Method of using a measuring tape for directly determining physical treatment and physiological values

Abstract: A measuring tape (10) has indicia thereon for measuring a patient, the indicia representing increments of a physical treat­ ment or physiological value based upon a correlation between the length of a patient and that value. Drug dosages, tube sizes and medical equipment settings, such as defibrillators, are ex­ amples of the type of values which can correlated to body length and placed on the tape (10). 1

Description: This invention relates to a quick yet nevertheless accurate way of determining therapeutic physical treatment and physiological values. The invention is particularly useful in an emergency, intensive care, or surgical environment where accurate determination of body weight has, in the past, been important in determining proper medical treatment values, such as drug dosages, etc. yet difficult to obtain because time is of the essence and scales are either not available or impractical to use because of the patient's condition. Furthermore, as medical treatment has become more complex, drug dosages have become more critical. Since most drug dosages have been based historically on the body weight of the patient, the physician must first estimate the weight of the patient, then either consult tables to determine the appropriate dosage, or determine the dosage by memory and then multiply dosage times estimated weight for each drug. In either case, the possibility of error is present and in fact increased by the pressure of time and circumstance which often attend emergency medical treatment. However, it has been recognised that in many cases weight is an inaccurate and inappropriate basis on which to determine physical treatment values, such as drug dosages, tube lengths and sizes, medical equipment settings and like patient-related treatment and apparatus. Yet, weight remains the most commonly practised way of determining these values. In many cases, length is a much more appropriate way to determine many physical treatment values. For example, the length of an endotracheal tube is very closely related to the overall length of a patient, whether that patient is underweight, overweight, or of an idea weight. Likewise, it is now known that an obese patient weighing significantly more than a patient of normal weight will certainly not need an increase in the dosage of most drugs proportional to his weight and, in fact, can be dosed to toxic levels in this way. This is because many drugs distribute only in the lean body tissue. Yet, patient treatment values are still most often determined by estimating the patient's weight. FR-A-0 411 334 and US-A-3 531 866 disclose measuring tapes which have indicia thereon which in relation to a certain length of a body indicate treatment parameters or parameters referring to an apparatus. French Patent Specification 411 334 (LASSABLIERE 1910) describes a method of determining the amount of food to be given to an infant using a tape measure, which can be used to measure either the length or chest measurement of the infant. The tape measure has a notation indicating the amount of food - milk is specified - to be given to a child in accordance with the measured length or chest dimension. SUMMARY OF THE INVENTION According to one aspect of the invention there is provided a method of selecting the correct patient treatment values in emergency situations, comprising : measuring the body length of the patient, using a tape having increments (20, 21, 22 ...) of heel-to-crown length, each increment bearing indications of correct drug dosage appropriate to that increment, and predetermined by a co-relation between the measured heel-to-crown height of a patient and a correct drug dosage value, and rapidly selecting the correct drug dosage without the exercise of clinical expertise, calculation or reference to other data sources. According to another aspect of the invention, there is provided a method of selecting the correct patient treatment values in emergency situations, comprising : measuring the body length of the patient using a tape having increments (20, 21, 22 ...) of heel-to-crown length, each increment bearing indications of correct defibrillation technique, the value of which is expressed as an energy measurement appropriate to that increment, and predetermined by a co-relation between the measured heel-to-crown height of the patient and a correct defibrillation technique energy value, and rapidly selecting the correct energy value without the exercise of clinical expertise, calculation or reference to other data sources. According to a third aspect of the invention, there is provided a method of selecting the correct patient treatment values in emergency situations, comprising measuring the body length of the patient using a tape having increments (20, 21, 22 ...) of heel-to-crown length, each increment bearing indications of medical apparatus, the value of which is expressed in apparatus size, appropriate to that increment, and predetermined by a co-relation between the measured heel-to-crown height of a patient and a correct apparatus size, and rapidly selecting the correct apparatus size without the exercise of clinical expertise, calculation or reference to other data sources. In this third aspect of the invention, the apparatus size may be the size of an endotracheal tube. According to a still further aspect of the invention there is provided a method of determining the correct patient treatment values in emergency situations, comprising : measuring the body length of the patient, using a tape having increments (20, 21, 22 ...) of heel-to-crown length, each increment bearing indications of more than one of : drug dosage, defibrillation technique energy value and apparatus size, appropriate to that increment, and predetermined by a co-relation between the measured heel-to-crown height of the patient and drug dosage, energy value and apparatus size, and rapidly selecting more than one of the correct drug dosage, defibrillation technique energy value and apparatus length without the exercise of clinical expertise, calculation or reference to other data. BRIEF DESCRIPTION OF THE DRAWINGS The present invention will be further explained by way of examples with reference to the following drawings in which :- Figure 1 is a perspective view of one embodiment of the measuring tape according to the present invention, Figure 2 is an enlarged fragmentary view of the tape shown in Figure 1 in accordance with one embodiment of the invention, Figure 3 is an enlarged fragmentary view of the tape shown in Figure 1 in accordance with another embodiment of the invention, Figure 4 is a perspective view illustrating the manner of usage of the embodiment shown in Figure 1, Figure 5 is a side elevation view of the measuring tape according to another embodiment of the invention wherein the tape is mounted for use on the side of a stretcher, and Figure 6 is a side elevation view of the measuring tape according to another embodiment of the invention wherein the tape is affixed to the side of a stretcher in its extended form. DESCRIPTION OF THE PREFERRED EMBODIMENT Referring now specifically to the drawing, a measuring tape according to one embodiment of the invention is shown in figure 1 and indicated broadly at reference numeral 10. Tape 10 can be constructed with numerous differing physical characteristics. Preferably, tape 10 comprises a steel-type tape having a cupped cross-section which provides increased rigidity to the tape yet allows flexibility when needed. According to the embodiment shown in Figure 1, the tape is retractably mounted inside an enclosure 11. One end of the tape is connected to a spring return mechanism (not shown). Measuring tape 10 is used by withdrawing the tape from enclosure 11 by means of a ring 12. To retract the tape, a button 13 on top of enclosure 11 is pushed which causes tape 10 to retract into enclosure 11. A belt clip 14 is provided so that the enclosure 11 can be secured to the user's belt or a pocket. Referring now to Figure 2, a view of a portion of measuring tape 10 is shown in more detail. As can be seen, the tape 10 is provided with indicia 20-35. Each indicia represent a length of measuring tape 10 correlated to body weight in kilograms. Accordingly, by measuring the body of the patient from head to tow, the ideal or lean body weight of the patient can be determined directly. By body weight is meant statistics from the National Center for Health Statistics which have been used to plot the statistical relationship between weight and length variables for normally children. The fiftieth percentiles for boys and girls have been averages to make a single table of length-weight relationships. This data has been transposed onto tape 10 which, in accordance with standard medical nomenclature, is marked in one kilogram increments. This information is derived from a standard medical textbook, entitled Nelson Textbook of Paediatrics, 12th Ed. 1979, Library of Congress, Cat.Card No. 81-48409 (W.B. Saunders Company). This information is summarized in Table I, below :- Of course, other weight tables can be used and separate measures can be used for boys and girls. It has been found that correlating weight and length in this manner achieves a much more accurate result than merely visually estimating body weight based upon the overall size of the child--the procedure now commonly followed in emergency rooms. The weight figures used are for "lean", or ideal body weight. Therefore, the measuring tape 10 automatically takes into account that, for example, drug dosage does not increase in direct proportion to an increase in weight. This is desirable since most emergency drug dosages are based on "lean" body weight since drugs do not distribute into fatty tissue at the same rate or to the same extent as into organ and muscle tissue during the time frame of emergency treatment. The term "physical treatment values" is used throughout and has thus far has referred to drug dosages and endotracheal tubes lengths. Many other values can be correlated in the same manner, such as defibrillator settings, catheters, intravenous lines and the like. The term "physiological values" has been used and can refer to, for example, idea weight per unit of length, calorie requirements for a given length, blood pressure parameters and even information concerning when certain levels of growth and development should be attained. The tape can also be used to guide parents in taking children for medical and dental examinations, and when certain steps relating to personal and dental hygiene should be commenced. Referring now to Figure 3, a still more details view of tape 10 is shown, specifically indicia 26-30. Here it can be seen that several items of useful information have been actually reproduced on measuring tape 10. In addition to several commonly prescribed drugs, a defibrillator setting in joules and an endotracheal tube size has been provided for quick reference by an emergency room physician or paramedic. In addition to or in substitution of some or all of the indicia shown in Figure 3, information concerning anaesthesia dosages, antibiotic dosages and twenty-four hour maintenance fluid requirements can be included. In fact, any information which is based on body length or ideal body weight can be placed on measuring tape 10. In addition, measuring tape 10 can be used in a number of different ways. As is shown in Figure 4, the tape can be used as is a conventional measuring tape. That is, the enclosure 11 is placed at one end of the patient and the measuring tape 10 is extended so that the ring 12 of measuring tape 10 is at the other end of the patient. Then, the weight or other weight-correlated information is read directly off of tape 10, as described above. As is shown in Figure 5, enclosure 11 can be mounted at the head or foot end of a stretcher. When a patient is placed on the stretcher, a measurement can be taken by extending measuring tape 10 downwardly along the length of the stretcher to the other end of the body. Another variation of the invention is shown in Figure 6, where a measuring tape 10' is fixed along the length of a stretcher so that a reading can be taken directly without manipulating the tape at all. It is only necessary to make sure that one end of the body is adjacent one end of the tape. The tape 10 has been described above with reference to total heel-to-crown body length. However, the term "body length" as used herein also refers to any body part length or body subsegment length to which a desired value can be correlated.

Claims: A method of selecting the correct patient treatment values in emergency situations, comprising: measuring the body length of the patient, using a tape (10) having increments (20, 21, 22 ...) of heel-to-crown length, each increment bearing indications of correct drug dosage appropriate to that increment, and predetermined by a co-relation between the measured heel-to-crown height of a patient and a correct drug dosage value, and rapidly selecting the correct drug dosage without the exercise of clinical expertise, calculation or reference to other data sources. A method of selecting the correct patient treatment values in emergency situations, comprising: measuring the body length of the patient using a tape (10) having increments (20, 21, 22 ...) of heel-to-crown length, each increment bearing indications of correct defibrillation technique, the value of which is expressed as an energy measurement appropriate to that increment, and predetermined by a co-relation between the measured heel-to-crown height of the patient and a correct defibrillation technique energy value, and rapidly selecting the correct energy value without the exercise of clinical expertise, calculation or reference to other data sources. A method of selecting the correct patient treatment values in emergency situations, comprising: measuring the body length of the patient using a tape (10) having increments (20, 21, 22 ...) of heel-to-crown length, each increment bearing indications of medical apparatus, the value of which is expressed in apparatus size, appropriate to that increment, and predetermined by a co-relation between the measured heel-to-crown height of a patient and a correct apparatus size, and rapidly selecting the correct apparatus size without the exercise of clinical expertise, calculation or reference to other data sources. A method as claimed in Claim 3, in which the apparatus size is the size of an endotracheal tube. A method of determining the correct patient treatment values in emergency situations, comprising: measuring the body length of the patient, using a tape (10) having increments (20, 21, 22 ...) of heel-to-crown length, each increment bearing indications of more than one of: drug dosage, defibrillation technique energy value and apparatus size, appropriate to that increment, and predetermined by a co-relation between the measured heel-to-crown height of the patient and drug dosage, energy value and apparatus size, and rapidly selecting more than one of the correct drug dosage, defibrillation technique energy value and apparatus length without the exercise of clinical expertise, calculation or reference to other data.

Inventors: BROSELOW JAMES B, BROSELOW, JAMES B.
Applicants: BROSELOW JAMES B, BROSELOW, JAMES B.
Application year: 1986
Main classification: A61B5
IPC codes: A61B5, A61B10, G01B3