Abstract:
The present invention provides a medical support pillow and method for supporting a patient in the lateral position while maintaining an open airway. The Lateral Airway Support Pillow includes a chest support, a shoulder recess, a head support, and a posterior bolster. The orientation of these components support the patient in the lateral position, with the spine and airway in a straight position, thus eliminating possible airway obstruction. One embodiment of the invention contains a head support with a posterior recess and a neck support which provides for straightening the neck and airway and aligning the oral, pharyngeal, and laryngeal axes of the airway. Other embodiments position and elevate the patient in such a manner to treat or prevent soft tissue pressure injury, gastroesophageal reflux, congestive heart failure, or sleep apnea.

Description:
RELATED APPLICATIONS 
       [0001]    The present application is related to U.S. Pat. No. 3,648,308, issued Mar. 14, 1972, for ELEVATED TRACTION PILLOW, by Greenawalt, included by reference herein. 
         [0002]    The present application is related to U.S. Pat. No. 3,829,917, issued Aug. 20, 1974, for THERAPEUTIC PILLOW, by De Laittre, included by reference herein. 
         [0003]    The present application is related to U.S. Pat. No. 4,320,543, issued Mar. 23, 1982, for MEDICAL PILLOW, by Dixon, included by reference herein. 
         [0004]    The present application is related to U.S. Pat. No. 4,424,599, issued Jan. 10, 1984, for CERVICAL PILLOW, by Hannouche, included by reference herein. 
         [0005]    The present application is related to U.S. Pat. No. 4,494,261, issued Jan. 22, 1985, for HEAD AND NECK CUSHION, by Morrow, included by reference herein. 
         [0006]    The present application is related to U.S. Pat. No. 4,918,774, issued Apr. 24, 1990, for MEDICAL SUPPORT PILLOW, by Popitz, included by reference herein. 
         [0007]    The present application is related to U.S. Pat. No. 5,581,831, issued Dec. 10, 1996, for ERGONOMIC PILLOW, by Xiang, included by reference herein. 
         [0008]    The present application is related to U.S. Pat. No. 6,446,288 B1, issued Sep. 10, 2002, for MEDICAL SUPPORT PILLOW FOR FACILITATING ENDOTRACHEAL INTUBATION, by Pi, included by reference herein. 
         [0009]    The present application is related to U.S. Pat. No. 6,751,818 B2, issued Jan. 22, 2004, for AIRWAY MANAGEMENT APPARATUS AND METHOD, by Troop, included by reference herein. 
     
    
     FIELD OF THE INVENTION 
       [0010]    The present invention relates to a supportive pillow for medical and surgical procedures and more particularly to a supportive pillow which allows the patient to maintain an open and adequate airway while in the lateral position. 
       BACKGROUND OF THE INVENTION 
       [0011]    Medical practice and patient care has experienced significant changes over the recent past including huge increases in the number of outpatient medical, surgical, and radiologic procedures. The use of flexible fiberoptic endoscopy for diagnostic and therapeutic procedures has grown worldwide. Conscious sedation and short-acting anesthetic agents have enabled a much greater variety of procedures to be accomplished on an outpatient basis. Because of the brief duration of many of these procedures and the use of conscious sedation, the placement of a mechanical airway is omitted. This may result in manipulation or support of the patient by the nursing or anesthesia staff to maintain an adequate airway during and after a procedure until the patient is fully recovered. Many of these procedures are performed in the lateral position, further complicating patient position and airway management. 
         [0012]    The state of medical practice dictates the care of more elderly and of more obese patients, further complicating the positioning and airway management of these patients during a procedure. The patient support addressed in the Troop patent (U.S. Pat. No. 6,751,818) discloses an airway management apparatus which supports the chest, neck, and head of a patient, allowing the abdominal mass to be displaced, thus improving airway position and ventilation. This cushion does not accommodate the lateral position which is widely used. 
         [0013]    The Xiang patent (U.S. Pat. No. 5,581,831) addresses the support of a patient in the lateral position for comfort, but the chest is not supported independently of the shoulder, resulting in lateral angulation of the cervical spine and the airway. The shoulder is allowed to impinge on the neck, and the head is not supported in a position to maintain a secure airway. This device also does not support the patient from shifting laterally or easily rolling off of the cushion. 
         [0014]    There has been a vast increase in the number of patients in rehabilitation hospitals and extended care facilities requiring nursing the nursing staff to position them and to move them while they are recumbent. Supporting and cushioning patients to avoid soft tissue pressure injury over a bony prominence is a major priority of patient care. The morbidity and mortality from complications of pressure sores is great and consumes massive financial and personnel resources. Many patients require apnea monitoring during long term care and airway maintenance requires considerable time and attention from nursing and respiratory therapy staff. Techniques of padding and bolstering patients with common bed pillows in the lateral position yield inadequate results and require multiple staff members to reposition patients every two hours. 
         [0015]    The treatment of gastroesophageal reflux and congestive heart failure, as well as other conditions, require elevation of the head of the patient&#39;s bed. The classic recommendation is to place blocks or bricks under the legs of the bed at the patient&#39;s head. Several drawbacks are apparent in this technique. The patient usually slides out the foot of the bed, and a bed partner is made uncomfortable by the position of the bed. The use of blocks or bricks is not possible with a water mattress. The expense of an adjustable hospital bed is prohibitive for most patients. The technique does not lend itself to maintaining good airway support in the head-elevated supine position or the lateral position. Many of these patients are obese and have sleep apnea and the elevated position does not support the head and neck, thus complicating the already compromised airway. 
         [0016]    Because of the increased use of the lateral position in diagnostic and therapeutic procedures requiring sedation or anesthesia, without the use of a mechanical airway, attention is drawn to adequate support and positioning of the patient during and after these procedures. Likewise, the use of the lateral position in long term care requires attention to proper positioning, padding, and airway support. Therefore, a Medical Support Pillow that meets these multiple needs is the object of the present invention. 
         [0017]    It is therefore an object of the invention to support and stabilize the patient in the lateral position while maintaining an open airway. 
         [0018]    It is another object of the invention to enhance spontaneous respiration by aligning the airway in the anterior-posterior, and lateral directions. 
         [0019]    It is another object of the invention to assist the anesthesiologist in placing a mechanical airway prior to a procedure requiring the lateral position. 
         [0020]    It is another object of the invention to support the patient with limited mobility in such a way to maintain an adequate airway and protect against soft tissue pressure injury. 
         [0021]    It is another object of the invention to provide support and elevation of the head, neck and thorax of the patient in the supine or either the right or left lateral positions. 
       SUMMARY OF THE INVENTION 
       [0022]    In accordance with the present invention, there is provided a medical support pillow and method for supporting a patient in the lateral position while maintaining an open airway. The Lateral Airway Support Pillow includes a chest support, shoulder recess, head support, and posterior bolster. For purposes of the discussion, the following definitions are offered: 
         [0023]    ANTERIOR—toward the direction the patient is facing while in the lateral position. 
         [0024]    POSTERIOR—opposite the direction the patient is facing while in the lateral position. 
         [0025]    CEPHALAD—toward the head of a patient on the Lateral Airway Support Pillow. 
         [0026]    CAUDAL—toward the feet of a patient on the Lateral Airway Support Pillow. 
         [0027]    The Lateral Airway Support Pillow supports the chest of the patient in the lateral position by elevating it above the level of the mattress of the patient support. This allows the shoulder recess to receive the shoulder and upper arm of in a natural position without the shoulder compressing or impinging upon the head, the chest wall, or the neck. The anterior portion of the head support receives the head while maintaining a straight orientation of the thoracic and cervical spines in the lateral direction. The elevation of the chest and the head at an incline allows the abdominal contents to fall away from the diaphragm, thus easing spontaneous ventilation. In most patients, this will insure an open airway. In some patients, however, relaxation of the soft tissues of the pharynx will compromise the airway during and after sedation or anesthesia. These patients will benefit from the placing of the head and neck over a neck support and into a posterior recess of the head support. This aligns the oral, pharyngeal, and laryngeal axes for an open airway and unimpeded spontaneous respiration. The superior shoulder of the patient is moved posteriorly against the posterior bolster, allowing the head to be positioned in the posterior recess of the head support. 
         [0028]    Another aspect of the of the present invention allows for the patient to be positioned supine on the Lateral Airway Support Pillow while induced under general anesthetic. The head could be placed in the posterior recess of the head support for aligning the oral, pharyngeal, and laryngeal axes of the airway, and then endotracheal intubation or the placement of a laryngeal mask could be easily achieved. The patient could be rolled to the lateral position for the surgical procedure. This technique would prove useful for thoracic surgery or hip surgery in the lateral position. The patient would supported securely and uniformly with the Lateral Airway Support Pillow without fear of pressure injury to the soft tissues. Post operative recovery, including airway management, would be facilitated by use of the Lateral Airway Support Pillow. 
         [0029]    Another aspect of the invention allows for the support of a long-term care patient with limited mobility, in the lateral position, to prevent pressure injury to the soft tissue of the presacral area and other areas. A reversible version of the Lateral Airway Support Pillow without the posterior recess in the head support positions the patient in either the left or right lateral position while awake or asleep. This device is called the Reversible Lateral Support Pillow. 
         [0030]    Another aspect of the invention is useful for patients requiring elevation of the head and thorax for the treatment of conditions such as gastroesophageal reflux, congestive heart failure and sleep apnea. This device has a middle portion for supporting the patient in the supine position with the thorax, neck, and head elevated and supported. Should the patient desire to recline in either the right or left lateral position, accommodation with bilateral chest supports, shoulder recesses, and head supports is presented. The head, neck, and chest are supported and elevated in the lateral positions as they are in the supine position. This version of the invention would also be useful in the long-term care setting. It is called the Bilateral Support Pillow. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0031]    A complete understanding of the present invention may be obtained by reference to the accompanying drawings, when considered in conjunction with the subsequent, detailed description, in which: 
           [0032]      FIG. 1  is a perspective view of a lateral airway support pillow, viewed from the anterior and caudal aspects of the invention; 
           [0033]      FIG. 2  is a perspective view of a lateral airway support pillow viewed from the cephalad end of the invention; 
           [0034]      FIG. 3  is a top plan view of a lateral airway support pillow, in use, with the head of the patient positioned on the anterior planar surface of the head support; 
           [0035]      FIG. 4  is a top plan view of a lateral airway support pillow, in use, with the head of the patient positioned in the posterior recess of the head support; 
           [0036]      FIG. 5  is a perspective view of a patient on the lateral airway support pillow with the head in the posterior recess of the head support, demonstrating the extended neck and an open airway; 
           [0037]      FIG. 6  is a left perspective view of an alternative embodiment of the invention, termed the reversible lateral support pillow; 
           [0038]      FIG. 7  is a right perspective view of a reversible lateral support pillow, reversed to accommodate a patient in the right lateral position; 
           [0039]      FIG. 8  is a top plan view of a reversible support pillow in use, with the patient supported in the straight left lateral position; 
           [0040]      FIG. 9  is a rear view of a patient lying on the reversible lateral support pillow or the lateral airway support pillow; and 
           [0041]      FIG. 10  is a perspective view of an additional embodiment of the lateral support pillow termed the elevated bilateral support pillow. 
       
    
    
       [0042]    For purposes of clarity and brevity, like elements and components will bear the same designations and numbering throughout the Figures. 
       DESCRIPTION OF THE PREFERRED EMBODIMENT 
       [0043]      FIG. 1  is a perspective view of a lateral airway support pillow, viewed from the anterior and caudal aspects of the invention. 
         [0044]      FIG. 2  is a perspective view of a lateral airway support pillow viewed from the cephalad end  14  of the invention. 
         [0045]      FIG. 3  is a top plan view of a lateral airway support pillow, in use, with the head of the patient positioned on the anterior planar surface of the head support  24 . 
         [0046]      FIG. 4  is a top plan view of a lateral airway support pillow, in use, with the head of the patient positioned in the posterior recess of the head support  26 . 
         [0047]      FIG. 5  is a perspective view of a patient on the lateral airway support pillow with the head in the posterior recess of the head support  26 , demonstrating the extended neck and an open airway. 
         [0048]      FIG. 6  is a left perspective view of an alternative embodiment of the invention, termed the reversible lateral support pillow. 
         [0049]      FIG. 7  is a right perspective view of a reversible lateral support pillow, reversed to accommodate a patient in the right lateral position. 
         [0050]      FIG. 8  is a top plan view of a reversible support pillow in use, with the patient supported in the straight left lateral position. 
         [0051]      FIG. 9  is a rear view of a patient lying on the reversible lateral support pillow or the lateral airway support pillow. 
         [0052]      FIG. 10  is a perspective view of an additional embodiment of the lateral support pillow termed the elevated bilateral support pillow. 
       DESCRIPTION OF THE PREFERRED EMBODIMENTS 
       [0053]    Preferred embodiments of the invention are described below with reference to various examples of how the invention can best be constructed and be used. Like reference numerals are used throughout the description and the drawings to indicate corresponding parts. 
         [0054]    Referring now to FIG.  1 ., the Lateral Airway Support Pillow is fashioned to support a patient in the lateral position. It fully supports the chest, neck, and head of the patient in such a position so as to preserve an adequate airway and to stabilize the patient in such a position to satisfactorily perform the required procedure. It is made to be used on a patient support such as a bed, transfer cart, or operating table. It has a base  10  having a substantially planar surface to allow positioning on the patient support. It has a posterior surface  16  and two ends, one designated as the caudal end  12  and an opposing margin as the cephalad end  14 . 
         [0055]    Major components comprise a chest support  18  which is of size and thickness to lift the thorax of the patient a distance from the patient support, thus allowing the dependent shoulder and the upper arm of the patient to reside in the shoulder recess  20 . The shoulder recess  20  is of adequate size to allow the shoulder and upper arm to assume a natural position, and not be compressed by the weight of the patient. 
         [0056]    The head support  22  is substantially thicker than the chest support  18  and thus aligns the cervical spine with the thoracic spine. As the hips of the patient lie on the patient support, the cervical and thoracic spines are aligned with the lumbar spine. The head support  22  contains a posterior recess and an anterior planar surface. The anterior planar surface receives the head of the patient. The dependent side of the head and face are the surfaces contacting the anterior planar surface of the head support  24 . The posterior recess of the head support  26  receives the posterior portion of the patient&#39;s head when the patient is rolled posteriorly onto the posterior bolster  30 . This allows the neck of the patient to extend over and be supported by the neck support  28 . The airway is straightened in the anterior-posterior plane by this action and the tracheal, laryngeal, and oral axes of the upper airway are aligned. The Lateral Airway Support Pillow maintains the position once the patient is properly introduced into the posterior recess of the head support  26 . Further traction or manipulation is not necessary to maintain a secure airway. The size and depth of the posterior recess of the head support  26  is sufficient to receive the head and straighten the airway. 
         [0057]    Referring to FIG.  2 ., the Lateral Airway Support Pillow is viewed from the cephalad end  14  to illustrate the detail of the head support  22 . The size, depth, and position of the posterior recess of the head support  26  and its relationship to the anterior planar surface of the head support  24  are demonstrated. The posterior bolster  30  extends the full length of the Lateral Airway Support Pillow from the caudal end  12  to the cephalad end  14 . The posterior bolster  30  serves to support the head of the patient when it is in the posterior recess of the head support  26 , and to support the back of the patient when the patient is rotated posteriorly. 
         [0058]    Referring to FIG.  3 ., the patient is depicted from overhead, lying in the lateral position on the Lateral Airway Support Pillow with the head of the patient on the anterior planar surface of the head support  24 . The chest support  18  is shown positioned under the patient&#39;s chest to allow the dependent shoulder and upper arm to occupy the shoulder recess  20 . The posterior recess of the head support  26  is seen posterior to the patient&#39;s head. 
         [0059]    Referring to FIG.  4 ., the superior shoulder of the patient is rotated posteriorly to rest on the posterior bolster  30 , allowing the head to be introduced into the posterior recess of the head support  26  and the neck and to be extended and the airway straightened. The neck is extended over and resting on the neck support  28 . The back of the patient is reclining on, and fully supported by the posterior bolster  30 . 
         [0060]    Referring to FIG.  5 ., the patient is rotated posteriorly and fully reclining in the Lateral Airway Support Pillow. This view demonstrates the position of the chest and head fully supported by the chest support  18  and the head support  22 . The position of the dependent shoulder and the upper arm is well demonstrated in this view. The head of the patient is in the posterior recess of the head support  26  and the straight orientation of the neck and airway is apparent. 
         [0061]    Referring to FIG.  6 ., an alternative embodiment of the Lateral Airway Support Pillow is seen in the form of a Reversible Lateral Support Pillow. This perspective view from the caudal end  12  and anterior surface illustrates the detail of the chest support  18  and the caudal end  12  of end of the posterior bolster  30 . The position of the posterior bolster  30  and the thicker anterior edge of the chest support  18 , with the thinner mid-portion of the chest support  18 , provides a cradle for the lateral surface of the chest of the patient. Security from rolling off of the Reversible Lateral Support Pillow is afforded. The shoulder recess  20  is seen to occupy the space between the chest support  18  and the head support  22 . This accommodates the dependent shoulder and the upper arm of the patient. The head support  22  is seen to be in a similar configuration as the chest support  18 , with the posterior bolster  30  and the thicker portion at the anterior edge of the head support  22  providing a secure cradle for the head. The large size of the head support  22  accommodates a variety of positions for the head when the patient is in the straight lateral position or the postero-lateral position. 
         [0062]    Referring to FIG.  7 ., the Reversible Lateral Support Pillow is lying on the reverse side, thus accommodating a patient in the right lateral position. This view demonstrates that the reverse side is a mirror image to that depicted in  FIG. 6 . 
         [0063]    Referring to FIG.  8 ., the patient is in the straight lateral position on the Reversible Lateral Support Pillow. The patient&#39;s dependent shoulder and upper arm are placed in the shoulder recess  20 . The head support  22  is noted to provide adequate space for a variety of positions. The posterior bolster  30  allows the patient to be in a postero-lateral position while keeping the sacrum from contacting the patient support and therefore preventing pressure induced soft tissue injury. 
         [0064]    Referring to FIG.  9 ., the patient is shown in the lateral position reclining on either the Lateral Airway Support Pillow of the Reversible Lateral Support Pillow and demonstrating the straight-line orientation of the cervical, thoracic, and lumbar portions of the spinal column. This orientation provides support and comfort for the patient and assists in the maintenance of the open airway. The invention also supports the patient without pressure from the patient support on the sacrum. 
         [0065]    Referring to FIG.  10 ., an alternative embodiment is depicted for use for a patient wishing to elevate the head and chest above the level of the patient support, and yet still be able to lie in the supine position or in the left or right lateral positions. This invention would be useful in the management of gastroesophageal reflux, congestive heart failure, or sleep apnea. The head, neck, and thorax remain elevated in the lateral position as illustrated in  FIG. 9 . This embodiment contains a chest support  18 , a left shoulder recess  20 , a right shoulder recess  20 , and a head support  22 . The head support  22  is fashioned to cradle the head of the patient in the center of the head support  22  when the patient is in the supine position, or on either the left lateral planar surface or the right lateral planar surface of the head support  22 , depending on the position of the patient. 
         [0066]    The alternative embodiment described as the Reversible Lateral Support Pillow demonstrates that all embodiments of this invention could be constructed to be reversible by reproducing a mirror image of the obverse side on the reverse side. Some applications such as flexible fiberoptic endoscopy are most commonly performed in the left lateral position and a pillow made without the reversible feature would perform satisfactorily. Alternatively, applications such as hip surgery or chest surgery would utilize a reusable, reversible Lateral Airway Support Pillow. A Reversible Lateral Support Pillow would found useful in the long-term care unit to be able to alternate lateral positions while supporting the patient and helping eliminate soft tissue pressure injury. 
         [0067]    Materials for the construction of these units could include urethane foam material which is formed to a specific shape in a mold or is constructed of smaller pieces of foam fastened to each other with adhesive. Different densities of foam may be employed to render a pillow of a desirable shape to function as described herein. 
         [0068]    Other options include constructing a pillow with one or more inflatable chambers. This would allow for adjustment of size and rigidity of each chamber, thus allowing different support characteristics to patients of varying sizes and weights. The individual chambers could be inflated by a recycling, variable pressure pump, thus stimulating the circulation to the soft tissue and preventing points of prolonged high pressure. 
         [0069]    Since other modifications and changes varied to fit particular operating requirements and environments will be apparent to those skilled in the art, the invention is not considered limited to the example chosen for purposes of disclosure, and covers all changes and modifications which do not constitute departures from the true spirit and scope of this invention. 
         [0070]    Having thus described the invention, what is desired to be protected by Letters Patent is presented in the subsequently appended claims.