Patent Publication Number: US-2007118061-A1

Title: Arm positioning device

Description:
BACKGROUND OF THE INVENTIONS  
      1. Field of Inventions  
      The present inventions relate generally to the transportation of persons on backboards, gurneys, stretchers, wheelchairs, stair chairs and the like.  
      2. Description of the Related Art  
      There are many instances where a sick, injured or otherwise less than fully mobile person is transported in a prone or seated position by firefighters, emergency medical technicians (“EMTs”), ambulance personnel, hospital personnel, and others (collectively “transporting personnel”). The person is typically placed on a backboard, gurney, stretcher, wheelchair, stair chair or the like (collectively “patient transport devices”) that is carried or pushed by the transporting personnel. For example, an injured person may be placed on a backboard, carried down a flight of stairs, transferred to a gurney, placed in an ambulance, driven to a hospital, removed from the ambulance, and transported to various locations within the hospital on the gurney.  
      One issue associated with transporting a person on a patient transport device is the position of the person&#39;s arms. The person&#39;s arms are typically arranged in a transport position that is comfortable and out of harms way. For example, the arms may be bent slightly at elbows and crossed at the wrists near the waist, or bent significantly at elbows and crossed at the wrists over chest. The exact positioning will, of course, depend on the situation. Unfortunately, arms do not always stay in the desired transport position. The arms of unconscious persons will frequently fall over the side of the patient transport device, as shown in  FIG. 1 , which exposes the person to injury and increases the difficulty associated with transport. Similarly, a conscious child or a conscious adult who is panicked or otherwise disturbed may reach out over the edge of the patient transport device to, for example, grab onto something out of fear. This also exposes the person to injury and increases the difficulty associated with transport. In addition to exposure to injury and transporting personnel difficulties, intravenous connections and other medical devices may be dislodged when a conscious or unconscious person&#39;s arms fall, or are otherwise moved, beyond the sides of the patient transport device.  
      One proposed solution to the problems associated with arm movement is to position the person&#39;s hands palm-to-palm and then tape the arms together by winding tape around the wrists a few times. There are a number of shortcomings associated with this proposed solution. For example, it results in discomfort during transport and pain when the tape is removed. Tape may also tear the skin when it is removed, and some people are allergic to tape.  
     SUMMARY OF THE INVENTIONS  
      An arm positioning device in accordance with one embodiment of a present invention includes a first wrist cuff defining a first wrist opening and a second wrist cuff defining a second wrist opening and secured to the first wrist cuff such that the first and second wrist openings are oriented generally transverse to one another. A method in accordance with one embodiment of a present invention includes the step of securing a first arm to a second arm at the wrists such that the wrists cross one another and first and second arms are generally transverse to one another at the wrists.  
      Such inventions are advantageous for a variety of reasons. For example, such inventions obviate the above-described issues associated with transporting a person on a patient transport device because they allow the person&#39;s arms to be maintained in a desirable transport position. More specifically, the inventions orient the person&#39;s arms so that they crossed at the wrists near the waist, or over chest, where they are out of harms way. Securely holding the arms in this manner also prevents an unconscious person&#39;s arms from falling over the side of the patient transport device, and makes it very difficult for the person to reach out beyond the perimeter of the patient transport device.  
      The above described and many other features of the present inventions will become apparent as the inventions become better understood by reference to the following detailed description when considered in conjunction with the accompanying drawings. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
      Detailed descriptions of exemplary embodiments of the inventions will be made with reference to the accompanying drawings.  
       FIG. 1  is a perspective view showing a person being carried on a backboard in conventional fashion.  
       FIG. 2  is a perspective view showing a person being carried on a backboard with both arms positioned by one embodiment of a present invention.  
       FIG. 3  is a perspective view showing a person being carried on a backboard with both arms positioned by one embodiment of a present invention.  
       FIG. 4  is a perspective view showing a person being carried on a backboard with one arm positioned by one embodiment of a present invention.  
       FIG. 5  is a perspective view showing a person being carried on a gurney with one arm positioned by one embodiment of a present invention.  
       FIG. 6  is a partial top view showing a person being carried on a gurney with one arm positioned by one embodiment of a present invention.  
       FIG. 7  is a perspective view showing one embodiment of a present invention in a closed orientation.  
       FIG. 8  is a top plan view of one embodiment of a present invention in an open orientation.  
       FIG. 9  is a bottom plan view of one embodiment of a present invention in an open orientation.  
       FIG. 10  is an exploded perspective view of one embodiment of a present invention.  
       FIG. 11  is a plan view of a portion of one embodiment of a present invention.  
       FIG. 12  is a side view of a portion of one embodiment of a present invention.  
       FIG. 13  is a side view of a portion of one embodiment of a present invention. 
    
    
     DETAILED DESCRIPTION OF THE EXEMPLARY EMBODIMENTS  
      The following is a detailed description of the best presently known modes of carrying out the inventions. This description is not to be taken in a limiting sense, but is made merely for the purpose of illustrating the general principles of the inventions. The present inventions are also applicable to a wide variety of patient transport devices. Two particularly relevant examples of such devices are backboards and gurneys and, accordingly, the illustrated embodiments of the present inventions are discussed primarily in the context of backboards and gurneys. The present inventions are not, however, limited to backboards and gurneys and may be used in combination with other patient transport devices that currently exist, or are yet to be developed. For example, the present inventions are applicable to stretchers, wheelchairs and stair chairs.  
      As illustrated in  FIGS. 1-3 , a person may be transported on a backboard  10  with a support portion  12  and an alternating series of large apertures  14  and small apertures  16 . An arm positioning device  100  in accordance with one embodiment of the present invention may be used to quickly, easily and securely orient the person&#39;s arms in a transport position that is comfortable and out of harms way, as is shown in  FIGS. 2 and 3 , in order to prevent the person&#39;s arms from moving, either voluntarily or involuntarily, beyond the lateral edges of the backboard  10 , as is shown in  FIG. 1 . To that end, the arm positioning device  100  includes first and second wrist cuffs  102   a  and  102   b  that may be used to orient the arms relative to one another in the manner illustrated in  FIGS. 2 and 3 . The exemplary transport position illustrated in  FIG. 2  involves bending the arms slightly at the elbows and crossing the arms at the wrists near the waist. To that end, the arm positioning device  100  is attached to the wrists and secures the arms to one another such that they are crossed at the wrists. Alternatively, in the transport position illustrated in  FIG. 3 , the exemplary arm positioning device  100  is secured to the wrists and used to orient the arms such that the arms are bent significantly at elbows and crossed at the wrists over chest. The arm positioning device  100  may also be secured to the person in such a manner that the person cannot pull his/her hands through the device or move the device substantially towards an elbow. In the illustrated embodiment, this is accomplished by providing first and second wrist cuffs  102   a  and  102   b  that are adjustable in size.  
      The relative orientation of the first and second wrist cuffs  102   a  and  102   b  and the ability to adjust their size also allows the arm positioning device  100  to secure a single arm to a patient transport device in order to hold the arm in a medically necessitated orientation. As illustrated for example in  FIG. 4 , the arm positioning device  100  may be used to quickly and easily secure a person&#39;s wrist to the backboard  10  near the person&#39;s hip. More specifically, the wrist cuff  102   a  is secured to a portion of the backboard between one of the large apertures  14  and an adjacent small aperture  16 , while the wrist cuff  102   b  is secured to the wrist. Securing the wrist to the backboard  10  in this manner is especially useful in those instances where medical personnel intend to make an intravenous connection to the person by way of a vein in the top of the hand. The arm may be rotated  180  degrees if access to a vein in the forearm is desired. The construction of the arm positioning device  100  also allows to wrist to be quickly and easily disconnected when removing the patient from the backboard  10  is desired. Turning to  FIGS. 5 and 6 , the exemplary arm positioning device  100  may also be used to similarly secure an arm to a gurney  20  that has a frame  22 , a pad  24 , and a side rail  26  with a plurality of vertically extending posts  28 . The wrist cuff  102   a  may, for example, be secured to one of the vertical posts  28 , while the wrist cuff  102   b  is secured to the wrist. Here too, the arm may be oriented with the palm facing down ( FIG. 5 ) or up ( FIG. 6 ).  
      Turning to  FIGS. 7-9 , the first and second wrist cuffs  102   a  and  102   b  of the exemplary arm positioning device  100  include respective straps  104   a  and  104   b , which are secured to one another, and variable size closure mechanisms that allow the wrist openings  106   a  and  106   b  defined by the straps to be varied in size when the arm positioning device is placed in the closed orientation ( FIG. 7 ). The straps  104   a  and  104   b , which have free (or “longitudinal”) ends  108   a / 110   a  and  108   b / 110   b  and mid-portions  112   a  and  112   b  where the straps cross one another, are preferably formed from a relatively soft, flexible material (e.g. neoprene, fabric, soft leather, medical foam, or webbing) that will be comfortable for the wearer. Also, although the present inventions are not so limited, the first and second wrist cuffs  102   a  and  102   b  of the exemplary arm positioning device  100  are oriented perpendicular to one another. In other words, the angle θ between the straps  104   a  and  104   b  ( FIG. 8 ) is 90 degrees and the longitudinal axes of the wrist openings  106   a  and  106   b  ( FIG. 7 ) will be perpendicular to one another. The angle θ between the straps  104   a  and  104   b  may vary by, for example, up to 45 degrees in some generally transverse (as apposed to perpendicular) implementations.  
      The straps  104   a  and  104   b  may be secured to one another with an attachment device such as stitching  114  ( FIGS. 8 and 9 ). The stitching  114  may be in the illustrated “x within a square” pattern or any other suitable pattern. Other exemplary attachment devices for joining the straps  104   a  and  104   b  include, but are not limited to, rivets and adhesive. So connected, the strap mid-portions  112   a  and  112   b  are coextensive with one another, and the other portions of the straps  104   a  and  104   b  are not.  
      Although the present inventions are not limited to any particular closure mechanisms, the closures mechanisms in the illustrated embodiment are hook and loop fasteners, such as those commonly sold under the trade name Velcro. Referring more specifically to  FIGS. 8 and 9 , the straps  104   a  and  104   b  include respective strips of hook material  116   a  and  116   b  on strap sides  117   a  and  117   b  and respective strips of loop material  118   a  and  118   b  on the other sides, which are strap sides  119   a  and  119   b . The strips of hook material  116   a  and  116   b  and loop material  118   a  and  118   b  are each secured to the associated straps with stitching  120  that preferably extends completely around the perimeter of the strip of hook (or loop) material. Other exemplary variable size closure mechanisms include, for example, buckles and ties.  
      In the illustrated embodiment, the strips of hook material  116   a  and  116   b  and loop material  118   a  and  118   b  extend from the associated strap free end  108   a ,  110   a ,  108   b  or  110   b  to the associated strap mid-portions  112   a  or  112   b . The stitching  114  (or other attachment device) extends though both of the straps  104   a  and  104   b  and all four of the strips of hook material and loop material  116   a ,  116   b ,  118   a  and  118   b . This arrangement creates a considerably stronger connection between the first and second wrist cuffs  102   a  and  102   b  than would be the case if the strips of hook material and loop material  116   a ,  116   b ,  118   a  and  118   b  did not extend into the strap mid-portions  112   a  or  112   b  and the stitching  114  only extended through the straps  104   a  and  104   b . The stronger connection prevents the straps  104   a  and  104   b  from being separated, or twisted relative to one another, by a combative or otherwise agitated person. As such, the present arrangement facilitates the use of softer, more comfortable strap material (e.g. 4 mil thick neoprene) than would be practicable without it.  
      Turning to  FIG. 10 , the strength of the connection between the straps  104   a  and  104   b  is further augmented in the exemplary arm positioning device  100 ′, which is otherwise identical to arm positioning device  100 , through the use of a center piece  122  that is positioned between the straps and is also secured with the stitching  114  or other attachment device. Suitable materials for the center piece  122  include leather and seatbelt-type webbing material.  
      With respect to adjustability, and as discussed above, the strips of hook material  116   a  and  116   b  and loop material  118   a  and  118   b  on each of the first and second wrist cuffs  102   a  and  102   b  combine to cover, albeit on opposite sides and with overlap at mid-portions  112   a  and  112   b , the entire length of the straps  104   a  and  104   b . As such, relatively large wrist openings  106   a  and  106   b  may be formed by bending the straps  104   a  and  104   b  from the open orientation illustrated in  FIGS. 8 and 9  to a closed orientation where only relatively small portions of the hook material  116   a  and  116   b  near the strap ends  108   a  and  108   b  are connected to relatively small portions of the loop material  118   a  and  118   b  near the strap ends  110   a  and  110   b . Alternatively, relatively small wrist openings  106   a  and  106   b  may be formed by bending the straps  104   a  and  104   b  from the open orientation illustrated in  FIGS. 8 and 9  to a closed orientation where the portions of the hook material  116   a  and  116   b  near the strap ends  108   a  and  108   b  are connected to portions of the loop material  118   a  and  118   b  near the strap mid-portions  112   a  or  112   b  (note  FIG. 7 ). Still smaller wrist openings  106   a  and  106   b  may be formed by rolling up portions of the straps  104   a  and  104   b  with the hook material  116   a  and  116   b  and then connecting a region of the hook material spaced inwardly from the strap ends  108   a  and  108   b  to the loop material  118   a  and  118   b  near the strap mid-portions  112   a  or  112   b  (note  FIGS. 5 and 6 ).  
      The present inventions may also be provided with structures that allow the transporting personnel to quickly disengage the closure mechanisms and remove the straps from the patient&#39;s wrists. As illustrated for example in  FIGS. 11 and 12 , each of the first and second wrist cuffs  102   a  and  102   b  (only wrist cuff  102   a  is shown) may be provided with a tab  124 . The tabs  124  allow the transporting personnel to get a good grip on the longitudinal end  110   a  of the strap  104   a , as well as the longitudinal end  110   b  of the strap  104   b , so that the strips of hook and loop material can be pulled apart. The tabs  124 , which are secured to strap sides  117   a  and  117   b  with stitching  126 , may be of any suitable configuration and material. The exemplary tabs  124  are each in the form of a loop, wherein a length of material is bent back over itself. Both free ends of the length of material are secured to the associated strap with the stitching  126 . The loop gives the transporting personnel the option of, for example, squeezing the tab  124  between the thumb and forefinger or running a finger through the opening in the loop. Alternatively, as illustrated in  FIG. 13 , the exemplary tab  128  is in the form of a strip, wherein one free end of a length of material is secured to the strap sides  117   a  (and  117   b ) with stitching  126 . Webbing is one example of a suitable material for the tabs  124  and  128 .  
      Although the inventions disclosed herein have been described in terms of the preferred embodiments above, numerous modifications and/or additions to the above-described preferred embodiments would be readily apparent to one skilled in the art. By way of example, but not limitation, the inventions include any combination of the elements from the various species and embodiments disclosed in the specification that are not already described. The straps  104   a  and  104   b , which are each unitary structures, may be formed from multiple pieces that are secured to one another. With respect to usage, the arm positioning devices described above may also be used to secure a leg to a patient transport device at the ankle (in a manner similar to the arm illustrated in  FIGS. 4-6 ) if, for example, the person being transported is having a seizure. Multiple arm positioning devices may be used to secure each of a person&#39;s arms in the manner illustrated in  FIGS. 4-6  and/or each of a person&#39;s legs in the manner discussed above. A combative person might be restrained by securing one arm to a patient transport device the near the person&#39;s head and securing the other arm near to the patient transport device near the thigh. A combative person&#39;s legs might also be secured to the patient transport device. Here, a total of four of the arm positioning devices would be used. It is intended that the scope of the present inventions extend to all such modifications and/or additions and that the scope of the present inventions is limited solely by the claims set forth below.