DE202005006552U1 - Critical patient transport system, has equipments e.g. infusion pump and drainage pumps, which are utilized during transport of patient inside or outside hospital, where supports are provided for equipments at top and bottom of bed - Google Patents

Abstract

The system has monitoring and treatment devices to supervise and treat a patient in an intensive care unit or an emergency treatment room. A set of equipments e.g. defibrillator, respirator, infusion pump (6), syringe pumps and drainage pumps are provided and utilized during transport of the patient inside or outside hospitals. Supports are provided for the equipments at the top and bottom of a bed.

Description

STATE OF THE ART:

For the and interclinical transport of intensive care patients exist so far not yet a generally accepted overall system. This can be tedious Transport preparation and follow-up work for the nursing staff, poor monitoring and treatment options by the intensive care physician during transport and significant risks for intensive care patients.

So far tries every hospital, with the facilities available to him this dilemma as well as possible escape with the help of self-constructions. conventional Intensive care units with a wall rail system bring the treating Doctor already with simple and planned treatment measures such as a Umintubation, performing an intubation anesthesia or when laying Cavakathetern over the internal jugular vein in size Difficulties Accessibility to the patient's head is usually not only through the headboard of the intensive care bed and the "bed gallows", but especially by the attached to the wall rails devices for Patients running numerous infusion lines, the ECG cable, the connecting elements to the blood pressure monitor and the hoses of the Ventilator. The need for immediate intervention such as reintubation and resuscitation occur due to insufficient space at the head of the patient incalculable risks, a significant loss of time and risks due to disconnection and accidental ripping out of indwelling, Cavakathetern, Endotrachealtuben, stomach probes, etc. arise.

The mentioned difficulties can be substantially by ceiling tripods improve. The infusion tubes, breathing tubes and monitor cables are arranged from both sides of the bed fed. Access to the patient's head is - for the benefit of the physician, Sister and patient - free and unhindered.

DISADVANTAGES OF THE STAND OF THE TECHNIQUE:

Indeed is an essential and fundamental Overall problem neither by wall rail systems nor by ceiling tripods to solve. This problem then arises when the patient leaves his intensive care in another intensive room, in the emergency room Intensive care unit, to an X-ray or CT examination or brought to the operating room got to. It will now be necessary to remove the infusion pumps from the wall rail system or detached from the ceiling stand and at least the pumps with the most important drugs in the intensive care bed to install; the differentiated ventilation mode is replaced by a less adequate ventilation continued with an emergency respirator, its cleaning after the overall procedure is required; the differentiated monitoring is going through - if at all The supervision replaced with a simple transport monitor. The whole procedure requires the provision of special equipment for intra-hospital transport, brings uncertainties in the application of essential drugs - which actually should be applied without interruption and without bolus - and endangers the patient also in other ways (eg by changing the ventilation pattern as well as through poor monitoring while of transport). The working hours of intensive sisters and doctors in the conversion phase in the intensive care unit and at the new examination or treatment site (eg in the CT room) is connected by connecting the patient to anesthesia machine and another monitor, by another conversion before the return transport as well as a fourth device change after the return transport the patient to the intensive care unit, where now all retrofitting maneuvers again reversed Need to become, unnecessary bound.

Tries, to improve the handling of intra-hospital transport, led to Construction of different equipment trolleys in a simple way to take over the infusion and syringe pumps of the patient capital and the one pre-equipment with oxygen bottles, emergency respirators and transport monitors exhibit. When attaching such carts on the headboard of the patient arise already described in the wall rail system disadvantages the inadequate accessibility to the patient's head. When attaching the equipment carrier at the foot of the bed are the special long distances to the head, neck and thorax of the patient disadvantageous. In both docking systems equally unfavorable is the too long length of entire dock system bed equipment rack, what z. B. can cause problems during transport in short elevators; the total length of hospital lifts is not standardized. Also the considerable problems of the conversion of ventilator and monitoring with the possibility incorrect settings are not resolved by such equipment cart.

The Siemens company was working on a project to improve the intra-hospital transport of emergency patients. The emergency patient brought to the hospital by the ambulance service was to be stored on a specially designed stretcher and mechanically ventilated via a laterally docked implement carrier with a Servo-ventilator 300, consistently monitored with Sirecust monitor and infusion pumps and emergency medication delivered via infusion pumps. Unfortunately, the whole project was finished in late 1992 by you for reasons of profitability.

Nonetheless let yourself the intention at that time of an improved intraclinical emergency patient transport system without major difficulties into my concept of the intra-clinical intensive care transport system integrate easily in the proposed way.

OBJECT OF THE INVENTION:

Of the Approach, an extensive problem-solving of all described difficulties in intra-hospital transport, is as follows:

One Intensive bed or Stretcher with or without side-mounted or attachable intensive rails and a trolley, which is separate from the head and / or foot side the bed is like a bridge over the slide appropriate patient support device on the intensive rails of the bed or stretchers or on the bed or stretcher itself lock and after electromotive (or otherwise) Pulling up the legs of the equipment cart firmly anchored, so that he practically "piggyback" mitfährt form a basic unit.

One replaced such in the clinic universally applicable overall system the wall rail system of the intensive care unit largely. The wall sockets or a ceiling stand are only for gas and electricity supply, but no longer as a bracket for monitor, Ventilator, Infusion pumps and syringe pumps. The dockable equipment carrier is designed so that it has all the essential monitoring and treatment units of the intensive care patient.

With Help of the light rollers of the intensive care bed or stretchers can be the total unit (weighing about five hundred pounds of bed, patient and equipment carrier together) drive and maneuver surprisingly easy.

Of the Equipment carrier is normally above the Abdomen, pelvic and thigh area of the patient, so something footward from Bed or Stretchermitte arrested, so that head and thorax area of the Patients always freely accessible stay. The four vertical beams (Lifting columns) of the equipment cart are only about fifty Millimeters wide and lie the intensive care of the patient support device closely, so that in the case of intensive care bed a total width resulting in hospital doors of about a thousand millimeters or just above drive through at least one thousand one hundred millimeters wide easily can be. In the use case stretcher results in a total width of only about eight hundred millimeters. The overall height of the device carrier is with just less than two thousand millimeters so that every standard door (also in the elevator) can be easily passed.

On the intensive care unit - and when receiving an emergency patient - be in the novel Transport system the same monitor, the same respirator, the same Infusion pumps and syringe pumps and the same other monitoring and treatment equipment united in the docking car without device replacement used. At over 99% of ICU patients and emergency patients are expected to have six Syringe pumps and three infusion pumps compliant or more than be enough.

Without unnecessary Time loss can be with this system z. B. in-hospital intensive care patient transport to carry out a radiological examination. During the the entire examination or treatment process, the monitoring and treatment equipment unchanged connected. After the investigation leaves the Patient (with device docked again) immediately without loss of time for radiology the examination room and is driven to the intensive care unit. To Uncoupling the equipment cart the initial state is restored quickly without endangering the patient.

Exactly as simple as in intensive care patients, the procedure arises for the intra-hospital transport of a newly admitted emergency patient represents.

Of the polytraumatized patient is placed on a stretcher, the Intensivüberwachungs- and treatment equipment, which is on the equipment cart are connected, and the equipment cart is attached to the stretcher for the docked intra-hospital transport. To what extent the equipment wearer the patient to accompany in the operating room and should depends on the balance of the Overall situation and must with the hospital hygienists and representatives the operative disciplines in principle and prospectively discussed become.

SOLUTION OF THE TASK:

The here proposed intra- and interclinical intensive care patient transport system allows uninterrupted Monitoring and therapy measures from the intensive care unit to other diagnostic facilities or treatment centers in the same or another hospital.

The goal of the effort was a novel intensive care patient and emergency patient transport To develop a system that, unlike all others not based on the fact that special, held only for the actual transport monitoring and treatment devices are used, but that the same devices in both the inpatient stay in the intensive care unit as well as the transport itself without Deconnection can be used without interruption.

Of the Docking car has a own chassis with smooth castors, so he next to both the intensive care bed in the intensive care unit or in another Room (eg X-ray room) stand alone or docked on the bed or stretcher can be. In the undocked state, a locking brake actuated become.

To the advantage for the patients in the intensive care unit or the emergency room nursing staff and doctors can the car by means of electromotive (or mechanical or hydraulic or pneumatic) leg height adjustment in height optimal to the eye level be set by the supervisor, so that the best possible overview of monitors and optimal operability of the devices result.

Of the Gear tray stands right or left at the headboard of bed or stretcher at free accessibility to the head area of the patient.

In This normal position results in a perfect view of the Displays and direct operability of the devices as well as the driving position: In this case, the docking car is usually one hundred and eighty degrees turned (opposite the resting position), so that the displays and controls optimally aligned in the driving condition to the head of the bed.

Of the Docking process from the rest position to the transport position is Quite simple: bed or stretcher will be around a meter driven down the street. Under fuse the infusion hoses, breathing hoses and Patient cable, the device carrier is one hundred eighty Degree turned and bridge-like (usually from the head of the bed) across the bed to reach the optimal position over drove the patient. The locking devices of the device carrier are on the lateral intensive rails of the patient support device (Intensive care bed or stretcher) or on the bed or stretcher itself activated, and the legs of the equipment wearer become Electromotive (or mechanical or hydraulic or other Manner), so that he now without own mobility part a whole unit becomes.

Long Infusion lines, overlong (the longest available as standard) breathing tubes and the usual, of the length sufficient electrical cables allow a de-connectionless Docking and undocking process.

Of the Docking and undocking can be done mechanically by installing Ball Roller rails between the equipment carrier and the intensive care (similar a drawer slide) be relieved.

At the Destination of transport, z. B. in the CT room, a suitable intermediate position for the Device carrier for trouble-free Bypassing the patient on the examination table and then elected the definitive position. If this definitive position such a behind the gantry is, by way of exception the breathing tubes and the monitor cables are disconnected at short notice while the Syringe pumps can be passed through the gantry.

When Abdockvorgang the wheels - reverse as in the docking - again extended by electric motor (or otherwise) to stand on the ground, the locks are released
and the equipment carrier is reversed as in the docking backwards driven to the appropriate position on the new examination table or treatment location.

The for the Intensive transport described procedure also applies mutatis mutandis to the emergency patient transport using the Stretchers.

Of the In-hospital intensive care patient transport with docked equipment cart usually with the foot part of the bed drawn by the intensive nurse. For the am Head end pushing doctor affects the docking car, unfortunately, disturbing the view from the front so that he looks at certain passages stoop need to look forward below the lower device platform to be able to - or he must look ahead on the side of the bed. For better coordination with He should therefore go with her on the way to the previous sister communicate verbally, for a trouble-free transport sure.

All Displays and controls of monitor, ventilator and syringe and infusion pumps are placed on the front of the docking car and can of persons of different sizes at any time flawlessly be viewed or operated.

The electromedical devices are on two panels (or a single panel or more than two panels) of z. B. about a thousand times six hundred millimeters in intensive care and z. B. about eight hundred times six hundred millimeters in stretcher stacked. On the lower platform are the ventilator and the monitor or a monitor-defibrillator-pacemaker combination device, as well as a 51-oxygen cylinder and a 51-compressed air cylinder in a box, on which a coverable tub for receiving the 02 and compressed air hoses (for Connection to the central gas supply system) is positioned. A gas outlet strip is located between the monitor and the gas cylinders.

On the upper platform of the equipment carrier for the intensive care bed find two packages of three syringe pumps on top of each other and two infusion pumps in the front row and behind them up to seven infusion pumps or another detachable package of three Syringe pumps and in addition up to four infusion pumps place, corresponding to the equipment carrier of the Stretchers the smaller platform less pumps. Each one extendable IV pole with one to three transverse arms located at two or four upper Corners of the device carrier; the Cross arms are designed so that the total width of the device carrier is not possible by supernumerary Infusion bottles is increased. In the middle between the pumps are an automatic Cable drum for connecting the electrical system to the wall socket, the Distributor for the electrical connection cable, additional 220-volt outlets (eg for the connection of the intensive care bed), the grounding and the control unit and the operating device for the electromotive operated jacks. At the front and rear (each about 1000 mm upper and lower platform sides) is ever one (twenty-five sometimes ten millimeters) intensive rail of nearly a thousand Millimeter in length attached, which any and each adequate attachment of three Hose and cable holders (articulated tripods) as well as additional equipment allows. The variably mounted universal tripods or swivel arms serve for guidance the infusion lines, the monitor cable and the breathing tubes and guarantee avoidance of "cable salad" and "spaghetti syndrome", so disliked Apparitions, so far almost fateful with the activity were connected in the intensive care unit and during patient transport.

At the head of the intensive care bed or stretcher, there is room for an oxygen unit (with the head part removed), which in case of emergency ensures manual ventilation with a respiratory bag with metered oxygen supply and suction with closed secretion collecting system; It also includes the necessary accessories and an O ₂ quick release coupling.

At the footboard of the bed an emergency medical case and / or a patient curve and X-ray image holder carried with writing board become.

A Chest drainage unit can be mounted on the docking system's rail system be attached; The water jet pump is powered by the compressed air of the Dockyard operated. - One Leaves syringe tray to be accommodated on the upper deck of the equipment cart.

Consequently find all the needed monitoring and treatment equipment as well as for a safe patient transport required emergency systems their adequate Place - whole unlike conventional systems that are at the head or foot of the bed be docked. The result is a coherent overall concept.

To the Transfer of intensive care patients and emergency patients themselves between Bed / stretcher and other patient storage facilities (e.g. B. the CT table) is a rollboard. In other cases, before especially in freshly delivered emergency patients, in intensive care patients with unstable vertebral fractures and with limited space in the examination room, the one working "bed at examination table "not a patient lift can be used instead.

The Medical equipment can also be arbitrary in other ways and Way on the equipment carrier or The bed or the stretcher can be arranged according to the individual Requirements, existing standards and device specifications the corresponding clinic.

ADVANTAGES OF THE INVENTION:

• 1. The presented system makes it possible the patient's own monitoring and treatment equipment in the intensive care unit itself, during intra-hospital transport and to use at the destination without interruption and without disconnection. It is able to replace transport systems, which are on their own initiative Clinics in cooperation with various companies lack of presence developed a satisfactory universally applicable overall concept were.
• 2. With the new system, a. a significant gain in safety for patients and staff due to uninterrupted - setting errors during device replacement avoiding - continued monitoring and respiratory and drug therapy during transport achieved (this safety gain is particularly important in critical phases before and after surgery for the stability of vital patient functions), b. a significant reduction in the transfer rate This also reduces the time it takes to initiate urgent surgery for the benefit of the patient, c. some patient transport to diagnostic facilities, which was previously omitted in consideration of the overall transport risk conventional way, are now carried out almost risk-free, d. a huge amount of time is saved for the intensive care staff; A better utilization of radiological equipment and a reduced waiting time of the radiological personnel result from shorter residence times of the emergency and intensive care patients on the examination table.
• 3. The (including Patient) approx. 500 kg total unit can be operated by two persons drive and maneuver surprisingly easy.
• 4. The presented problem solution is basically suitable for all Intensive beds and stretcher.
• 5. In the redesign of an interdisciplinary emergency department offers the presented solution as innovative system component and optimized problem solving at.
• 6. In principle, the new system for interhospital transfer of intensive care patients, for the one transport with carry-like ones Overall construction is not sufficient, particularly well suited. With the presented system is this problem easier to solve than with systems, the equipment carriers at the head- or foot part of the bed. The loading and unloading is done via a hydraulic tail lift.
• 7. The cost aspects for Such an overall concept seems unfavorable only at first glance. In Truth can stationary workstation electromedical equipment for conversion be used in a mobile workplace if they meet a contemporary standard correspond. Bed, stretcher and dock cars together are cheaper as a single newly purchased high quality ceiling pendulum system. renovations in the intensive care unit are at introduction of the new system altogether not mandatory. The savings potential of personnel costs by The use of such systems is enormously high.
• 8. Another important advantage of the illustrated system is to be seen in the case of its consistent realization at a hospital evacuation the intensive care patients quickly and safe in other premises or other hospitals can be moved. This new aspect was caused by recent terrorist attacks and flood disasters clear.

1

Easy roller

2

Electromotive operated lifting support

 3

intensive rail

4

control panel of the ventilator

5

monitor or monitor defibrillator combination device

6

infusion pumps

7

package of three syringe pumps on top of each other

8th

infusion bottle

9

IV pole

10

51-O ₂ bottle with fittings

11

51-Druckluftflasche with fittings

12

cross connections for stabilization between the jacks

13

grounding

14

power strips

15

intensive care bed or stretcher

16

patient

17

lock between intensive rail of the patient support device and equipment carrier

18

Infusionsarm for each three infusion bottles

19

Handrail for infusion pump or syringe pump

20

control panel the electromotive driven jacks

21

room for further Infusion and / or other device

22

cable drum

23

gas outlets

24

Ventilator "Servo-ventilator 300 "shaped operating unit

25

Ventilator "Servo-ventilator 300 "-Patiententeil

26

Compact ventilator

Claims (10)

Intensive care and emergency patient transport system, characterized by the fact that it covers all surveillance and treatment equipment has, with intensive care patients in the intensive care unit and / or the intensive care unit Emergency patient in the emergency room is monitored and treated and him while of internal and / or extra-clinical Transport and at the destination itself (monitor or monitor-pacemaker-defibrillator combination device, ventilator, infusion and syringe pumps, nutritional pump, Drainage systems and other equipment as well as infusion bottles and special food), so that a transport without Interruption, without disconnection of hoses or cables and without use other alternative emergency equipment is feasible and characterized by using every intensive care bed and every stretcher can, without the docking at the head or foot part of the bed or stretchers and without using a separately driven implement carrier, System according to claim 1, characterized in that the equipment carrier in bridge form is designed as a compact unit so that it largely the Function of the intensive rails and ceiling pendulum at the intensive care workstation and use the emergency room as a stand-alone unit or to take over its add-on components, System according to the preceding claims, characterized by that it's like a bridge over head or foot part of the bed / stretcher in an ideal position above the abdomen-pelvis-thigh area the patient is mobile and lockable and after the electromotive hoisting (or mechanical or otherwise) the legs a compact, easy to drive and maneuverable "piggyback" solution forms with the patient support device, System according to the preceding claims, characterized by that docking and undocking without deconnection of hoses and Cables feasible is System according to the preceding claims, characterized by if necessary, to facilitate the docking and undocking over ball roller rails features, System according to the preceding claims, characterized by that the whole system no longer as an intensive care bed and the total width of the system is approx a thousand millimeters (intensive care bed) and about eight hundred millimeters (Stretcher), to allow easy passage through hospital doors, System according to the preceding claims, characterized by that by design the head and chest area of the patient freely accessible for treatment measures can stay System according to the preceding claims, characterized in that the equipment rack includes all the important monitoring and treatment equipment (monitor or monitor-defibrillator combination, ventilator, infusion and syringe pumps, drainage systems and other equipment, infusion bottles and special food and the electrical and gas supply [5 -1 O ₂ and 5-1 compressed air cylinders, gas hoses for connection to wall sockets], infusion holders and intensive rails [for attaching other accessories, eg hose and cable holders]), System according to the preceding claims, characterized by that the equipment cart in his normal standing position next to intensive care bed or stretcher Electromotive (or mechanical or otherwise) height adjustable is, so caregivers and doctors their optimal depending on the eye level Monitoring and operating height can adjust System according to the preceding claims, characterized by that it is designed to work for all types of in-hospital Intensive and emergency patient transport is just as suitable as for out-of-hospital care Transport in an intensive care wagon (ITW).