adjacent projections about the periphery ofsaid shell.

9. A device for the immobilization andposit'ional control of a patient comprising an elongated tubular shell having a peripheral cross section of polygonal exterior configuration with a multiplicity of faces defining a multiplicity of planes ex E tending longitudinally thereof about its periphery for stable seating upon a relatively planar surface in a' multiplicity of positions rotated about the longitudinal axis thereof, said device having a cell defined internally of said tubular shell, in a fixed position and provided by the aperture thereof, said cell being dimensioned and configured to receive a major portion of the body of a patient therein; and retaining means internally of said shell and fixed against rotation relative thereto for maintaining the body of the patient fixed at all times in said cell against rotation relative to said shell, whereby said device may be supported on a relatively planar surface in a multiplicity of stable positions upon said planes when rotated about its longitudinal axis, and the body of the patient can be placed in a multiplicity of prone positions corresponding thereto by turning said device about said axis.

10. The device of claim 1 wherein said shell is formed of a plurality of longitudinally extending sections separable to permit facile placement of the patient in said cell.

11. The device of claim 10 wherein at least two sections are I hingedly connected and means are included for releasably securing said sections together to retain the patient therein.

12. The device of claim 1 wherein said shell has an extending portion at one end thereof to provide a support surface outwardly of the cell for the upper portion of the patient's body. .2

13. The device of claim 1 wherein said retaining means comprises an inflatable bladder insaid cell.

14. The device of claim 1 wherein said retaining means comprises resiliently deformable material on the interior surface defining said cell, said resiliently deformable material defining a passageway of at least somewhat smaller dimensions than the dimensions of the corresponding portion of the patients body to be received therein.

15. The device of claim 9 wherein said shell is separable into a plurality of longitudinally extending sections and wherein means is provided for releasably interengaging said sections.

16. The device of claim 15 wherein at least two of said sections are hingedly joined.

17. The device of claim 15 wherein said retaining means is a support member, having an aperture dimensioned and configured to receive and closely conform to a portion of the body of a patient and having a peripheral configuration conforming to the cross section of the aperture of said tubular member, whereby the patient is held relatively immobile relative to said shell when received in said aperture of said support member and said support member is assembled in said cell.

18. The device of claim 17 wherein a plurality of support members are spaced along the length of said tubular member,

sections so that upon assembly of said sections with the patient therein, part of his body is confined in said aperture and is rendered relatively immobile relative to said shell.

19. The device of claim 1 wherein said shell is constructed of a synthetic plastic that is substantially transparent to X-rays to render said device particularly suitable for use in radiography.

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