Patent Publication Number: US-2007118990-A1

Title: Wheel Chair to Assist in Lifting a Fallen Patient

Description:
This is a Continuation-in-Part of U.S. patent application Ser. No. 10/907,902 filed Apr. 20, 2005. 
    
    
     FIELD OF THE INVENTION  
      The present invention relates generally to the field of hospital equipment and, more particularly, to an articulated wheelchair which presents a low profile to the floor to assist a healthcare worker in placing a patient on the wheelchair.  
     BACKGROUND OF THE INVENTION  
      Various apparatus known in the art are commonly used by healthcare providers to transport patients from one place to another. For example, wheelchairs are commonly used to move patients in all kinds of medical care or retirement environments while the patient sits in the wheelchair in a vertical position. For another example, gurneys are used in hospitals, nursing homes, and other places to move patients from one place to another while the patient remains in a substantially horizontal position. All too often, patients in such environments fall and end up lying on the floor and health care providers have a difficult time in lifting the patient onto a wheelchair, gurney, or bed.  
      Unfortunately, injuries often occur to healthcare providers and to patients when patients are lifted from the floor. In the art, there is just no easy way for a healthcare worker alone to get down to the level of the patient and lift the patient to a chair or bed. All too often, fewer than three people are available to move a patient from the floor. In fact, nurses and orderlies are often called upon to attend to patients alone. This can easily result in back strain for the nurse or orderly, and despite the nurse&#39;s best efforts, may result in injury to the patient.  
      Thus, there remains a need for means to assist in lifting a patient from the floor onto a device such as a wheelchair or a gurney. Such a device should be simple and inexpensive, yet safe to the patients it serves. The device should allow a healthcare worker to lift a patient without a great deal of physical effort, and permit the healthcare worker to perform the task alone. The present invention is directed to filling this need in the art.  
     SUMMARY OF THE INVENTION  
      The present invention addresses these and other drawbacks in the prior art by providing a convertible bed or gurney and wheelchair that flexibly converts from one mode to the other mode with the patient&#39;s head at either end of the device, and including a winch device to easily and safely move a patient onto the device.  
      The gurney/wheelchair of this invention is thus bi-directional. In a first embodiment, the device comprises five panels, including a center panel, a pair of intermediate panels, and a pair of end panels. The intermediate panels are interlocked so that they always remain parallel to one another. The end panels operate independently of one another. The device further includes a power means to raise and lower the center panel, which in turn raises and lowers the other panels. A pair of U-shaped support bars mechanically support a pair of parallel structural beams so that the device can be positioned over a standard toilet from either direction in respect of the device of this invention. Further, means is provided to mechanically assist a patient onto the gurney/wheelchair.  
      In another preferred embodiment of the invention, only two such panels are integral to the articulated chair, but a hoist panel is attachable to the device when needed to lift a patient from the floor. The device of this embodiment presents a low profile so that the chair can be cantilevered over a hospital bed to minimize the effort is moving a patient from the bed onto the device. This low profile feature of the invention also enables the healthcare worker to lower the seat of the device until it is a close as possible to the floor.  
      These and other features, objects, and advantages will be readily apparent to those of skill in the art from a review of the following detailed description along with the accompanying drawing figures. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
      So that the manner in which the above recited features, advantages, and objects of the present invention are obtained and can be understood in detail, more particular description of the invention, briefly summarized above, may be had by reference to the embodiments thereof which are illustrated in the appended drawings.  
       FIG. 1  is a side elevation view of a combination wheel chair/gurney of the present invention as seen from the point of view of an operator, such as for example a nurse or orderly.  
       FIG. 2  is a top view of the wheel chair/gurney of  FIG. 1 .  
       FIG. 3  is a side elevation view of the wheel chair/gurney, as seen from the opposite side, showing the device in various positions.  
       FIG. 4  is a cross-sectional view taken along section  4 - 4  as indicated in  FIG. 1 , showing details of a motor and a platform raising spindle.  
       FIG. 5  is a cross-sectional view taken along section  5 - 5  as indicated in  FIG. 1 , showing details of a bottom wheel-frame and connecting U-bars.  
       FIG. 6  is a cross-sectional view taken along section  6 - 6  as indicated in  FIG. 5 , showing the clearance provided by the U-shaped bars around a toilet commode.  
       FIG. 7  is a cross-sectional view as indicated in  FIG. 8  showing hinge connections and linkage details.  
       FIG. 8  is a side view of  FIG. 7  showing the connecting linkage of side panels.  
       FIG. 9  is the same as  FIG. 8 , except that the side panels are moved to an intermediate position, in order to illustrate function of linkage of the preferred embodiment.  
       FIG. 10  is the same as  FIG. 8 , except that side panels are moved to an extreme 90° position.  
       FIG. 11  is the same as  FIG. 7 , but with more detail of the connecting linkage.  
       FIG. 12  is a cross-sectional view as indicated in  FIG. 11 .  
       FIG. 13  is the same as  FIG. 12 , except that the side panels are rotated into an intermediate position and also in order to illustrate the function of a ratchet mechanism of this invention.  
       FIG. 14  is the same as  FIG. 12 , except that the side panels are rotated in the opposite direction.  
       FIG. 15  depicts an alternative connecting linkage with chains and sprockets.  
       FIG. 16  depicts an alternative connecting means with sheaves and cables.  
       FIG. 17  depicts an alternative simplified linkage.  
       FIG. 18  is an elevation view of the device of this invention in position, equipped with a padded sheet and winch, to pick up a fallen person off the floor.  
       FIG. 19  is a top view of  FIG. 18 .  
       FIG. 20  is a cross section of a winch.  
       FIG. 21  is an enlarged detail of  FIG. 20 .  
       FIG. 22  is a cross-section as indicated in  FIG. 21 .  
       FIG. 23  is a ratchet detail (like  FIG. 21 ) in a disengaged position.  
       FIG. 24  is a side elevation for of a presently preferred embodiment of the invention providing a minimal profile.  
       FIG. 25  is a front view of the device shown positioned over a hospital bed (depicted in phantom).  
       FIG. 26  is a top view of the device of  FIG. 24 .  
       FIG. 27  is a top view of the device shown in partial section taken along section lines  27 - 27  as shown in  FIG. 24 .  
       FIG. 28  is a side view of the device with a winch attached, showing the use of the device to bring a patient onto the device.  
       FIG. 29  is a top view of the device with the winch attached. 
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS  
      Referring to  FIGS. 1 and 2 , the present invention, in a first aspect, comprises a stretcher/wheelchair  12  to and from which a patient or handicapped person is transferred from a hospital or other type bed. The apparatus may support the patient for movement in a sitting or a prone position in the device. The device is bi-directional, meaning either end of the device may receive the head of the patient. Thus, the device may be wheeled to the side of the patient&#39;s hospital bed from either side, regardless of whether the patient&#39;s head is oriented to the right or the left. Once the patient has been placed into the device in its bed or gurney orientation, the device may be converted to a wheelchair, if desired. The patient may then be wheeled to a dinner table, to a shower, or even to a standard toilet, as described more fully below. Alternatively, the device serves as a typical wheeled bed or gurney, at the convenience of the healthcare provider.  
      The device, which defines a stretcher/wheelchair  12 , comprises five panels, including a center panel  14 , a pair of intermediate panels  16  and  20 , and a pair of end panels  18  and  22 . The panels are connected to adjacent panels by hinges  24 ,  26 ,  28 , and  30 , as illustrated. The hinge  26  connects the end panel  18  and the intermediate panel  16  and this hinge operates independently of the other hinges. The hinge  26  includes a plurality of grooves or holes adapted to receive a spring loaded plunger  29 , so that the hinge  26  may be releasably secured in any of a variety of positions. Similarly, the hinge  30  connects the end panel  22  and the intermediate panel  22  and this hinge operates independently of the other hinges, and is preferably constructed in a manner previous described in respect of the hinge  26 . The hinges  24  and  28 , however, operate together with a linkage in a manner shown and described below.  
      The center panel  14  is coupled to a complementary pair of parallel bearing sleeves  32  and  34 , by which the entire stretcher  12  slides up or down along a pair of parallel stanchions  36  and  38 . The stanchions  36  and  38  are supported at their lower ends by a wheeled base  40  having wheels  41 , preferably four of such wheels. Preferably, the two wheels adjacent the operator or healthcare provider are provided with foot-operated brakes. The wheeled base  40  comprises a pair of parallel bars  42  and  44 , which are joined together by two U-shaped bars  46  and  48 , as shown best in  FIG. 5  and described below in greater detail. The bars  46  and  48  can be swung from left to right, to permit the device  12  to be positioned over a standard toilet, whether the patient&#39;s head is positioned to the right or the left on the device  12 .  
      The center panel  14  is built like a toilet seat, with an opening  58  in the center, so it can be used as a toilet seat or as an access opening to a patient&#39;s private parts when the patient is in the shower being scrubbed by a nurse. The intermediate panel  16  is formed of an outer metal frame  60  and a mesh covering  64 , which allows water to be sprayed upon a patient&#39;s back, particularly in a shower. Similarly, the intermediate panel  20  is formed of an outer metal frame  62  with the mesh covering  64 .  
      The end panels  18  and  22  alternately serve as a foot rest or as a handle to push the wheelchair, depending on whether the patient&#39;s head is positioned to the right or to the left. Panels  16  and  20  are always in a position parallel to one another due to a connecting linkage  80 . The end panel  18  includes a central support plate  66  and access openings  70 . Similarly, the end panel  22  includes a central support plate  68  and access openings  72 . The access openings  70  and  72  provide access for a nurse&#39;s hands to operate a manual actuator  74  or  76  to operate the locking hinge  26  or the locking hinge  30  by manual manipulation of the spring loaded plunger  29 .  
      In operation of the present invention, with the patient lying in a hospital or similar bed, the device  12  is wheeled to the patient&#39;s bedside with the device oriented in a stretcher-like position as illustrated in  FIGS. 1, 2 , and  4 . An adjustable handrail  78  is then released and pushed out of the way, as shown in phantom in  FIG. 4 . Once the device  12  is at the patient&#39;s bedside, the panels  14 - 22  are positioned over a mattress  75 , and then lowered down onto the bed, as shown in  FIG. 4 . Now the patient can be rolled onto the stretcher in a manner most convenient to the healthcare provider. For example, if the patient is rolled ¼ turn away from the stretcher before the stretcher is positioned over the mattress, then the patient can be simply rolled carefully onto the stretcher. Or, the patient can be pulled onto the stretcher with a bed sheet until he is located in the middle of the stretcher, lying on his back.  
      It should be noted again that the device  12  is bi-directional, so that the patient&#39;s head may be located to right or to the left, depending on how he was lying in his hospital or similar bed, and the device can receive the patient in either direction. The patient does not have to be turned around in bed, or the device does not have to be turned around or carefully positioned from a particular side of the bed, which may not always be convenient or even possible.  
      Once the patient has been moved from his hospital bed onto the device  12 , the stretcher can be raised to clear the bed. Once the device  12  is clear of the patient&#39;s bed, the patient can be transported with the device  12  remaining in a stretcher-like orientation, or the hinges can be operated to orient the device into a wheelchair-like orientation, as shown best in  FIG. 3 , which should now be referred to for the following detailed description.  
      If the patient&#39;s head is located to the left as seen in  FIG. 3  and his feet are to the right, then panel  18  can be adjusted to a position that is parallel with the center panel  14 . This places panel  18  in the position  18 ′, shown in phantom in  FIG. 3 . Similarly, the intermediate panel  16  is positioned as shown to serve as a backrest for the patient while panel  20  must remain parallel to panel  16  due to the interlocking linkage  80 , shown and described below in greater detail. The end panel  22  is positioned as shown to serve as a footrest for the patient, and since the end panels operate independently of all of the other panels, the panel  22  may be positioned for the comfort and convenience of the patient.  
      Conversely, if the patient&#39;s head is positioned to the right as seen in  FIG. 3 , then the panel  20  may be positioned as shown in phantom as position  20 ″ or position  20 ′″. The panel  16  is interlocked with panel  20 , and will assume position  16 ″ or  16 ′″, respectively. The panel  18  may then be placed in position  18 ″ or  18 ′″ as a footrest, for the convenience and comfort of the patient.  
      Furthermore, the panels  16 - 22  of the chair can be left in an intermediate position, as shown in  FIG. 3  by panels  16 ″,  18 ″,  20 ″, and  22 ″. This position may be enjoyed by a patient to simply sit and relax, or read, or enjoy the sun in a solarium, for example.  
      Referring once again to  FIG. 4 , a section view of the device  12  taken along section lines  4 - 4  of  FIG. 1  is depicted. This detail view of the invention illustrates the power operation of the apparatus to raise and lower the panels. Inside stanchion  38  is a spindle  50 , on which rides a nut  52 , which is mechanically coupled to the center panel  14 . The nut  52  rides up and down along the spindle when the spindle  50  is rotated by a battery driven motor  54  clockwise or counter clockwise. Power is fed to the motor  54  from a battery  56 , shown in  FIG. 1 . The battery is preferably rechargeable, and resides in a sealed case so that the device may safely be used in the shower with a patient sitting therein.  
       FIGS. 4, 5 , and  6  together illustrate another feature of the present invention. If a patient needs to be moved to a toilet, the wheelchair device  12  can be lowered until the footrest (either  18  or  22 ) almost touches the floor, then the chair can be backed over the toilet, as shown in  FIGS. 5 and 6 . However, in order to do so, the structural supports which join the pair of parallel bars  42  and  44  must permit the movement of the device either to the right or the left in order to retain the previously described bi-directional feature of this invention. This is accomplished by joining the parallel bars  42  and  44  by a pair of U-shaped bars  46  and  48 , which are rotatably mounted to the bars  42  and  44 . If the U-shaped bars  46  and  48  are in the way of the toilet, they can be swung to the other side.  
      There are two of these bars connecting the two side bars  42  and  44  to keep the bars  42  and  44  parallel and to provide greater rigidity and stability to the device  12 . So that the two U-shaped bars move together simultaneously with a hand crank  84 , they are connected by a bar  86  ( FIGS. 5 and 6 ). In fact, the hand crank  84  may be omitted, and the U-shaped bars can be moved as a unit simply by moving one of them.  
      As previously described, one of the features of the invention resides in the fact that the intermediate panels  16  and  20  are interlocked together so that they always remain parallel to one another. This feature is shown and described in greater detail in  FIGS. 7, 8 ,  9 , and  10 . These figures illustrate the mechanism that holds the two side panels  16  and  20  parallel.  
      Referring first to  FIGS. 7 and 8 , the hinges  24  and  28  (see also  FIG. 1 ) are mechanically coupled to the central panel  14 . A pair of plates  102  and  104  ride on the hinges  24  and  28 . To the back of theses plates are welded a set of ratchet wheels  106  and  108 , and the panels  16  and  20  are bolted to these ratchet wheels with bolts  110  (See  FIG. 12 ). Two pairs of linkages  112  and  114  are attached to the plate  102  by a pivot pin  116  and a pivot pin  118 . Pins  120  and  122  rest against a step  134  in plate  102  so the linkage pairs can never swing “inward”, only outwardly as illustrated in  FIG. 9 . The inward ends of the linkage pairs hold swivel pins  124  and  126  which are connected by rods  128  and  130  to the identical linkage on the plate  104 . Thus, the panels  16  and  20  are always in a parallel position. Nuts  132  on the ends of the rods  128  and  130  can be used to adjust the length of the rods, which determines the exact degree of parallel of the two panels  16  and  20 , which is particularly important for the straight position of the five panels of the stretcher part  12  when lowered onto the edge of a patients bed. This feature is illustrated in  FIGS. 9 and 10 , wherein in  FIG. 9  the panels  16  and  20  as positioned at an acute angle to the horizontal, but parallel to one another, and in  FIG. 10 , the panels  16  and  20  are positioned at a vertical.  
       FIGS. 11 and 12  show the locking mechanism which locks panels  16  and  20  into a desired position. Attached to frame  14  is a pin  136  on which rotates a cam  138 . To rotate the cam, a crank  140  is mounted onto it via set screw  142 , which also engages a groove  144  in pin  136  to prevent the crank  140  and cam  138  from slipping off the pin  136 . The cam  138  is situated inside a yoke  146 . When the cam  138  is turned 90° clockwise, as shown in  FIG. 13 , the yoke  146  is pushed to the left as viewed in  FIG. 11 , which increases spring pressure against a tooth  148  and into engagement with the ratchet  106 , while tooth  150  is pulled out of ratchet wheel  108  to let it rotate freely in the same direction as  106  (in this case clockwise), because the two ratchet wheels are still connected via linkage rods  128  and  130 . In this case, panel  20  on the left goes up, while panel  16  on the right goes down by the same degree. This entire process can, of course, be reversed by rotating crank  140  and cam  138  counter-clockwise, as shown in  FIG. 14 .  
       FIG. 15  shows an alternative connection between side panels  16  and  20 , which is a bicycle chain  151  and sprockets  152  and  154 . This structure maintains the panels  16  and  20  in a parallel relationship, but with an alternative arrangement to that previously described. Bolt connections  156  and  158  are necessary to adjust chain tension and precise position of sprockets and side panels. Since the device  12  is intended to be used in a wet environment, such as a shower, all parts must be stainless steel. In this case, stainless steel bicycle chain and sprockets are rather expensive, and therefore less preferred.  
       FIG. 16  illustrates another preferred embodiment, showing cables  160  and sheaves  162  instead of chains and sprockets. Here, as in previous embodiments, tensioning devices  164  must be employed and in addition anti-friction devices  166  to prevent the cables from slipping.  
      A simplified linkage  170  could be used, as shown in  FIG. 17 . However, this linkage can only be practical for rotating motions of less than 90°, because at 90°, points  172 ,  174  and  176  would be in a straight line with points  178 ,  180  and  182 . That, for obvious reasons, would no longer work to hold the two side panels  16  and  20  parallel. The linkage  170  shown in dotted lines approaches that position to be able to rotate the side panels 90° or even a little more, thus the linkage shown in  FIGS. 8-10  is preferred.  
      As shown in  FIGS. 18 and 19 , in another aspect of the invention, a patient that has fallen to the floor may be brought onto the device with mechanical assistance from the device, without much effort by nursing personnel. This feature of the present invention reduces the likelihood of back injuries to nurses or other healthcare professionals trying to handle immobilized patients.  
      As illustrated in  FIGS. 18 and 19 , the center panel  14  of the device  12  is first put in its lowest possible position, with panel  16  and panel  18  in a straight line. The hinge  24  is then tilted until the panel  18  touches the floor, while panel  20  rises by the same amount. A person P, who has fallen to the floor, is then rolled or pulled onto a pallet  190  formed of a sheet of nylon, which is padded on top with a layer of foam rubber  192 . The upper end  194  of the sheet is attached to belts  196  and  198 , which in turn are attached to a winch  200 , which is hooked to a frame member of panel  22 . When the winch is operated, belts  196  and  198  are reeled into it and pull sheet  190  with the person P on top up onto the platform of the chair, from where the person can be raised and put into a normal position, without any strain or possible back injury to the healthcare professional assisting the patient.  
      FIGS.  20  to  23  are details of the winch  200 , which consists of two spools  202  and  204 , which are both mounted on a common shaft  206 . The shaft  206  is able to rotate in bearings  208  and  210 , which are held in base structure  213 . The spool  202  is equipped with a ratchet wheel  212 . A lever  214  carries a ratchet tooth  216 , which is pushed into contact with ratchet wheel  212  by a spring  218 . As can best be seen in  FIG. 22 , the ratchet wheel  212  together with spool  202  rotates when lever  214  is moved back and forth; and spool  204  rotates with it, since it too is connected to common shaft  206 . An operator rests his other hand on spool  204  to keep both spools from rotating backwards, while tooth  216  is being rotated into the next notch of ratchet wheel  212 .  
      To pull the pallet  190  down and un-spool belts  196  and  198  from the winch, the ratchet can be put into a disengaged position, as shown in  FIG. 23 . By exerting pressure “A” against lever, it will move against spring  220 , thereby allowing spring  222  to push ratchet tooth  216  down alongside ratchet wheel  212 . Now spools  202  and  204  are free to rotate, when belts  196  and  198  are un-spooled.  
      To re-engage tooth and ratchet, tooth  216  is pulled up via pin handle  224  against spring  222 , spring  220  can expand and push lever  214  back over ratchet wheel  212 .  
      Those of skill in this art will appreciate that certain protective covers may be provided throughout the device  12  to protect patients and healthcare providers and to provide a more esthetic appearance to the device, without detracting from the structure and/or function of this invention.  
       FIG. 24  depicts a presently preferred embodiment of the invention which provides a low profile to assist in moving a patient onto an articulated chair or patient assist device  300 . This embodiment of the invention provides a small vertical dimension so that device can be brought onto the patient&#39;s hospital bed and the patient need only be lifted a short distance onto the device. The device is also adapted to fit over a conventional toilet so that the patient does not have to be lifted off the device and onto the toilet and vice versa.  
      The device, which defines a patient assist device  300 , comprises a seat panel  302  and a back panel  304 . For normal, routine operation for moving a patient from one location to another, the patient&#39;s bottom will rest upon the seat panel and the patient&#39;s back will rest on the back panel. The panels are connected by a hinge  306 . The hinge  306  may be adjusted in angle by a ratchet element  308 , for example.  
      The seat panel  302  is coupled to a complementary pair of parallel bearing sleeves  320  and  322 , by which the seat and back panels slide up or down along the pair of parallel stanchions  36  and  38 , as previously described in respect of the embodiment of  FIGS. 1 and 2 . Please note that, in the embodiment of  FIG. 1 , the sleeves  32  and  34  extend below the center panel  14 . The distance by which the sleeves extend below the center panel limits just how far the device can be lowered toward the floor. However, in the embodiment of  FIG. 24 , the sleeves do not extend below the seat panel  302 , allowing the device to be lowered toward the floor as low as possible. The stanchions  36  and  38  are supported at their lower ends by a wheeled base  310  having wheels  311 , preferably four such wheels. One or more wheels may be provided with a foot-operated brake.  
      The device also provides a pair of hand rails  324  and  326  (see  FIG. 25 ). The hand rail  324  is preferably releasable, so that it swings completely out of the way, as shown in phantom as hand rail  324 ′ in  FIG. 25 .  FIG. 25  depicts the device in position over a bed  328  and in close proximity thereto. Also, the hand rail  326  is preferably fixedly mounted, since the patient will only be using the side of the device toward the hand rail  324  to slide onto the seat panel  302  during normal operation. When the device is used to winch a fallen patient onto the device, as described below, then both hand rail will be in the up position, and once again the hand rail  326  need not be lowered.  
      The mechanism to raise and lower the seat panel  302  and the structure attached thereto may operate in the same manner as previously described in respect of  FIG. 4 . The nut and spindle arrangement rotated by a battery driven motor  54  and power is fed to the motor from a battery  56  by a three-position switch  332 . The battery is preferably rechargeable, and resides in a sealed case  330  so that the device may safely be used in the shower with a patient sitting therein.  
       FIGS. 26 and 27  depicts another feature of the presently preferred embodiment of this invention. In this embodiment, the U-shaped bars  46  and  48  (See  FIGS. 4-6 ) are eliminated. Rather, the wheeled base  310  comprises a left frame member  340  (from the vantage point of a patient sitting in the device), a front frame member  342 , and a right frame member  344 , all preferably formed as a unitary base  310 . By eliminating the U-shaped bars  46  and  48 , the device is not as sturdy as the embodiment of  FIG. 1  et seq., but the device is lighter, easier to maneuver, and less expensive. As shown in  FIG. 27 , the base  310  permits the device to be wheeled over a toilet  346 , for example, without having to move the patient off the device. As shown in  FIG. 26 , the seal panel  302  is preferably formed of a pair of spaced apart panel portions  348  and  350 . This feature provides spaces  352  and  354  between the panel portions. Otherwise, the seat panel is built like a split toilet seat, with an opening in the center, so it can be used as a toilet seat or as an access opening to a patient&#39;s private parts when the patient is in the shower being scrubbed by a care provider.  
      Finally,  FIGS. 28 and 29  depict the advantage of the low profile of the presently preferred embodiment of the invention when moving a fallen patient onto the device. Since the sleeves do not extend below the bottom of the seat panel, the entire apparatus can be brought down almost in contact with a floor  360 . This makes it much easier to slide a patient P onto the device.  
      The device includes a removable winch panel  362 , which preferably hooks into a pair of outwardly extending pins  364 . The bottom of the winch panel  362  rests against a shoulder  366  of the wheeled base  310  so that the which panel forms about a 30° angle with the floor. Also, note that since the winch panel is a distinct element (i.e. it does not have to serve a dual purpose as in previous embodiments since this embodiment is not bi-directional) the winch panel is preferably longer than the back panel  304 . This feature of the invention is particularly advantageous in that it assists in bringing the patient P further onto the device.  
      The procedure for bringing a patient onto the device is the same as previously described. However, this embodiment preferably includes only one belt  370  coupled to the sheet of nylon  190 , which is padded on top with the layer of foam rubber  192 . This feature also simplifies the coupling to the winch  200 .  
      The principles, preferred embodiments, and modes of operation of the present invention have been described in the foregoing specification. This invention is not to be construed as limited to the particular forms disclosed, since these are regarded as illustrative rather than restrictive. Moreover, variations and changes may be made by those skilled in the art without departing from the spirit of the invention.