United States Patent [1 1 Weinstock et al.
[ Mar. 5, 1974 PATIENT RETENTION DEVICE [76] Inventors: Miriam E. B. Weinstock, 502 Old Chappaqua Rd., Briarcliff Manor, N.Y. 10510; William N. Woodruif, 52 Central l-lwy., Stony Point, N.Y. 10980 22 Filed: Oct. 19, 1972 21 Appl. No.: 298,883
[52] US. Cl 250/444, 250/439, 250/451 Moore et al.
Primary ExaminerJames W. Lawrence Assistant Examiner-B. C. Anderson Attorney, Agent, or Firm-Daniel M. Rosen [57] ABSTRACT A wheelable chair forretaining a patient in an immobile position for radiographic purposes is provided with an articulated arm and an X-ray cassette holder. The holder is positioned by means of the articulated arm in a manner such that it engages with the chest of the patient in a manner sufficient to support and retain the patient in the proper position. Further retention is provided by means of straps or belts interconnecting the cassette holder with the patient, a set of straps for retaining the hands of the patient in a proper position on the holder, and a chin rest which will properly position the head of the patient during the radiographic exposure. The chair, itself, is manipulatable by means of wheels so as to properly position the patient relative to the X-ray device.
14 Claims, 2 Drawing Figures PATIENT RETENTION DEVICE This invention relates to patient retention mechanisms and, more particularly, to a wheelable chair which may be employed for chest X-rays and the like while restraining the subject in an immobile position sufficient for the radiographic exposure.
In dealing with infirm, unconscious, or youthful patients, problems of taking a proper radiographic exposure for examination of chest cavities and the like pres ents a difficult problem in so far as retention of patients in an immobile position is concerned. It is desirable when performing radiographic analysis of various body portions to be able to conveniently position to X-ray equipment at the desired position of greatest exposure. It is also desirable, during the exposure, to maintain the patient in as immobile a position as possible. In many types of chest X-ray applications, it is required that the patient be in a standing position in order that the chest cavity be exposed to the extent required for proper exposure. The standing position is a requisite due to the necessity of maintaining the position of arms and shoulders as required for the exposure position. Due to the difficulty of accomplishing this effectively in an infirm, unconscious, or extremely youthful patient, it would be extremely desirable to have a chair or like support which could duplicate the function of a standing position. As noted above, it would be further desirable that the chair be easily movable so that it can be properly positioned with respect to a source of X-ray radiation for radiographic exposure. It would be further desirable that the chair would be adjustable to the extent desired in order to further facilitate ease of position.
It is, therefore, the primary object of the present invention to provide a novel and unique mobile-chair support for cooperation of a radiographic exposure device which will facilitate radiographic exposure in the desired portion of the patients body while maintaining the patient in a relatively immobile position.
It is a further object of the present invention, to provide a novel and unique mobile chair supporting device for cooperation with a radiographic exposure mechanism, which can be moved directly to the patient, as by the side of a bed or chair, and will position the patient without regard to the patients movement or state of consciousness in a manner substantially duplicating the requisite body position for the most desired exposure of the chest cavity.
The foregoing objects are accomplished in a device for maintaining a subject such as a patient in position for radiographic purposes. The device includes an adjustable arm mounted to a chair support with a radiographic cassette holder mounted to the adjustable arm. The cassette holder is adjustable with respect to the chair support to a position engaging a body portion of the patient sitting in said chair support... The engagement of the cassette holder and patient results in the holding of the patient in a relatively immobile position. The X-ray cassetteholder further includes a securing means for maintaining the patient in the retained position. The retention means includes a belt mechanism coupled to the X-ray cassette holder and attached to the patient for further securing the patient against the X-ray cassette holder. In addition, the X-ray cassette holder includes a hand hold or strap retention portion for maintaining the arms in an upraised position for proper body cavity X-ray. Finally, the X-ray holder can include a chin rest support for maintaining the head in the correct position. The chair support is mo bile in that it includes wheels and may be positioned with respect to a radiographic mechanism for exposing the X-ray cassette film. The foregoing objects and description as well as further objects, features and advantages of the present invention will become more apparent from the following more detailed description and appended drawings wherein FIG. 1 is a perspective view of the chair support of the presentinvention, and FIG. 2 is a detailed side elevation of the X-ray holding device employed in cooperation with the chair mechanism of FIG. 1.
Referring now to FIG. 1, a chair support is illustrated and as shown includes aseat portion 10, aback portion 12, handles 14 and 16, and side-arms l8 and 20. The seat and back maintain the patient in a sitting position. Mobility of the chair is provided by a set ofwheels 22 and 24 which are as illustrated, relatively large. The wheels are coupled to the chair by means offrame members 26 and 28 which connect thehandle portion 14 and 16 to thewheels 22 and 24. The chair includes a set offront wheels 30 and 32 which are each in turn held in position by means offront frame members 34 and 36. The front frame members are coupled by means of sidereturn frame members 38 and 40 to therear frame members 26 and 28 at therear wheels 22 and 24. A cross-beam42 is provided for structural integrity. Anadditional cross-beam 44 is shown interconnecting therear frame members 26 and 28 for reasons which will be discussed hereinbelow.Wheels 22 and 24 are rotatable about central pivots corresponding to a junction point between therear frame members 26 and 28 and theside frame members 38 and 40, while thefront wheels 30 and- 32 are preferably castorably mounted upon thefront frame members 34 and 36 thereby giving the chair universal movement. Coupled to arear wheel 24 iswheel braking mechanism 46 which can be employed to lock the position of the rear wheels and thereby securing the chair in fixed position. Theseat portion 10 is coupled to the front andrear members 34, 36 and 26, 28 respectively by means of adjustingcoupling'units 48 which can include ascrew tensioning mechanism 49 for the purpose of vertically raisingand lowering the chair seat with respect to the frame members. In addition, theback portion 12 can be vertically adjustably positioned along thehandle portions 14 and 16 in either a raised or lowered configuration in order to supply varying support positions as desired for retention purposes.
Attached to aside frame member 50 is an articulated arm indicated generally as 52. The arm is attached to the chair by means of anattachment unit 54 through which theshaft 56 forming the lower portion of the arm passes. The shaft may be vertically adjustable through theunit 54 and held in position by means'of a screw tightening mechanism orclamp 58. Theattachment unit 54 can serve additional functions other than holding theshaft 56 to theframe member 50, for example, thehooks 60 can be mounted to the'unit 54 for the holding of medical devices or any other apparatus employable in the environment wherein the chair will be used. In the addition to thehooks 60 provided on theattachment unit 54, theattachment unit 54 can be employed as a retention device for holding small articles as by the inclusion of drawers, shelves, and the like. Theshaft 56 is attached at an upper end thereof in a pivotal manner to afurther arm 62 which is adaptable to rotate over a 180 horizontal range with respect to theshaft 56. Thearm 62 is in turn coupled to anarm 64 by means of a universaljoint connection 66 whereby thearm 64 may rotate with a 180 horizontal relationship as indicated by thearrow 69 and with respect to thearm 62 and over a vertical plane as indicated by thearrow 70 with a range which may be 90.
Coupled to thearm 64. is the retention device, aradiographic cassette holder 72. The cassette holder includes anupper frame member 74, alower frame member 76, and first and second interconnectingframe members 78 and 80. As illustrated in greater detail in FIG 2, theholder 72 is formed by means of anupper carrier 82 and alower carrier 84. Theupper carrier 82 is slidably mounted by means ofappropriate coupling members 86 which are mounted to the back of the upper carrier and include apertures corresponding to the external dimension of theframe members 78 and 80 and which enable theupper carrier 82 to be slidably positioned in a vertical manner with respect to thelower carrier 84. Thecoupling mechanism 86 coupled to the back of theupper carrier 82 may be fix positioned on theframe members 78 and 80 by means of adjustably tightenedthumb screws 88. The cassette which the cassette-holder 72 carries is positionable between theinner surfaces 90 and 92 and is generally illustrated by means of thedashed section line 94. The upper and lower carriers can be adjusted in vertical dimension to accommodate varying height cassettes.
Thecassette holder 72 is attached to thearm 64 by means of aflexible coupling 96. Theflexible coupling 96 permits thecassette holder 72 to have a degree of rotation about a point located approximately in the center of theflexible coupling 96 and which permits freedom of rotation as indicated by the arrow set 98. Thus, a large degree of adjustable movement is provided by means of the articulated arm defined by thearms 56, 62, 64 and theflexible coupling 96, all of which serve to adjustably couple thecassette holder 72 to the chair. The width of the upper andlower frame members 74 and 76 is preferably designed to fit just within thechair arms 18 and 20, however, it will be evident that theframe member 74 and 76 can be made shorter for the purposes of retaining selected body portions or providing pressure at an area of smaller dimen- Referring again to FIG. 1, thelower frame member 76 includes a securing means, including a first and second retention straps orbelts 100 and 102-. Thebelts 100 and 102 each cooperate withlinkages 104 and 106 which may be provided on the seat back and which can be engagable by thestraps 100 and 102 so as to provide additional immobilization by virtue of retention of theholder 72 against the patient sitting in the chair. The retention pressure is applied between the chair back 12 and thefront portion 82A and 84A of the upper andlower carrier members 82 and 84. Thelinkages 104 and 106 are not essential, and it will be apparent that a single belt or multiple belts can be employed, and thatbelts 100 and 102 may simply be wrapped around the patient and buckled in the back in the manner equivalent to an automotive seat belt or the like. Thefront portions 82A and 84A of the upperandlower carrier member 82 and 84 may be padded and contoured to the general shape of the body to aid the retention. Such.
contour can be generally provided by means of a slight radius of curvature. In addition to the retention feature, the use of the straps to secure the holder to the patient prevents relative motion between the holder and the patient, and thus further aids in the effectiveness of the radiographic exposure.
With theholder 72 in position, theframe members 78 and may be employed at their upper segments as additional retention and positioning devices. Thus, referring to FIGS. 1 and 2 theframe member 78 and 80 each include a strap loop indicated generally as 108 and 110 which may be affixed to the wrists or arms of a patient positioned in the chair. While positioning the straps to the wrists or arms of the patient, the patients arms are thereby maintained in an elevated position, thus positioning the chest in proper relationship relative to the source of radiographic intensity for proper exposure. The portion of theframe 78 and 80 where thestraps 108 and 110 are attached can also be used as hand holds, should the patient be capable, for accomplishing this same purpose of arm elevation.
In addition, theupper carrier 82 may include thereon an area 82B which will serve as a means whereby the patients chin may be supported, thereby maintaining the patients head out of interference between the cassette held in theholder 72 and the patients body. This area 828 may also be provided with a contour and padding to adapt to this purpose of chin support.
Once in position, the chair is manipulated by means of suitable force applied to thehandles 14 and 16 until the cassette held in thecassette holder 72 is located opposite a source of radiographic energy such as the X-ray device generally indicated as theunit 112. To further aid in positioning of the chair for proper radiographic imaging, the chair also includes a tilt back mechanism including across-frame member 114 which includes twoside portions 116 and 118, each of which are respectively swivalable about thewheels 22 and 24, and across frame piece 120. In operation, thecross member 114 is swung about its pivot point until the vshaped portion of the side pieces 1 l6 and 118 strike thecross bar 44. At this point thecross member 120 is outside of the back portion of the chair and relatively low and may be engaged by a foot or the like and upon application of downward pressure will cause the chair to tilt backward. This will enable relatively easy movement to be made of the chair and enable more precise positioning.
Wheels 22 and 24 are purposely made of relatively large dimension with respect to thefront wheels 30 and 32. The relatively large diameter of thewheels 22 and 24 serve to prevent the chair from accidentially being tipped backwards as by a patient applying a backward force while sitting on the'chair.
The chair frame may be constructed of tubular aluminum, whereas the chair back and seat may be of leather, caning, plastic, wood or other suitable materials. The articulated arm may be metallic or of heavy plastic, with metallic joints, as may be the cassette holder. The choice of materials is not essential, however, such choice being a convenience of strength and economy.
Thus, a chair support for providing proper radiographic exposure of a patient is provided with means for immobilizing the patient in the proper position, which means includes the cassette holder. The adjustment features and retention features of this device en- 'able a practical utilization to be made of radiographic equipment when a patient is unable to either maintain himself with rigidity of immobility and must be restrained in a sitting position.
Other variations and changes will beobviously apparent to those skilled in the art. For example, theupper frame member 74 may be adjustably positioned on theframe shaft members 78 and 80 such that it may be raised and lowered thereon. Further, it may be advantageous to employ telescoping frame members for theshafts 78 and 80, such that theupper frame member 74 may be vertically positioned. It will be understood that the devices shown in the various embodiments are done so for purposes of illustration, and, that the invention may be modified and embodied in various other forms without departing from the scope and spirit of the invention.
What is claimed is:
l. A device for maintaining a subject in position for radiographic purposes comprising a chair support frame including a seat portion and a back portion for supporting a subject in a sitting position, an adjustable articulated arm having a lower first shaft portion mounted to said frame, a second shaft portion rotatably mounted to said lower first shaft portion anda flexible couplinginterconnecting said second shaft portion to a cassette holder, said cassette holder being adjustable in accordance with the adjustability of said first and second shaft portions and said flexible coupling, said cassette holder including anupper carrier member, a lower carrier member, an upper frame member, a lower frame member'and first and second spaced interconnecting frame members, said upper carrier member positionable with respect 'to said lower carrier member along said spaced interconnecting frame members in accordance with the size of a radiographic cassette, said upper carrier member and lower carrier member each including front portions forming a retention surface facing said subject, said holder being adjustably positionable to apply retention pressure through each said retention surface to said subject against and in cooperation with said back portion, said holder further including securing means for securing said subject to said holder.
2. The combination of claim 1 further including a plurality of wheels pivotally mounted to said chair support frame, said chair support frame for interposing said subject between a source of radiographic radiation and said cassette holder.
3. The combination of claim 1 wherein said securing means includes a retention strap securing said subject to said holder.
4. The combination of claim 1 wherein said securing means includes a retention strap engagable with said chair for immobilizing said subject.
5. The combination of claim 1 wherein said first and second front portions have a contour generally conformable with the shape of the subject to be retained.
6. The combination of claim 5 wherein said first and second front positions are padded.
7. The combination of claim 1 wherein said chair seat portion is vertically adjustable.
8. The combination of claim 1 wherein said holder includes means for securing the arms of a subject thereto in an elevated position.
9. The combination of claim 8 wherein said means for securing the arms of a subject includes first and second wrist straps affixed to said holder and engagable with the wrists of said subject for maintaining said arms in said elevated position.
10. The combination of claim 1 wherein said back portion is vertically adjustable.
11. A device for maintaining a subject in position for radiographic purposes comprisingan armed chair support frame including a seat portion and a back portion for supporting a subject in a sitting position, said chair frame including a plurality of wheels pivotally mounted to said chair support frame, said chair support frame including handles for manual manipulation of said chair support frame to interpose said subject between a source of radiographic radiation and a radiographic cassette, said radiographic cassette contained within a radiographic cassette holder adjustably positioned against said subject for supporting and maintaining said subject in proper position for said radiographic pur poses, said radiographic cassette holder including an upper frame member, a lower frame 'member and first and second spaced interconnecting frame members, said upper carrier member positionable with respect to said lower carrier member along said spaced interconnecting frame members in accordance with the size of a radiographic cassette, said radiographic cassette holder adjustably positioned by an adjustable articulated arm having a lower first shaft portion mounted to said frame, a second shaft portion rotatably mounted with two degrees of movement for both vertical and horizontal movement to said lower first shaft portion and a flexible coupling interconnecting said second shaft portion to said lower frame member of said radiographic cassette holder for movement of said holder through said flexible coupling throug'h angles relative to vertical, said uppercarrier member and said lower carrier member each including respective first and second front portions having a contour generally conformable with the shape of the subject to be retained and positionable through said shaft portions and-said flexible coupling within said arms of said chair frame and against said subject, the upper portion of said uppper carrier member including a chin support area for supporting the head of said subject, and further including securing means for securing said radiographic cassette holder to said device for securing said subject for radio- I graphic purposes.
12. The combination of claim 11 wherein said holder' and said back portion are vertically adjustable.