Surgery – Body rests – supports or positioners for therapeutic purpose
Reexamination Certificate
2002-02-05
2003-09-23
Brown, Michael A. (Department: 3764)
Surgery
Body rests, supports or positioners for therapeutic purpose
C005S632000, C005S636000, C005S639000, C005S645000
Reexamination Certificate
active
06622727
ABSTRACT:
TECHNICAL FIELD
The present invention relates generally to patient support systems, and more specifically to a wedge pillow and arm cushions for use in supporting patients during a surgical procedure.
BACKGROUND OF THE INVENTION
Most patients undergoing a surgical procedure under general anesthesia will require endotracheal intubation. Endotracheal intubation is done immediately after the patient is anesthetized. Endotracheal intubation is done by first placing a laryngoscope in the patient's mouth, allowing for a direct view of the glottis (vocal cords) where an endotracheal tube will be placed in order to ventilate the patient. The laryngoscope consists of a handle with a long metal blade or tongue attached to a light source. The blade is used to lift the tongue and surrounding structures such as the epiglottis or valecula so as to give the physician a clear view of the glottic opening.
To perform the intubation properly, it is first critical to ensure that the patient is correctly positioned to receive the laryngoscope. A sniffing position is required to align the oral, laryngeal, and pharyngeal axes and allows direct visualization of the glottic opening. However, it is extremely difficult to achieve this position in patients who are pregnant or obese, as it is difficult to access the patient's mouth and to maneuver the laryngoscope handle or blades. If endotracheal intubation is not performed quickly and correctly, the patient can become hypoxic (i.e. experience a lack of oxygen) due to lack of ventilation, leading to potentially serious consequences. Further, in the time between anesthetizing and correctly placing the endotracheal tube, a patient is at risk for aspirating gastric contents into their lungs. The risk for aspiration is particularly high for pregnant women and obese patients. The risk for aspiration is also high for patients with gastroesophogeal reflux disease, peptic ulcer disease, or a hiatal hernia.
To reduce the risk of hypoxia and aspiration, it is common for folded blankets to be placed under the head and neck of a patient to raise the angle of the thoracic spine. This helps to create the necessary sniffing angle that is necessary to align the oral, laryngeal, and pharyngeal axes that is critical for successful direct laryngoscopy. Further, the increased angle of the thoracic spine creates a gravitational effect to keep gastric contents within the stomach, thereby decreasing the risk of aspiration. However, the stacking of blankets is inefficient and wasteful in that it requires extensive trial and error to achieve the proper sniffing angle. Further, the stacking of blankets does not provide adequate pressure point padding for the head and neck.
Another problem associated with the use of stacked sheets to achieve and maintain this sniffing angle is that the increased height of the head and neck relative to the arms hyperextends the arms at the shoulder joint. Foam pads are typically placed under the arms to prevent the hyperextension. However, these foam pads are not tall enough to prevent hyperextension of the arms at the shoulder joints.
It is thus highly desirous to optimize positioning of patients during endotracheal intubation to reduce the risk of hypoxia and aspiration. It is also desirous to provide pressure point padding of the head and arms during surgical procedures that may require endotracheal intubation. It is also desirable to prevent hyperextension of the arms at the shoulder joint as a result of the establishment and maintenance of a sniffing angle during endotracheal intubation.
SUMMARY OF THE INVENTION
A wedge pillow is provided that is placed under the patient prior to surgery that may require endotracheal intubation. The wedge pillow raises the angle of the thoracic spine and provides a platform and pressure point padding for the back of the head and neck. The wedge pillow allows excessive and redundant tissue to fall away from the head and neck, thereby allowing excellent positioning, easy access to the oropharynx, and perfect sniffing position, or alignment of the three critical axis (Oral, Laryngeal, and Pharyngeal), that allow for direct visualization of the glottic opening. This reduces the risk of hypoxia and aspiration associated with establishing and maintaining an endotracheal intubation that is typically necessary during general anesthesia surgery.
An extended arm cushion is also provided that may be used in conjunction with the wedge pillow and provides pressure point padding for the arms. The length of the extended arm cushion is formed in a curve, wedge, or half-moon shape that keeps the arm from becoming malpositioned during surgery. The extended arm cushion is typically used in conjunction with the Velcro strap to secure the arm and cushion to the operating table armboard. The armrest cushion prevents or minimizes the amount of hyperextension of the arm at the shoulder joint during surgery.
REFERENCES:
patent: 2700779 (1955-02-01), Tolkowsky
patent: 3883906 (1975-05-01), Sumptor
patent: 4270235 (1981-06-01), Gutmann
patent: 4850067 (1989-07-01), Latorre
patent: 5479667 (1996-01-01), Nelson et al.
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