Patent Publication Number: US-2010115695-A1

Title: Dampened Belt Retractor

Description:
PRIORITY 
     This application is a continuation-in-part of U.S. patent application Ser. No. 12/121,713 filed May 15, 2008, which is a continuation-in-part of both U.S. patent application Ser. No. 11/403,112 filed Apr. 12, 2006, and U.S. patent application Ser. No. 11/788,962 filed Apr. 23, 2007. This application claims priority to each of the above-referenced applications, which are incorporated herein by reference in their entireties. 
    
    
     FIELD 
     This application relates generally to locking belt retractors. More particularly, this application relates to a dampened belt retractor that may be used with patient repositioning units that facilitate movement or suspension of the individual on a flexible member by utilizing existing lift technology on a moveable bed or on the frame. 
     BACKGROUND 
     Immobility of a patient contributes greatly to the deterioration of patient health. Immobile patients are prone to bedsores and pneumonia. A bed sore can take months or years to heal depending on the severity and location of the sore. Pneumonia occurs in immobile patients because secretions pool in the lungs fostering bacterial growth. Generally side-to-side turns of such patients, approximately every two hours, can prevent many occurrences of bedsores and pneumonia. Additionally, side-to-side turns are necessary to accomplish examinations of the patient. However, turns of this nature are generally the responsibility of hospital nurses, orderlies, or other staff in similar types of facilities. 
     Additionally, patients require the head of the bed to be raised to facilitate breathing and increase comfort. As a result of this incline, patients tend to slide toward the foot of the bed, impeding a patient&#39;s normal breathing and digestive functions and resulting in patient discomfort. 
     When a patient is obese or larger than the staff member, the force required to properly reposition the patient is considerable. Consequently, multiple staff members are required to reposition the patient manually. Moreover, if additional staff members are unavailable, the lone staff member is susceptible to injuries while attempting to transfer or reposition the patient without either mechanical assistance or, additional staff labor. 
     Back injury is a common work injury of nurses and hospital staff generally as a result of moving overweight, obese or patients who are significantly larger than the staff member. The act of turning a patient from side to side precludes proper body mechanics for lifting. In addition, obesity in the United States is increasing in marked amounts. Patient weight increases will only exacerbate the rate of back injuries among nurses, and increase the number of workers compensation claims filed as a result of such injuries as well as reduce the number of able body hospital staff. Consequently, assistance is necessarily required to accomplish necessary patient movement as well as protect hospital staff members against injury proximately resulting from patient repositioning, turning and transference. 
     Moreover, the task of patient repositioning is labor intensive and time consuming. Generally, patient movement requires at least two staff members. Generally nurses are female and significantly smaller in stature and weight then the patients they are assigned to care for. Furthermore, hospitals and skilled nursing facilities are homes to patients weighing in excess of 250 pounds. Consequently, at least three staff members are sometimes required to reposition a patient of this size. With the increase of nursing and staffing shortages, it is frequently impossible to gather enough staff members to move a large or oversized patient. Thus, either patient care suffers or the risk of injury to staff members is greatly increased. 
     Another problem is money. Devices that incorporate machines, motors, and other complicated machinations to effectuate lift and other movement cost much more money than those that don&#39;t as well as incur more potential for civil liability should one of those machinations fail. Further, existing devices do not have a simple and effective means of gripping fabric, draw sheets, or standard hospital bed linens on which a patient is lying. Typically, devices such as that found in U.S. Pat. No. 5,890,238 to Votel are meant for patient transfer only at least because the gripping design is not designed for a caregiver to attach to linens. 
     Therefore a need exists for a functional, yet simple to operate, patient repositioning apparatus. Such an apparatus must be operational by one staff member without compromising patient safety and staff member safety; easy to install and operate as well as not consume scarce space in hospital or skilled nursing facility; must not compromise patient safety when effectuating the tasks of patient repositioning; can be used by a single caregiver to reposition a patient; is capable of easy attachment to linens for suspension of a person; and does not require expensive internal machinations to accomplish patient lift but uses existing lift technology on beds to accomplish suspension or movement of a patient. 
     SUMMARY 
     This application describes and discloses a dampened belt retractor for use with a patient positioning apparatus that includes a base, at least one support column, at least one positioning arm capable of being positioned over a bed and having a buckle and dampened strap capable of securing to a patient support connected to bed linens or other flexible member so that a patient can be partially or totally suspended when an adjustable bed is lowered or when the patient support is raised. 
     Patient repositioning may be effectuated by positioning the arms over a patient, extending straps out of an automatically locking belt retractor with buckle inserts into receiving buckles on a patient support or support bar secured to bed linens. The extending straps may automatically lock at a desired length and retract when weight is removed from the straps. The retraction mechanism may include a dampener to prevent the straps and buckle from retracting quickly and potentially causing damage to the patient positioning apparatus or injury to a person close to the straps. A patient positioning apparatus may be free-standing or may be mounted to a ceiling or a wall or may include a swiveling support column. A fabric gripper may be used to connect the flexible member to the apparatus. 
     These and other aspects of the present invention will become more fully apparent from the following description and appended claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The following description can be better understood in light of Figures, in which: 
         FIG. 1  is an elevated perspective view of an exemplary embodiment of a patient positioning apparatus with arms in an extended position; 
         FIG. 2  is an elevated perspective view of an exemplary embodiment of a patient positioning apparatus with arms in a retracted position; 
         FIG. 3  is an elevated perspective view of an exemplary embodiment of a patient positioning apparatus positioned over a moveable bed and attached to a flexible member; 
         FIG. 4  is an elevated perspective view of an exemplary embodiment of a patient positioning apparatus positioned over a moveable bed and attached to a flexible member with an individual reposing on the flexible member; 
         FIG. 5  is a side view of an exemplary embodiment of a patient positioning apparatus positioned over a moveable bed and attached to a flexible member with an individual reposing on the flexible member; 
         FIGS. 6-9  illustrate an exemplary embodiment of a flexible member gripper; and 
         FIG. 10  illustrates an exemplary embodiment of a dampened strap retractor; and 
     
    
    
     Together with the following description, the Figures demonstrate and explain the principles of a dampened strap retractor for use with patient positioning systems and associated components and methods. In the Figures, the thickness and configuration of components may be exaggerated for clarity. The same reference numerals in different Figures represent the same component. 
     DETAILED DESCRIPTION 
     In the illustrated embodiments, aspects and features of patient repositioning systems and associated components and methods are disclosed and described below. 
       FIG. 1  is illustrative of an embodiment for repositioning an individual, such as a patient, reposing in a standard hospital bed. As used in this application, suspended or suspend may also include partially suspended or partially suspend where the bed or some other member also assists in supporting the patient. In some embodiments, positioning system  1  may include moveable base with wheels  7 , vertical support column  13 , and one or more positioning arms  17  on the top of system  1  containing straps  23  extending from dampened belt retractors  21  that extend downward and secure to flexible member  33  ( FIGS. 3-4 ). As used throughout this disclosure, flexible member  33  may be a bed sheet, bed linen, sling, plastic sheet, blanket, quilt, quilted bat, or any other material that may be used to support an individual. 
     As shown in  FIGS. 3 and 4 , a patient on support surface  25 , such as a bed, hospital bed, cot, stretcher, or other surface on which an individual may repose, may be repositioned using system  1 . In some embodiments system  1  may be used to reposition a patient by using the vertical movement of a standard hospital bed. (e.g., electrical, crank actuated, other mechanical motion, etc.) Bed  25  may be raised upward towards positioning arms  17 , until gripping straps  23  with retractable belt assembly  21  on arms  17  are in position to be attached. Once there is enough length of straps  23 , buckle  24  on the ends of straps  23  may be inserted and locked into buckle latch  29  coupled to flexible member  33 . Once buckles  24  are locked, bed  25  may be lowered, separating flexible member  33  from bed  25 , causing the patient or a portion of the patient to be suspended above bed  25 . 
     One embodiment of a base portion includes one or more legs  3  capable of extending in opposite directions from either the anterior or posterior of support column  13 . 
       FIGS. 1 and 2  also show support column  13  coupled to base  2 . Column  13  and base  2  may be coupled by welding, pins, bolts, etc. In some embodiments, support column  13  may be fixed and capable of supporting a repositioning structure including horizontal support  15  and one or more positioning arms  17 . The repositioning structure may be fixedly or removably coupled to support column  13  such as the top of support column  13  as shown in  FIGS. 1 and 2 . The repositioning structure may also be fixed to any place on the support column  13  so long as it is capable of being positioned over an individual on a support surface for repositioning. 
     Support column  13  may be constructed of powder-coated steel and may be 4 inches square, so as to withstand the weight of an individual  26  of any known weight, and suspended by arms  17 . Dampened belt retractors  21  may be coupled to positioning arms  17  using support tabs  16  (See,  FIG. 9 ) whereby a rivet (not shown) may be inserted through tab  16  and through positioning arm  17 . Other similar methods will be immediately recognizable for securing similar assemblies to metal structures such as those disclosed. For example, support column  13  may be more than one support column attached to base  2 . In such arrangements, the more than one support columns may have a smaller dimension than a single column since multiple columns would support the load rather than a single column. 
     Similarly, support column  13  may include additional nested columns. An outer column of the support column may swivel around an inner column with apertures. The outer column support, also having apertures, may be capable of aligning with those of the inner column by inserting the outer column over the inner column. In this way the swivel can be locked by inserting a locking pin through each of the inner and outer column support apertures. Other known manners of creating a swiveling column will be immediately recognized by those skilled in the art. 
     Most hospital beds are of a standard height. Because of the uniform height of hospital beds, a fixed height support column  13  may be effective in providing sufficient height to system  1 . However, because some beds may vary in height and in the levels of vertical movement, some embodiments may also accommodate vertical movement of support column  13 , or of the overall height of system  1 . 
     To effectuate vertical movement of system  1 , a crank assembly or a hydraulic assembly as described in related U.S. patent application Ser. No. 11/170,605 “Patient Mobility Apparatus” to White disclosed above may be incorporated into the present invention. 
     The repositioning structure coupled to support column  13  may be used for repositioning a patient  26  in bed  25 . The position of the repositioning structure and associated structures such as arms  17  relative to bed  25  and the motor of bed  25  may be used together to repositioning a patient  26 . For example, standard hospital beds typically come with an electric motor or other adjustable beds used to raise, lower, or otherwise place bed  25  in various positions. Taking advantage of this standard lifting and repositioning feature along with system  1  may allow for a single caregiver to easily reposition patient  26 . 
       FIGS. 3 and 4  illustrate repositioning movement using an illustrated embodiment. In  FIG. 3 , person  26  is laid flat on flexible member  33  that has pockets  27  capable of receiving support bar  47 , making portions of flexible member  33  adjacent to pockets  27  rigid. Support bar  47  may also have receiving buckles  29  for receiving straps  23  with buckle inserts  24 . A caregiver may position bed  25  to an appropriate distance below arms  17  such that straps  23  are slack and buckle inserts  24  can be inserted into receiving buckles  29 . Once buckle inserts  24  are inserted into the receiving buckles  29 , a caregiver may then either allow tension in the straps  23  through adjustment of the straps  23  through automatic adjustment using automatic retraction in the dampened belt retractors  21 , or through manual adjustments methods. Any remaining slack may be taken out by lowering bed  25  until patient  26 , or a portion of patient  26  is suspended on flexible member  33  and above bed  25 . Once patient  26  is suspended, a caregiver may change bed linens, place pillows under portions of patient  26 , or perform other various tasks related to caring for a patient 
     In some embodiments, such as those illustrated in  FIGS. 6-9 , support bar  47  may be attached to flexible member  33  to provide receiving buckles  29  for insertion to effectuate repositioning of patient  26 . 
     For example,  FIG. 4  demonstrates one embodiment being used to turn a patient a quarter turn by inserting only buckle inserts  24  into receiving buckles  29  of support bar  47  on one side of flexible member  33 . In this way, once bed  25  is lowered, patient  26  may be partially suspended as flexible member  33  lifts under one side of patient  26 , causing patient  26  to roll to one side. Once patient  26  is partially rolled to one side, a nurse or other caregiver may place pillows or other supports under the lifted side of patient  26  such that when bed  25  is raised, patient  26  can rest on the pillows or other supports to maintain a turned position. Thereafter, system  1  may be removed from flexible member  33 , or may be otherwise disconnected until needed again. In other embodiments, system  1  may be used to move patient  26  from lying on their back to their front, or vice versa. 
     To change patients&#39; bed linens, flexible member  33  may be placed underneath patient  26  and bed linens, or flexible member  33  may be the bottom-most layer of bed linens. Bed  25  may then be raised enough to allow for the insertion of the buckle inserts  24  into receiving buckles  29  on one side of flexible member  33 . The dirty bed linens may then be loosened from one side of bed  25 . By then lowering bed  25 , patient  26  may roll to one side of bed  25 , allowing removal of a portion of the dirty bed linens, and partial replacement with clean bed linens. Bed  25  may then be raised and buckle inserts  24  removed from receiving buckles  29  and flexible member  33  may be spread back onto the bed mattress. Once the dirty bed linens are rolled off of the mattress and next to patient  26 , exposing a bare portion of the mattress on bed  25 , the clean linens may be spread on the bare side of the mattress with the remaining clean linens rolled up next to the patient  26 . Then, on the other side of bed, flexible member  33  may be similarly raised allowing the dirty linens to be removed from bed  25  and allowing the clean linens to cover the entire mattress. Bed  25  may then be lowered whereby patient  26  rolls onto the clean linen and over the remaining clean linen portion rolled next to patient  26 . The bed may then be raised and buckle inserts  24  removed from flexible member  33 . Therefore, the dirty linen may be finally removed and the clean linen can be pulled out from underneath the patient  26  and spread uniformly over the mattress. 
     In their simplest form, arms  17  may remain fixed and extend outward from support column  13 , thereby allowing them to be positioned over patient  26  in bed  25 . In one embodiment, as shown in  FIG. 1  and in an exploded view in  FIG. 9 , arms  17  may be joined to horizontal support  15  through locking arm pivots  19  that allow arms  17  to extend outward when in use and to retract inward toward support column  13  when not in use. The pivot pin arrangement may incorporates pivot shafts  4  placed inside flange bearing  6  and bearing extension plate  8 , allowing shaft  4  to rotate. Shaft  4 , bearing  6 , and extension plate  8  may then be situated over an aperture on both the top and bottom of arm  17 . On the bottom of arm  17  may be a hole stiffener  10  and sleeve  11  into which shaft  4  can be inserted and over, which may be inserted top washer  12  and bottom washer  22 , and spring loaded handle  14  capable of engaging and disengaging washers  12 ,  22 , thereby allowing arms  17  to rotate. When handle  14  is released, washers  12 ,  22  may engage to lock arm  17  in place. Alternatively, a simple pivot mechanism may also provide the desired function. The advantage of a washer assembly is that it may allow both of arms  17  to retract and extend at an equal height. Other embodiments of exemplary assemblies may also provide movement acceptable for purposes of achieving the objects of the embodiments disclosed herein. 
     Once arm  17  is positioned over a patient  26 , it may be secured to flexible member  33  through the use of a buckle assembly as describe above, and capable of supporting patient  26 , and may be sufficiently strong to support any size and weight of patient  26 . Because patients may be large and/or overweight, retractable straps with buckles using heavy duty nylon, polyester, canvas or other similar materials can be used to provide sufficient strength to support a patient of any weight. As shown in  FIG. 10 , re Further, the receiving mechanism for the buckles can be attached to the support sheet, a gripper or other mechanism secured to the support sheet or in other embodiments those skilled in the art will immediately appreciate. 
     Some embodiments for securing support arms  17  to flexible member  33  may be to use a sling-type arrangement as shown in  FIGS. 8-8   a . In such embodiments, support hooks  45  with hook gates  47 , such as with a carabiner, may be used to support flexible member  33  by holding support bar  47 , placed in pocket  27 , and then attaching to support arms  17 . 
     In some embodiments, straps  23  of any durable material can be fixed, permanent or removable, to either dampened belt retractors  21 , belt  23  or the receiving buckles  29  that incorporate a traditional belt and buckle arrangement. Using this arrangement, straps  23  can be extended to a desired length, much as retractable seatbelts in cars may be secured at a particular length. When not in use they can then be placed to the side of the bed. As shown in  FIG. 10 , dampened belt retractors  21  may include case  210 , rotational dampener  212  attached to center pin  218 , about which strap  23  is wound, and spring  214  also attached to center pin  218  that provides the retracting force to strap  23 . A locking mechanism may also be included to provide locking at a particular length of strap  23 . 
     Case  210  also includes holds  216  which may be integrally molded into case  210  to hold an exterior portion of rotational dampener  212  in a fixed relationship with case  210  such that it provides dampening to center pin  218  when the interior portion of rotational dampener  212  rotates along center pin  218  in response to spring  214  retracting belt  23 , causing a resistive force to the retraction based on the angular velocity of the spool holding retracting belt  23  thereby decreasing the belt retraction velocity. Thus, the higher the rotational velocity of center pin  218 , the more resistive force is applied by rotational dampener  212 . 
     Flexible members  33  may provide a stable, flexible, lifting platform on which to lift patients. Some exemplary flexible members  33  may be made of vinyl, nylon, canvas, bed sheets, draw sheets, mattress pads, or other materials or configuration sufficient to accomplish lifting a patient or a portion of a patient reposing on flexible member  33 , as desired. In other embodiments, harnesses, slings, stretchers or other known suspension supports may also be used in and with the embodiments disclosed herein. Flexible members  33  may also incorporate buckles fastened to them using known techniques such as sewing heavy duty buckle ends to reinforced material and stitching onto the body of flexible member  33 . 
     In some embodiments, a detachable fabric gripper may be used as is shown in  FIGS. 6-9 , which may be attached to linens found in hospitals and other patient care facilities. Fabric clamp  200  may include support bar  220 , insert bar  230 , and attachment members  240 . Support bar  230  may have a general cross-section that provides an internal space  228  for holding and for insertion of insert bar  230 . Some exemplary cross-sections may be diamond, oblong, polygonal, or any other configuration that would allow functional use with an insert bar as described herein. For example, as shown in  FIG. 18 , support bar  220  may have a generally rectangular cross-section with one side of the rectangle having an opening  222  to allow insertion of insert bar  230 . Flanges  224  and  226  may define opening  222 , and may function to engage portions of insert bar  230  when placed into support bar  220  to maintain insert bar  230  within support bar  220 , or otherwise provide structure to reduce the ability of insert bar  230  to fall out of support bar  220 . While flanges  224  and  226  are opposing in the illustrated Figures, flanges  224  and  226 , or other similar features of some embodiments, may be offset or with varying angles. 
     Support bar  220  may have a length sufficient to support an individual or a desired portion of an individual. For example, support bar  220  may be between about two and about seven feet long. In some embodiments, support bar  220  may be shorter to only support an upper or lower portion of an individual as needed. For example, system  1  may be used to suspend the legs of an individual, such that a shorter support bar  220  may be preferable to a longer support bar  220 . Similarly, any of the devices described herein for attaching to flexible member  33  may be similarly arranged in length. 
     In some embodiments, resilient member  250  may be located in support bar  220 . As shown in  FIG. 9 , resilient member  250  may bias insert bar  230  towards a top of insert bar  230  and towards attachment members  240 , and against an interior surface of insert bar  230 . Resilient member  250  may be one or more leaf springs attached to a bottom interior surface of support bar  220 , or may be one or more coil springs, or any other type of resilient member sufficient to bias insert bar  230  into contact with support bar  220 . 
     In some embodiments, resilient member  250  may be attached to insert bar  230 , or may be integral with insert bar  230 . For example, as shown in  FIGS. 8-9 , fastener  252  may couple resilient member  250  to support bar  220 . Resilient member  250  may also provide sufficient force to trap flexible member  33  between insert bar  230  and support bar  220 , as shown in  FIG. 19 . In some embodiments, resilient member  250  may also provide a tactile assurance that insert bar  230  is properly seated in support bar  220  by providing a “click” as insert bar moves past flange  224  and is moved by resilient member into position in support bar  220 . 
     Insert bar  230  may be shaped such that it approximates the cross-sectional shape of internal space  228  of support bar  220  such that flexible member  33  is contacted and compressed between insert bar and support bar  220  at various points to prevent slippage or removal of flexible member  33  as a load is applied to flexible member  33 , as described above with using system  1 . 
     In some embodiments, fabric clamp  220  may provide structure such that when a load (as represented by arrow c in  FIG. 19 ) is applied to flexible member  33 , the load is borne initially by support bar  220 . For example, as shown in  FIG. 19 , a load applied to flexible member  33  may be borne by flange  226  of support bar  220 . As further shown in  FIG. 19 , when a load is applied to flexible member  33 , insert bar  230  is pressed upwardly, as indicated by the arrows a, and against flange  226 , as indicated by arrow b, compressing flexible member  33  between at least contact areas  229  between insert bar  230  and support bar  220 . As the load of flexible member  33  increases, the compression force between insert bar  230  and support bar  220  increases such that flexible member  33  may be prevented from slipping with respect to or separating from fabric gripper  210 . 
     In some embodiments, contact areas  229  may include a coating, surface finish, applied material, or other technique to provide a slip-resistant surface. For example, contact areas  229  may be coated with rubber, foam tape, or other applied material, or may have a rough surface from machining, rough sanding, or other manufacturing process. In some embodiments, the slip-resistant surface features may be applied to contact areas  229  of support bar  220 , to corresponding regions of insert bar  230 , to both support bar  220  and insert bar  230 , or to any and all surfaces of support bar  220  and insert bar  230  that may contact flexible member  33 . 
     Attachment members  240  may be coupled to support bar  220 . In some embodiments, attachment members  240  may be pivotably coupled to upper flange  227  of support bar  220  using fasteners  242 , such as rivets, bolts, wave washers, springs, or using any known techniques, or may be fixed to support bar  220  by welding, fasteners, etc., or may be integral with support bar  220 . Attachment members  240  may be buckles, such as seat belt buckles, as shown in  FIGS. 6-9 , or may be a ring or carabiner-type attachment. In some embodiments, attachment members  240  may be any configuration that allows attachment to a support member, such as support arms  17  of system  1 , for example, a simple loop, a hole in support bar  220 , a bracket, or any other devices or means to connect support fabric gripper  210  to system  1 . Each fabric gripper  210  may include one or more attachment members, depending on the desired length and application. 
     In some embodiments, flexible member  33  may be placed in fabric gripper  210  by laying a portion of flexible member  33  over opening  222 , placing insert bar  230  into internal space  228  of support bar  220  such that resilient member  250  compresses, thereby trapping a portion of flexible member  33  between insert bar  230  and support bar  220 . Flexible member  33  may be removed from fabric gripper  210  by pulling a portion of flexible member  33  extending past flange  224  downward such that resilient member  250  is compressed and the top portion of insert bar  230  moves past flange  226 , allowing insert bar  230  to rotate out through opening  222 , freeing flexible member  33 . 
     While the above description contains various preferred, exemplary, and other specific embodiments, these should not be construed as limitations on the scope, but as exemplifications of the presently preferred embodiments thereof. Many other embodiments and variations are possible within the teaching of this document. Thus, the scope of the invention should be determined by the appended claims and their legal equivalents, and not solely by the examples and embodiments given.