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WO1992007527A1 - Vetement de contre-pression - Google Patents

Vetement de contre-pression Download PDF

Info

Publication number
WO1992007527A1
WO1992007527A1 PCT/US1991/008142 US9108142W WO9207527A1 WO 1992007527 A1 WO1992007527 A1 WO 1992007527A1 US 9108142 W US9108142 W US 9108142W WO 9207527 A1 WO9207527 A1 WO 9207527A1
Authority
WO
WIPO (PCT)
Prior art keywords
garment
counterpressure
patient
lower torso
section
Prior art date
Application number
PCT/US1991/008142
Other languages
English (en)
Inventor
Francis J. Mccabe
Original Assignee
Mccabe Francis J
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US07/609,170 external-priority patent/US5146932A/en
Priority claimed from US07/607,994 external-priority patent/US5259397A/en
Application filed by Mccabe Francis J filed Critical Mccabe Francis J
Publication of WO1992007527A1 publication Critical patent/WO1992007527A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/30—Pressure pads

Definitions

  • This invention relates generally to body treatment care and specifically to counterpressure garments used in emergency treatment of victims suffering from hypovolemic shock and in the presence of intractable bleeding.
  • Shock is a life threatening condition that results when the body is unable to maintain circulation to the heart, lungs and brain. It may be caused by trauma, blood loss, toxins or other circulatory diminishment.
  • routine shock first-aid of lying the victim prone with the lower extremities raised to move blood to the critical organs, it is also known to apply surface counterpressure to the lower extremities sufficient to overcome the pressure in the capillary and venus system to force increased circulation to the critical organs.
  • Circumferential pneumatic counterpressure (CPC) devices are well known inflatable garments used to apply pressure around the arms, legs and/or abdomen to control intractable bleeding and ameliorate shock. Examples of such devices are described in U.S. Pat. No. 3,933,150 issued January 20, 1976, to Kaplan et al., and U.S. Pat. No. 4,039,039 issued August 2, 1977, to Gottfried.
  • the application of CPC device causes a dramatic rearrangement of the blood circulation within a victim's body. It causes the victim's blood pressure to rise and the volume of blood available to the heart, lungs and head to greatly increase, while the amount of blood in the extremities is decreased.
  • CPC garments Another problem associated with CPC garments is the rapid pressure drop from the accidental puncturing of one or more bladders. A rapid depressurization could be fatal since the victim's blood pressure can decrease by as much as 60 mm HG.
  • Pressurized garments are also susceptible to temperature and atmospheric pressure changes, forcing the ambulance crew to adjust the garment's pressure. For example, if a skier at the top of a mountain is involved in an accident and is placed in a CPC garment, the relative pressure within the garment's bladders will decrease when the skier is brought down to ground level. Outdoor to indoor temperature changes can also raise or lower the relative pressure.
  • the pneumatic pressure fittings are sometimes metallic, a victim normally cannot be x-rayed for possible fractures or have an MRI * taken while in the garment. Further, the garment usually cannot be cut away in selected areas to expose portions of the victims body for treatment, as the cutting would open an air bladder and cause depressurization.
  • the present invention involves a counterpressure garment which utilizes a resilient material, such as elastic material, or a compressible material, such as foam, or both in the legs and abdomen sections and adjustable fasteners to provide the external counterpressure necessary to transfer the blood supply back to the primary organs of a victim suffering from hypovolemic shock and possibly to slow or stop bleeding.
  • the garment further utilizes a locatable abdomen flap containing a compressible foam block to provide appropriately direct counterpressure to the abdomen area.
  • a further advantage is that its pressure is not effected by temperature and atmospheric pressure changes. This independence from temperature and atmospheric pressure also makes this garment suitable for use as a "comfort" garment under Astronauts' space suits, to keep their blood pressure stable.
  • Figure 1 is a perspective view of the inside of a counterpressure garment according to the invention, laid in a flat position.
  • Figure 2 is a perspective view of the outside of the counterpressure garment of Figure 1, laid in a flat position.
  • Figure 3 is a perspective view of a victim laid on the counterpressure garment of Figure 1.
  • Figure 4 is a perspective of a victim enclosed in the counterpressure garment of Figure 1.
  • Figure 5 is a perspective view of the inside of a counterpressure garment having separate pressure engagement means.
  • Figure 6 is a perspective view of the outside of a counterpressure garment having separate pressure engagement means.
  • a counterpressure garment 10 depicted in a flat position in Figures 1 and 2, is adapted to be wrapped about a victim's legs and lower torso to apply external counterpressure to the lower circulatory system, as shown in Figures 3 and 4.
  • a pair of leg sections 12a and 12b are adapted to enclose the victim's legs, while a lower torso section 14 is adapted to enclose the victim's lower torso and abdomen. Between the leg and lower torso sections, the perineal are remains exposed for hypodermic or tube insertion.
  • a center yoke 16 provides a foundation for both the leg and torso sections, and is preferably constructed of a foam core contained inside an impermeable cover for comfort and durability.
  • the leg sections 12a, 12b each include a center elastic band 18a, 18b which is preferably made of a core web of elastic material, such as coarse weave spandex, sandwiched loosely between an inner and outer cover, such as a neoprene cover.
  • the neoprene material is used to allow screening of written directions onto the material and to protect the elastic material from damage and moisture.
  • the neoprene covers are stitched to the edges of the elastic bands and are sufficiently loose to be expandable to a width equivalent to the elastic in a fully stretched condition.
  • the elastic bands 18 have a dumbbell shaped cut-out 20 for the knee area to free the joint for movement.
  • the elastic bands 18 are sewn at one edge to an inner support seam 21 o polypropylene webbing and at their other edge to a similar outer support seam 22.
  • the yoke 16 is sewn to the upper section of the inner support seams 21, as shown in Figure 2.
  • An outer flap 24 is sewn to the outer support seam 22.
  • the flap 24 is contoured to a leg by having a wider upper section 24a for the thigh area, a narrow section 24b for the knee, and an intermediate width section 24c for the calf area.
  • the thigh section 24a and the calf section 24c each have a plurality of evenly spaced horizontal velcro strips 26 sewn to their inside face, as depicted in Figure 1.
  • a pair of molded plastic pull tabs 28, 29 are attached directly to the outer support seam 22, one tab
  • An inner flap 30 is sewn to the inner support seam 21.
  • the flap 30 is similarly contoured to the leg by a wider thigh section 30a, a narrow knee section 30b, and an intermediate width calf section 30c.
  • the flap 30 has a plurality of spaced horizontal velcro strips 32 on it outer face, as shown in Figure 2.
  • the leg sections 12 are thus adapted to be tightly wrapped around the victim's legs by folding the inner flap 30 around the inside of the leg and then pulling the outer flap sections 24c, then 24a, one-at
  • the mating can be made at different overlaps to accommodate various leg thickness while still stretching the elastic bands to provide circumferential compression.
  • the stretched elastic provides the requisite counterpressure to the leg by attempting to contract to its relaxed length, thus compressing the leg on all circumferential sides.
  • the lower leg sections may also be provided with a second set of flaps 25, 31 outside of the flaps 24c and 30c, for the lower calf area, as shown in Figure 2.
  • the flaps 31 have horizontal velcro strips on their outside face, while the flaps 25 have the strips on their inside face, and are mated in the same manner as the flaps 24c and 30c to provide tighter mating over the lower calf and ankle area.
  • the lower torso section 14 has two elastic bands 34a, 34b sewn to a support seam 36 on one side of the yoke 16, and a single elastic band 44 sewn to a support seam 38 on the other side of the yoke.
  • the elastic bands 34a, 34b and 44 each have a convex dumbbell shape and are also made of a elastic core sandwiched in neoprene, similar to the leg flaps.
  • the two elastic bands 34a and 34b each have a support seam 37 supporting an end flap 39 Figure 2, which has a velcro pad 40 sewn on its inside face, as shown in Figure 1, and a hand grip edge binding 46 made by stitching the material edges around a strip of batting cord.
  • a polypropylene pull tab 42 is attached directly to the support seam 37 associated with each of the bands 34a and 34b.
  • the single band 44 terminates against an outer support seam 48 Figure 2, to which is also sewn a fastener flap 50 and a zipper flap 52 Figure 1.
  • the fastener flap 50 has a plurality of spaced horizontal velcro strips 51 covering its outside face, as shown in Figure 2.
  • the zipper flap 52 supports one non-metallic zipper track.
  • the matching non- metallic zipper track is attached to a removable abdomen compress 54, which comprises a compressible foam block 56 enclosed in a neoprene cover.
  • the foam block 56 has a slight pear-shape to correspond roughly with the soft abdomen area between the rib cage.
  • the abdomen compress is normally kept zipped to the garment, and is used whenever direct inward pressure on the abdomen is desired, such as to control suspected intra-abdominal hemorrhage. If direct abdomen pressure is not needed, the compress can be removed by the zipper. An excess of fabric can be used in the abdomen compress to permit sizing adjustments.
  • the zipper flap 52 is located inside from the fastener flap 50, such that the abdomen compress 54 can be placed over the victim's abdomen before the lower torso section 14 is fastened around the victim.
  • the lower torso section 14 is wrapped around the victim by folding flap 50 inward, then pulling the bands 34a and 34b by their pull tabs 42 one-at-a-time around the torso to stretch the elastic, and then mating the velcro pads 40 to the horizontal velcro strips 51, at the overlap necessary to hold the elastic in a stretched condition.
  • a removable stiffener plate or plates can be situated in the lower torso section.
  • the counterpressure garment is laid flat as in Figure 1, and the victim is placed face up on the garment with the tip of the garment below the lowest rib, as shown in Figure 3.
  • Appropriate graphic markings and instructions such as SPINE, LINE, LEFT LEG and RIGHT LEG may be screened onto the neoprene surface to assist in placing the victim.
  • the rescue personnel then kneel by the victim and enclose the legs by pulling the leg flaps to stretch the elastic and mating the velcro strips, as shown in Fig. 4.
  • the calf flap 24c is mated first, then the lower calf flap 25, then the thigh flap 24a.
  • the abdominal compress is placed over the soft abdomen area, and the lower torso flaps are pulled to stretch the elastic and fastened by the velcro strips. If portions of the garment must be cut away to expose area of the victim's body for treatment or insertion, the appropriate area can be marked, the flaps opened and the area cut out with a scissors, then refastened. Since there are no air bladders, cutting away material will not destroy counterpressure by the elastic in the covered areas. As the garment and zipper are all non-metallic, the patient can be x-rayed for fractures or have an MRI taken while in the garment.
  • the garment 10 may be primarily of a compressible material, such as foam.
  • a cloth or fabric is used to cover the foam on both inside and outside faces, making a "sandwich”.
  • the adjustable length fastening means may be the "Velcro" mating strips or pull-straps and buckles although any fastening means can be used to secure the garment, including zippers, buttons, snaps and the like.
  • the selection of the elastic or compressible material is made so that when applying the fastening means, a range of pressure placed upon the material does not significantly effect the counterpressure applied to the victim. For example, if a 35 lb. application to the pull-straps is needed for the required counterpressure, a 30 to 40 lb. application will not bring the counterpressure applied to the victim out of the beneficial range.
  • the beneficial range is the range where the victim benefits from the application of the counterpressure garment, i.e.
  • the counterpressure is not so insignificant such that the application of the garment does not increase the blood supply to the victim's vital organs, and is not so great as to cause further injury to the victim.)
  • the inherent properties of the material eliminate the strength of the attendant as a variable in determining the counterpressure applied to the victim.
  • the number of "Velcro” mating strips or pull-straps is proportional to the counterpressure applied to the victim. A greater number of "Velcro” mating strips or pull-straps decreases the effort needed to achieve an equivalent counterpressure. For example, if two (2) pull-straps are used and the needed counterpressure requires a 30-40 lb. application to set each pull-strap, then by increasing the number of pull-straps to four (4) would decrease the pressure needed to set the pull-straps to 15-20 lbs. each.
  • the fastening means Ilia, 111b is used solely to hold the garment about the victim. A separate variable pressure engagement means is used to set the needed counterpressure.
  • a zipper 114 in each leg section is the preferred type of fastener to be utilized as the variable pressure engagement means, but any fastener which can compress the material and hold it in place can be used.
  • a zipper allows a more gradual increase in counterpressure that either the "Velcro" strips or the pull-straps. This method provides a gradient for controlling the counterpressure, and also helps in eliminating the strength of the attendant who applies the garment, as a variable in setting the counterpressure.
  • Pockets 117 can also be sewn into the exterior of the lower torso section to secure the stiffener plates 116 (See Fig. 6) .
  • Abdomen flaps on the lower torso section allow the counterpressure garment to be adjusted to a particular victim.
  • Leg flaps serve the same purpose.
  • Other sizing adjustments can be made by properly situating the contoured stiffener plate over the victim's stomach. An excess of fabric is designed into the abdomen flap which permits this sizing adjustment. This allows the counterpressure to be applied to the appropriate point of the victim's abdomen.
  • additional fasteners can be placed in the material to aid in sizing each section to the victim. For example, if an additional zipper is used as a sizing means, it can be left open or unzipped when the victim is a large person, and closed or zipped when the victim is smaller. Further, the fastening means can be used to adjust the size for the individual victim, by using wide mating strips of "Velcro".
  • Any section can be used independently from another section by not engaging the pressure engagement means or by providing a detachable interconnecting means between each lower section and the upper section. If a detachable interconnecting means is desired, the greatest flexibility is achieved by using zippers 115, as shown in Figs. 5 and 6. "Velcro" mating strips would also be suitable as a detachable interconnecting means.
  • the structural strength of foam allows the foam counterpressure garment to be used as a splint. For example, if a broken bone, sprain, or torn ligaments are present, the counterpressure garment can be used to restrict movement and provide the necessary support of the affected area.
  • One variation would be to manufacture a suit which utilizes compressible material (e.g., foam) and resilient material (e.g., elastic) in one suit.
  • This combination foam/elastic counterpressure garment may have advantages over a counterpressure suit made of only one of the aforementioned materials.
  • Other variations include adding one or more inflatable bladders to each section, or substituting buttons or snaps as the primary fastener.

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  • Health & Medical Sciences (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Professional, Industrial, Or Sporting Protective Garments (AREA)

Abstract

Vètement de contre-pression (10) utilisé en premier lieu dans le traitement d'une victime souffrant d'un choc hypovolémique. Le vêtement (10) est constitué par un matériau élastique ou compressible tel que de la mousse ou une matière élastique, ou une combinaison des deux, avec un moyen de tension ou de compression du matériau pour atteindre ou s'approcher de sa limite de tension ou de compression et le fixer. Ceci produit la contre-pression nécessaire pour augmenter la circulation sanguine vers les organes vitaux.
PCT/US1991/008142 1990-11-01 1991-10-31 Vetement de contre-pression WO1992007527A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US07/609,170 US5146932A (en) 1990-11-01 1990-11-01 Elastic counterpressure garment
US07/607,994 US5259397A (en) 1990-11-01 1990-11-01 Foam counterpressure garment
US607,994 1990-11-01
US609,170 1990-11-01

Publications (1)

Publication Number Publication Date
WO1992007527A1 true WO1992007527A1 (fr) 1992-05-14

Family

ID=27085641

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1991/008142 WO1992007527A1 (fr) 1990-11-01 1991-10-31 Vetement de contre-pression

Country Status (4)

Country Link
CN (1) CN1063610A (fr)
AU (1) AU9066191A (fr)
MX (1) MX9101872A (fr)
WO (1) WO1992007527A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1993012739A1 (fr) * 1991-12-24 1993-07-08 Second Skin Pty. Ltd. Attelle dynamique assurant la stabilite posturale
DE29807189U1 (de) 1998-04-21 1998-07-02 Brandl, Monika, 48599 Gronau Sicherheitsvorrichtung gegen akuten Blutverlust, in Kleidungsstücke eingearbeitet (Pressursystem)
WO2004019812A2 (fr) 2002-08-30 2004-03-11 Progressive Gaitways, Llc. Vetement elastique et systeme de sanglage destine a favoriser la mobilite, le support et le maintien du corps
US9125787B2 (en) 2011-09-30 2015-09-08 Covidien Lp Compression garment having a foam layer
US9402779B2 (en) 2013-03-11 2016-08-02 Covidien Lp Compression garment with perspiration relief
WO2022195366A1 (fr) * 2021-03-16 2022-09-22 Neures Sp. Z O.O. Combinaison pour compression destinée à être utilisée dans le traitement de troubles neurologiques ou psychiatriques
RU2819993C1 (ru) * 2023-08-07 2024-05-28 федеральное государственное бюджетное образовательное учреждение высшего образования "Башкирский государственный медицинский университет" Министерства здравоохранения Российской Федерации Устройство для наружной компрессии нижней половины тела у пациентов в состоянии гиповолемии

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102781482B (zh) * 2009-11-24 2016-05-18 瑟克艾德医学产品有限公司 用于治疗循环障碍的有刻度压缩装置
US20120078288A1 (en) * 2010-09-29 2012-03-29 Tyco Healthcare Group Lp Compression garment having grip
US8096964B1 (en) * 2010-09-29 2012-01-17 Tyco Healthcare Group Lp Compression garment having grip
CN102283687A (zh) * 2011-07-08 2011-12-21 中国人民解放军军事医学科学院卫生装备研究所 非充气式弹力抗休克复苏治疗服
FR3070835B1 (fr) * 2017-09-11 2019-08-30 Xavier Bouquillard De Milleret Vetement de protection a coussins gonflables ameliore

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3823712A (en) * 1971-08-18 1974-07-16 Aerazur Constr Aeronaut Pneumatic apparatus for holding the posture of paralyzed, diseased, disabled or wounded persons
US3933150A (en) * 1974-02-08 1976-01-20 David Clark Company Incorporated Medical pneumatic trouser for emergency autotransfusion
US3993056A (en) * 1975-01-24 1976-11-23 Institut National De La Sante Et De La Recherche Medicale Orthopaedic appliances
US4276341A (en) * 1979-05-02 1981-06-30 Kabushiki Kaisha Asahi Gomu Wet suit material and wet suit made thereof
US4325148A (en) * 1980-04-23 1982-04-20 Canada Cycle And Motor Company Limited Uniforms for ice hockey players
US4700407A (en) * 1986-06-26 1987-10-20 Sinisalo Sport Oy Protective garment

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3823712A (en) * 1971-08-18 1974-07-16 Aerazur Constr Aeronaut Pneumatic apparatus for holding the posture of paralyzed, diseased, disabled or wounded persons
US3933150A (en) * 1974-02-08 1976-01-20 David Clark Company Incorporated Medical pneumatic trouser for emergency autotransfusion
US3993056A (en) * 1975-01-24 1976-11-23 Institut National De La Sante Et De La Recherche Medicale Orthopaedic appliances
US4276341A (en) * 1979-05-02 1981-06-30 Kabushiki Kaisha Asahi Gomu Wet suit material and wet suit made thereof
US4325148A (en) * 1980-04-23 1982-04-20 Canada Cycle And Motor Company Limited Uniforms for ice hockey players
US4700407A (en) * 1986-06-26 1987-10-20 Sinisalo Sport Oy Protective garment

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1993012739A1 (fr) * 1991-12-24 1993-07-08 Second Skin Pty. Ltd. Attelle dynamique assurant la stabilite posturale
US5582583A (en) * 1991-12-24 1996-12-10 Second Skin Pty Ltd. Dynamic postural stability splint
DE29807189U1 (de) 1998-04-21 1998-07-02 Brandl, Monika, 48599 Gronau Sicherheitsvorrichtung gegen akuten Blutverlust, in Kleidungsstücke eingearbeitet (Pressursystem)
WO2004019812A2 (fr) 2002-08-30 2004-03-11 Progressive Gaitways, Llc. Vetement elastique et systeme de sanglage destine a favoriser la mobilite, le support et le maintien du corps
EP1545372A4 (fr) * 2002-08-30 2008-04-02 Progressive Gaitways Llc Vetement elastique et systeme de sanglage destine a favoriser la mobilite, le support et le maintien du corps
US9125787B2 (en) 2011-09-30 2015-09-08 Covidien Lp Compression garment having a foam layer
US9402779B2 (en) 2013-03-11 2016-08-02 Covidien Lp Compression garment with perspiration relief
WO2022195366A1 (fr) * 2021-03-16 2022-09-22 Neures Sp. Z O.O. Combinaison pour compression destinée à être utilisée dans le traitement de troubles neurologiques ou psychiatriques
RU2819993C1 (ru) * 2023-08-07 2024-05-28 федеральное государственное бюджетное образовательное учреждение высшего образования "Башкирский государственный медицинский университет" Министерства здравоохранения Российской Федерации Устройство для наружной компрессии нижней половины тела у пациентов в состоянии гиповолемии

Also Published As

Publication number Publication date
MX9101872A (es) 1992-07-08
AU9066191A (en) 1992-05-26
CN1063610A (zh) 1992-08-19

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