Spine immobilization apparatus

A spine immobilization method and apparatus are provided which make use of a normally flat, flexible bladder filled with beads or micro-balloons that form a rigid mass when the pressure within the bladder is decreased below ambient through the use of a suction pump so that the bladder can be conformed to the torso of the victim and provide the desired restraint. The bladder is strapped to the victim prior to being rigidified by an arrangement of straps which avoid the stomach area. The bladder is adapted to be secured to a rigid support, i.e., a rescue chair, so as to enable removal of a victim after the bladder has been made rigid. A double sealing connector is used to connect the bladder to the suction pump and a control valve is employed to vary the pressure within the bladder so as to soften and harden the bladder as desired.

CROSS REFERENCE TO RELATED APPLICATION 
This application discloses subject matter in common with currently filed, 
copending application Ser. No. 057,465 entitled PRESSURE CONTROL VALVE. 
FIELD OF THE INVENTION 
The present invention relates to a method an apparatus for immobilizing the 
spine of a patient. 
BACKGROUND OF THE INVENTION 
Since the spinal cord is the connecting pathway for most mechanisms of the 
body's various organs, injury to it can cause dysfunction in almost all 
biological systems. Spinal cord injuries are calmitous, not only 
physically but psychosocially and financially. Approximately 10,000 to 
12,000 new spinal cord injuries occur each year in the United States. In 
spite of advances in methods and appliances designed for the protection of 
the cord in spinal injuries, there are still too many patients able to 
move their extremities shortly after the accident who suffer irrepairable 
damage to the spinal cord through attempts that are made to move the 
patient from the scene of the accident to the hospital. 
There are a number of techniques for the transport or removal of an 
accident victim suspected of having a spinal injury. For example, some of 
these techniques are described in Fire Service First Aid Practices, Fifth 
Edition, Oklahoma State University; Krueger et al., "Transportation and 
First Aid in Patients with Spinal Cord Injuries", New York State Journal 
of Medicine, Vol. 63, pp. 682-690, March 1963. In general, the techniques 
involve providing appropriate support for the body before any lifting 
takes place. An example of such a technique concerns the use of a spine 
board to which the victim is strapped (see the Fire Services First Aid 
Practices publication). Reference is also made to U.S. Pat. Nos. 4,034,748 
(Winner) and 3,737,923 (Prolo). 
As explained hereinbelow, the present invention utilizes a flexible bladder 
which is constructed so that it can be made rigid, and thereby conform to 
the shape of the victim, under the control of the user. In a specific 
embodiment, the bladder is filled with a plurality of so-called 
"microballoons" or spheres which form a rigid mass when the pressure 
within the bladder is less than ambient. A number of patents disclose 
devices of this type. One example is U.S. Pat. No. 3,212,497 (Dickinson) 
which discloses a moldable temporary splint comprising a flexible bag 
containing particles which consolidate into a rigid mass when the bag is 
evacuated. Two patents which employ this technique in restraining or 
immobilizing a patient are U.S. Pat. No. 3,762,404 (Sakita) and U.S. Pat. 
No. 3,745,998 (Rose). The Sakita patent discloses a "positioning aid" for 
immobilizing a part of the body of a medical patient which comprises an 
airtight bag filled with beads which form a rigid mass when the vacuum in 
the bag is destroyed by opening a self-closing valve. In certain 
embodiments, the bag is used to support the torso. The Rose patent 
discloses a somewhat similar vacuum-formed "support structure and 
immobilization device." A further patent of interest is U.S. Pat. No. 
4,024,861 (Vincent) which discloses a spinal support in the form of an 
inflatable bag to which the victim is secured by straps so as to 
immobilize his spine during movement. Reference is also made to U.S. Pat. 
No. 3,415,243 (Sheldon) which discloses a surgical cast that includes a 
plurality of reagents which are reactive when intermixed to form a 
hardenable cast material and which are imbedded in surgical gauze. Rupture 
of an encapsulation for one of the reagents enables mixing of the 
reagents. 
SUMMARY OF THE INVENTION 
As was discussed briefly hereinabove, in accordance with the present 
invention, a spine immobilization method and apparatus are provided which 
makes use of rigidifiable bladder construction which is broadly similar to 
those described previously. The bladder construction is specifically 
adapted for use in immobilizing the spine of an accident victim and, as 
will become apparent, possesses a number of advantages over the general 
purpose support or immobilization devices of the prior art. The method and 
apparatus of the invention enable the spine of such an accident victim to 
be immobilized and restrained from movement in a very rapid, efficient 
manner and permit the victim to be safely removed from the accident scene 
in an extremely short time after help arrives. 
According to a preferred embodiment thereof, the spine immobilization 
apparatus of the invention comprises a normally flat, flexible bladder 
including means contained therein (such as the microballoons referred to 
above) for causing the bladder to become rigid in response to a change in 
the internal pressure within the bladder. The bladder includes a head 
portion and a body portion adapted to conform to the head and torso of a 
patient whose spine is to be immobilized. The spine of the wearer is 
immobilized when the bladder becomes rigid. The apparatus also includes an 
inlet/outlet device for connecting the interior of said bladder to a 
pressure source, preferably in the form of a vacuum pump, as well as a 
securing or positioning arrangement for securing said bladder in position 
on the patient and for assisting in securing said bladder to a rigid 
support for enabling the patient to be transported. 
The securing arrangement preferably comprises a first pair of straps which 
cross one another over the chest of the patient above the stomach region 
and a further pair of straps which engage a lower portion of the torso 
beneath the stomach region, so that the stomach region is kept free of any 
restraining forces. This is important in that the stomach muscles are 
required in breathing under these circumstances and any restraint on the 
stomach and hence on breathing could be detrimental to the health of the 
patient. Advantageously, a forehead strap arrangement and a chin strap 
arrangement are also provided, the forehead strap arrangement comprising a 
pair of straps one of which includes a hook pile fastener and the other of 
which includes a loop pile fastener, thereby enabling ready connection and 
disconnection. 
The rigid support preferably comprises a conventional collapsible rescue 
chair and the securing arrangement of the apparatus also comprises a 
plurality of straps for securing the bladder to the chair. 
The flexible bladder further comprises filter means for filtering air 
passing into the bladder and for preventing the microballoons contained in 
the bladder from escaping from the bladder. As noted, the pressure source 
preferably comprises a vacuum pump which produces a subatmospheric 
pressure within the bladder; the apparatus also includes a suitable 
connection means e.g., a connecting line formed from rubber tubing, for 
connecting the bladder to the pump as well as a self-sealing connector 
between the bladder and pump for retaining the negative pressure within 
the bladder when the connection to the vacuum pump is broken by 
disconnecting the connector. A control valve disposed in the connecting 
line controls the air admitted into and released from bladder so as to 
control rigidification, i.e., hardening and softening of the bladder. 
In the use of the bladder in removing an accident victim having a possible 
spinal injury from the accident scene, the bladder is applied to the back 
of the torso of the victim so as to conform the shape of the bladder to 
the shape of the torso of the victim; suction is applied to the bladder to 
rigidify the bladder and to thereby immobilize the spine, the rigidified 
bladder is then secured to a rigid support which permits the victim to be 
transported; and the victim is thereafter transported from the accident 
scene using the rigid support. 
The step of conforming of the shape of the bladder to the shape of the 
torso of the victim preferably includes an intermediate step of reducing 
the suction applied to the bladder so as to soften the bladder when the 
latter has been previously rigidified to thereby permit the bladder to be 
more closely fit to the shape of the torso of the victim. Filler material, 
formed, e.g., by blankets rolled to form wedges, is inserted in the space 
which exists between the bladder and the rigid support in the area of the 
back. 
Other features and advantages of the present invention are set forth in or 
apparent from the detailed description of a preferred embodiment of the 
invention found hereinbelow.

DESCRIPTION OF A PREFERRED EMBODIMENT 
Referring to FIG. 1, there is shown a plan view of the back side of the 
bladder and strapping assembly of the spine immobilization apparatus of 
the present invention. The bladder and strapping assembly, which is 
generally denoted 10, includes a flat bladder portion or bladder 12 which 
is preferably fabricated of a tough, flexible, resilient airtight 
material. Suitable plastic materials are manufactured by Stevens 
Elastomeric and Plastic Products, Inc., Easthampton, Mass., under the 
trade name of Urethane Film. A first Urethane Film includes urethane and a 
polyester whereas a second Urethane Film includes urethane and a 
polyether. Also, bladder 12 may comprise a fabric coated with an 
elastomeric material such as neoprene. 
The bladder 12 includes a head portion 12a to which is attached a first 
pair of straps or webbings 14 and 16 which serve as forehead straps. Strap 
14 is attached, such as by sewing, to a doubler 14a which is bonded to the 
bladder 12. Strap 14 has secured thereto one half of a releasable fastener 
such as a well-known "Velcro" fastener comprising releasably interlocking 
loop and hook piles. In the exemplary embodiment under consideration, a 
loop pile 14b is attached to the near face of strap 14. Similarly, strap 
16 is attached to a doubler 16a and has a hook pile secured to the far 
(non-illustrated) face thereof. A further loop pile 18 is attached to a 
doubler 18a bonded to head portion 12a of bladder 12 so as to face 
forwardly or outwardly from the plane of the drawing below strap 14 and a 
further hook pile 20b is attached to the far side of a further strap 20 
secured to a further doubler 20a bonded to bladder 12. Strap 20 
constitutes a chin strap for the bladder 12. 
A pair of slots 22 and 24 located between the head portion 12a of bladder 
12 and a body portion 12b permit separate folding of the sides of the head 
portion 12a around the head of a victim. 
The body portion 12b of bladder 12 includes a further pair of doublers 25 
and 28 bonded thereto. Doubler 26 has three webbing anchors 26a, 26b and 
26c sewn thereto, three steel D-rings, respectively denoted 26aa, 26bb, 
26cc being attached to individual ones of the anchors, as illustrated. 
Similarly, doubler 28 has three webbing anchors 28a, 28b and 28c sewn 
thereto, with D-rings 28aa, 28bb and 28cc attached to these anchors. 
A further pair of strap or webbing assemblies 30 and 32 are secured to the 
top of body portion 12b adjacent to the slots 22 and 24, respectively. The 
strap assemblies 30 and 32 are substantially indentical and need not be 
described separately. Thus, as shown in FIG. 2, strap assembly 30 
comprises a doubler 30a to which is attached a webbing anchor 30b which 
carries a pair of D-rings, only one of which, denoted 30bb, is shown. An 
elongate strap 30c is sewn to doubler 30a. In the partial showing of strap 
assembly 32 in FIG. 1, a corresponding webbing anchor 32b and D-ring 32bb 
are illustrated. 
A further strap or webbing assembly 34 is located at the bottom of bladder 
12. Strap assembly 34 comprises a doubler 32a having a pair of straps 34c 
and 34d sewn thereto. 
An aperture 36 located in bladder 12 adjacent to doubler 26 cooperates with 
a filter assembly (not shown in FIG. 1) to provide deflation of bladder 12 
in a manner described below in connection with FIG. 3. 
Before considering the bladder deflation system shown in FIG. 3, reference 
will be made to FIG. 4 where the flat bladder of FIGS. 1 and 2 is shown in 
the operative position thereof, i.e., as attached to an accident victim. 
As illustrated, the head portion 12a wraps around the head of the victim 
with straps 14 and 16 being secured together by the "Velcro" fasteners 
around the forehead and strap 20 connected to "Velcro" pile 18 beneath the 
chin. Strap 30c of strap assembly 30 extends diagonally across the chest 
and is secured to the D-ring 28aa of upper webbing anchor 28a while strap 
32c extends diagonally across the chest in the opposite direction and is 
secured to the D-ring 26aa of the other upper webbing anchor 26a. 
Similarly, strap 34c extends from the rear of bladder 12 between the legs 
of the victim and is secured to D-ring 26cc of lower webbing anchor 26c 
while strap 34b also extends between the legs of the victim and is secured 
to the D-ring 28cc of the other lower webbing anchor 28c. It is important 
to note that the upper and lower straps 30c, 32c, and 34b, 34c do not 
enage the stomach region of the patient because an individual with a 
spinal injury utilizes the stomach muscles to breath and thus any 
restrictions in this region should be avoided. 
Referring to FIG. 3, the bladder assembly of the present invention is shown 
in the "inflated" state thereof. FIG. 3 is a highly diagrammatic view with 
the straps omitted and the torso of the victim, denoted T, facing towards 
the bottom of the drawing. As explained hereinabove, the bladder 12 is 
filled with very fine microballoons (not specifically shown but indicated 
schematically at 38). Suitable microballoons are sold by Emerson & Cuming, 
Inc., Canton, Mass. The "hydrospace" grade microballoon is preferred 
because of its resistance to moisture absorption. When air is withdrawn 
from the bladder 12, the microballoons form a rigid, concrete-like mass. 
In FIG. 3, a portion of the microballoon filled bladder 12 is shown in 
engagement with the torso T of the accident victim. A filter unit 40 
mounted in opening 36 (FIG. 1) in the bladder 12 includes a filter 42, a 
filter protector ring or annulus 44 having a plurality of equispaced holes 
in the wall thereof and a circular disc-like filter adapter plate 46. 
Filter 42 may comprise a Toyota fuel filter No. RE-165. Adapter plate 46 
is connected to screws 48 to protector ring 44 and plate 46 includes an 
inlet nipple 46a adapted to be attached to a length of tubing or hose 50 
through which suction is applied. An adjustment valve 52 is included in 
the connection tubing 50 which provides a controlled amount of inlet air 
so as to permit variation of the evacuation rate. In this way, a paramedic 
can reversibly soften and harden the microballoons 38 which are contained 
within the bladder 12 and thereby soften and harden the "conformal 
blanket" formed by the bladder 12 so as to best fit the patient. A 
conventional quick-disconnect coupling 54 is employed which is of the type 
that will provide double shut-off to maintain the vacuum on both sides of 
the coupling 54 and thus valve 52 is also used to provide inlet air so as 
to soften bladder 12 when the latter has been made rigid due to prior 
vacuum pumping. The valve 52 is the subject of commonly assigned, 
concurrent filed patent application Ser. No. 057,465, entitled PRESSURE 
CONTROL VALVE. 
A conventional vacuum pump 56, powered by power supply 51, is connected to 
the socket of coupling 54 through a further length of tubing 58. A 12-volt 
d.c. pump is preferred. A power supply for such a pump is readily 
available on ambulances or fire trucks. Where 115VAC, 60 Hz power supply 
is available, pump 56 may be a diagram vacuum pump Model 2017 CA18 
manufactured by Thomas Industries of Sheboygan, Wis. 
Referring to FIG. 6, the use of the spine immobilization apparatus of the 
invention is illustrated. As shown in FIG. 6, an accident victim V is 
viewed through the doorway of a sub-compact car A and is slumped over the 
wheel with his head rammed into the windshield W. The position of the 
victim illustrated is, of course, typical for many types of collisions. 
Today there are many tools commercially available that are suited for 
accident rescue use that enable an operator to quickly cut or burn through 
an accident vehicle skin and remove sections that impede rescue of a 
vehicle occupant. The bladder assembly of the invention is used in 
connection with an articulated rescue chair 60. The rescue chair may be a 
"Ferno-Washington" No. EM5-585-4357 which is manufactured under one or 
more of the following patents: U.S. Pat. Nos. 3,122,758; 3,057,655; 
3,289,219; 3,637,232; 3,684,307; 3,088,770; 2,877,047; 3,498,698; 
2,747,919; 2,958,873; 2,841,438; 3,380,085; 3,644,944; and 3,752,527. It 
will thus be understood that the rescue chair 60 is a commercially 
available device and the construction thereof forms no part of the present 
invention. The rescue chair 60 comprises four snap together pieces, viz. 
two back pieces and two buttocks pieces, which form the back support 
portion 62 and buttocks support portion 64. The latter includes a small 
metal buttocks support plate 64a. The angle .alpha. between the back 
portion 62 buttocks support portion and 64 can be adjusted and a knob 66 
locks the angle chosen. 
In order to immobilize the spine of the victim V, bladder assembly 10 is 
slipped behind his back and the straps 14, 16, 20, 30c and 32c are engaged 
as described above in connection with FIG. 4 so that straps 14 and 16 are 
closed together at the forehead, strap 20 is engaged with fastener 18 
beneath the chin and straps 30c and 30d criss-cross over the chest. Vacuum 
pump 56 is then connected to the filter assembly 40 including filter 
support plate 46 so that a vacuum can be applied to the microballoons 38 
within bladder 12. As the air is withdrawn from bladder 12 through 
inlet/outlet 46a, the microballoons 38 form a rigid, concrete-like mass as 
described hereinabove. As also was mentioned, valve 52 can be used to 
control the entry and outgo of air so that the bladder can be softened in 
order to best fit the same to the torso of the victim. 
After the spine of the victim has been immobilized, the bladder assembly 10 
is attached to the rescue chair 60. The bladder assembly is connected to 
the rescue chair 60 by means of a pair of straps or webbings 70 (one of 
which is shown) which attach to each side of an upper portion of the back 
portion 62 of chair 60 and to the D-rings 30bb and 32bb of the bladder 
assembly 12, one such strap 70 being visible in FIG. 6. In addition, a 
further pair of straps 72 (one of which is shown) connect D-rings 28bb and 
26bb to a lower part of the back portion 62 of rescue chair 60. Loose 
webbing straps 34b and 34c form a lap belt suitable to the victim. The 
rescue chair 60 is slipped into position with as little movement of the 
patient as possible, although it will be appreciated that the use of 
bladder assembly 10 greatly decreases the risk of movement by immobilizing 
the spine. In order to fill the space between the back of the victim V and 
the back portion 62 of chair 60, a pair of simple cloth wedges 74 and 76 
are inserted in this space. These wedges are preferably formed by blankets 
or the like which are compactly rolled to achieve the wedge shape. With 
the wedges 74, 76 in place and all straps suitably adjusted, the victim 
can be removed from the automobile through prescribed manipulation of the 
rescue chair 60. 
Although the invention has been described in detail with respect to an 
exemplary embodiment thereof, it will be understood by those of ordinary 
skill in the art that variations and modifications may be effected within 
the scope and spirit of the invention.