Surgery – Instruments – External pressure applicator
Reexamination Certificate
1998-09-24
2001-10-09
Nasser, Robert S. (Department: 3736)
Surgery
Instruments
External pressure applicator
Reexamination Certificate
active
06299629
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to methods and apparatus for regulating tourniquet pressure.
BACKGROUND OF THE INVENTION
State of the art tourniquet systems are described in the following U.S. Pat. Nos.:
4,106,002 to Hogue, Jr., 4,321,929 to Lemelson et al, 4,469,099 to McEwen, 4,479,494 to McEwen, 4,520,819 to Birmingham et al, 4,520,820 to Kitchin et al, 4,548,198 to Manes, 4,635,635 to Robinette-Lehman, 4,637,394 to Racz et al, 4,671,290 to Miller et al, 4,691,738 to McCune, 4,773,419 to Tountas, 4,979,953 to Spence, 5,048,536 to McEwen, 5,181,522 to McEwen.
SUMMARY OF THE INVENTION
The present invention seeks to provide an improved automatic system for computing, establishing and maintaining suitable levels of tourniquet pressure.
There is thus provided, in accordance with a preferred embodiment of the present invention, an automatic tourniquet system including variable pressure cuff apparatus for applying a variable pressure to a limb or artery of a patient in order to occlude blood flow thereat and control apparatus for determining the operative pressure of the variable pressure cuff apparatus and including apparatus for estimating the minimum effective cuff pressure required for complete occlusion.
There is also provided, in accordance with another preferred embodiment of the present invention, automatic tourniquet system including variable pressure cuff apparatus for applying a variable pressure to a limb or artery of a patent in order to occlude blood flow thereat and control apparatus for determining the operative pressure of the variable pressure cuff apparatus and including apparatus for monitoring the blood pressure of a patient and apparatus for determining the operative pressure as the product of blood pressure and a factor.
Further in accordance with a preferred embodiment of the present invention, the blood pressure used in the apparatus for determining is a weighted combination of the systolic and diastolic blood pressure.
Still further in accordance with a preferred embodiment of the present invention, the factor is selected according to at least one of the following: the limb or artery on which the cuff apparatus is mounted, the size of the cuff apparatus, and whether the patient is an adult or a child.
Further in accordance with a preferred embodiment of the present invention, the control apparatus includes apparatus for causing the cuff apparatus to apply an initial pressure which is at least twice the blood pressure for a predetermined limited time.
Still further in accordance with a preferred embodiment of the present invention, the initial pressure is a constant for a limb/artery.
Still further in accordance with a preferred embodiment of the present invention, the predetermined limited time is less than 10 minutes.
Still further in accordance with a preferred embodiment of the present invention, the weighted combination is the mean blood pressure.
Further in accordance with a preferred embodiment of the present invention, the apparatus for monitoring includes apparatus for measuring the systolic and diastolic blood measure.
There is also provided, in accordance with another preferred embodiment of the present invention, a tourniqueting method including the steps of:
a. providing two or more adjacent occlusive cuffs,
b. inflating the first cuff,
c. after a predetermined or user-selected time interval, inflate the second cuff,
d. once the second cuff is inflated, deflate the first cuff, thereby relieving pressure on the first cuff body site,
e. after a predetermined or user-selected time interval, inflate the first cuff,
f. once the first cuff is inflated, deflate the second cuff, thereby relieving pressure on the second cuff body site, and
g. if the operation has not yet terminated, repeat steps c-f until the operation is terminated, and
h. upon receipt of an interrupt indicating that the operation is terminated, provide a deflation control signal to the inflated cuff or cuffs.
There is also provided, in accordance with another preferred embodiment of the present invention, an automatic tourniquet technique including the steps of applying a variable pressure to a limb or artery of a patient in order to occlude blood flow thereat and determining the operative pressure of the variable pressure cuff apparatus and including the steps of monitoring the blood pressure of a patient and setting the operative pressure as the product of blood pressure and a factor.
Further in accordance with a preferred embodiment of the present invention, the blood pressure used in the determining step is a weighted combination of the systolic and diastolic blood pressures.
Still further in accordance with a preferred embodiment of the present invention, the factor is selected according to the limb or artery on which the cuff apparatus is mounted.
Still further in accordance with a preferred embodiment of the present invention, the determining step includes causing the cuff apparatus to apply an initial pressure which is at least twice the blood pressure for a predetermined limited time.
Additionally in accordance with a preferred embodiment of the present invention, the initial pressure is a constant for a limb/artery.
Still further in accordance with a preferred embodiment of the present invention, the predetermined limited time is less than 10 seconds.
Additionally in accordance with a preferred embodiment of the present invention, the weighted combination is the mean blood pressure.
Further in accordance with a preferred embodiment of the present invention, the monitoring step includes measuring the systolic and diastolic blood measure.
In accordance with another preferred embodiment of the present invention, there is provided automatic tourniqueting apparatus for controlling inflation and deflation of two or more adjacent occlusive cuffs, including an occlusive cuff inflation/deflation signal generator operative to provide control signals suitable for implementing at least some of the steps of the following schedule:
a. inflating the first cuff;
b. after a predetermined or user-selected time interval, inflate the second cuff;
c. once the second cuff is inflated, deflate the first cuss, thereby relieving pressure on the first cuff body site;
d. after a predetermined or user-selected time interval, inflate the first cuff,
e. once the first cuff is inflated deflate the second cuff thereby relieving pressure on the second cuff body site,
f. if the operation has not yet terminated, repeat steps c-f until the operation is terminated, and
g. upon receipt of an interrupt indicating that the operation is terminated, provide a deflation control signal to the inflated cuff of cuffs.
There is also provided, in accordance with another preferred embodiment of the present invention, apparatus for automatically performing an IV regional anesthesia for use in conjunction with a double tourniquet cuff system including proximal cuff and a distal cuff and a cuff inflation/deflation device, the apparatus including a double tourniquet cuff control unit operative to control the cuff inflation/deflation device according to a proximal and distal cuff inflation and deflation schedule.
Further in accordance with a preferred embodiment of the present invention, the schedule includes:
a. in response to a user's signal, proximal cuff inflation until a particular relatively high cuff pressure is reached,
b. once a particular relatively low cuff pressure is reached, maintaining the low cuff pressure in the proximal cuff,
c. in response to a user's signal, distal cuff inflation until a particular relatively high cuff pressure is reached,
d. once a particular relatively low cuff pressure is reached, maintaining the low cuff pressure in the distal cuff,
e. after the relatively high cuff pressure is reached in the distal cuff, entirely deflating the proximal cuff, and
f. in response to a user's signal, on-and-off deflating the distal cuff.
Further in accordance with a preferred embodiment of the present invention, the distal cuff deflation schedule includes a schedule of
David Yehouda
Engel Joel
Gruenfeld Frank Vincenz Jonas
Levy Ofer
Opatowsky Alexander
FMS-Future Medical System, S.A.
Nasser Robert S.
Young & Thompson
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