HRP980391A2 - Universal mattress for sitting, laying, decubitus prevention and curing - Google Patents

Description

The field to which the invention relates

This invention relates to a universal mattress with a control device on which one can comfortably sit, lie down, lean on, protect against decubitus and treat decubitus while simultaneously preventing the formation of new decubitus wounds. It belongs to the group of medical aids.

The invention and the name MUTI are dedicated to my mother who, after breaking her hip, developed a pressure ulcer and succumbed to an infection in the clinical center at the Faculty of Medicine. More recently, the author realized that hospitals and medical staff, even in clinical centers, have few conditions and adequate aids to prevent, and even less to treat, patients with pressure ulcers.

Technical problem

If, during long-term sitting or lying down, the pressures are higher than allowed, the blood circulation is hindered. In addition to the fact that these pressures are painful and tiring, they are also the main reason for the occurrence of pressure ulcers.

According to some published works, the pressure corresponding to the mean pressure in the arterial complex of capillaries is considered to be about 4 kPa (30 mm Hg = 40.8 g/cm2) as a permissible pressure, which should not significantly affect blood circulation and the formation of pressure ulcers. According to other authors (K. D. Neander), the permissible upper limit of pressure at the point of support corresponds to the mean pressure in the venal bundle of capillaries of 1.6 kPa (12 mm Hg = 16.5 g/cm2). However, measurements by Khan, M. Le, and colleagues show that the pressure at the point of support, near prominent bony prominences, increases 3- to 5-fold. The importance of this finding in medicine is known; places on the body where there is little fatty tissue under the skin are critical places and are destined for the formation of pressure ulcers (fig. 2.7). In order to enable unhindered blood flow in critical places, the external pressure, according to fluid mechanics, would have to be 3 to 5 times lower than 1.6 kPa.

In contrast to the small permissible pressures, pressures in critical places when lying on a hard surface can reach a value of 40 kPa (300 mm Hg = 408 g/cm2) (fig. 2.7), and when sitting up to 666 kPa (5,000 mmHg = 6.8 kg/cm2) (E. R. Tichauer) (fig. 2.3 and 2.4). Such high pressures on a well-designed and executed air mattress, according to the tests of the author of this invention, can approach the permissible pressure in the venal complex of capillaries (fig. 2.5 and 2.6), while a pressure lower than 1.6 kPa can only be achieved by completely releasing the body from the support.

Healthy people react to inappropriate pressure with spontaneous or controlled movements. Immobile and often elderly people cannot perform movements, so they must be allowed to periodically (every two hours) completely separate their body from the support, which is achieved by turning the patient or using an anti-decubitus mattress. If the patient turns, the problems are:

- it is difficult to organize turning in some collectives and at home where there is a lack of staff for quality care, i.e. where there is a lack of resources for care

- turning is painful for the patient and worsens his health condition

- there are few contact surfaces with adequate pressure, so it is difficult to find new contact points when turning

- in all cases it is not possible to avoid decubitus. Problems when using anti-decubitus mattresses:

- they work with a much higher pressure than necessary

- do not occasionally and completely separate parts of the body from the support

- they are difficult to wash, take a long time to dry, take a long time to get wet, have poor ventilation

- a mattress that would simultaneously serve for therapy and prophylaxis against pressure ulcers is missing

- most anti-decubitus mattresses do not have artificial ventilation, heating and cannot accept liquid from washing and urinating.

In general, it can be said that there is a lack of functional anti-decubitus mattresses. There are several reasons, the main one being that they are expensive.

In developed countries, the so-called in a rich society, the costs of hospital treatment for pressure ulcers are from 20,000 to 30,000 DM per patient, and it is estimated that 3 to 14% of patients get pressure ulcers (R. D. Neander), so it is questionable how to treat the poor in poor countries? That is why it is the author's wish that MUTI + CO, according to the invention, serve as a modest contribution to solving the problem of decubitus ulcers and that:

- hospitals and retirement homes have a sufficient number of functional and cheap anti-decubitus mattresses so that patients, who may be expected to develop pressure ulcers, immediately upon admission receive an anti-decubitus mattress with such performance that enables the medical staff to choose the relevant parameters for care

- lonely, poor and helpless patients receive free of charge a modestly equipped but functional mattress that is easy and simple to handle (with a small movement of the finger)

- disabled people, drivers and other users have such a seat that provides optimal pressure

- the mattress can be used as a bed on the floor, in a tent, etc., i.e. in all catastrophic situations.

State of the art

The state of the art is visible from the description of medical and technical problems. It can be briefly summarized:

- a large number of anti-decubitus mattresses do not provide optimal pressure or a simultaneous change of the place of support; they regularly work with 2 to 4 times higher pressure than necessary

- there is a lack of appropriate aids for the treatment of pressure ulcers, especially those that enable simultaneous treatment and protection against pressure ulcers

- pillows and mattresses are rarely used when sitting and lying down, which provide optimal pressure - optimal comfort

- they are difficult to wash and dry, they have no artificial ventilation or heating

- they are regularly expensive and therefore inaccessible to a large number of potential customers.

Presentation of the essence of the invention

The description, purpose and benefits of universal mattresses, pillows and control devices, according to the invention, can be seen from the working characteristics - performance.

1. Purpose and name of the mattress

The mattress, that is, the pillow, according to the invention, is an independent and functional unit that serves to protect against and treat decubitus, as well as for comfortable sitting, lying and leaning. Mattresses and pillows can be used as inserts for beds, chairs, wheelchairs (fig. 16.4), for seats in vehicles, for supporting the head, as an extra bed (fig. 15.3), directly on the floor and ground (fig. 15.1 and 15.2 ).

In order for the mattress to be functional and have a versatile (already mentioned) application, the author solved and created several type mattresses and control devices that have about thirty working features, which makes it a first (I) in this domain.

Accordingly, the full name of the mattress is derived:

MATTRESS UNIVERSAL TYPE I

MATTRESS UNIVERSAL TYPICAL I

MATTRATZ UNIVERSELL TYPISCH I.

The name obtained from the first letters is MUTI, and the other names are:

- for the control device (controls), CO

- for MUTI and control device, MUTICO

- for protection against decubitus (prevention), P - MUTI

- for the prevention and treatment of pressure ulcers, PT - MUTI

- head-mattress, H - MUTI

- cushion for sitting and resting (arm-chair), AC - MUTI

- wheelchair cushion (invalid-cair), IC - MUTI

- vehicle cushion (car), C - MUTI. Derived names of individual types of MUTI are given with the description.

2. Optimal working pressure

2.1. MUTICO makes it possible to achieve and work with optimal pressure in which body weight, body position and anthropological measurements of the user are optimally incorporated.

2.2. In order to achieve optimal pressure, the MUTI is made of two rows of chambers of a certain diameter (fig. 1.4 and 1.6) and of highly flexible walls, or a mattress of chambers is combined with a layer of sponge (fig. 2.2). Such a solution achieves a larger contact surface in terms of the depth and surface of the mattress, that is, the pressure that is closest to the allowable pressure under the given conditions (optimal pressure).

2.3. That the pressures with MUTICO, according to the invention, are satisfactorily resolved is proven by the fact that the working pressure when the user is sitting is less than 6 kPa (fig. 2.1 and 2.2), when he is lying on his back and on one series of chambers it is less than 4.2 kPa ( fig. 2.6), and when it lies on both series of chambers it is less than 3.33 kPa (fig. 2.5). This means: if only the pressure in the capillaries would be meritorious for successful blood circulation, then the mattress solution, according to the invention, would meet the requirements even when relying on one series of chambers.

3. Changing the place of support

3.1. MUTICO makes it possible to change the place of support from two series of chambers to one of the series of chambers, and vice versa, it sits from series to both series of chambers. Changing the place of support can easily be done by CO automatically, semi-automatically and manually, which can easily be done by the user himself or a member of the household; and it should be kept in mind that it is a replacement for two medical workers when turning.

3.2. When changing the place of support from two series of chambers (A + B) to one series of chambers (A or B), according to the author's research, the contact area decreases from F1 to F2 (F3), and the pressure increases from P1 to P2 ( P3) according to the correlation P1xF1 = P2xF2 = P3xF3 = PnxFn, where P1 and F1 are the pressure and contact surface on two series of chambers (A+B), P2 and F2 on the series of chambers A, and P3 and F3 on the series of chambers B. How empirically established pressure P1 optimal for the contact surface F1, that is the resulting pressure P2(P3) on the surface F2(F3) is also optimal. When changing the contact surfaces from F2(F3) to F1, the pressure is automatically reproduced to the starting value OP1. The advantage of the solution, according to the invention, is obvious: when changing the place of support, the pressures from OP1 to OP2 are self-adjusted and self-reproducing from OP2 to op1, which means that the working pressures are always equal to the optimal ones.

3.3. MUTICO enables the programming of times in which the places of support are changed, from a few minutes to an hour or more. This makes it possible to change the support points more often at higher pressures, and vice versa, to change the support points more slowly at lower pressures.

3.4. It is possible to change the discharge speed of individual series of chambers from a few seconds to a few minutes. Corresponding to the emptying time of the chambers, the changes at the point of contact can be imperceptible up to sudden changes, which can be compared to the very slow operation of pistons on an engine. Although it can be assumed that jerky changes are more akin to the movements of healthier individuals, the invention allows for the selection of what is considered best for the user.

4. Distribution of contact surfaces

Depending on the layout of the chambers in the upper and lower row of the MUTI and the position of the MUTI in the bed, it is possible to:

4.1. alternate contact surfaces along the chambers of individual series with MUTI - R and MUTI - PP,

4.2. alternate contact surfaces over the entire MUTI - PD surface (fig. 10),

4.3. adjust contact surfaces according to body shapes with MUTI - PD (fig. 11 and 12),

4.4. lean on the MUTI - PD surface with parallel chambers or on the surface with oblique chambers,

4.5. place MUTI so that:

- the chambers lie parallel to the longer side of the bed,

- the chambers lie parallel to the shorter side of the bed,

4.6. put one or more MUTIs across the bed, or use smaller MUTIs for pressure ulcer therapy and prevention of pressure ulcers in predetermined places, and fill the other surfaces of the bed with sponge pillows or similar.

According to the invention, according to the statements of 4.1. until 4.5. the possible arrangement of contact surfaces is large. Scientific workers should, on the basis of blood circulation and anthropological measures, evaluate what arrangement and size of chambers are the most favorable for a certain population of users, for unhindered blood circulation; technically speaking, MUTI can meet any request.

5. Therapy of decubitus

On the same MUTI bed, which is used to protect against decubitus, with additional equipment (fig. 18), decubitus can be treated at the same time (fig. 17). During the therapy, the patient uses the same benefits provided by MUTI + CO as for protection against decubitus, the only difference is that during the treatment of decubitus there are vertical forces around the decubitus wound, in a radius of choice (10, 12, 15, 20 cm) , equal to zero.

6. Material and parts

The invention ensured that the materials and parts from which MUTI - CO is made are available on the market, that they are made in large quantities and series, that means they are available at a price, that the technologies of processing and finalization into the finished product are possible or already known, that the product is long-lasting and reliable in operation.

7. Washing and drying

7.1. MUTI is easy to wash (with a stream of water), and after washing it dries quickly (it is ready for use again in a few minutes)

7.2. On wet surfaces, they are easily dried with a dry cloth.

8. Collection and drainage of liquid (urine)

8.1. MUTI is designed in such a way that it can accept liquid (urine, liquid from burns or washing), so that it does not remain on the surface and does not irritate parts of the body.

8.2. Collected liquid can be poured into a collection container (accessory, fig. 19).

9. Ventilation and heating

9.1. Both the shape and arrangement of the chambers at MUTI enable natural ventilation, both above the deflated chambers (fig. 20.2) and between the chambers (fig. 20.3).

9.2. With the built-in heater and thermostat (fig. 21.1), artificial ventilation and heating are enabled (fig. 20 and 21; air currents 1 and 2).

9.3. The air blown out of the chambers (fig. 20 and 21, air flow 3) can also be used for ventilation of the MUTI.

10. Combined mattresses and pillows

10. 1. By combining mattresses and pillows made of chambers with a layer of sponge, a functional and aesthetically designed tapestry for seats (fig. 16.2), for seats and backrests (fig. 16.5), and for beds (fig. 15.1) can be achieved, with to all performances offered by MUTI - PP, or MUTI - PD.

10.2. A mattress with one row of chambers (fig. 13.1) can be made into a seat with two rows of chambers, and a backrest with one row (fig. 13.2).

10.3. A mattress with one row of chambers can be used for the seat and backrest (fig. 13.3).

11. Head pillow

MUTI of one row of chambers with a sponge (fig. 14.3), then MUTI - PP, or MUTI - PD (fig. 14.4), with or without a sponge, can be used as an independent unit for supporting the head. If another support is placed under the pillow (fig. 14.1 and 14.2), which can be used to change the height of the support, the pillow can be used at the same time to change the tilt of the head

12. Command device

12.1 The control device enables changing the contact surfaces while maintaining, self-adjusting and reproducing the optimal pressure. Other benefits of the command device:

12.2. According to the invention, in order to comply with the operating feature 12.1, different control devices and air sources are available that have matching tasks, but are of different prices because the purchasing power of the consumer is taken care of. But even with a US$30 manual control device, but with more attention and care, results similar to those provided by a US$300+ programmed and automated device can be achieved.

12.3. Air cannot escape from one series of chambers before the optimal pressure is established in one series of chambers or in both series.

12.4. When changing the place of support from two series to one series of chambers and vice versa, i.e. for one cycle, the consumption of compressed air amounts to 20 to 50% of the theoretically necessary consumption.

12.5. Using the MUTI and handling the control device is harmless because the working medium is low-pressure air (less than 100 g/cm2).

The effects provided by working features from 1 to 12 are: the change of the place of support, the frequency of change, the intensity of emptying the chambers, the optimal pressure in the chambers and others are solved; with these working features, it is possible to simulate movement (for immobile people). But such benefits can be pleasant and useful for healthy people. If we add other benefits, such as easy washing and drying, ventilation, heating and others, all the conditions for successful prevention of pressure ulcers and their treatment are met, and this is the basic task of the invention.

DESCRIPTION OF WORKING CHARACTERISTICS

Optimal pressure

The task of the invention is to make the MUTI work with optimal pressure, i.e. to avoid unnecessary and uncontrolled establishment of high pressures at the support points. Optimum pressures can be achieved with a larger contact surface according to PxF = G; where P = pressure in g/cm2, F = contact area in cm2 and G = weight of the user in grams (the choice of measurement unit g/cm2 is appropriate for the description of the invention, and will be used more often).

A larger contact surface is achieved if the body lies deeper into the mattress, which enables a higher mattress height and low pressure in the chambers and flexible mattress walls. The increase in the height of the mattress is limited and justified to a certain extent, so that we can also talk about the optimal height of the mattress. The optimal mattress height is again the height that provides a high degree of utilization of the contact surface, without losing comfort and stability when resting.

According to the invention, it is believed that the optimal height for the versatile use of the mattress is around 80 mm. A lower mattress (less than 50 mm) must have higher pressures inside the chambers, especially when sitting, in order to avoid resting the protruding parts of the body on a hard surface (compare fig. 1.1 and 1.3). Mattresses higher than 100 mm can be unstable and uncomfortable, and they do not achieve an interesting increase in the contact area. What's more, with a larger chamber diameter (50 cm), the utilization of the contact surface across the width, i.e. along the edges of the body, decreases (comparison fig. 1.2, W2 and fig. 1.5, W5; where W2 is less than W5). This contradiction was solved, according to the invention, by making a mattress from two rows of chambers with a smaller diameter R (fig. 1.4). This achieves twice the height of the mattress than the width of one chamber, that is, the support width increases from W2 to W4 (fig. 1.4).

The optimal mattress height can also be achieved by combining mattresses with one row of chambers with a diameter of R above which there is a layer of sponge of a certain height. The first distribution of body weight, or pressure, is established on the sponge layer. The second (re)distribution of pressure (body weight) is indirect, from the sponge layer to the row of chambers (Fig. 2.2). Finally, the pressure is distributed over the entire contact surface, but in such a way that it is higher above the inflated chambers, and variable and lower above the deflated ones, which depends on the diameter of the chambers, the pressure in the inflated chambers, the thickness of the sponge and others.

A mattress with chambers filled with sponge is a good solution if the pressure on the support surface, and below the deflated chambers, is lower than the pressure in the venules.

The optimal pressure, as a basic feature of the invention, is achieved, maintained, reproduced and self-adjusted thanks to the solutions of the chambers, the choice of materials, and the construction of the MUTI and the control device.

The influence of the length of the pressure effect on the onset of pressure ulcers

In addition to the strength of the pressure, it is necessary to worry about the time of the pressure, it proves:

- much needed turning of the patient

- in published works it can be read that the product of the time intervals (hours or minutes) in which the places of support and the pressure on the place of support are changed, should be a constant.

From the point of view of the invention, it is assumed that the dependence of pressure on the time of reliance on the appearance of pressure ulcers is certainly present, but it is not known whether the product of pressure and time is a constant or some other correlation is valid, and it is necessary:

- adjust the time of changing the place of support to the needs of the user of the aid

- use optimal pressure at the point of support.

The stated requirements are realized with MUTI - CO in the following way:

- the user lies down on the mattress in a lying position. Both series of chambers are then inflated until the mattress body separates from the hard surface. The read pressure value, increased by approximately 10%, corresponds to the optimal working pressure (ORP1) that is set for a specific user on the reducer valve

- when it is time to change the place of support, one series of chambers is deflated and the other remains inflated. The weight of the body is transferred from two series of chambers to one, within which the pressure increases from ORP1 to ORP2 through self-adjustment.

- the next exchange cycle consists of inflating the deflated series of chambers until the initially set optimal working pressure ORPi is reached in both series of chambers. The weight of the body is again transferred from one series of chambers to both.

According to the author's research, when changing the place of support, the following was observed:

- -compressed air utilization is at least 50%, because part of the air is reused

- if when lying on two series of chambers the optimal working pressure is about 3.3 kPa (34 g/cm2), then the pressure when resting on one series of chambers increases to approximately 4.2 kPa (43 g/cm2), i.e. by approximately 35 %, and not 100%, as should theoretically be expected

- the optimal working pressures inside the MUTI, according to the invention, when lying on one series of chambers, and especially on two series, are lower than the upper limit of the pressure prevailing in the arterial tangle of capillaries.

- the pressure supported on one series of chambers is lower the lower the initial pressure, when supported on two chambers.

Changes in touch surfaces

The change of contact surfaces in MUTI - PP takes place along individual series of chambers, namely when series A (fig. 9.1) is inflated, or series B (fig. 9.3) and when both series A and B are inflated (fig. 9.2).

The support surface of the MUTI - PD, when changing the condition in the chambers, changes both in length and width, as well as in the depth of the mattress (fig. 11). These changes are reflected by the fact that the height of the mattress changes under load from one section of the mattress to another.

In order to better monitor these changes in the support surface, it is necessary to illustrate the description with MUTI cross-sectional drawings (Figs. 10, 11 and 12), namely when certain series of chambers A or B or both, A and B, are inflated. Example 1 If only one series of chambers is inflated, A (fig. 10.1) or B (fig. 10.3), then there are:

- under the surface marked with PDP three inflated chambers, namely parallel - diagonally - parallel located chambers

- under the surface marked with PD are parallel and diagonally located chambers

- under the surface marked with PP there are two parallel chambers

- under the surface marked with D, there is only one, diagonally arranged chamber

- under the surface marked with P there is only one chamber, and it is arranged in parallel

- there are no inflated chambers below the surface marked with 0. Example 2.

Using the same markings, the inter-chamber arrangement and the number of chambers are shown when both series of chambers are inflated (fig. 10.2). It can be seen from the picture that the central space is filled by parallel and diagonally arranged PD chambers, and at the ends of the pillow, two fields each are filled with PP and PDP chambers (instead of PP and PDP chambers, it is possible to fill the ends of the MUTI with PD chambers and a layer of sponge).

If a rubber sheet is placed between the upper and lower rows of chambers, and one series of chambers is inflated (fig. 11.1), the gaps between the inflated chambers in the lower row are bridged. Then the chambers from the upper row, under the weight of the body, cannot fill the space between the chambers in the lower row, especially in the middle of the pillow, which happens when there is no canvas, but the weight from the upper row of chambers is transferred to the canvas, and through the canvas to the chambers in the lower row (comparison of Fig. 11.1 and Fig. 11.2). This achieves that in places where the canvas is stretched, regardless of which series of chambers is inflated, the height of the mattress is approximately equal to the height of a mattress with two rows of chambers.

The canvas between the rows of chambers can be tensioned differently. When it is less tight, the chambers from the upper row lie more between the chambers of the lower row; in this way, the height of the mattress can be reduced from 2R to R, especially in the central part of the mattress. If the canvas is tightened, the height of the mattress can be increased from R to 2R.

The height of a mattress with a PD arrangement of chambers can also be changed if a canvas of a certain width is moved between the chambers along the pillow (fig. 12). For example, by moving the canvas from position I to II, or to III, the area of the PD chambers increases at the expense of the areas of the P and D chambers.

Device for the treatment of pressure ulcers

The basic prerequisite for the successful treatment of pressure ulcers is to relieve the place where pressure ulcers appeared from the effects of vertical and horizontal forces (F in g/cm2). Vertical forces can be completely removed if the body, in the part where the decubitus is, is separated from the support (fig. 17). Horizontal forces are more difficult to remove. However, the action of these forces can be mitigated if the free space around the diseased area is increased and if outside the free space the pressures on the healthy tissue are as small as possible.

The height of the MUTI (h) under the body in a place with decubitus is reduced by clamping the chambers with two round plates of a certain diameter (Fig. 18.1 and Fig. 18.2).

The required distance between the panels for unhindered air flow is provided by the elements that serve to connect the panels (fig. 18.3 and 18.4).

The panels can be placed anywhere on the mattress, so that openings are made on the rubberized canvas. One panel is placed under the rubberized canvas, and the other above the pillow chambers and weighted together with connecting elements.

For the treatment of pressure ulcers, MUTI - PD is the most convenient, and the most suitable place is in the middle of the mattress.

Liquid collector

If the patient urinates uncontrollably, or if liquid is spilled, MUTI can retain a certain amount of that liquid (fig. 19). Namely, MUTI is a container in itself because it is obtained by closing the front sides with chamber collectors, and there is a rubberized canvas on the bottom and sides. If a porous tampon (fig. 19.1) is placed at the bottom of the central part of the MUTI (fig. 19.3), which absorbs and capillaryly drains the liquid to the urine bag (fig. 19.4), the MUTI can also serve as a container for liquid in an emergency. Urine or liquid from washing can also be discharged at the collector openings (fig. 19.2).

Natural ventilation

The pillow allows natural air flow:

- above deflated chambers (fig. 20.2)

- between chambers (fig. 20.3).

Artificial ventilation

When changing the place of support from two series to one series of chambers, a certain amount of air is released. This amount can be directed between the MUTI chambers, and from there to a specific support surface (fig. 20 and 21, air stream 3). Air can also be introduced directly from the air source into a certain area of the MUTI (fig. 20 and 21, air flow 2) and thus ventilate the MUTI.

If the air is heated by a heating device (fig. 21.1), then the warm air can be blown into the chambers (fig. 20 and 21, air stream 1) and blown out of the chambers into the MUTI spaces (air stream 3). Depending on the temperature of the air entering the chambers, and the frequency of changing the place of support, the temperature of the air inside the MUTI can be affected. The heated air can be diverted by means of a valve (fig. 21.2) and let in directly between the chambers (fig. 20.1, air current 2), thus tempering the MUTI space as desired.

Brief description of the drawing

They are shown in the drawings

Sl. 1.1 - 1.6. the influence of the diameter of the chambers on the size of the contact surfaces

Sl. 2.1- 2.7. reached pressures on MUTI and comparison with pressures on hard surface

Sl. 3.1 - 3.11. component parts of MUTI, types of collectors, chamber profiles

Sl. 4.1 - 4.7. distribution of compressed air to the MUTI, inside the MUTI and valve sections

Sl. 5. MUTI - R of one row of chambers

Sl. 6. MUTI - PP with parallel-parallel arrangement of chambers

Sl. 7. MUTI - PD from one hose with parallel-diagonal arrangement of chambers

Sl. 8. MUTI - PD of two hoses with parallel-diagonal arrangement of chambers

Sl. 9. change of contact surfaces with MUTI - PP

Sl. 10. change of contact surfaces with MUTI - PD

Sl. 11.1 - 11.3. arrangement of one inflated series of chambers on three sections of MUTI - PD, with canvas between the rows of chambers and without canvas

Sl. 12. change of contact surfaces with MUTI - PD when moving the canvas between rows of chambers

Sl. 13.1 - 13.4. application of MUTI - R on seats with and without backrest, with and without sponge

Sl. 14.1. and 14.4. MUTI for the head with a support for tilting the head

Sl. 15.1 - 15.3. application of MUTI as an insole for a bed, for an extra bed, on the floor, with or without a sponge

Sl. 16.1 - 16.5. application examples of MUTI for wheelchairs, head restraints, reclining seats and seats

Sl. 17. MUTI for pressure ulcer therapy

Sl. 18.1 - 18.4. device for pressure ulcer therapy

Sl. 19.1 - 19.4. liquid collection and drainage

Sl. 20.1 - 20.3. natural ventilation MUTI and ventilation with exhaust air from chambers

Sl. 21.1 - 21.4. heating device, and distribution of warm or cold air inside the MUTI

Sl. 22.1 - 22.10. display of MUTI operation with automatic, semi-automatic and manual control device, and possible sources of compressed air

Sl. 23.1 - 23.8. semi-automatic command device with air source

THE ROAD TO MUTI PERFORMANCE

The MUTI is constructed according to the guidelines derived from the description of the operating characteristics. MUTI consists of chambers made of rubber hose of a certain diameter. The choice of rubber for making mattresses is due to the following features:

- technologies of rubber hoses and processing are well known and established

- the walls of the chambers, which are made of the appropriate type of rubber, adapt well to the shape of the body

- increased pressures caused by folds of upholstery or laundry are less pronounced at the point of contact because part of the folds lie in the elastic rubber sheath

- the mattress made of rubber hoses is easy to wash, squeeze, wipe and is quickly ready for reuse

- the tire is resistant to friction and normal mechanical loads

- the thin rubber wall easily withstands up to five times higher pressures inside the chambers, without permanent deformation, than the pressures foreseen by the invention.

If another synthetic material is found that has similar or better properties than rubber, and is inexpensive, the production of pillows can easily be redirected to a more favorable material. Chambers can be complex:

- in one row, MUTI - R (fig. 5)

- in two rows, MUTI - 2R (fig. 6) MUTI with two rows of chambers can have:

- parallel arrangement of chambers in the upper and lower row of MUTI - PP (fig. 6)

- parallel arranged chambers in one row and obliquely (diagonally) arranged chambers in the second row, MUTI - PD (fig. 7 and 8). MUTI - PD is made from:

- one hose of a certain length when used for support without changing the place of support (fig. 7)

- two hoses of a certain length, when used to change the place of support (fig. 8). Every second chamber of the mattress consisting of individual chambers (MUTI - R, or MUTI - PP) is connected to the air distributor (fig. 3.1) in two series of chambers A and B (fig. 4.1).

At one end of the MUTI there are air inlet and outlet valves (fig. 4.3), when the MUTI is used as an independent unit, and two more valves at the other end of the collector, when several MUTIs are used for one bearing (fig. 4.2). The valves are designed so that they become permeable when an air connection is pressed into the valve opening (fig. 4.5). When the connection is pulled out (fig. 4.7), the valve closes the air outlet (fig. 4.6). The bypass valve designed in this way allows the MUTI to be used to change the place of support or as an independent unit for sitting. For more reliable sealing, when MUTI is used only for support, plugs are provided (fig. 4.4).

The ends of the chambers of one mattress are inserted into the chamber collector (fig. 3.2). Chamber collectors enable:

- location of chamber ends

- greater integrity of the mattress

- they contribute to the aesthetic appearance of the mattress

- enable more comfortable leaning on the ends of the mattress.

The chamber can serve as a collector:

- a piece of rubber hose of a certain diameter, hermetically sealed with a valve, which is folded and glued to the ends of the mattress chambers (fig. 3.7). Such collectors are easy to make, can be inflated to the desired pressure, are simpler and cheaper

- molded or injected rubber collector (fig. 3.5)

- polyurethane sponge, rubber, etc. (Fig. 3.6)

- rubberized cloth used for the bottom of the MUTI and folded around the ends of the chambers;

a soft insole is placed between the knee chamber and the canvas for a more comfortable support.

The width of the chamber collector, or MUTI (Š), depends on the number (n) and diameter of the chambers (R) and is equal to Š = R x n.

It can be assumed that the following range of collectors, i.e. the width and height of MUTI, would meet the needs of the market:

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Mattresses of different lengths and for various purposes can be made with the chamber manifold of the specified heights and widths.

Common mattress lengths:

- bearing up to 2,000 mm

- seats up to 500 mm

- backrest up to 650 mm

- head pillow up to 900 mm.

The chambers are glued (in the inflated state) to the rubberized canvas (fig. 5.1). This secures the bottom of the MUTI from mechanical damage, then achieves the necessary arrangement and secures the position of the chambers, which also defines the field of action of the individual chambers.

Only the bed cover is placed on the upper side of the mattress, that is, the usable side. It is more favorable if it is made of elastic fabric that expands in places of greater depressions of the body, which increases the contact surface and allows good ventilation between the pores of the fabric. MUTI can also be invested in a pillow case.

DESCRIPTION OF CERTAIN TYPES OF MATTRESSES

Mattress with one row of chambers, MUTI - R

MUTI - R consists of a series of chambers (n) arranged in a single row with a diameter of R (fig. 5). From mattresses with one row of chambers (fig. 13.1), the following types of pillows have been developed:

- a complete mattress with one row of chambers that serves as a seat and a backrest (fig. 13.3). At the transition from the seat to the backrest, a suitable strip is placed that helps the pillow bend to the desired angle. MUTI can have a common pillowcase with a backrest or with a seat. The pillow can be placed in a separate pillow case and tied to the seat with a ribbon

- a complete mattress with one row of chambers, from which a backrest with one row of chambers and a seat with two rows of chambers are made (fig. 13.2)

- MUTI combined with chambers and a layer of sponge (fig. 13.4), which is obtained by placing a layer of sponge above the mattress with chambers, then putting them together in the pillowcase, or putting only the cover over the sponge. Since the sponge can be shaped by machine if desired, such pillows are suitable where, in addition to function, an aesthetic appearance is also required.

Mattresses with two rows of parallel stacked chambers, MUTI - PP

Chambers for MUTI - PP (fig. 6) are made by joining the ends of a rubber hose with diameter R and length L by vulcanizing in a closed circle, similar to a bicycle tube; then the inner tube is stretched (fig. 3.4) and thus one chamber is obtained from two tubes lying one above the other.

Every second MUTI - PP chamber is connected to the corresponding air distributor (fig. 3.1). A rubberized canvas is placed on the underside of the pillow. Reinforced canvas can be passed between the rows of chambers or chambers from one row can be glued with corresponding chambers from another row.

Mattresses with oblique and parallel arrangement of chambers, MUTI - PD

Making mattresses from individual MUTI - R and MUTI - PP chambers requires more manual work, which makes the product more expensive. Therefore, according to the invention, it is envisaged to make a mattress from one complete rubber hose (fig. 7) or two (fig. 8) complete rubber hoses, in two rows, but in such a way that a mattress is obtained in one row with parallel stacked chambers, and in the other row with obliquely arranged chambers. The mutual arrangement of parallel and associated oblique chambers is similar to a right triangle. If the mattress is made of two hoses, the longer side of the triangle (a) is equal to the length of the parallel stacked chamber, the shorter side of the triangle (b) is equal to twice the diameter of the chambers (b = 2R) and corresponds to the step - offset when winding the hose, and the length of the diagonally placed chamber (c) is c2 = a2 + (2R)2. If the mattress is made from one hose, the shorter side of the triangle (b) is equal to the diameter of the chambers R and corresponds to the offset when winding the hose, and the length of the hypotenuse (c) is equal to the diagonal, i.e. c2 == a2 + R2. Since the length of the hypotenuse is equal to or slightly different in length and angle from the diagonal, parallel-diagonal (PD) has been adopted as an appropriate name for the aforementioned arrangement of chambers.

The advantages of mattresses with slanted and parallel arranged chambers in relation to parallel-parallel arrangement are:

- it is easier to mass produce them

- it is possible to change the contact surfaces along the width and length of the MUTI, as well as to change the height on various sections of the MUTI

- by moving and tightening the canvas between the rows of chambers of a certain width, the height of the MUTI can be changed from R to 2R, and thus the mattress can be adjusted to the shape of the body.

The production of MUTI - PD begins by winding two rubber hoses, that is, one rubber hose from one corner of the MUTI to the opposite corner according to a certain arrangement and with an offset of 2R, that is, R, around two axes separated by the length of the pillow. On the sides of the pillow, due to technological and functional reasons, in addition to diagonally arranged chambers, there are placed two parallel stacked chambers or a layer of sponge of the appropriate section. This achieves a greater height at the side ends of the mattress, which can prevent the patient from falling. One of the typical chamber collectors is attached to the front sides of the mattress.

A non-return valve is placed at one end of the rubber hose, and if necessary at both ends. A rubberized canvas is placed on the underside of the mattress. Between one and the other row of chambers it is possible to:

- glue the canvas over the entire surface

- use a canvas of a certain width that can be moved along the mattress and that can be tightened

- pass a cloth of a certain width between the rows of chambers, wrap it around one row of chambers and connect the ends of the cloth (with a detachable connection) to the bottom of the pillow

- glue the upper and lower chambers of the same series at the points of contact of the chambers.

COMMAND DEVICE

For the needs of MUTI, several types of control devices have been constructed:

1. fully manually operated (fig. 22.1) and partially manually operated (fig. 22, item 22.7 and item 22.9),

2. semi-automatic (fig. 22.2 and 23),

3. automatic (fig. 22.3).

1. HAND-OPERATED COMMAND DEVICE

1.1. Hand-operated CO consists of a hand-operated (fig. 22.6) or foot-operated (fig. 22.5) pump with a non-return valve and a pressure reduction valve (fig. 22.4).

1.2. Partially manually operated CO consists of an electromagnetic (diaphragm) pump (fig. 22.7), a non-return valve (fig. 22.11), a reduction valve (fig. 22.4) and a manually operated control mechanism (fig. 22.9).

2. SEMI-AUTOMATIC COMMAND DEVICE, PCO

PCO consists of:

2.1. source of compressed air

2.2. command device

2.1 Source of compressed air

As a source of compressed air for the operation of semi-automatic and automatic control devices and inflation MUTI serves:

2.1.1. mini compressor station,

2.1.2. central compressor station with air distribution

2.1.1 The mini-compressor station consists of:

- electromagnetic pumps (fig. 23.1) with a variable resistor that regulates the flow of air (lit/min), i.e. the working pressure of the pump

- non-return valve (fig. 23.2) which is installed behind the pump, which prevents air loss from the system; this avoids pressure reduction in the chambers, i.e. frequent switching on and off of the pump. The non-return valve must seal reliably at low pressures such as those prevailing in the system (20 kPa and below).

- tank (fig. 23.3) of certain volume, which together with the non-return valve ensures quiet and reliable operation of the system.

- microswitch (fig. 23.4) which serves to automatically turn on the pump. In order for the microswitch to successfully perform its function, it uses the large pressure difference that prevails in the reservoir and in the MUTI; thus, the system is reliably inflated to the desired pressure, before the pump "self-shuts off". The microswitch has a screw for adjusting the working pressure in the tank.

The device for the production of compressed air designed in this way, according to the invention, is an independent mini-compressor station that, once switched on, continues to work automatically. The mini-compressor station is a complete product according to the invention.

2.1.2. Central compressor station

Functional, high-quality and reliable supply of a large number of MUTIs with compressed air is achieved using a compressor station with a higher capacity and working pressure.

The installation of a compressor station and distribution of compressed air is justified in hospitals, retirement homes, etc., that is, in all places where there is a techno-economically justified number of consumers.

The compressor station must be placed in a separate soundproof room. A central air distribution is installed from the compressor station to the individual beds, and a reduction valve with a (kuplung) clutch socket is installed next to the bed. If MUTI is to be used, it is sufficient to press the clutch plug from the control device onto the reducer-valve clutch socket.

2.2. Command device

Consists of:

- reduction valve (fig. 23.5) which enables reliable reaching and reproduction of the desired pressure inside the MUTI. A scale is engraved on the reduction valve from which the working pressure inside the MUTI can be read

- manometer (fig. 23.6) which is used for visual monitoring of the pressure in the chambers and changes in the condition in the chambers. As it belongs to the group of sensitive pressure gauges, which makes the product more expensive, a pressure gauge from a pressure gauge can be used as a substitute for periodic pressure control, or the pressure can be read from a reduction valve

- control mechanism (fig. 23.7 and 22.9) which consists of a manually operated 5/2 valve and which is adapted for the needs of MUTI. It has three working positions, namely the zero (center) position in which both series of chambers are inflated and two extreme positions, in which one of the series of chambers (A or B) is inflated.

- throttle valve (fig. 23.8) which enables the adjustment of the speed of deflation of the chambers. If a tube immersed in a glass of water is placed on the opening of the throttle valve, which is used for blowing out air, the rate of air outflow from the chambers can be visually monitored, and if a manometer (from a pressure gauge) is connected to the same opening, the pressure in the chambers can be controlled.

3. AUTOMATIC COMMAND DEVICE

The automatic control device consists of:

3.1. source of compressed air

3.2. corresponding switches

3.3. two electromagnetic valves 3/2

3.4. time relays

3.5. manometer

3.6. reduction valve

3.7. chokes

The air source, pressure gauge, reduction valve and choke are identical to those used by the semi-automatic device.

3.2. Switches and manometers work on the principle of changing the pressure in the tank and in certain series of chambers.

3.4. With the time relays, the time intervals during which the inflation and deflation of individual series of chambers are performed are adjusted.

USE OF COMMAND DEVICE

For the tasks according to the invention, all the mentioned command devices and sources of compressed air can be used, that is, from very simple to fully automated.

On the automatic control device, which is recommended for immobile patients, it is necessary to program the desired pressure, the time intervals in which the places of support are changed, and the time of filling and emptying the chambers before use.

On a semi-automatic control device with its own air source, it is necessary to move the handle to one of three available positions at certain time intervals, which depends on which batch is to be inflated or deflated. The pressure value, emptying time of the chambers, working pressure of the pump, i.e. speed of filling the chambers are set beforehand.

In the absence of an automatic or semi-automatic CO, one of the manually operated devices or a pump and pressure gauge can be used to change the place of support and achieve the desired pressure. When inflating the MUTI with CO on a manual drive, the connection is pushed into the valve opening of the series of chambers to be inflated (A or B, or A+ B, Fig. 22.10). After inflating to the desired pressure, pull out the connection (fig. 4.7) and put the cap in the valve opening (fig. 4.4). If one of the series of chambers is to be deflated, the connection (without a pump) is pressed into the valve opening of the series of chambers that is to be deflated. If partially manually operated CO is used, then it is not necessary to insert and remove the connections from the valve, when changing the state in the chambers.

If the MUTI is used only for sitting or lying down, and there is no need to change the place of support, then the chambers are inflated to the pressure set on the pressure regulator, i.e. until the user feels which pressure suits him best, or until he separates from the hard substrates. When the desired pressure is reached, the pump and the pressure regulator are separated from the MUTI, and the valve opening is closed with a plug. The desired pressure can always be achieved and reproduced with the pressure regulator.

Claims (19)

1. Universal mattress and pillow for sitting, lying down, prevention of decubitus and its treatment with air-filled chambers, hereinafter referred to as mattress or pillow and control device, indicated by the fact that one chamber consists of two (or more) tubes of smaller diameter, from material adapted to the shape of the body, that the tubes are stacked one above the other (within which the same pressure prevails) so that the mattress has a height two (or more) times greater than the width of the field occupied by the chamber, which achieves a larger contact surface per pillow depth and greater utilization the surface of the pillow (comparison 1.3 and 1.4), and these are the basic prerequisites for establishing the optimal working pressure, i.e. the lowest working pressure that can be achieved with a properly constructed air mattress. 2. A mattress, according to claim 1, characterized by the fact that the chambers are connected in two series that are alternately inflated and deflated, that the contact surfaces are changed from two series of chambers to one series of chambers, and vice versa, that the optimal pressure is established for a specific user when it rests on two series of chambers, that pressure when changing the place of support from two to one series adjusts itself to some new size, but again optimal for the newly created conditions, that the originally established pressure reproduces itself when changing the place of support from one to two series of chambers, which means that the pressure at the point of contact between the mattress and the body, according to the invention, is always optimal. 3. A mattress, in accordance with requirements 1, indicated by the fact that there are two basic types of mattresses, namely with a parallel-parallel arrangement of tubes, where the tube in one row lies parallel to the tube in the second row (6), where there is an exchange of contact surfaces along the chambers of individual series (9), and the second arrangement is such that the pipe in one row lies parallel (with one side of the mattress), and in the other obliquely (diagonally) to the corresponding parallel pipe in the first row (7 and 8), where the change of contact surfaces is simultaneous along parallel and diagonally arranged mattress chambers (10). 4. A mattress with parallel-diagonal chambers according to claim 1 and 3, characterized by the fact that it is produced from one integral hose if it is used only for support (7), or from two (or more) integral hoses if it is used to change the place of support (8) ), that its height can be influenced by inserting the canvas between the rows of tubes (11.1), that the canvas moves along the mattress and tightens it differently (12), and that the support side with parallel chambers and the side with diagonally arranged chambers can be used chambers, or the mattress is placed in the bed so that the chambers lie parallel to the longer side of the bed, i.e. across the bed, which all together enables the adaptation of the contact surfaces of the mattress to the shape of the body and that, based on blood flow and anthropological measurements, the arrangement and diameter of the chambers that is the most favorable for a certain population of users, according to the invention. 5. The mattress, in accordance with claim 1, characterized by the fact that it is easy to wash (with a stream of water), that it dries quickly after washing, that it is ready for use again in a few minutes, that wetted surfaces can be easily dried with a cloth, that the construction of the mattress allows the reception of liquids when washing, urinating and the like and that the collected liquid can be taken by gravity into the collection container with the additional equipment (19). 6. Mattress, according to claim 1, characterized by the fact that the shape and arrangement of the mattress chambers enables natural ventilation (20) and that artificial ventilation and heating (21) can be performed with additional equipment. 7. A mattress with a control device, in accordance with requirements 1 and 2, characterized by the fact that it enables changing the place of support at arbitrarily chosen time intervals, then changing the speed of emptying the chambers, changing the speed of filling the chambers, installing a vibrator, so that it is possible to select those parameters that best suit the user. 8. A mattress, in accordance with requirements 1, 2, 3, 4, 5, 6, 7, characterized by the fact that it enables optimal working pressure, which is sufficient for comfortable support, then changing the place of support, adapting the contact surfaces of the mattress to the contours of the body, easy washing and drying of contact surfaces, ventilation, heating and others, which fulfill all the conditions for successful prevention of pressure ulcers, and this is the basic task of the invention. 9. A mattress according to claims 1, 2, 3, 4, 5 and 6, characterized in that the mattress for the prevention of decubitus can be used for the treatment of already acquired decubitus (17) by mounting a device (18) under the decubitus wound, which eliminates vertical forces on the wound in the diameter of choice, and around that place the patient uses the same benefits provided by the anti-decubitus mattress according to the invention, which prevents the formation of new decubitus wounds. 10. A mattress according to claim 1, characterized by the fact that the chamber mattress is combined with a layer of spongy material, where the change in contact surfaces is identical, but less pronounced, to the type of mattress that is under the sponge, and the advantage of such a mattress is that in case of uncontrolled deflation of the chambers the body does not rest on a hard surface, and the advantage of the sponge is that it can be shaped and thus used with a chamber mattress for furniture, furthermore, the sponge can be used as a supplement to a chamber mattress in those places where the pressures are not critical and the sponge layer is larger height can be placed on the side of the bed and thus prevent the patient from falling. 11. Mattress according to claim 1, characterized by the fact that for more successful functioning of the mattress, a permeable-tight valve (4.4) is constructed, which becomes permeable to air in both directions when the connection (4.7) is pressed into the opening of the valve (4.5), if the mattress is used for changing the place of support, and it is airtight when the connection is pulled out of the valve (4.6), and then the plug is put on for better sealing, and then the mattress is used for support. 12. The mattress, according to claim 1, characterized by the fact that it can be used as a head pillow within which the optimal pressure (14.3, 14.4) can be selected and that the tilt of the head can be changed with the support under the pillow (14.2). 13. A semi-automatic, portable command device, consisting of an air source, a pressure regulation device and a control mechanism, according to claim 1, characterized by the fact that it enables changing the place of support from two series of chambers to one and vice versa, achieving, maintaining and reproducing the optimal pressure, adjusting the intensity of filling and emptying the chambers, automatic switching on and off of the air pump, stopping the pump only after the desired pressure inside the chambers has been reliably reached, central handling, or separate control with a control mechanism such as changing the place of support, regulation of the emptying speed of the chambers, regulation of the pressure in the chambers, all from the bed, similar to the control for the TV, then it is possible to read the pressure through the regulator or using the built-in pressure gauge or occasional control of the pressure with a pressure gauge from the pressure gauge (if no pressure gauge is installed). 14. Automatic control device, according to claim 1, characterized by the fact that it is programmed and automatically enables changing the place of support and reproducing the optimal pressure. 15. Control device, according to requirements 1, characterized by the fact that a manual, foot or electromagnetic minipump is used as the air source, and a control valve is used to achieve, reproduce and read the pressure, and a control mechanism is used to change the place of support. 16. Control device, in accordance with requirements 1, characterized by the fact that a hand, foot or electromagnetic pump is used as an air source, a regulating valve is used to achieve and reproduce the pressure, and the change of position is achieved by manually pressing and pulling the air plug into the corresponding valve of the mattress. 17. Control device, according to requirements 1, characterized by the fact that in the absence of any control device, a pump and a pressure gauge from a pressure gauge are sufficient for establishing the optimal pressure and changing the place of support. 18. Control device, in accordance with claim 1, indicated that in places with a large number of users it is expedient to install a central compressor station and distribution of compressed air, and at the place of consumption of compressed air, i.e. next to the bed, to install a reduction valve (with coupling socket), to which, when needed, the steering mechanism is connected. 19. The command device, according to requirements 1, characterized by the fact that the air from one series of chambers cannot exit before the optimal pressure is established in the second series of chambers, then provides a single cycle of changing the place of support, consumption of compressed air 20 to 50% of the theoretically necessary amount, that handling the control mechanism is safe because the working medium is low-pressure air (lower than 10 kPa).