Patent Publication Number: US-11648163-B2

Title: Size adjustable sling

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     This application is a Divisional Application of U.S. Nonprovisional application Ser. No. 15/629,032, filed on Jun. 28, 2017, which claims priority to U.S. provisional application 62/513,481 filed on Jun. 1, 2017, the contents of which are incorporated herein by reference. 
    
    
     TECHNICAL FIELD 
     The subject matter described herein relates to slings used as part of a sling assembly for nonambulatory persons, and more particularly to a size adjustable sling. 
     BACKGROUND 
     Caregivers in hospitals and other health care facilities may employ various devices to transport patients with severely limited mobility, or to assist those patients in their efforts to move about on their own. One such device is a sling assembly. A sling assembly includes a sling made of cloth or other material suitable for cradling the patient. The sling typically includes two or more loops. One example of a sling assembly also includes a carriage which is supported near the ceiling of the facility by a ceiling mounted rail system. The sling assembly also includes a deployable and extendable tether extending downwardly from the carriage. The sling assembly also includes a slingbar attached to the lower end of the tether. The slingbar includes hooks which receive the loops of the sling. 
     In typical practice, a caregiver maneuvers the sling under the patient, for example underneath a patient lying on a bed. The caregiver then hooks the sling loops onto the slingbar hooks. The caregiver operates a carriage mounted motor to retract the tether into the carriage until the patient is suspended a suitable distance above the bed and floor. The caregiver can then pull on the sling, causing the carriage to move along the rail system until the patient is positioned in the vicinity of a destination, for example a chair. The caregiver then operates the motor to extend the tether out of the carriage in order to deposit the patient on the chair, after which the caregiver can disconnect the sling from the slingbar hooks and maneuver the sling from under the patient. Alternatively the caregiver can deposit the patient near the chair in a standing posture, disconnect the sling from the hooks, place the sling aside, and assist the patient into the chair. 
     Sling assemblies as just described have many merits. However one drawback is that the dimensions of a given model of sling may not be suitable for patients of all sizes (height, weight, girth, morphology) or even for a wide range of patient sizes and/or may not be suitable for all clinical situations. In other words, the concept of “one size fits all” does not apply, or at least involves considerable compromise. For example if the lateral dimension of the sling (the left to right dimension from the patient&#39;s perspective) is too small, the patient will feel squeezed across his shoulders and/or torso when suspended in the sling. If the lateral dimension of the sling is too large, the patient may feel inadequately supported, for example the patient may feel side to side instability or may feel a lack of support in his lower back. 
     One way to address the sling/patient sizing problem is to manufacture a sling with a variety of loops. When attaching the sling to the slingbar hooks, the caregiver selects the sling loops most suitable for the patient size or clinical situation of interest. For example loops that are more widely laterally separated may be more suitable for a patient of large girth, while loops that are less widely separated may be more satisfactory for a smaller patient. 
     Although the multi-loop solution may have merit, the presence of numerous loops may increase the likelihood that a loop might inadvertently snag on a nearby object during patient transport, causing delay and inconvenience. 
     Another way to address the sling/patient sizing problem is for the sling manufacturer to offer a multitude of differently sized slings, smaller slings for smaller patients; larger slings for larger patients. The multiple sling solution has the disadvantage that the health care facility needs to purchase a variety of slings and the caregiver is faced with the challenge of selecting the correct size sling for each individual from the numerous sizes available. 
     It is therefore desirable to provide a single sling which will accommodate all (or a very wide range) of patients and clinical situations or a sling which can be offered in a very small number of different sizes which, taken collectively, accommodate all (or a very wide range) of patients and clinical situations. 
     SUMMARY 
     A sling for supporting a subject includes a a left flank with a left end, a right flank with a right end, and an interflank panel. The interflank panel has a left extremity permanently joined to the left end of the left flank and a right extremity permanently joined to the right end of the right flank. The sling also includes left and right closure elements which are securable to each other and releasable from each other to adjust an effective dimension of the sling. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The foregoing and other features of the various embodiments of the patient support sling described herein will become more apparent from the following detailed description and the accompanying drawings in which: 
         FIG.  1    is a perspective view of a conventional sling assembly comprised of a slingbar and a fixed dimension patient support sling attached to the slingbar. 
         FIG.  2    is a plan view of the back face of the sling of  FIG.  1   , laid flat. 
         FIG.  3    is a back side plan view of a sling as described herein, laid flat, and showing left and right flanks and an interflank panel in the form of a substantially continuous sheet of material and also showing a closure comprising left and right closure elements. 
         FIG.  4    is an enlarged cross sectional view in the direction  4 - 4  of  FIG.  3    with the closure elements released from each other so that the effective lateral dimension of the sling is an open dimension. 
         FIG.  5    is an enlarged cross sectional view similar to that of  FIG.  4    with the left and right closure elements secured to each other so that the effective lateral dimension of the sling is a closed dimension which is smaller than the open dimension. 
         FIG.  6    is a view similar to that of  FIG.  5    showing an alternate arrangement in which the left closure element joins the interflank panel to the left flank and the right closure element joins the interflank panel to the right flank. 
         FIGS.  7 A,  7 B,  7 C, and  7 D  are views similar to those of  FIGS.  4 - 5    showing a series embodiment of the sling in which the interflank panel comprises multiple interflank segments of different order and additional closure elements of different order, the successive FIGS. showing the panel at a progressively reduced lateral dimension. 
         FIG.  8    is a view similar to that of  FIGS.  7 A- 7 D  in which closure elements which are not being used to establish the effective dimension of the sling are not secured to each other. 
         FIG.  9    is a view similar to that of  FIG.  8    showing closure elements of different order secured to each other. 
         FIGS.  10  and  11    are a plan view of the patient face of a sling and a perspective view of a portion of the sling whose closure elements are zip halves colored to indicate the effective lateral dimension of the sling. 
         FIGS.  12 - 13    are views similar to those of  FIGS.  10 - 11    showing a sling whose closure elements are male and female components of a hook and loop fastener and in which fastener patches are colored to indicate the effective lateral dimension of the sling. 
         FIGS.  14 A- 14 C  are views similar to those of  FIGS.  7 A- 7 D  showing a parallel embodiment of the sling in which the interflank panel comprises multiple interflank segments and additional closure elements, the successive FIGS. showing the panel at a progressively reduced lateral dimension. 
         FIG.  15    a view similar to that of  FIGS.  14 A- 14 C  in which a reduced lateral dimension of the sling has been attained by securing nonadjacent closure elements to each other. 
         FIGS.  16 ,  17 ,  18  and  19    are views of a portion of a sling showing a selection of alternative closure elements which can be secured to each other without the assistance of an intervening component. 
         FIGS.  20 ,  21 ,  22 ,  23  and  24    are views of a portion of a sling showing a selection of alternative closure elements which can be secured to each other with the assistance of an intervening component. 
         FIG.  25    is a cross sectional view similar to  FIG.  5    showing a frangible closure member in an unbroken state. 
         FIG.  26    is a perspective view showing the frangible closure member of  FIG.  25    in the unbroken state. 
         FIG.  27    is a view similar to that of  FIG.  25    showing the frangible closure member in a broken state. 
         FIG.  28    is a view similar to that of  FIG.  25    showing an alternative frangible closure member in its unbroken state. 
         FIGS.  29 A,  29 B, and  29 C  is a set of views similar to the views of  FIGS.  25  and  27    showing multiple frangible closure members, the successive FIGS. showing the interflank panel at a progressively expanded lateral dimension. 
     
    
    
     DETAILED DESCRIPTION 
     Reference will now be made to embodiments of the invention, examples of which are illustrated in the accompanying drawings. Features similar to or the same as features already described may be identified by reference numerals which are the same as or similar to those already used. 
       FIG.  1    shows a sling assembly  18  which includes slingbar  20 , a representative, fixed dimension patient support sling  22  attached to the slingbar, and a subject or patient P seated in the sling. A tether  30  extends upwardly from the slingbar to a carriage  32 . The carriage includes a motor and other components so that operation of the motor retracts the tether into the interior of the carriage in order to raise the patient away from floor F, or deploys the tether out of the carriage in order to lower the patient toward the floor. The carriage is mounted on a rail  36  of a rail system. The rails of the rail system are secured to a ceiling beam  38  so that the patient can be moved horizontally. 
     Referring additionally to  FIG.  2   , the fixed dimension sling includes a fabric patient support panel assembly  50  for cradling the patient. The drawing shows the back face of the sling, i.e. the face that faces away from the patient being supported. The opposite face is referred to as the front or patient face PF. The panel assembly extends longitudinally from an upper edge  52  to a lower edge  54  and laterally from a left edge  56  to a right edge  58 . Upper and lower loops  66 ,  68  extend from the panel assembly. When in use, the support loops are hooked onto hooks  70  on the slingbar as seen in  FIG.  1   . 
     The conventional sling of  FIGS.  1 - 2    has an actual lateral dimension D 1,ACT  and an effective lateral dimension D 1,EFF . The actual and effective lateral dimensions of the illustrated sling are the distance from left edge  52  to right edge  54 . Both dimensions vary in the longitudinal direction. However at any given longitudinal coordinate, the effective lateral dimension is the same as the actual lateral dimension even when the weight of a patient places the sling under tension. 
     The sling also has an actual longitudinal dimension D 2,ACT  and an effective longitudinal dimension D 2,EFF . The actual and effective lateral dimensions of the illustrated sling are the distance from upper edge  56  to lower edge  58 . Both dimensions vary in the lateral direction. However at any given lateral coordinate, the effective longitudinal dimension is the same as the actual longitudinal dimension even when the weight of a patient places the sling under tension. 
     As noted previously, fixed dimension slings, such as the one just described, may not be suitable for all patients or clinical situations, or even for a broad range of patients and clinical situations. Existing ways of accommodating the drawbacks of fixed dimension slings may introduce problems of their own. 
       FIGS.  3 - 5    are views of one embodiment of a sling as disclosed herein.  FIG.  3    is a view of the back face of the sling, which is the face that faces away from the patient. The opposite face is the patient facing face and is indicated as PF in  FIGS.  4 - 5   . The sling includes a panel assembly  50  including a left flank  80  with a left end  82 , a right flank  84  with a right end  86 , and an interflank panel  100 . The interflank panel has a left extremity  102  permanently joined to the left end  82  of the left flank  80  and a right extremity  104  permanently joined to the right end  86  of the right flank  84 . The interflank panel has a width W which is the distance from the left extremity to the right extremity. As used in this specification, including the accompanying claims, “left” and “right” are used as, and should be interpreted as, terms of distinction rather than terms of direction even though in most of the examples “left” and “right” happen to also correspond to directions. 
     The sling also includes a left closure element  110 L and a right closure element  110 R. The example closure elements are zip halves  110 LZ,  110 RZ, one of which includes a zip slider  114 . Taken collectively, the zip halves and zip slider comprise a zipper  116 . 
     The closure elements are securable to each other ( FIG.  5   ) so that the effective lateral dimension D 1,EFF  is a relatively smaller closed dimension. The closure elements are also releasable from each other ( FIGS.  3 - 4   ) so that the effective lateral dimension D 1,EFF  is an relatively larger dimension which is greater than the closed, relatively smaller dimension. Because the effective lateral dimension can be adjusted to two different discrete dimensions as seen by comparing  FIG.  5    to  FIGS.  3 - 4   , the sling can accommodate a wider range of patients than would be the case if the sling were a nonadjustable, fixed dimensional sling. For example the sling adjusted as seen in  FIG.  5    can be used for patients classified as “small” while the same sling adjusted as seen in  FIGS.  3 - 4    can be used for patients classified as “large”. The sling is designed so that when the closure elements are secured to each other and the sling is used as intended (to bear the weight of a patient within the rated load capacity of the sling) the closure elements will not separate from each other even though the sling is bearing a patient&#39;s weight (force of gravity) acting on the sling with a vertically downwardly oriented component. 
     “Securable to each other” as used in the foregoing paragraph and throughout this specification means that the closure elements can be engaged with each other without the assistance of an intervening component to keep the elements engaged. One example is the two zip halves of a zipper which interlock with each other when the zipper is closed or zipped. The zip slider is not considered to be an intervening component because although it effects the joinder and separation of the zip halves, it plays no role in maintaining the engagement of the zip halves with each other. Another example is a shirt button which interacts with material surrounding a buttonhole to resist passing through the buttonhole when the shirt is buttoned. “Securable to each other” also means that the closure elements can be drawn toward each other with the assistance of an intervening component. One example is left and right sides of a shoe, playing the role of two closure elements, which can be drawn toward each other by a shoelace (the intervening component) in order to prevent the wearer&#39;s foot from slipping inside the shoe or slipping out of the shoe. Unlike a zip slider which plays no role in maintaining the engagement of two zip halves, the shoelace plays a continuing role in keeping the left and right halves of a shoe drawn toward each other. 
     “Releasable from each other” as used throughout this specification is the opposite of “securable to each other”, for example the way the two zip halves of a zipper can be disengaged from each other to open or unzip the zipper or the way a shirt button can be passed edgewise through its buttonhole to unbutton the shirt. In the case of closure elements that require the assistance of an intervening component, “releasable from each other” means the closure elements can be released from their previously selected drawn-together state. 
       FIGS.  3 - 5    show an example in which left flank  80 , right flank  84 , and interflank panel  100 , are permanently joined to each other by virtue of being a continuous piece of material. Accordingly, the ends  82 ,  86  of the panel flanks and the extremities  102 ,  104  of the interflank panel are not distinct features but instead are locations for distinguishing between the interflank panel and the flanks. In  FIGS.  4 - 5    the ends  82 ,  86  of the flanks and the lateral extremities  102 ,  104  of the interflank panel  100  are aligned with the operative edges  118  of the zip halves  110 LZ,  110 RZ (and are indicated for the convenience of the reader by light vertical hash marks superimposed on the panel assembly near the operative edges of the zip halves). “Permanently joined” means designed so that the flanks will not separate from the interflank panel under the influence of forces to which the joint is subjected when the sling is used for its intended purpose. 
       FIG.  6    shows an alternate arrangement in which the left flank  80 , right flank  84  and interflank panel  100  are recognizably distinct elements. The left flank  80  has a distinct left end  82 , the right flank  84  has a distinct right end  86 , and the interflank panel  100  has distinct left and right extremities  102 ,  104 . Left zip half  110 LZ overlies and is permanently joined to both the left flank  80  and the interflank panel  100 . Right zip half  110 RZ overlies and is permanently joined to both the right flank  84  and the interflank panel  100 . As with the continuous material embodiment, “permanently joined” means designed so that the interflank panel and the flank will not separate from each other under the influence of forces to which the sling is subjected when the sling is used for its intended purpose. 
     In the example of  FIGS.  3 - 6   , the dimension of interest is the lateral dimension. With the closure elements secured to each other as in  FIG.  5   , the interflank panel  100  is folded up behind closure elements  110 L,  110 R and flanks  80 ,  84 . As used herein, “behind” is not limited to the region R bounded by the nonoperative edges  120  of the zip halves, but instead means in the direction of arrow B. The effective lateral dimension D 1,EFF  of the sling, which is the dimension perceived by the patient, is the nonconvoluted distance from sling edge  56  to sling edge  58 . The width W of interflank panel  100  does not contribute to the effective dimension D 1,EFF . The effective lateral dimension of the sling as seen in  FIG.  5    is the minimum lateral dimension of the sling achievable with the described closure elements and interflank panel. The minimum dimension may also be referred to as the closed dimension. However the actual dimension, by definition, includes interflank panel width W even when the panel is folded up behind the closure elements and flanks. As a result the effective dimension D 1,EFF , is less than the actual dimension D 1,ACT . By contrast, with the closure elements released from each other as in  FIGS.  3  and  4    (and  FIG.  6   ) the effective dimension D 1,EFF  equals the actual dimension D 1,ACT . The effective lateral dimension of the sling as seen in  FIG.  3 - 4    (and  FIG.  6   ) is the maximum lateral dimension of the sling achievable with the described closure elements and interflank panel. This dimension may also be referred to as the open dimension of the sling. 
     In the examples in this specification, when the sling is at a lateral dimension smaller than its maximum lateral dimension, the folded up, excess portion of the interflank panel material is on the patient facing side PF of the sling, next to the patient. However the sling could be constructed so that the excess material is on the back side of the sling. 
     Referring principally to  FIGS.  4 - 5    selected portions of the sling can be made visually distinctive in order to indicate its effective dimension to an observer. For example, the material of interflank panel  100  may be colored red. When the red color is visible ( FIG.  4   ), its visibility indicates that the sling is at its maximum or open lateral dimension. When the red color is not visible ( FIG.  5   ), the sling is at its minimum or closed lateral dimension. Alternatively, color can be applied to the zip halves or to the material in the immediate vicinity of the zip halves so that the color appears as longitudinally extending stripes. When the colored stripes are close together they indicate that the sling is at its closed or minimum dimension. When the stripes are spatially separated they indicate that the sling is at its open or maximum dimension. The color coding may also be useful for indicating which left and right closure elements are preferred to be secured to each other (even though nonpreferred connections can be made). If the sling is manufactured such that not all the left closure elements are compatible with all the right closure elements, the color coding can be used to indicate which left and right closure elements are compatible with each other. 
     The direction in which the closure elements extend is referred to as a closure direction. In the foregoing example the closure direction is the longitudinal direction because the closure elements, i.e. zip halves  110 LZ,  110 RZ, extend longitudinally along the sling. The dimension of interest, i.e. the adjustable dimension, is the dimension in the lateral direction. Additionally or alternatively, the dimension of interest could be the longitudinal dimension D 2 . Speaking generally, the closure elements extend in a closure direction, and the effective dimension is perpendicular to the closure direction. 
       FIGS.  7 A- 7 D  are views similar to those of  FIGS.  4 - 5    but showing an embodiment in which interflank panel  100  comprises multiple interflank segments and multiple closure elements. In the illustrated embodiment the interflank segments include a medial section or segment  100 M and one or more pairs of intermediate sections or segments laterally between the medial segment and the left and right flanks  80 ,  84 . The intermediate segments of  FIGS.  7 A- 7 D  are a first left intermediate segment  100 -IL 1  extending laterally leftwardly from the medial segment, a second left intermediate segment  100 -IL 2  extending laterally leftwardly from the first left intermediate segment to the left flank  80 , a first right intermediate segment  100 -IR 1  extending laterally rightwardly from the medial segment, and a second right intermediate segment  100 -IR 2  extending laterally rightwardly from the first right intermediate segment to the right flank  84 . In general, on either side (left or right) of the medial segment, the intermediate segment closest to the medial segment is of order one, the intermediate segment next (second) closest to the medial segment (if any) is of order two, the intermediate segment third closest to the medial segment (if any) is of order three, and so forth. The numerical subscript of the reference numerals indicates the order of the segment. Lower order segments can also be thought of as being laterally inboard of higher order segments; higher order segments can be thought of as being laterally outboard of lower order segments. A vertical hash mark is used in the illustrations to indicate a notional boundary between adjacent segments. 
     The embodiment of  FIGS.  7 A- 7 D  also includes additional closure elements in comparison to the embodiment of  FIGS.  4 - 5   . These include a first left intermediate closure element  110 -CL 1 , a second left intermediate closure element  110 -CL 2 , a first right intermediate closure element  110 -CR 1 , and a second right intermediate closure element  110 -CL 2 . Each closure element, including closure elements  110 L and  110 R, has an order associated with it. The closure elements  110 -CL 1  and  110 -CR 1  closest to the medial segment are of first order; the closure elements next closest to the medial segment  110 -CL 2  and  110 -CR 2  are of second order, and so forth. In the illustrations order is indicated by different crosshatching, positively sloped for first order, horizontal for second order, negatively sloped for third order. In general, on either side (left or right) of the medial segment, the intermediate closure element closest to the medial segment is of order one, the intermediate closure element next (second) closest to the medial segment (if any) is of order two, the intermediate closure element third closest to the medial segment (if any) is of order three, and so forth. The numerical subscript of the reference numerals indicates the order of the segment. Lower order closure elements can also be thought of as being laterally inboard of higher order closure elements; higher order closure elements can be thought of as being laterally outboard of lower order closure elements. 
     The operative edges  118  of the zip halves face laterally toward centerplane CP of the sling. This specification refers to such an embodiment as a series embodiment to distinguish it from the embodiment of  FIGS.  14 A- 14 C , which is referred to as a parallel embodiment. 
     Closure elements are considered to be compatible with each other if they are securable to each other (and releasable from each other after having been secured together). In one variant of the sling all the right closure elements are compatible with all the left closure elements. In another variant only left and right closure elements of equal order are compatible with each other. One way of achieving incompatibility is by making the teeth of the zip halves different sizes so that they cannot interlock with each other. Unless indicated otherwise, the examples described in this specification are the variant in which all the right closure elements are compatible with all the left closure elements. 
     In general, the interflank panel comprises a single medial segment, a quantity n I  of left intermediate segments, and an equal quantity n I  of right intermediate segments where n I ≥0. The interflank panel also includes n C  left intermediate closure elements and an equal quantity n C  of right intermediate closure elements where n C =n I . The effective dimension is adjustable to one or more intermediate effective dimensions greater than a minimum effective dimension and less than a maximum effective dimension. 
       FIG.  7 A  shows the sling at its maximum or open effective lateral dimension D 1,MAX . None of the closure elements are secured to each other. All of the intermediate segments contribute to both D 1,ACT  and to D 1,EFF . D 1,EFF =D 1,MAX =D 1,ACT . 
       FIG.  7 B  shows the sling at a first intermediate effective lateral dimension D 1,INT1 . Closure elements  110 -CL 1  and  110 -CR 1  are secured together. Medial segment  100 M is folded up behind closure elements  110 -CL 1  and  110 -CR 1  and behind the first intermediate segments  100 -IL 1 ,  100 -IR 1 . As with the nonsegmented embodiment of  FIGS.  4 - 5   , “behind” is not limited to the region R bounded by the nonoperative edges  120  of the zip halves, but instead means in the direction of arrow B. All of the interflank segments contribute to D 1,ACT . All the interflank segments except  100 M contribute to the effective dimension. D 1,EFF =D 1,INT1 &lt;D 1,ACT . 
       FIG.  7 C  shows the sling at a second intermediate effective lateral dimension D 1,INT2 . Closure elements  110 -CL 2  and  110 -CR 2  are secured together. Closure elements  110 -CL 1  and  110 -CR 1  remain secured together. Medial segment  100 M and first intermediate segments  100 -IL 1  and  100 -IR 1  are folded up behind closure elements  110 -CL 2  and  110 -CR 2 . Medial segment  100 M and first intermediate segments  100 -IL 1 ,  100 -IR 1  contribute to D 1,ACT , but not to D 1,EFF . D 1,EFF =D 1,INT2 &lt;D 1,INT1 &lt;D 1,ACT . 
       FIG.  7 D  shows the sling at a minimum intermediate effective lateral dimension D 1,INT3 , which is the minimum lateral dimension D 1,MIN . Closure elements  110 L and  110 R are secured together. Closure elements  110 -CL 1  and  110 -CR 1  remain secured together as do closure elements  110 -CL 2  and  110 -CR 2 . Medial segment  100 M, first intermediate segments  100 -IL 1  and  100 -IR 1 , and second intermediate segments  100 -IL 2  and  100 -IR 2  are folded up behind closure elements  110 L and  110 R. Medial segment  100 M, first intermediate segments  100 -IL 1 ,  100 -IR 1 , and second intermediate segments  100 -IL 2 ,  100 -IR 2 , contribute to D 1,ACT , but not to D 1,EFF . D 1,EFF =D 1,INT3 &lt;D 1,ACT . 
       FIG.  8    is a view similar to that of  FIGS.  7 A- 7 D . The illustration shows that, unlike  FIGS.  7 A- 7 D , the closure elements which are not being used to establish the effective dimension of the sling, do not need to be secured to each other. 
       FIG.  9    is a view similar to that of  FIG.  8    except that closure elements of different order, specifically  110 L and  110 -CL 2 , are secured to each other. If all the left closure elements of  FIG.  9    are compatible with all the right closure elements, the securement arrangements of the following table can be obtained. 
     
       
         
           
               
               
               
             
               
                   
                 TABLE 1 
               
               
                   
                   
               
               
                   
                 Connected Closure 
                   
               
               
                   
                 Elements (zip halves) 
                 Size 
               
               
                   
                   
               
             
            
               
                   
                 None 
                 Maximum 
               
               
                   
                 110 L , 110 R   
                 Minimum 
               
               
                   
                 110-CL 2 , 110-CR 2   
               
               
                   
                 110-CL 1 , 110-CR 1   
               
               
                   
                 110-CL 1 , 110R 
               
               
                   
                 110-CR 1 , 110L 
               
               
                   
                 110-CL 2 , 110R 
               
               
                   
                 110-CR 2 , 110L 
               
               
                   
                 110-CL 2 , 110-CR 1   
               
               
                   
                 110-CL 1 , 110-CR 2   
               
               
                   
                   
               
            
           
         
       
     
     With the multi-segmented arrangement illustrated in  FIGS.  7 A- 7 D and  8 - 9    a multitude of discrete effective lateral dimensions less than the maximum lateral dimension can be achieved depending on which closure elements are secured to each other and the quantity and widths of the interflank segments. For example the sling adjusted as seen in  FIG.  7 D  can be used for patients classified as “small” while the same sling adjusted as seen in  FIGS.  7 C,  7 B, and  7 A  can be used for patients classified as “medium”, “large”, and “extra large” respectively. The sling is designed so that when the closure elements are secured to each other and the sling is used as intended (to bear the weight of a patient within the rated load capacity of the sling) the closure elements will not separate from each other even though the sling is bearing a patient&#39;s weight (force of gravity) acting on the sling with a vertically downwardly oriented component. 
     The concept of making selected portions of the sling visually distinctive in order to indicate its effective dimension to an observer, as explained in connection with  FIGS.  4 - 5   , can be extended to the embodiments in which the interflank panel includes multiple interflank segments and multiple closure elements ( FIGS.  7 A- 7 D, and  8 - 9    described above, and  FIGS.  14 A- 14 C and  15    described below).  FIGS.  10 - 11    show an example in which the interflank panel  100  includes a medial segment  100 M, a left intermediate segment  100 -IL 1  extending laterally leftwardly from the medial segment to the left flank  80 , and a right intermediate segment  100 -IR 1  extending laterally rightwardly from the medial segment to the right flank  84 . Compatible closure elements  110 -CL 1  and  110 -CR 1  (illustrated as zip halves) or the sling material in the vicinity of those closure elements are green and give the impression of longitudinally extending green stripes. Compatible closure elements  100 L and  100 R or the sling material in the vicinity of those closure elements are red and give the impression of longitudinally extending red stripes. 
     When neither the green nor the red closure elements are connected to each other, both green stripes and both red stripes are visible, indicating that the sling is at its maximum or open lateral dimension and is compatible with a “Large” patient. When only the green closure elements are connected to each other, both red stripes are visible and the green stripes appear as a single stripe (or closely separated stripes). This indicates that the sling is at an intermediate lateral dimension and is compatible with a “Medium” patient. When the red closure elements are connected to each other, the green stripes are not visible (irrespective of whether or not the green elements are connected to each other) and the red stripes appear as a single stripe (or closely separated stripes). This indicates that the sling is at its minimum or closed lateral dimension and is compatible with a “Small” patient. If a green closure element is connected to a red closure element, a red stripe and a green stripe are visible close to each other, and a single red stripe is visible separated from the red/green combination. 
       FIGS.  12 - 13    show a color coding arrangement used on a sling whose closure relies on hook and loop closure elements. The illustrated sling includes a left flank  80 , a right flank  84  and an interflank panel  100  (not visible in  FIG.  12   ). Exactly one right closure element in the form of a tab  128  extends laterally from the right flank. At least two left closure elements reside on the left flank. The illustrated embodiment includes two left closure elements, a first left closure element in the form of a green colored attachment patch  130 GR and a second left closure element in the form of a red colored attachment patch  130 RD. Second patch  130 RD is laterally spaced from first patch  130 GR so that second patch  130 RD is laterally further away from left end  82  of left flank  80  than is first patch  130 GR. In one alternative the exactly one right closure element is a more longitudinally extensive strip, the first left closure element is a more longitudinally extensive strip, and the second left closure element is a more longitudinally extensive strip. In another alternative the exactly one right closure element is a set of longitudinally distributed tabs, the first left closure element is a first set of longitudinally distributed patches and the second left closure element is a second set of longitudinally distributed patches. 
     When the tab is not secured to either green patch  130 GR or red patch  130 RD, both patches are visible, indicating that the sling is at its maximum or open lateral dimension and is compatible with a “Large” patient. (In  FIG.  13    the intersegment panel is depicted as being folded, however the closure elements are not secured to each other and therefore cannot react a laterally directed force.) When the tab is secured to the first (green) patch, only the red patch is visible indicating that the sling is at an intermediate lateral dimension and is compatible with a “Medium” patient. When the tab is secured to the second (red) patch, neither the red patch nor the green patch is visible, indicating that the sling is at its minimum or closed lateral dimension and is compatible with a “Small” patient. 
       FIGS.  14 A- 14 C  are views of an embodiment similar to the embodiment of  FIGS.  4 - 5    in that it includes a pair of closure elements (zip halves  110 L/ 110 A 1  and  110 R/ 100 E 2 , described in more detail below) whose operative edges, when secured to each other, cause the sling to be at its minimum lateral dimension. The embodiment of  FIGS.  14 A- 14 C  is also similar to that of  FIGS.  7 A- 7 D and  8 - 9    in that interflank panel  100  comprises multiple interflank segments and multiple closure elements. The embodiment of  FIGS.  14 A- 14 C  is referred to a a parallel embodiment to distinguish it from the series embodiment of  FIGS.  7 A- 7 D and  8 - 9   . The interflank segments of the illustrated embodiment are first through fifth segments  100 A,  100 B,  100 C,  100 D,  100 E which are laterally between flanks  80 ,  84 . 
     The embodiment of  FIGS.  14 A- 14 C  also includes additional closure elements in comparison to the embodiment of  FIGS.  4 - 5   . The additional closure elements are intermediate closure elements  110 A 2 ,  110 B 1 ,  110 B 2 ,  110 C 1 ,  110 C 2 ,  110 D 1 ,  110 D 2  and  110 E 1 . The closure elements at the left end  82  of left flank  80  and at the right end  86  of right flank  84  are labelled as  110 L and  110 R as in the series embodiment, and also as  110 A 1  and  110 E 2  to maintain consistency with the numbering of the eight additional closure elements ( 110 A 2  through  110 E 1 ) of  FIGS.  14 A- 14 C . Pairs of closure elements which neighbor each other and whose interconnecting features (e.g. the operative edges  118  of a zip half) face toward each other (one left facing (even numbered subscripts) and one right facing (odd numbered subscripts)) are defined as corresponding closure elements. In the illustrations different pairs of corresponding elements are indicated by common crosshatching. Corresponding closure elements are compatible with each other as already defined in connection with  FIGS.  7 A- 7 D,  8 , and  9    (securable to each other and, once secured together, releasable from each other). Noncorresponding left facing and right facing closure elements, e.g. elements  110 B 1  and  110 D 2 , may be designed to be compatible with each other or incompatible with each other. Unless indicated otherwise, the examples described in this specification are the variant in which all the right facing closure elements are compatible with all the left facing closure elements. A spacer strip  122  may be present between closure elements having different letter suffixes, e.g. between  110 C 2  and  110 D 1    
     In general, the interflank panel includes m segments and m=1 additional (interflank) closure elements. The lower limit case is m=1, m−1=0, which is the same as the series embodiment of  FIGS.  4 - 5   . The effective dimension is adjustable to one or more intermediate effective dimensions greater than a minimum effective dimension and less than a maximum effective dimension. 
       FIG.  14 A  shows the sling at its maximum or open effective lateral dimension D 1,MAX . None of the closure elements are secured to each other. All of the interflank segments contribute to both D 1,ACT  and to D 1,EFF . D 1,EFF =D 1,MAX =D 1,ACT . 
       FIG.  14 B  shows the sling at a first reduced effective lateral dimension D 1,RED1 . Closure elements  110 C 1  and  110 C 2  are secured together. Third segment  100 C is folded up behind closure elements  110 C 1  and  110 C 2 . All of the segments, including the folded segment  100 C, contribute to actual dimension D 1,ACT . All the segments except  100 C contribute to the effective dimension D 1,EFF . D 1,EFF =D 1,RED1 &lt;D 1,ACT . 
       FIG.  14 C  shows the sling at a second reduced effective lateral dimension D 1,RED2 . Closure elements  110 C 1  and  110 C 2  are secured together as in  FIG.  10 B . In addition, three other pairs of closure elements are secured to each other ( 110 A 1 / 110 L to  110 A 2 ;  110 D 1  to  110 D 2 ; and  110 E 1  to  110 E 2 / 110 R). D 1,EFF =D 1,RED2 &lt;D 1,RED1 &lt;D 1,ACT . 
       FIG.  15    shows the sling at another reduced effective lateral dimension. The reduced dimension is obtained by securing closure elements  110 B 1  and  110 D 2  to each other (bypassing  110 B 2  and  110 C 2 ). 
     With the multi-segmented arrangement illustrated in  FIGS.  14 A- 14 C and  15    a multitude of effective lateral dimensions less than the maximum lateral dimension can be achieved depending on which closure elements are secured to each other, how many closure elements are secured to each other, and the quantity and widths of the interflank segments. 
     The foregoing describes the use of left and right closure elements without an intervening component to adjust a dimension of a sling. The left closure element can be alternatively referred to as a right facing closure element, and the right closure element can be alternatively referred to as a left facing closure element. Zip halves are the predominant examples used so far in this specification. The following paragraphs describe a nonexhaustive set of alternatives in the context of a nonsegmented sling, i.e. one in which the interflank panel is not broken down into medial and intermediate segments. 
     In  FIG.  16    the left (right facing) closure element is a row of buttonholes  134  and the right (left facing) closure element is a row of buttons  136 . 
     In  FIGS.  17 - 18   , the left (right facing) closure element is a row of female snap receptacles  142  and the right (left facing) closure element is a row of male snap studs  144 . 
     In  FIG.  19   , the left (right facing) closure element is a row of buckles frames  146 , each attached to the left end  82  of left flank  80  and each including a tongue  148 . The right (left facing) closure element is a strap  150  with holes  152  for receiving the tongue. 
     Sling adjustability can also be effected by left and right closure elements that require an intervening component. The following paragraphs describe a nonexhaustive set of such closure elements. 
     In  FIG.  20    the left (right facing) closure element is a row of left eyelets  156 , and the right (left facing) closure element is a row of right eyelets  158 . The intervening component element is a lace  160 . 
       FIGS.  21 - 23    show a corset-like arrangement in which the left (right facing) closure element is a row of left loops  164 , and the right (left facing) closure element is a row of right loops  166 . The intervening component is a lace  160 . Alternatively, as seen in  FIG.  24   , the left and right closure elements are each a row of hooks  168 ,  170 . Either way the lace has a fixed end  174  and a free end  176 . The free end is secured to one of two or more terminals  178 BL (black),  178 GR (green), (red)  178 RD to establish how tightly the left and right flanks  80 ,  84  are drawn toward each other, thereby establishing the effective lateral dimension of the sling. The optional color coding of the terminals indicates large, medium and small sizes. 
     Referring to  FIG.  25   , another embodiment of a size adjustable sling includes a panel assembly  50  including a left flank  80  with a left end  82 , a right flank  84  with a right end  86 , and an interflank panel  100 . The interflank panel has a left extremity  102  permanently joined to the left end of the left flank and a right extremity  104  permanently joined to the right end of the right flank. 
     Referring additionally to  FIG.  26    a frangible closure member  210  secures the left flank to the right flank. The frangible closure member in the example of  FIGS.  25 - 26    is a strip of material  180  sewn to the left end of the left flank and to the right end of the right flank by a thread  182 . The closure member is frangible in the sense that it is designed to be breakable only by an influence, such as a force or forces, which are purposefully concentrated on the closure member. The closure member is designed so that it will remain intact under other influences, such as a load which is distributed on the sling and which has a vertically downwardly directed component. An example of such an influence is part or all of a patient&#39;s weight when borne by the sling. 
     An influence is considered to be purposefully concentrated on the closure member if the influence is applied with the goal of breaking the closure member. One example is a tearing force exerted by a person who grasps each flank near the upper edge of the sling, e.g. at locations G L , G R , and pulls in opposite directions to tear the closure member. Another example is the use of scissors to cut the closure member. As demonstrated by these two examples, the closure member may be designed to be broken with a tool or without a tool. If the closure member is designed to be broken with a tool its design may also provide for breakage without a tool. 
       FIG.  27    shows the sling after the closure member has been broken. In the example of  FIG.  27    the act of breaking the closure member has left behind two remnants,  210   a ,  210   b  as a result of the formerly intact strip  210  having been torn or cut. In another example, not shown, the breaking of the closure member could be effected by breakage of one or both threads  182 . A comparison of  FIG.  25    to  FIG.  27    shows that the sling has a smaller effective dimension D 1,EFF  when the frangible closure member is intact and has a larger effective dimension when the closure member is broken. 
     The frangible closure member is a sacrificial or one-way closure member in the sense that breakage of the closure member is irreversible. This is in contrast to the closure elements of the embodiments described in connection with  FIGS.  1 - 24    in which the closure elements can be readily re-secured to each other after having been released from each other. Accordingly, the sling with the frangible closure member may be designed as a single-patient sling. That is, the sling is designed to be disposed of after it is no longer needed for the patient to whom its size had been adjusted. Two exceptions are that a sling which has been used as seen in  FIG.  25    can be used again for another “small” patient, and the sling which has been used as seen in  FIG.  27    can be used again for another “large” patient. 
       FIG.  28    shows another embodiment in which the frangible closure member  210  is a thread  182 . In yet another embodiment, not illustrated, the frangible closure member is a heat sealed “weld” joint that can be cut with scissors. 
       FIGS.  29 A- 29 C  are views similar to  FIGS.  25  and  27    except that interflank panel  100  comprises a medial segment  100 M and one or more pairs of intermediate sections or segments laterally between the medial segment and the left and right flanks  80 ,  84 . The example shows one pair of intermediate segments, a left intermediate segment  100 -IL 1  extending laterally leftwardly from the medial segment, and a right intermediate segment  100 -IR 1  extending laterally rightwardly from the medial segment. 
     Referring to  FIG.  29 A , a first frangible closure member  210 - 1  secures left flank  80  to right flank  84 . A second frangible closure member  210 - 2  secures left intermediate segment  100 -IL 1  to right intermediate segment  100 -IR 1 . The effective lateral dimension of the sling D 1,EFF , is its minimum lateral dimension. 
       FIG.  29 B  shows the sling after frangible closure member  210 - 1  has been broken, leaving behind two remnants,  201 - 1   a  and  210 - 1   b . The effective lateral dimension of the sling D 1,EFF , is an intermediate lateral dimension, which is larger than the minimum dimension of  FIG.  29 A . 
       FIG.  29 C  shows the sling after frangible closure member  210 - 2  has been broken, leaving behind two additional remnants,  201 - 2   a  and  210 - 2   b . The effective lateral dimension of the sling D 1,EFF , is its maximum lateral dimension, which is larger than the intermediate dimension of  FIG.  29 B . 
     In the embodiment of  FIGS.  29 A- 29 C  the sling includes an additional frangible closure member for each pair (one left and one right) of intermediate segments. For example the embodiment specifically shown in  FIGS.  29 A- 29 C  includes one pair of intermediate segments and one closure member  210 - 2  in addition to closure member  210 - 1 . A sling similar to that of  FIGS.  29 A- 29 C  which includes n left intermediate segments and n right intermediate segments includes n+1 closure members, one for each of the n left and right intermediate segment pairs and one for securing the left flank to the right flank. 
     In the embodiments of  FIGS.  25 - 29 C , the frangible closure member  210  or  210 - 1  can be viewed as holding the flank ends in close proximity to each other. The closure member is irreversibly breakable thereby enabling the flank ends to separate from each other and enlarging an effective dimension of the sling. The embodiment of  FIGS.  29 A- 29 C  includes additional frangible closure members which can be viewed as holding a left intermediate segment and a right intermediate segment in close proximity to each other. In a specific embodiment the left intermediate segments can be numbered  1  through n and the right intermediate segments can be similarly numbered  1  through n with the number  1  corresponding to the segments closest to the medial segment, the number  2  corresponding to the next most outboard segments, and so forth. A frangible closure member, in addition to member  210 - 1 , is provided for each pair of intermediate segments, and each of these additional closure members can also be numbered  1  through n. Closure member  210 - 1  holds the flanks in close proximity to each other until broken. Like numbered left and right intermediate segments are held in close proximity to each other by the same-numbered closure member until the member is broken. 
     Although this disclosure refers to specific embodiments, it will be understood by those skilled in the art that various changes in form and detail may be made without departing from the subject matter set forth in the accompanying claims. 
     The terms “substantially” and “about” may be used herein to represent the inherent degree of uncertainty that may be attributed to any quantitative comparison, value, measurement or other representation. These terms are also used herein to represent the degree by which a quantitative representation may vary from a stated reference without resulting in a change in the basic function of the subject matter at issue.