US2693794A - Medical restraint - Google Patents

Description

1954 J. v. NEVILLE MEDICAL RESTRAINT 3 Sheets- Sheet 1 Filed May 25, 1953 w m g R O; N M M w M d ATTORNEY Nov. 9, 1954 J. v. NEVILLE 2,693,794

MEDICAL RESTRAINT Filed May 25, 1953 3 Sheets-Sheet 2 INVENTOR Jal/N FHA/ON )VA'V/L (E,

ATTORNEY Nov. 9, 1954 Filed May 25, 1953 J. V. NEVILLE MEDICAL RESTRAINT SSheets-Sheet 3 ATTORNEY United States Patent MEDICAL REST-RAINT John Vernon Neville, Columbus, Mont., assignor to The Neville-Robison Company, Duluth, .Minn., a corporation Application May 25, 1953, Serial No. 357,228

8 Claims. (Cl. I28-2.05)

This invention relates to an arm restraining device. More particularly, it relates to a portable brace for holding the arm of a patient and restraining it from harmful movement while administering an intravenous infusion or transfusion.

It is a principal object of the invention to providean improved device of this type which is portable, simple in construction, light in weight, easy to keep clean, and heat in appearance.

It is a further object of the invention to provide such a device which may be detachably secured to a bed rail or the arm of a chair or the like, in such manner as to afford maximum comfort for the patient during the intravenous infusion or transfusion, or other surgical or medical treatment being performed.

A still further object of the invention resides in the provision in such a device of an improved tourniquet. The device is so constructed as to be capable of use with either arm of the patient, and the tourniquet device likewise may be so used.

Another object of the invention resides in the provision in such a device of a combined blood pressure cufl These and many other objects and advantages of the invention will become more apparent from the following specification and claims and the accompanying drawings, in which:

Fig. 1 is a perspective view of the invention showing the device in use;

Fig. 2 is a top plan view of the invention;

Fig. 3 is a side elevationalview of the invention;

Fig. 4 is an end view;

5 is a sectional view taken on the line 55 of 1g.

Fig. 6 is an enlarged sectional view taken on the line 66 of Fig. 5 and looking in the direction of the arrows;

Fig. 7 is an enlarged side elevational view of one end of the device showing the tourniquet;

Fig. 8 is a sectional detail of the tourniquet securing means, taken on even a greater enlarged scale;

Fig. 9 is a side elevational view, on the same scale as Fig. 8, of the part shown in Fig. 8;

Fig. 10 is a transverse section through the same;

Fig. 11 is an enlarged side elevational view of one end of {fthe device as modified to provide a blood pressure cu- Fig. 12 is a. perspective view of the same when in use, and

Fig. 13 is a cross sectional view ofv the same when in use;

In the preferred embodiment of the invention illustrated in the drawings .the device is comprised of a. main support member 10 which preferably is of moldedtransparent plastic material.

For all uses, the device need not be of transparent plastic material. It may be of translucent plastic or plastics which do not permit light to pass therethrough. Ex? amples of suitable plastic or'plastic-like materials which can be employed are Lucite, Plexiglas, Fi-bergl'as, and Durez. In actual embodiments of the invention a rigid transparent plastic material of about one-fourth of an inch in thickness has proved satisfactory.

Light metals such as. aluminum or magnesium can also be used to advantage in some instances.

Preferably,.thematerial;. regardless of its "nature, should be such as: to be capable of withstanding sterilizing temperatures (212 F. for ten minutes should suflice) withrestraining arm strap and I 2,693,794 Patented Nov. 9, 1954 '2 out deformation or other injury thereto. The material should preferably also be able to withstand cold chemical sterilization.

The restraint member 10 basically is in the form of a half-cylinder and is of a length which would extend from the hand of a patient to a point well abovethe elbow and approaching the shoulder. From Figs. '1 and 2 .it will be noted that the forwardend of restraint member 1-0Iis .pro* vided with a cutout 11, and with a transverse cylindrical gripping handle 12. The gripping handle 12 may, like wise, be constructed of the same or different material from that used for the restraint member 10, and may, for ex ample, be in theform of a hollow cylinder and may be secured to the member v10 by means of a headed rod or bolt 13 passing therethroughand through the front end- .portions 14 and 15 of the member 10 and secured by suitable means to clamp the handle to the restraint member.

It is important that the handle 12 be of a diameter of at least about one inch and in actual practice a diameter of one inch or slightly greater has proved to be satisfactory. Where the diameter of the handle is less than substantially one inch, the patient will not feel the handle sufiiciently to grip it securely. From birth there is a natural gripping reflex inherent in or instinctive of manwhich occurs spontaneously even in partial unconsciousness if some stimulus is provided in the palm of'the hand to start the reflex. Thus a newborn infant will gr'asp'an'y thing which touches the hand if it is big enough to hold. The invention makes use of this gripping reflex. The handle 12 gives the hand something to hang on to, giving a sense of security. Additionally, when the hand is clenched, on the handle, the muscles of the forearm squeeze the blood out of the veins in the center of the forearm thus forcing their blood into the veins under the skin. This renders them'more visible, and easier to see and enter with a needle, when the device-is used for in travenous infusions or transfusions, as will be described.

Where the ends of the cylindrical handle 12 are jointed tothe portions 14 and 15 of the front end of the restraint member 10', any suitable adhesive or the like may be-employed so as to render the structure even more rigid;

It will be noted from the drawing figures and particularly from Fig. 1 that the device, in use, is adapted to be detachably secured to the arm 16- of a chair or some other suitable support such as the rail" of a bed, or the rail of a stretcher on which the patient may be carried. This detachable securing feature of the device to the arm rest of a. chair or the like is not essential but is desirable. It may be accomplished simply such as by means of a strap 17 or the like which is passed through two slots 18 (Fig. 2) in the bottom of the restraint member 10. Strap 171's conveniently provided with a buckle 19 ad'aptedto engage any one of a series of holes 20 after the strap has been passed beneath the arm 16 of a chair, or bed rail-or the like. The restraint member 10 may, if desired, be pro vided, nearer its rear end with a second pair of slots 18 which likewise may be used with a strap (not shown) but similar to the strap 17. This securing'mea-ns described is the device illustrated.

blood.

The arm of a patient is' adapted to be held steadiiy within the apparatus, as shown in Fig. l-,- by means of two straps 21 and 22. In accordance with one embodiment of the invention these may be of any suitable'material such as flexible plastic, and they may as shown, eachbe at-- tached to the outside undersurface of the apparatus at 23 and 24 respectively. The wrist strap'21 extends over the wrist of: the patient to the opposite outer" surface-of the support where it is secured thereto by means of the snap fastener 25 or the like. Likewise, the arm strap 22 is adapted to extend over the amt of the patient. to the other side of the support where it may be secured to the outer undersurface' thereof by means of snap'iiasteners'26 and 27, one or more of such fasteners being provided so that the strap is adapted forusewith arms of dilierent dimensions. The purpose of the restrain-ingstraps 2L and" 22 is to keep the arm of the patient in a restrained -posi-- tion without beingtight enoughto' obstruct the -flow of It will be noted that the upper side edges of the restraint member are not straight from front to back. At the rear portion of the member 10 the upper side edges are straight and are parallel to the longitudinal axis of the device. These side edges at the rear are indicated in the drawings by the reference numeral 28. The intermediate section of the member 10 has upper side edges 29 which dip downwardly to some extent from the edges 28 at the rear and then, progressing toward the front of the device. The purpose of having the side edges 29 of the member cut away or lower than the edges 28 is to enable the doctor or nurse to locate a vein on the side of the arm or elbow of the patient. Most veins at the bend of the elbow are about the center of the front aspect of the elbow, but not all. In repeated use of veins they become clotted and not fit for further use, so it becomes necessary to use veins to the side of the elbow. The immobilizer, that is, the restraint member, is thus cut away on both sides to enable a needle to be inserted in these lateral veins without being covered or hidden by the sides of the restraint member. It is thus not necessary to remove the restraint to attack the veins on the side of the elbow. These side edges 29 curve upwardly at 30 and then extend forwardly as at 31 on about the same level as the edges 28. There is then a gradual downward slant to the point 32 which is adjacent the wrist of the patient when the device is being used. The side edges at 32 are turned inwardly to securely and neatly encircle the wrist and prevent withdrawal of the hand.

Mention has been made of the fact that the device incorporates a special improved type of tourniquet. This tourniquet is comprised of a hollow rubber tube 33, one end of which is passed through an opening 34 in the bottom of the restraint member 10 near the rear end of the restraint member. The hole 34 is positioned at a point which is upwardly of the elbow of the patient when the apparatus is worn. With reference to Figs. 6 and 7, it will be noted that the end 35 of the tube 33 is prevented from being pulled through the hole 34 by the very simple and effective expedient of inserting in the end of the rubber tube a small object 36 such as a rivet or the like, which is indicated in dotted outline in,

Fig. 6.

The rubber tube 33 when used as a tourniquet as shown in Fig. 1, is adapted then to be passed around the arm of the patient, in either direction as desired, pulled to a stretched condition and then secured in stretched position (so as to act as a tourniquet) by securing it to either of the two fastening elements 37, 38. In Fig. 1

the tube 33 is shown as secured to the fastening element r 38. These fastening elements 37 and 38 are identical in construction and the description of one of them, 38, should thus suflice. Conveniently, it may be comprised of a rectangular block member secured to the outer surface of the restraint member 10 by a suitable adhesive or formed integral with the support member. As will be noted perhaps best from Figs. 7, 8, 9 and 10, the element 38 is provided with a cutout slot or groove 39 (Figs. 9 and 10) which may be of substantially circular cross section at the top and bottom of the element 38, but which narrows as at 40 at the intermediate portion.

It is realized, of course, that as the tube 33 has been tightly drawn over the arm of the patient, the free end 41 of the tube 33 changes its cross-sectional dimensions because it is stretched. While it is under tension, and with its reduced dimensions, it may be slipped into the cutout slot or groove 39 in the element 38. When it is then released, and tends to assume its normal dimensions, it will become lodged in the groove 39 which compresses it sufficiently to anchor it against any slippage. The tourniquet tube can be released only simply by again pulling on the free end 41 thereof to distort this end of the tube by stretching it to the point that its cross-sectional dimensions are such that it may he slipped out of the groove 39.

It has been indicated that the upper arm restraining strap 22 is adjustable. Instead of, or in addition to, the form of strap 22 referred to, a wrap-around cuff of the type which is employed with a sphygmomanometer for taking blood pressure. Such an arrangement has been illustrated in Figs. 11, 12 and 13. It may consist of an inflatable rubber bag 42 surrounded by a strap 43 of cloth or the like which passes over the arm of the patient. It may be removably "secured in operative position by means of snap fasteners the invention may provide 4 44, or the like. The rest of the apparatus which is of the aneroid type and which is shown here only diagrammatically, is comprised of a rubber tube 45 connected to the inflatable rubber bag 42 and leading to an air gauge 46 and then through a check valve 47 controlled by a release valve 48, to an air bulb 49 or other source of air under pressure. In taking the blood pressure, the rubber bag is placed over the brachial artery above the bend of the elbow, secured by the band wound around the arm and inflated by means of the rubber bulb. Pressure is thus applied'to the cuff and the artery is compressed until the pressure in the bag just balances the pressure in the artery or until the point is reached when blood can no longer pass through the artery. This point is determined by listening with a stethoscope placed over the artery below the constriction. The operation involves pumping up until too much pressure is applied, then slowly releasing pressur The reading on the guage at which the first pulse is heard is the systolic pressure of the arterial system. v

In addition to performing its usual function of registering the blood pressure, the cuff may be used, either in place of, or together with, the tourniquet device for the veins in the arm to become disthe insertion of a transfusion or 50 such as illustrated in the purpose of causing tended preparatory to intravenous feeding needle Fig. 1.

Some of the various uses of the device have already been indicated. It will be noted that, particularly in connection with intravenous feeding which requires two to three hours, to permit the intravenous fluid to enter the circulation, the use of this retrainer renders it unnecessary for a nurse to stand idly by with only the duty of keeping the patient from moving the arm. With this restrainer there is the grapsing handle to facilitate the distention of the veins, the tourniquet to make the veins stand out, with its great advantage of easy release after the needle is inserted. If desired, the blood pressure cuff arrangement can be used so that the blood pressure of the patient can be checked. The elbow is kept straight by the restraining straps, and since the device can be secured either to a tray at the. side of an operating table or to the bed frame, the patient can be safely left to receive the fluid.

'T he advantages of the restrainer when used at a blood donor center should now be evident.

It will be noted that whether the device be used just as an arm restraint for blood transfusions or intravenous feeding, as a blood pressure device, or as a tourniquet, it possesses all of the necessary requirements. Moreover, being light in weight, it is portable and convenient to handle and may be used any place such as when the patient is on a stretcher, a bed, in a chair or even when the patient is standing. When of transparent plastic, all parts of the patients arm may be watched at all times. The surfaces of the device are smooth and the material is such that a clean and sterile condition may be easily maintained.

The dimensions and contours of the device are such as to enable the patients arm to be comfortable even though movement thereof is restrained, except for the grasping movement of the hand which is desirable for some types of operations, but even here the remainder of the arm is held quite firmly. For the uses described it is not desired to hold the arm completely and perfectly immobile. A device which would be.placed about the arm completely and tightly enough to immobilize would cause injury to the part so immobilized by the unconscious struggling of an anesthetized patient. A certain degree of motion is therefore preferable for protection purposes, but not too much.

The adaptability of the device for various surgical or medical treatments is one of its important features. Other possibilities of use of the various parts .of the device, in different combinations, will now be apparent to doctors and others who have use for apparatus of this general type.

In a general manner, while I have, in the above description, disclosed what I deem to be the practical and efficient embodiment of my invention, it should be well understood that I do not wish to be limited thereto and that there might be changes made in the arrangement, disposition and form of the parts without departing from the principle of the present invention as compreheiided withinthe-s'cope ciftheaecompaiiying ela'i'ms.

"1. A portable brace for restrainingfmovement "of-fa persons arm duringrnedical onsurgi'eal "trfe'atm'ent ch as during intravenous feed? g-"throughan arm iveli l, fsard bracecom'prising a main restraint 'erfbfngrdfin'aterial substantially semi-cylindricalin form; and of a diameter sufiicient to receive and to hold "at "least the back and side portions of the arm of apatient, leaving the inners'urfaces of the wrist, forearm 'nd'upper'arm exposed, saidt 'r'es'tr'aint member'being'ofj a length to extend from the hand to a point above the elbow, a transverse cylindrical handle at the front end of the restraint member "and positioned "to be grasped by the hand of the patientw'hose'armis h'eld'in said restraint member, said restraint 'rnerrilie'r"'l'ia'w'ling a substantially U-shaped cutout in its underside to provide space for the k'r'nikles and back of the -p'at "ntjs hand, a-forward restraining stra'p "secured "at"on'e "end to one side of the restraint member in the vicinity of the wrist retaining portion, and arm restraining strap secured at one end to one side of the restraint member near the upper end of the restraint member, and means for detachably securing the other ends of said straps to said restraint member after the straps have been passed across the arm of a patient.

2. A portable brace for restraining movement of a persons arm during medical or surgical treatment such as during intravenous feeding through an arm vein, said brace comprising a main restraint member of rigid material substantially semi-cylindrical in form and of a diameter sufiicient to receive and to hold at least the back and side portions of the arm of a patient, leaving the inner surfaces of the wrist, forearm and upper arm exposed, said restraint member being of a length to extend from the hand to a point above the elbow, a transverse grasping handle at the front end of the restraint member and positioned to be grasped by the hand of the patient whose arm is held in said restraint member, said restraint member having a substantially U-shaped cutout in its underside to provide space for the knuckles and back of the patients hand, a forward restraining strap secured at one end to one side of the restraint member in the vicinity of the wrist retaining portion of the restraint member, an arm restraining strap secured at one end to one side of the restraint member near the upper end of the restraint member, means for detachably securing the other ends of said straps to said restraint member after the straps have been passed across the arm of a patient, a tourniquet member secured at one end to restraint member disposed in the vicinity of the upper restraining strap, and means integrally secured to said restraint member for releasably engaging the free end of said tourniquet member.

3. A portable brace for restraining movement of a persons arm during medical or surgical treatment such as during intravenous feeding through an arm vein, said brace comprising a main restraint member of rigid material substantially semi-cylindrical in form and of a diameter suflicient to receive and to hold at least the back and side portions of the arm of a patient, leaving the inner surfaces of the wrist, forearm and upper arm exposed, said restraint member being of a length to extend from the hand to a point above the elbow, a transverse cylindrical grasping handle at the front end of the restraint member and positioned to be grasped by the hand of the patient whose arm is held in said restraint member, said restraint member having a substantially U-shaped cutout in its underside to provide space for the knuckles and back of the patients hand, a forward restraining strap secured at one end to one side of the restraint member in the vicinity of the wrist retaining portion, the upper side edges of the wrist retaining portion of said restraint member being turned inwardly, an arm restraining strap secured at one end to one side of the restraint member near the upper end of the restraint member, means for detachably securing the other ends of said straps to said restraint member after the straps have been passed across the arm of a patient, a tourniquet member disposed in the vicinity of the upper restraining strap, said tourniquet member being secured to the restraint member centrally thereof and extending inwardly thereof so as to pass around the arm in either direction, and means on both sides of said restraint member on the outer surfaces thereof for '6 releasably seciiring 'the ffee end' bf the toiifiiiqtiet hiember in operative position.

L-A 'por'tabl'e brace for "rest'r'ainin' persons arm during medical {or s ltreatmeri ch as during intravenous feeding th ugh anaim \feitn sai'd brace comprising 'a *fnain re'str'aifititier'nber "or -rigid material substantially 'semi-cyli drical *in ftirm and "'of a diameter su'flici'e'nt to 'receii'r'e '-a"1id"'to' hold -at 'le'astf' the back and side portions of the armwrwpatieat, leaving the inn'er surfaces of the w1ist,-=for'earh1 and upper arm exposed, said restraint "member fb'eing-df a length to extend from the hand to a 'pdintabovefth'e elbow, :a transverse cylindricalgrasping ha'ndle atfthe 'frdnf" rid of the restraint {member and f p'ositidned to b'e grasped by'the ha'nd of 'the patient w ose arm is held "in "said restraint member, said restraint member having "a substantially u-shaped utout in fits u aers-iae to "provide space for thefknu'ckles and back"of"th"eipaltieiltls hand, a forward restraining strapsecured at (the end *to one side of the restraint member in the vicinity of the wrist retaining portion, means for detachably securing the other end of said strap to said restraint member after the strap has been passed across the arm of a patient, an arm restraining strap secured at one end to said restraint member near the upper end thereof, said last-named restraining strap being in the form of a syhygmomanometer cuff.

5. A portable brace for restraining movement of a persons arm during medical or surgical treatment such as during intravenous feeding through an arm vein, said brace comprising a main restraint member of rigid mate r1al substantially semi-cylindrical in form and of a diameter sufiicient to receive and to hold at least the back and side portions of the arm of a patient from movement, leaving the inner surfaces of the wrist, forearm and upper arm exposed, said restraint member being of a length to extend from the hand to a point above the elbow, a transverse cylindrical grasping handle at the front end of the restraint member and positioned to be grasped by the hand of the patient whose arm is held in said restraint member, said restraint member having a substantially U-shaped cutout in its underside to provide space for the knuckles and back of the patients hand, a forward restraining strap secured at one end to one side of the restraint member near the upper end of the restraint member, and means for detachably securing the other ends of said straps to said restraint member after the straps have been passed across the arm of a patient, and means attached to the bottom of said restraint member for detachably securing said restraint member to a bed rail or the like.

6. A portable brace for restraining movement of a persons arm during medical or surgical treatment such as during intravenous feeding through an arm vein, said brace comprising a main restraint member of rigid transparent plastic substantially semi-cylindrical in form and of a diameter sufficient to receive and to hold at least the back and side portions of the arm of a patient, leaving the inner surfaces of the wrist, forearm and upper arm exposed, said restraint member being of a length to extend from the hand to a point above the elbow, a transverse cylindrical grasping handle at the front end of the restraint member and positioned to be grasped by the hand of the patient whose arm is held in said restraining member, said restraint member having a substantially U-shaped cutout in its underside to provide space for the knuckles and back of the patients hand, a forward restraining strap secured at one end to one side of the restraint member in the vicinity of the upper edges of said Wrist retaining portion of said restraint member being turned inwardly, an arm restraining strap secured at one end to one side of the restraint member near the upper end of the restraint member, means for detachably securing the other ends of said straps to said restraint member after the straps have been passed across the arm of a patient, the side edges of the intermediate portion of the restraint member, in the vicinity of the elbow of a patient whose arm is held in said restraint being substantially lower than the adjacent side edges of the restraint member.

7. A tourniquet comprising a rigid trough-like member having a portion adapted to receive at least a part of a limb of a person, a flexible rubber tube, means for securing one end of said tube to said member at a point at the bottom of said trough-like member, means for securing the free end of said tube selectively at points on either outer side of said member, said means each comprising a part having a longitudinal undercut groove, the opening to said groove being narrower at the central portion than at the ends and being of such dimensions as to permit no movement of the tube therein when the tube at that point is of normal cross section, and entry and removal of a portion of the tube therein only when the cross section of said portion has been reduced temporarily by stretching the same.

8. A cuff for a sphygmomanometer device, comprising, a trough-like member of rigid, lightweight material, substantially semi-cylindrical in form and of a diameter sufficient to receive and to hold at least the back and side portions of the arm of a patient, leaving the inner surfaces of the wrist, forearm and upper arm exposed, said member being of a length to extend from the hand to a point above the elbow, a transverse cylindrical grasping handle at the front end of said member and positioned to be grasped by the hand of a patient whose arm is held in said member, said member having a substantially U-shaped cutout in its underside to provide space for the knuckles and back of the patients hand at all times, arm restraining strap means near the forward end of said member and a sphygmomanometer cull clement secured to the sides of the trough-like member near its upper end so that the same may be passed over a patients arm when the same is held in said member.

References Cited in the file of this patent UNITED STATES PATENTS Number Name Date 2,266,230 Mazzeo et al. Dec. 16, 1941 2,551,617 Maybert May 8, 1951 FOREIGN PATENTS Number Country Date 253,311 Germany Mar. 23, 1912 .n-m n my. I

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