Abstract:
A medical emergency head and neck stabilization system for use on a patient carrying device such as a spine board includes a sleeve of cushioning material which fits over the end of the spine board. First and second side head restraints are affixable to the cushioning material and a head retaining strap is designed to pass over the patient&#39;s head, such as the forehead, and to be fixed in position on or around the sleeve.

Description:
FIELD OF THE INVENTION  
       [0001]     The present invention relates generally to medical emergency equipment and, more particularly, to a disposable patient head and neck immobilization assembly usable in extremes of weather as well as normally.  
       BACKGROUND OF THE INVENTION  
       [0002]     In medical emergencies and accidents, it is often necessary to immobilize a victim or patient prior to transporting the patient to a medical facility. Typically, a patient is placed on an immobilization board, known as a spine board, which maintains the patient in a flat, straight position. Additionally, in order to prevent further injury, the patient&#39;s head and neck must be further immobilized, typically by securing the patient&#39;s head to the spine board. Prior art devices for accomplishing such immobilizations are complex in design, difficult to apply and remove, and costly to manufacture. In most injury cases, one of the most important steps to be taken is the quick and safe immobilization of the patient. If immobilization requires manipulation of the patient&#39;s head and/or neck, then the goal of quick and safe immobilization is not realized. For example, the cervical collar disclosed in U.S. Pat. No. 4,043,325, which wraps around a patient&#39;s neck, requires that the patient&#39;s head be manipulated in order to secure the collar around the patient&#39;s neck which can cause further, often irreparable injury in some case. Similarly, the emergency neck immobilizer disclosed in U.S. Pat. No. 4,732,144 requires that the patient be manipulated in order to apply the device, which is complex in design and costly to manufacture. While these devices may help to immobilize a patient, they are usually cumbersome and uncomfortable, and may add to the feeling of anxiety being experienced by the patient, by being overly restrictive as well as posing a risk to the patient by manipulation of his or her head or neck. Furthermore, these prior art devices are not designed to be disposable, and therefore, must be sterilized after each use. This presents a hazard of contamination from various bodily fluids and presents an increased health risk.  
         [0003]     In U.S. Pat. Nos. 5,967,144 and 5,785,058, both issued to the present inventor, there are shown disposable head and neck immobilization devices which comprise a mask device of rugged denier nylon for covering the patient&#39;s head, and each one has a large opening therein for allowing the patient to breath easily and to see clearly. Such an opening does much to alleviate any anxiety and discomfort that the patient may feel. The mask is strapped, or otherwise mounted to, the spine board and functions to prevent movement in any direction of the patient&#39;s head and neck. Application of these masks requires a minimum of head manipulation.  
         [0004]     Most of the prior art arrangements present certain problems in inclement weather. Those that are made of nylon, for example, can become soaked, greatly increasing the discomfort of the patient and, in some cases, diminishing the effectiveness of the apparatus. Those that are made of plastic are substantially immune to atmospheric effects, but are generally uncomfortable for the patient to begin with. It is often necessary or desirable to place a cushion under the patient&#39;s head but the cushion itself can become soaked with the concomitant increase in patient discomfort. Also, a cushion under the head can result in the head being tilted which can cause a slight blockage of the patient&#39;s air passage resulting in some breathing impairment, which, for certain types of injuries, can be critical.  
       SUMMARY OF THE INVENTION  
       [0005]     The present invention is a disposable head and neck immobilization assembly that is, in its function and reliability, substantially impervious to the effects of weather or other ambient effects, and requires a minimum of patient manipulation, as well as maintaining clear breathing passages while allowing the patient to see and hear what is happening.  
         [0006]     In a preferred embodiment of the invention, the assembly comprises a sleeve of cushioning material such as preferred plastic bubble wrap which is dimensioned to be slipped over the spine board at the head end thereof. The top surface of the sleeve is preferably smooth, and the interior surface of the sleeve contains the air bubbles. The top surface of the sleeve has one or two large areas of adhesion material, for example, patches of Velcro® loops which are located on either side of the top surface of the sleeve centerline or extend across the top surface of the sleeve and are cemented in place. First and second head restraining blocks of, for example, Styrofoam, have a bottom surface with Velcro® hooks for firmly attaching the blocks to the large area surfaces. The blocks are, in use, spaced to bear against the sides of the patient&#39;s head to immobilize it from side-to-side or lateral movement without the necessity of moving the patient&#39;s head. The movable blocks can easily be positioned to accommodate the lateral dimensions of the patient&#39;s head. When the patient is lying on the spine board, his head is cushioned by the bubble wrap material between the two head restraint blocks. The bubble wrap is preferable to a pillow or other cushioning device in that it does not raise the patient&#39;s head and therefore it affords cushioning without blocking the patient&#39;s airway, which, as pointed out, often results from a raised position of the head.  
         [0007]     The patient&#39;s head is further immobilized by a single strap extending from and affixed to one side of the spine board bubble wrap sleeve, as by Velcro®, or other adhesion type material to the other side over the patient&#39;s forehead. The undersurface portion of the strap preferably has a light adhesive layer or pad thereon which lightly adheres to the patient&#39;s forehead to prevent slippages and to prevent vertical and rotational movement of the patient&#39;s head. In addition, it is desirable that the patient&#39;s body be strapped to the spine board to prevent bodily movement from possibly causing movement of the patient&#39;s head.  
         [0008]     When the patient is thus immobilized, being strapped to the spine board and with the head and neck immobilized by the restraint assembly of the invention, the patient&#39;s face is readily accessible, his nose and mouth are clear for easy breathing, the eyes are clear of any encumbrances or obstruction, and the patient&#39;s relative comfort and diminished anxiety is assured. Further, the restraint assembly of the invention is relatively immune from the detrimental effects of inclement weather, such as rain, especially due to Velcro® fastenings. The entire restraint assembly is designed for single use, and may be discarded when no longer needed. As a consequence, cleaning and sterilization are unnecessary.  
         [0009]     Spine boards may come in a variety of widths, such as, for example, fourteen inches to twenty inches. In another embodiment of the invention, the sleeve is made of a top layer of bubble wrap and a bottom layer, which are joined at their longitudinal edges by elastic material panels which enable the sleeve to fit snugly on virtually any width of spine board.  
         [0010]     The invention has numerous advantages, principal among which are a quick immobilization of the patient, primarily his or her head with virtually no manipulation of the patient&#39;s head or neck, and while maintaining communication between the patient and emergency personnel. Additionally, the patient&#39;s sight, hearing and breathing are virtually unimpaired.  
         [0011]     The apparatus of the invention is both simple in form and in use, and is made of materials that are readily available and not costly, which allows disposal of the apparatus after one use, a very important sanitary feature.  
         [0012]     In addition to the foregoing advantages, in use, the application of the restraint assembly to the spine board and the patient is quickly accomplished, compared to prior art arrangements, which is an extremely desirable feature, inasmuch as speed is usually of the essence, and manipulation of the patient is minimized.  
         [0013]     These and other features and advantages of the present invention will be readily apparent from the following detailed description, read in conjunction with the accompanying drawings. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0014]      FIG. 1  is an exploded perspective view of the various components of the apparatus of the invention;  
         [0015]      FIG. 2   a  is a plan view of one embodiment of the sleeve of the invention;  
         [0016]      FIG. 2   b  is an end view of the sleeve of  FIG. 2   a;    
         [0017]      FIG. 3   a  is a plan view of a second embodiment of the invention;  
         [0018]      FIG. 3   b  is an end view of the sleeve of  FIG. 3   a;    
         [0019]      FIG. 4  is a detail of the sleeve depicted in  FIG. 3   b;    
         [0020]      FIG. 5  is a plan view of the underside of the immobilizing strap of the invention.  
         [0021]      FIG. 6   a  is a side elevation view of the head restraining block of the invention;  
         [0022]      FIG. 6   b  is a bottom view of the head restraining block of  FIG. 5   a ; and  
         [0023]      FIG. 6   c  is a front elevation view of the head restraining block of  FIG. 5   a.   
     
    
     DETAILED DESCRIPTION  
       [0024]      FIG. 1  is an exploded perspective view of a first embodiment  11  of the present invention for use with emergency equipment. Common to all such emergency equipment is a spine board  12  which is standard equipment in paramedic and rescue vehicles. Board  12  may be made of any of a number of rigid light-weight material such as, for example, a hard plastic. A plurality of elongated holes  13  are strategically placed for functioning as hand holds for lifting and carrying the spine board. Holes  13  may also function as passages for straps and the like, not shown, especially for use in strapping the patient to the board.  
         [0025]     The various elements which constitute the apparatus of the invention are adapted to fit upon the head end  14  of the spine board  12 . Thus the apparatus of the invention comprises a sleeve  16  of commercially available bubble wrap formed so that the plastic bubbles  17  are on the interior  18  of the sleeve, and its exterior surfaces  19  are smooth. Sleeve  16  is adapted to being slid onto the spine board and to fit snugly thereon. Inasmuch as spine boards  12  are made in differing widths, from fourteen inches to twenty inches, for example, the interior width  18  of the sleeve  16  is dimensioned in this embodiment for one particular width spine board  12 . This does not necessarily represent an inconvenience inasmuch as most emergency vehicles carry only one particular width of spine board, hence they are to be equipped with sleeves  16  of the desired width.  
         [0026]     A Velcro® or other fastening type material patch or strip  21  is cemented to the smooth top surface  22  of the sleeve  16 . Velcro® fasteners comprise one member having a surface of material having a multitude of minute loops, and a second material having a surface of a multitude of minute hooks, which are adapted to mate with the loops. The top surface  23  of patch  21  is preferably although not necessarily, the loop portion of a Velcro® fastening assembly inasmuch as it is softer and more resilient than the hook portion, and, as will be discussed hereinafter, the back of the patient&#39;s head rests upon it.  
         [0027]     The patch  21  may comprise two spaced Velcro® patches so that the patient&#39;s head may rest upon the upper surface  22  of the sleeve between the two patches. One of the advantages of Velcro® is that the two members may be attached by pressing them together and then detached by simply pulling them apart, and the fastening assembly is reusable as needed.  
         [0028]     First and second substantially identical head restraint members  24  and  26  are adapted to be placed on the pad  21  on either side of the patient&#39;s head to prevent it from moving during transport. The bottom surface of each of the restraint members has a Velcro® hook pad  27 ,  28  cemented so that when placed on either side of the patient&#39;s head, the restraint members  24  and  26  are firmly held in position by the mating of the pad surface  23  with the hook pads  27  and  28 . The top surfaces  29  and  31  of the restraint members  24  and  26  have, respectively, notches  32  and  33 , the purpose of which will be clear hereinafter. Members  24  and  26  are preferably made from a very dense polyurethane based foam plastic of polyethylene or polypropylene, for example, yet is soft enough to accommodate the patient&#39;s head comfortably. Further, to prevent the foamed material from absorbing moisture, the members  24  and  26  preferably have a skin formed thereon which is substantially moisture proof.  
         [0029]     As thus far described, the assembly  11  provides for immobilizing the patient by strapping him or her to the spine board, with his or her head resting on the relatively soft surface  23  of pad  21  and cushioned by the sleeve  16 . The patient&#39;s head lies in a substantially flat position, with no bending of the neck, thus minimizing any blockage of his or her breathing passages. The restraint members  24  and  26  hold the head against lateral movement for protection against possible injury resulting from such movement.  
         [0030]     It is possible, even with the assembly as thus far described, that the patient may attempt to rotate his or her head, or that it may accidentally be so rotated. In addition, the head may be raised by the patient or by accident, such as the emergency vehicle passing over bumpy surfaces. To guard against such movement of the head, a retaining strap  34  is provided. Strap  34  is preferably made of a flexible plastic material and has, at each end, matching Velcro® patches  36  and  37 . In the present embodiment of the invention, one patch, such as patch  36  comprises loop material, and the other patch  37  comprises hook material. Strap  34  is long enough to pass over the patient&#39;s forehead, through notches  32  and  33 , around the edges of sleeve  16  and patches  36  and  37  mated on the underside of sleeve  16  of the spine board  12 . Centrally located on the underside of strap  34  is a cushioning pad  38  which, when the strap is properly in place, bears against the patient&#39;s forehead, for comfort. Pad  38  may have a lightly adhesive material on its surface to hold it in place, against the patient&#39;s forehead. As a consequence, the patient&#39;s head is substantially totally immobilized. The immobilization arrangement of the present embodiment of the invention is easy to apply and remove with virtually no manipulation of the patient and produces a decreased level of anxiety by allowing the patient to see and hear what is happening around them, and allows the patient, if able, to communicate freely. In addition, the apparatus of the invention may be discarded after a single use, thus eliminating the necessity of sterilization and the possibility of contamination.  
         [0031]      FIGS. 2   a  and  2   b  are, respectively, a plan view and a front elevation view of the sleeve  16  of the first embodiment of the invention. In order that the hand holds  13  at the head end  14  of the spine board  12  be made accessible, sleeve  16  has large cut-out portions  39  and  41 , extending as shown from the top or head or closed end  42  of sleeve  16  to the sides thereof. The cut-out portions  39  and  41  do not, in any way, impair the function of the assembly of the invention.  
         [0032]      FIGS. 3   a  and  3   b  depict a second embodiment of the invention in, respectively, a plan view and a front elevation view of a universal sleeve  43  which is readily usable with virtually any width spine board. In the figures the same reference numerals identify like parts with those of  FIGS. 1, 2   a , and  2   b . Sleeve  43  comprises an upper member  44  of bubble wrap material and a lower member  46 , with the top surface of member  44  being smooth and the bubble surface  47  thereof facing the bubble surface  48  of member  46 , as shown in  FIG. 3   b . Members  44  and  46  are joined at their substantially parallel side ends by an elastic material  49  and  51  as shown in  FIG. 3   b , the details of which are shown in  FIG. 4 .  
         [0033]     As can be seen in  FIG. 4 , strip  51  (and strip  49 ) comprises a first strip  52  of Velcro®, for example, which is cemented to the side edge of bubble wrap member  44 , as shown, and a second strip  53  of Velcro® material is cemented to the side edge of member  46 . The material of the strip  52  and  53  are preferably the hook portion of a Velcro® attachment, but the material may be the loop portion. Strips  52  and  53  are joined together by a strip of expansible or elastic material  54  which may be pleated, as shown, and which is preferably sewn thereto for strength, although it may be cemented, provided the cement forms a strong enough bond. The sleeve  43  thus allows an expansion or contraction of the width of the sleeve for use with spine boards of differing widths, thus it is not necessary for the emergency vehicle to be equipped with sleeves of varying widths.  
         [0034]      FIG. 5  is a plan view of the underside of the strap  34  having, at each end thereof strips  36  and  37  of Velcro®, which mate with each other when the embodiment of  FIG. 1  is used. In use, the cushioning pad  38  is placed against the patient&#39;s forehead and strap  34  passes over the head restraint member  24  and  26  through notches  32  and  33  and the ends  36  and  37  are joined on the underside of the sleeve  16 . Notches  32  and  33  prevent the strap  34  from slipping when placed over the patient&#39;s head. Pad  38  protects the patient&#39;s head from possible irritation by strap  34 , and may be equipped with a mildly adhesive surface to hold strap  34  in place on the patient&#39;s head. In the embodiment of  FIGS. 3   a ,  3   b , and  4 , the fastening portion  36  and  37  are intended to mate with portions  52  and  53  of side members  44  and  46 , hence if portions  52  and  53  are Velcro® loop members, portions  36  and  37  are hook members. This arrangement permits tightening and hence securing the sleeve  16  to the spine board  12 .  
         [0035]      FIGS. 6   a ,  6   b , and  6   c  are, respectively, a side elevation view of head restraint member  24  (member  26  being substantially identical thereto), a bottom view of member  24 , and a front elevation view thereof. as discussed in the foregoing, the bottom surface of member  24  has a Velcro® pad  27  cemented thereon. In the preferred configuration, pad  27  is the hook portion of a Velcro® attachment and pad  23 , which mates with pad  27 , is the loop portion, as previously discussed, all the opposite configuration might be used. The depth of notch  32  should be sufficient to prevent sideways slipping of strap  34  when it is positioned in the notch  32 . The notch  32  can be made deep enough so that the patient&#39;s ears are exposed for both observation thereof and communication with the patient.  
         [0036]     In the depicted embodiments of the invention, Velcro® has been used because of its adjustability and securing strength. Other fastening means or materials might readily be used, however, the simplicity and availability of Velcro® makes it the preferable fastening means. In like manner, the sleeve has been depicted as comprising bubble wrap, which is cheap and readily available. Other materials that perform the cushioning and waterproof functions of the sleeve as set forth in the foregoing for bubble wrap, might be used instead of bubble wrap, provided that it is also reasonably inexpensive so as to allow discarding thereof after a single use.  
         [0037]     The patient restraint system of the invention, as set forth in the foregoing, is simple, cheap, uses mostly waterproof materials, all of which are commercially available, while insuring more than adequate stabilization of a patient&#39;s head and neck on a spine board. The system permits the patient to breath easily, to be aware (if conscious) of his or her surroundings, and to communicate with the emergency personnel.  
         [0038]     It is to be understood that the various features of the present invention might be incorporated into other types of patient restraint systems, and that other modifications or adaptations might occur to workers in the art. All such variations or modifications are intended to be included herein as being within the scope of the present invention as set forth. Further, in the claims hereinafter, the corresponding structures, materials, acts and equivalents of all means or step-plus-function elements are intended to include any structure, material, or sets for performing the functions in combination with other elements as specifically claimed.