Abstract:
Bariatric gurney and process including a winch mounted in an ambulance for pulling the gurney up removable rails. The gurney includes extenders for increasing the patient support surface of the gurney and may include a removable patient safety bar.

Description:
[0001]     This application claims the benefit of priority to U.S. provisional patent application Ser. No. 60/419,499, filed Oct. 18, 2002, which is incorporated herein by reference. 
     
    
     FIELD OF THE INVENTION  
       [0002]     The present invention relates to a bariatric gurney and to a process of moving a bariatric patient.  
       BACKGROUND OF HE INVENTION  
       [0003]     The present invention relates to moving a heavy or very large patient from place to place, for example, from the hospital to the residence or vice versa. In many cases the ambulance service will refuse the employment in order to avoid injury to the personnel moving the patient and to avoid injury to the patient. The present invention is intended to eliminate or reduce such injuries and to make such movements easier.  
       SUMMARY OF THE INVENTION  
       [0004]     One embodiment of the present invention might involve a bariatric gurney arrangement including an ambulance having a floor. The gurney also has a carriage with wheels. Removable rails with sides on them are connected to the ambulance and lead to the floor for supporting the gurney and guiding the wheels up to the floor. Mounted on the ambulance is a winch which is connectable to the gurney for pulling the gurney up the rails to the floor. There are rings mounted on the floor and on the gurney and straps connect the rings on the floor and the gurney. The winch is arranged to pull the gurney to tighten the straps connecting the rings on the floor and the rings on the gurney for securing the gurney in place on the floor.  
         [0005]     A further embodiment of the invention is a bariatric gurney including a carriage arrangement. There are wheels on the carriage arrangement. A flat sheet is mounted on the carriage arrangement and for supporting a patient. A pair of extenders are mounted on the carriage arrangement on the opposite sides of the flat sheet. The extenders are fixable in a horizontal position to increase the support area of the flat sheet and are also fixable in a vertical position to make more narrow the width of the gurney.  
         [0006]     A further embodiment of the invention is a process for moving a bariatric patient. The process includes providing an ambulance having a floor and a winch and providing a gurney including a carriage with wheels. Rails are attached to the ambulance with the rails leading to the floor of the ambulance. The patient is placed on the carriage and the winch is attached to the gurney. The gurney is pulled up the rails to the floor of the ambulance by operation of the winch. Finally, the gurney is secured in place by attaching straps to the ambulance and then operating the winch to move the gurney to tighten the straps.  
         [0007]     Still another embodiment of the invention involves a bariatric gurney including a lower carriage. Wheels are mounted on the lower carriage. There is also provided an upper carriage mounted on the lower carriage for vertical movement while maintaining a horizontal orientation. A hydraulic cylinder is connected between the upper and lower carriage for raising and lowering the upper carriage relative to the lower carriage.  
     
    
     DESCRIPTION OF THE DRAWINGS  
       [0008]      FIG. 1  is a side elevation of the bariatric gurney of the present invention and a fragmentary view of an ambulance showing a step in the process of the present invention.  
         [0009]      FIG. 2  is a side elevation of the bariatric gurney of the present invention.  
         [0010]      FIG. 3  is a fragmentary end elevation.  
         [0011]      FIG. 4  is a top plan.  
         [0012]      FIG. 5  is a fragmentary perspective view of the rear of the ambulance showing a device for preventing damage by use of the winch in the ambulance.  
         [0013]      FIG. 6  is a perspective view of the inside of the ambulance showing means for securing the gurney in place in the ambulance.  
         [0014]      FIG. 7  is a perspective view looking into the ambulance showing the gurney secured in place in the ambulance.  
         [0015]      FIG. 8  is a perspective view showing in detail one of the wheels of the gurney.  
         [0016]      FIG. 9  is a perspective view showing the head end of the gurney secured in the ambulance.  
         [0017]      FIG. 10  is an enlarged perspective view showing in detail one of the wheels of the gurney.  
         [0018]      FIG. 11  is a perspective view of the gurney showing certain parts removed in order to show internal working parts.  
         [0019]      FIG. 12  is a perspective view of the foot end of the gurney with the mattress lifted to show obscured portions of the gurney.  
         [0020]      FIG. 13  is an enlarged cross section of a ramp taken along the line  13 - 13  of  FIG. 1  in the direction of the arrows. 
     
    
     DESCRIPTION OF THE PREFERRED EMBODIMENT  
       [0021]     For the purposes of promoting an understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended, such alterations and further modifications in the illustrated devices, and such further applications of the principles of the invention as illustrated therein being contemplated as would normally occur to one skilled in the art to which the invention relates.  
         [0022]     Referring to  FIG. 1 , the present invention involves moving a heavy or very large patient from the hospital to the residence or vice versa. In many cases the movement of a relatively large or heavy patient causes injury to the personnel moving the patient and also possibly to the patient and the present invention is intended to eliminate or reduce such injuries as well as to make such movements easier.  FIG. 1  shows the bariatric gurney  10  being moved into the rear of the ambulance  1   1  by means of a winch  12  which is mounted on the ambulance and includes a line  15 . The gurney  10  is moved up a pair of ramps  16  which are foldable at a joint  17  and may be supported by a set of chocks or cribbing  18  consisting of 2×4s in a criss-crossed position. After use the ramps  16  are folded and placed into a suitable vertical compartment in the rear side of the ambulance at  20 . Preferably the ramps are manufactured of steel or aluminum and have sides  13  ( FIG. 13 ) on them so as to prevent the wheels  21  on the gurney from rolling off of the ramps. The ramps also should be chosen so as to be able to hold up to 3,000 pounds.  
         [0023]     One example of a winch  12  that might be used in the invention is Model No. V42R 4200LB-12 VDC, manufactured by Rule Industries, Inc., of Gloucester, Mass. 01930.  
         [0024]     Referring to  FIG. 5  the rear of the ambulance is shown as having fixtures  21  A fixedly installed therein that provide mounting for a roller mechanism  22  which receives the winch line  15  and prevents it from damaging the back of the ambulance. The roller mechanism  22  has a roller  25  rotatably mounted thereon and over which the winch line  15  operates. The winch  12  should be chosen so as to be able to be reeled in on a stop and start fashion by an individual located inside of the rear of the ambulance  11  to make sure that the procedure is carried out without harm to the patient or to the attendants. The winch should also be capable of letting out the line on a stop and start fashion as controlled by an individual inside the rear of the ambulance for the purpose of unloading the patient and the gurney  10  from the ambulance.  
         [0025]      FIG. 2  shows an enlarged side elevation of the gurney  10 . The gurney  10  consists of a carriage arrangement  24  including a lower carriage  25 A and an upper carriage  26 . Mounted on the lower carriage  25 A are four wheels  21 . Also mounted on the lower carriage  25  are foot brakes  30  and  31  which may be actuated by depressing the pedals  32  and  33  respectively. Each of the pedals  32  and  33  is fixed to a respective shaft  35  and  36  which has a respective cam  37  and  40  fixed thereto. Each of the cams actuates a shaft  41  and  42  respectively which presses against the respective wheels in order to brake them.  FIG. 10  shows a representation of one of these mechanisms in greater detail and also shows a spring  45  which operates against a nut  46  to urge the shaft  42  upwardly so as to disengage the braking action when the pedal is not being depressed. The nut  46  is threadably received on the shaft  42 .  
         [0026]     A hydraulic cylinder  50  is mounted on the lower carriage and is used to raise and lower the upper carriage  26 . The manner of operation of the hydraulic cylinder to accomplish this is shown in  FIG. 11 . The hydraulic cylinder has its piston connected pivotally to the lower ends of the crisscross members  52  of the crisscross members  52  and  55 . The members  52  are pivotally connected at their lower ends  56  to the lower carriage  25  and are slidably connected at their upper ends by suitable rollers  58  to the tracks  59  mounted on the upper carriage  26 . The crisscross members  52  and  55  are privotally connected to each other at  53 . The members  55  of the crisscross members are pivotally connected at their upper ends to the upper carriage and are slidably connected to the lower carriage  25  by suitable rollers  57  at their lower ends in tracks  60  so that as the upper carriage moves up and down it is maintained in a horizontal position. The hydraulic cylinder  50  is pumped so as to raise the carriage by a foot pump  61  ( FIG. 2 ) actuated by the foot pedal  62 . The fluid in the hydraulic cylinder  50  may be released by opening a valve by actuation of a rotatable knob  65  to slowly let down the upper carriage  26 . The valve can be closed by activating knob  65  so as to lock the height position of the upper carriage at any desired height.  
         [0027]     Alternative means may be provided for raising and lowering the upper carriage  26  relative to the lower carriage  25 . Thus, the hydraulic cylinder may be replaced by electronic means that would require only moving a switch or a button one way or the other to slowly move the height of the upper carriage from one position to another.  
         [0028]     It should be noted that the connection of the piston  45  of the hydraulic cylinder  50  is correctly shown in  FIG. 2  and is not as suggested in  FIG. 11  because the function of the hydraulic cylinder is to pull together and to separate the lower ends  56  of the crisscross members  52  and  55 . Thus, the piston  51  of the hydraulic cylinder is pivotally secured at  53  to a member  54  fixed to the lower ends of the crisscross members  52 . When the hydraulic piston is forced outwardly, the hydraulic cylinder is moved rightward as viewed in  FIG. 2  and the upper carriage is lowered. When the hydraulic piston is moved into the hydraulic cylinder, the hydraulic cylinder is moved leftward as viewed in  FIG. 2  and the upper carriage is raised.  
         [0029]     The upper carriage  26  includes tubing  70  that extends all of the way around the upper carriage and together with cross members  69  ( FIG. 11 ) supports and mounts a flat sheet  67  which includes a lower flat sheet portion  71  which is best shown in  FIG. 12 . Pivotally mounted upon the upper carriage  26  is an upper flat sheet portion  72  bordered by tubing  75 . The flat sheet portions  71  and  72  may be made out of any hard relatively rigid sheet material, such as, for example, carbon fiber. A mattress  76  is supported upon the upper carriage and specifically upon the sheets  71  and  72 . The upper sheet portion  72  and the upper portion of the mattress  76  may be raised and lowered by a crank  77 . ( FIG. 2 ) The crank  77  is mounted for rotation on the upper carriage on the projecting member  78 . The crank is connected to the upper sheet portion  72  by link  79  which is pivotally connected to the upper sheet portion  72 . The link  79  is also pivotally connected to internally threaded member  81  which is threadedly received on the threaded portion  82  of the crank  77 .  
         [0030]     Also mounted upon the tubing  70  are side rails  80  and  90  which function as extenders of the patient supporting surface. As shown in  FIGS. 3 and 4  the side rails  80  and  90  can be locked in a horizontal or in a vertical position by means of locks  91 . Each of the locks  91  operates by engaging a bore in the respective tubing  70  or side rail  80  within which the rod of the lock is received. The locks  91  may screw into the respective tubing or side rail or may be spring biased. There are two bores located in each section of tubing with respect to each of the locks  91 . One of the bores allows the side rail to be positioned in a vertical position and the other allows it to be positioned in a horizontal position. As shown in  FIG. 3  the side rails  80  are locked in a horizontal position while one of the side rails  90  is locked in a vertical position. Also shown in  FIG. 3  in dotted lines the side bars can be moved upwardly so as to reduce the total sideward dimension of the gurney for moving it into and out of relatively small doors in a residence or the like and also for moving it into and out of the rear of the ambulance.  
         [0031]     Referring to  FIG. 6  one of the fixtures  21  is shown as mounting a ring  95  for securing the gurney in place when it is inside of the ambulance. Straps  96  connect the rings  95  to rings  97  fixedly mounted on the lower carriage as best shown in  FIG. 7 .  FIG. 7  is a view looking into the ambulance and therefore shows the end of the gurney away from the winch. After the straps  96  have been put in place the winch  12  can be tightened so as to tighten the straps  96  and secure the gurney in position in the ambulance.  FIG. 9  shows the head end of the gurney and also shows a chain  100  connected to rings  101  that are fixedly mounted on the head end of the lower carriage  25  for connecting the winch to the gurney.  
         [0032]     Referring again to  FIG. 12  there is illustrated a safety bar  105  that is fixedly mounted at the foot end of the upper carriage and specifically to the tubing  70 . The safety bar  105  prevents the patient and the mattress from sliding off of the gurney as it is being moved up the rails into the ambulance. Alternatively, the safety bar  105  may be fixedly but removably mounted on the upper carriage. Such removability may be useful in getting the patient on and off the gurney. Also shown in  FIG. 12  is Velcro™  107  mounted on both the mattress and the flat sheet portion in order to secure the mattress in place.  
         [0033]     The gurney has an overall length of 80 inches and a minimum width of 33 inches and a maximum width of 56 inches. The weight of the gurney is 400 pounds and the maximum weight capacity is designed to be 2000 pounds.  
         [0034]     The process of the present invention is intended to be used whenever a patient exceeds 500 pounds or is wider than a standard stretcher. The crew carrying out the process will go to the destination and inspect the destination and insure access to the residence. This would normally be completed prior to loading the patient onto the gurney. The transporting crew will then respond to the facility and assess the patient and the situation to see if transport can be effected. If it is determined that the patient&#39;s residence is not properly prepared for safe transfer the patient will not be transferred. The origin facility will be informed of the patient&#39;s residence not being suitable and the patient will remain in that facility until suitable and safe conditions exist for transfer. Assuming that transfer can be safely effected the crew makes sure sufficient manpower is on the scene to assure a safe transfer for all parties.  
         [0035]     Carrying out the transfer it is important that the ramps are properly set up and cribbed and that the arrangement is performed on level ground. When placing the gurney in the ambulance the front wheels should be lined up with the ramps with the head end first. Winch cable is then hooked up to the gurney by connecting to the chain  1   00 . One individual inside of the ambulance or truck operates the winch control and also watches the gurney coming up the rails or ramps to make sure that it is going up the ramps in a straightforward fashion. One or two persons are located at the lower end of the gurney to make sure that the rear wheels line up with the ramps. Once all four wheels are on the ramps and lined up the winch is not stopped. It should be kept going unless there is some emergency problem with the gurney. In going up the ramp it is important to make sure that the head end of the cot is not up so that the patient&#39;s head does not engage the upper portion of the ambulance. When the gurney is inside the ambulance the tie downs (straps) are locked down and the first tie downs to be locked down are the rear tie downs (straps  96 ). The front tie downs (straps  108   FIG. 9 ) are then locked in place and the winch is tightened up for more security.  
         [0036]     While the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character, it being understood that only the preferred embodiment has been shown and described and that all changes and modifications that come within the spirit of the invention are desired to be protected. For example, the entire framework of the gurney may be made out of stainless steel with the exception of the hydraulic cylinder.