Abstract:
An apparatus ( 18 ) for mounting surgical rails ( 40, 42 ) to a litter ( 10 ) having a pair of parallel poles ( 12 ) includes a pair of longitudinal members ( 20, 22 ) fixed to outboard sides of respective ones of the pair of poles ( 12 ). A pair of surgical rails ( 40, 42 ) is fixed to outboard surfaces of respective ones of the pair of longitudinal members ( 20, 22 ). Clamps ( 24, 26, 28, 30 ) at each end of each longitudinal member ( 20, 22 ) fix the longitudinal members ( 20, 22 ) to the pair of poles ( 12 ). A pair of cross bars ( 36, 38 ) extend between and are fixed to opposing clamps ( 24, 26, 28, 30 ) at each end of each longitudinal member ( 20, 22 ).

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    The present application claims the benefit of priority of U.S. provisional patent application Ser. No. 62/168,953 filed on Jun. 1, 2015 which is expressly incorporated by reference herein. 
     
    
     STATEMENT OF GOVERNMENT INTEREST 
       [0002]    The invention described herein may be manufactured, used and licensed by or for the United States Government. 
     
    
     BACKGROUND OF THE INVENTION 
       [0003]    The invention relates in general to emergency medical care and in particular to apparatus for securely attaching medical/surgical devices to an injured person carrier, such as a litter or stretcher. 
         [0004]    Every day people are injured, especially during armed conflicts, terrorism, accidents and natural disasters. The injuries may be serious and may require the injured person to be placed on a stretcher, litter or similar injured person carrier. An example of a litter is a NATO litter  10  shown in  FIG. 1 . The NATO litter  10  includes a pair of parallel poles  12  and a fabric that forms a bed  14  extending between the poles  12 . The poles  12  may be made of, for example, wood or a metal such as aluminum. Litter  10  may include stirrups  16  for supporting the litter  10  on the ground or a platform. As seen in  FIG. 3 , litter  10  may also include cross beams  17  that extend under the bed  14  between opposing stirrups  16 . 
         [0005]    The injured person may receive medical attention at or near the geographical site of the injury and then be transported via a litter by foot, land vehicle, air vehicle or other transporter to a medical treatment facility. The injured person may require treatment and/or surgery before being transported to a medical treatment facility. Sometimes one or more medical and/or surgical devices are required for treatment and/or surgery for the injured person prior to and/or while being transported to a medical treatment facility. Such medical and/or surgical devices may include, for example, retractors, arm boards, IV poles, suction devices, lights, monitors and other devices. 
         [0006]    To keep such medical/surgical devices close to the injured person, the medical/surgical devices may be somehow associated with the injured patient carrier. In combat areas, the transport of an injured person on a litter may be by two people who are walking or running over rough terrain, by a helicopter or other air vehicle that is subject to unpredictable air currents, by a military ambulance over rough terrain, or combinations of such transporters. The resulting ride could therefore be subject to unforeseen air currents or rapid aircraft movements that cause the aircraft to drop suddenly, make rapid and sharp turns and otherwise continue on its journey to transport the injured person(s) to a medical facility as quickly as possible. Such rapid transporter movements require that the medical/surgical devices are secured against reacting to the sudden change of movements and directions by flying off into space and/or within the transport vehicle and possibly further injuring the injured person or injuring persons who are assisting the injured person and/or flying or driving the transporter. 
         [0007]    Some stretcher based operating tables, like the English table, do not enable the placement and use of self-retaining fixed retractors like the Bookwalter retractors. This limitation greatly inhibits the scope and ease of surgeries possible on these platforms. The placement of arm boards and leg/foot rests on stretcher based operating tables is possible but it is very limited and cumbersome. The SMEED (Special Medical Emergency Evacuation Device) platform and CMS MOJO™ ready station allow for attachment of multiple devices in multiple locations, but they do not allow for the attachment of a wide variety of surgical devices necessary for better exposure and ease of operation. While the SMEED allows for attachment of valuable monitoring devices necessary in an ICU or transport setting, it cannot accept attachments for surgical retractors and does not facilitate better exposure, positioning or ease of operation. The MOJO™ ready station allows for attachment of some devices like trays and lights, which may help in surgery, but does not allow for attachment of arm boards, retractors, and leg rests. 
         [0008]    A need exists for an apparatus for securely fixing a wide variety of medical/surgical devices to a litter for use as an operating table and for transporting the litter along with the medical/surgical devices and the patient. 
       SUMMARY OF THE INVENTION 
       [0009]    One aspect of the invention is an apparatus for use with a litter having a pair of parallel poles. The apparatus may include a first longitudinal member and a second longitudinal member spaced apart from and parallel to the first longitudinal member. The apparatus may include four clamps. 
         [0010]    A first clamp has a circular inner surface and an opening for receiving one of the pair of parallel poles. The first clamp is fixed to one end of the first longitudinal member such that the opening faces the second longitudinal member. A second clamp has a circular inner surface and an opening for receiving the one of the pair of parallel poles. The second clamp is fixed to another end of the first longitudinal member such that the opening faces the second longitudinal member. A third clamp has a circular inner surface and an opening for receiving the other of the pair of parallel poles. The third clamp is fixed to one end of the second longitudinal member such that the opening faces the first clamp on the first longitudinal member. A fourth clamp has a circular inner surface and an opening for receiving the other of the pair of parallel poles. The fourth clamp is fixed to another end of the second longitudinal member such that the opening faces the second clamp on the first longitudinal member. 
         [0011]    A first cross bar extends between and is fixed to the first and third clamps. A second cross bar extends between and is fixed to the second and fourth clamps. A first rectangular bar is spaced apart from and fixed to an outer surface of the first longitudinal member. A second rectangular bar is spaced apart from and fixed to an outer surface of the second longitudinal member. The first and second rectangular bars are preferably standard surgical rails. 
         [0012]    In one embodiment, the first and second longitudinal members are hollow members. The first and second longitudinal members may each comprise a sub-member with a female end and a sub-member with a male end. The male end is inserted in the female end. 
         [0013]    The male end may include a spring-loaded latch and the female end may include an opening in which the spring-loaded latch is disposed to thereby lock the sub-members together. 
         [0014]    Each clamp may include a set screw for fixing the clamp to a respective one of the parallel poles. Each clamp may include a lock nut having a protuberance disposed in an opening in one of the first and second cross bars for securing the one of the first and second cross bars to the clamp. The set screw may engage a threaded opening in the lock nut. 
         [0015]    The first longitudinal member of the apparatus may be disposed outboard of the one of the parallel poles of the litter and the second longitudinal member may be disposed outboard of the other of the parallel poles of the litter. The first and second clamps may be fixed to one of the parallel poles and the second and third clamps may be fixed to the other of the parallel poles. The first and second cross bars may extend under a bed of the litter. 
         [0016]    The invention will be better understood, and further objects, features and advantages of the invention will become more apparent from the following description, taken in conjunction with the accompanying drawings. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0017]    In the drawings, which are not necessarily to scale, like or corresponding parts are denoted by like or corresponding reference numerals. 
           [0018]      FIG. 1  is a perspective view of a litter. 
           [0019]      FIG. 2  is a perspective view of the litter of  FIG. 1  with one embodiment of a surgical rail apparatus installed thereon. 
           [0020]      FIG. 3  is a bottom perspective view of  FIG. 2 . 
           [0021]      FIG. 4  is a top perspective view of one embodiment of a surgical rail apparatus without the litter. 
           [0022]      FIG. 5  is a bottom perspective view of  FIG. 4 . 
           [0023]      FIG. 6  is an exploded view of the surgical rail apparatus of  FIG. 5 . 
       
    
    
     DETAILED DESCRIPTION 
       [0024]      FIGS. 2 and 3  show one embodiment of a surgical rail apparatus  18  installed on a litter  10 . Apparatus  18  is of use when installed on litter  10  of other patient carrier. For clarity,  FIGS. 4-6  show the apparatus  18  without the litter  10 . 
         [0025]    Referring to  FIGS. 4-6 , surgical rail apparatus  18  includes a first longitudinal member  20  and a second longitudinal member  22  spaced apart from and parallel to the first longitudinal member  20 . A first clamp  24  has a circular inner surface  32   a  and an opening  34   a  for receiving one of the pair of parallel poles  12 . First clamp  24  is fixed to one end of the first longitudinal member  20  such that the opening  34   a  faces the second longitudinal member  22 . A second clamp  26  has a circular inner surface  32   b  and an opening  34   b  for receiving one of the pair of parallel poles  12 . Second clamp  26  is fixed to another end of the first longitudinal member  20  such that the opening  34   b  faces the second longitudinal member  22 . 
         [0026]    A third clamp  28  has a circular inner surface  32   c  and an opening  34   c  for receiving the other of the pair of parallel poles  12 . Third clamp  28  is fixed to one end of the second longitudinal member  22  such that the opening  34   c  faces the first clamp  24  on the first longitudinal member  20 . A fourth clamp  30  has a circular inner surface  32   d  and an opening  34   d  for receiving the other of the pair of parallel poles  12 . The fourth clamp  30  is fixed to another end of the second longitudinal member  22  such that the opening  34   d  faces the second clamp  26  on the first longitudinal member  20 . 
         [0027]    A first cross bar  36  extends between and is fixed to the first and third clamps  24 ,  28 . A second cross bar  38  extends between and is fixed to the second and fourth clamps  26 ,  30 . A first rectangular bar  40  is spaced apart from and fixed to an outer surface  44  ( FIG. 5 ) of the first longitudinal member  20 . A second rectangular bar  42  is spaced apart from and fixed to an outer surface  46  of the second longitudinal member  22 . In one preferred embodiment, the first and second rectangular bars  40 ,  42  are standard surgical rails. Standard surgical rails are known in the art and are able to receive and mount a wide variety of medical and surgical devices. Standard surgical rails have a rectangular cross-section. The North American standard surgical table side rail is 1.125 inches by 0.375 inches. The European standard surgical rail is 25 mm by 10 mm. As is known in the art, notches  48  may be formed in rails  40 ,  42  for ease of mounting and dismounting certain medical and surgical devices. The medical and surgical devices mounted on rails  40 ,  42  will be secure. The longitudinal members  20 ,  22  will not be subject to rotation about poles  12  or horizontal or vertical displacement. 
         [0028]    The components of apparatus  18  may be made of, for example, aluminum. Aluminum is strong and light in weight. Minimizing weight is very important when apparatus  18  is used in far forward military areas where much gear must be carried by soldiers and motorized transport is not available or difficult to obtain. In one embodiment, the first and second longitudinal members  20 ,  22  are hollow members. Members  20 ,  22  may have various shaped cross-sections. In one preferred embodiment, the cross-sections of members  20 ,  22  are rectangular or square tubes. The weight of apparatus  18  may be further reduced by the use of lightening holes  50  in members  20 ,  22  and lightening holes  52  in cross members  36 ,  38 . In one embodiment, first and second longitudinal members  20 ,  22  may have lengths in the range of about three feet to about four feet. Other lengths of first and second longitudinal members  20 ,  22  may be used depending on particular needs. Members  20 ,  22  should be at least as long as their corresponding rails  40 ,  42 , for stability. 
         [0029]    The detailed construction of one embodiment of apparatus  18  is best explained with reference to the exploded view shown in  FIG. 6 . The first longitudinal member  20  may comprise a sub-member  20   a  with a female end  21   a  and a sub-member  20   b  with a male end  21   b . The male end  21   b  may be fixed to sub-member  20   b  using, for example, a fastener  54 . Sub-member  20   b  with male end  21   b  fixed thereto is inserted in the female end  21   a  of sub-member  20   a . Male end  21   b  includes a latch  56  rotatably fixed in a latch housing  58  using a pin  60 . Latch  56  is spring-loaded in housing  58  with spring  62 . Male end  21   b  is inserted in female end  21   a  by depressing latch  56  using knob  64  which allows latch  56  to enter female end  21   a . Then, latch  56  snaps in a locked position in latch opening  68  in female end  21   a . Plugs  70  may be inserted in the other ends of sub-members  20   a  and  20   b.    
         [0030]    First rectangular bar  40  may include a pair of sub-bars  40   a ,  40   b  fixed to respective sub-members  20   a ,  20   b . As noted above, sub-bars  40   a ,  40   b  are preferably standard surgical rails. Sub-bars  40   a ,  40   b  are spaced apart from sub-members  20   a ,  20   b  using a plurality of spacers  72 . The spacers  72  create a gap between sub-members  20   a ,  20   b  and sub-bars  40   a ,  40   b  so that medical/surgical devices may be attached and mounted on sub-bars  40   a ,  40   b . Sub-bars  40   a ,  40   b  may be fixed to respective sub-members  20   a ,  20   b  using, for example, a plurality of threaded fasteners  74 . 
         [0031]    As can be seen in  FIG. 6 , second longitudinal member  22  may comprise sub-members  22   a  and  22   b  with sub-bars  42   a  and  42   b  attached thereto. The construction and latching mechanism of sub-members  22   a  and  22   b  and the manner of attaching sub-bars  42   a  and  42   b  is similar to that of sub-members  20   a ,  20   b  and sub-bars  40   a ,  40   b  and, therefore, will not be described in detail again. 
         [0032]    Cross bar  36  has flattened portions at each end with one flattened portion being a pivot end  78  and the other flattened portion being a slot end  80 . Cross bar  38  similarly has flattened portions at each end with one portion being a pivot end  84  and the other portion being a slot end  82 . Clamps  24 ,  26 ,  28  and  30  may be fixed to their respective sub-members  20   b ,  20   a ,  22   a ,  22   b  using, for example, fasteners  76 . The tops (as viewed in  FIG. 6 ) of clamps  24  and  30  include recessed portions  86  for receiving the pivot ends  78 ,  84  of their respective cross bars  36 ,  38 . Clamps  28 ,  26  may have generally planar top portions for receiving the slot ends  80 ,  82  of the cross bars  36 ,  38 . Clamps  24 ,  26 ,  28  and  30  may be fixed to parallel poles  12  of litter  10  using, for example, set screws  90  having turning knobs  92 . It should be noted that the set screws  90  primarily constrain vertical translation of poles  12  in clamps  24 ,  26 ,  28  and  30  and the cross bars  36 ,  38  primarily constrain rotation of the sub-members  20   a ,  20   b ,  20   c  and  20   d  about the parallel poles  12 . 
         [0033]    The ends of cross bars  36 ,  38  may be fixed to clamps  24 ,  26 ,  28  and  30  using, for example, lock nuts  88 . Each lock nut  88  includes a knob  94 , a protuberance  96  beneath the knob  94 , and a threaded through hole  98 . Protuberances  96  may have smaller diameters than knobs  94  to facilitate grasping knobs  94  with one&#39;s fingers. Protuberances  96  are seated in openings  78   a ,  80   a ,  82   a ,  84   a , in the flattened end portions of cross bars  36 ,  38 . Lock nuts  88  are tightened using knob  94  to thread lock nuts  88  on set screws  90 . 
         [0034]    Apparatus  18  may be disassembled and transported in four parts or pieces, which makes assembly of apparatus  18  to a litter  10  easy. After some practice, apparatus  18  may be assembled to a litter  10  in 30 seconds or less. Referring to the view of  FIG. 6 , the four disassembled pieces each include one sub-member  20   a ,  20   b ,  22   a , or  22   b  along with the sub-rail and clamp corresponding to that sub-member. The male ends of the sub-members  20   b  and  22   b  are disengaged from the corresponding female end sub-members  20   a  and  22   a , respectively. Because opening  80   a  in cross member  36  is slotted, cross member  36  may simply be loosened from clamp  28  and rotated about set screw  90  of clamp  24  so that cross member  36  is parallel to and still attached to clamp  24  and sub-member  20   b . Similarly, cross member  38  may be removed from clamp  26  and rotated about set screw  90  of clamp  30  so that cross member  38  is parallel to and still attached to clamp  30  and sub-member  22   b . Thus, the four pieces of apparatus  18  may be easily transported because of their relatively short length and light weight. The four pieces may be easily assembled to a litter  10  or other patient carrier. 
         [0035]    In some instances, one may desire a surgical bar or rail  40  or  42  only on one side of litter  10 . In that case, one may use one side of apparatus  18 , that is, one longitudinal member  20  or  22  with its corresponding surgical rail  40  or  42  and the corresponding clamps. In addition, the cross bars  36 ,  38  are used and are fixed to the opposite pole  12  of the litter  10  using the clamps, set screws  90  and lock nuts  88 , without a longitudinal member and surgical rail. 
         [0036]    Surgical rail apparatus  18  enables the attachment of surgical devices such as retractors, light systems, monitors, suction devices, IV poles, and other surgical devices that may be needed for surgery to a litter or stretcher. Apparatus  18  enables any litter or stretcher to be easily converted into an operating table. In rural and austere settings where both military and aid relief providers may be practicing, apparatus  18  provides a means to increase the number of operating tables. Surgeons can easily attach the surgical rail apparatus  18  to any litter or stretcher and attach any surgical devices needed to the apparatus  18 , thereby enabling the surgeons to operate immediately. 
         [0037]    When assembled to a litter, surgical rail apparatus  18  provides a surgical platform in mobile environments and/or space limited areas, such as the back of a truck, a helicopter, an airplane, a boat, a train, etc. Apparatus  18  may be easily removed from a litter, packaged up, moved to a new location and used on another stretcher. This capability is important if the current surgical environment becomes unsafe or unusable due to power outages, enemy presence, lack of patients or resources, natural disaster, fire, etc. 
         [0038]    In a non-military setting, there are incidents throughout the world that often overwhelm the host nation&#39;s abilities and resources. When international aid missions are deployed they are often limited in their ability to provide ICU (Intensive Care Unit) and surgical capabilities. This is due to the cumbersome amount of equipment and supplies needed to support an ICU or OR (Operating Room). The present invention is lightweight and easily portable and can transform any litter into an ICU bed or operating room table, thus allowing for improved care during international/national crisis. The surgical rails are also the same standard dimension and size used for OR tables around the western world and therefore can immediately accept thousands of already existing medical devices for use in OR and ICU settings. Healthcare providers that deploy around the world to austere, hostile, or mobile environments can now convert any litter into a functional ICU or OR capable bed and use the same equipment that they use in their primary practice. 
         [0039]    Surgical rail apparatus  18  may also enable one to fix legs (not shown) to the longitudinal members  20 ,  22  of the apparatus  18  so that the litter may be elevated to a functional height for surgical procedures. Rail apparatus  18  provides stability to the litter, allowing the litter to be elevated above the ground level. The surgical rail apparatus  18  may also enable one to attach support rods (not shown) to the longitudinal members  20 ,  22  so that multiple litters may be stacked on top of each other. The stacked litters retain the ability to hold multiple medical devices on the surgical rails of the apparatuses  18 , which is important when the surgical/medical devices must remain in place during transportation of the patients on the litters. In addition to enabling stacking, the surgical rail apparatus  18  provides multiple points for stabilizing and securing the litter and apparatus  18  combination to the floor, walls, ceilings, etc. of different transportation platforms. 
         [0040]    Many changes in the details, materials, steps and arrangement of parts described herein may be made by those skilled in the art within the principle and scope of the invention, as expressed in the appended claims. For example, various types of fasteners may be used and the components of the apparatus may have shapes and relative sizes that differ from the embodiment shown in the drawings.