INTERMITTENT PNEUMATIC COMPRESSION DEVICE
20200368100 ยท 2020-11-26
Inventors
Cpc classification
A61H1/00
HUMAN NECESSITIES
A61H2201/5048
HUMAN NECESSITIES
A61H2201/5015
HUMAN NECESSITIES
A61H2209/00
HUMAN NECESSITIES
A61H2201/169
HUMAN NECESSITIES
International classification
Abstract
An intermittent pneumatic compression (IPC) device includes a user interface allowing selection among different categories of circulation insufficiency. After one of the categories is selected the possible range for the treatment parameters are limited. The disclosed device includes an intermittent pneumatic compression device that has lockable, adjustable treatment parameters. A lockout mechanism activates after selection of the parameter values, preventing the patient from changing the selected values. The lockout mechanism requires an access device to make further changes to the values. An inflatable cuff for the foot includes both a zipper and hook-and-loop fasteners to maintain tension during compression and wherein the zipper can be opened to remove said cuff while preserving the hook-and-loop fastener relationship so that when the cuff is placed back into position and the zipper closed, the fixed adjustable dimension of the combination will be restored.
Claims
1. An intermittent pneumatic compression device comprising: a user interface allowing selection among three different categories of circulation insufficiency, said categories including three of the following four: (1) arterial insufficiency, (2) venous insufficiency, (3) lymphatic insufficiency or (4) deep vein thrombosis; the device having a range of a treatment parameter of air pressure range, pulse duration and pulse gap duration or total cycle time; and wherein when one of said three categories is selected the range of one of said treatment parameters differs from the range of another one of said selected categories in at least one of said treatment parameters and none of said three categories when selected has identical ranges to another category of said three in all of said treatment parameters.
2. The device of claim 1 wherein the user interface allows for selection among four different categories of circulation insufficiency, said categories including: (1) arterial insufficiency, (2) venous insufficiency, (3) lymphatic insufficiency and (4) deep vein thrombosis.
3. The device of claim 1 wherein the user interface is a touchscreen integrated into an electronic visual display.
4. The device of claim 1 wherein when the user selects arterial insufficiency, the device treatment parameters are limited to 80 to 120 mm HG for 0.35 to 0.55 seconds of compression during a 1 to 5 second cycle time in which the remaining time period allows for the release of the air pressure.
5. The device of claim 1 wherein when the user selects venous insufficiency, the device treatment parameters are limited to 60 to 100 mm HG for 0.45 to 0.6 seconds of compression during a 1 to 5 second cycle time in which the remaining time period allows for the release of the air pressure.
6. The device of claim 1 wherein when the user selects lymphatic insufficiency, the device treatment parameters are limited to 30 to 60 mm HG for 0.6 to 0.8 seconds of compression during a 1 to 5 second cycle time in which the remaining time period allows for the release of the air pressure.
7. The device of claim 1 wherein when the user selects deep vein thrombosis, the device treatment parameters are limited to 30 to 60 mm HG for 0.6 to 0.8 seconds of compression during a 1 to 5 second cycle time in which the remaining time period allows for the release of the air pressure. The deep vein thrombosis treatment repeats 3 cycles in a row every minute and then pauses for a period of time longer than the combined time of the three repeating cycles.
8. The device of claim 1 wherein the device treatment parameter for total treatment time may be altered.
9. The device of claim 1 wherein the device is capable of a range of air pressure between 20 to 130 mm Hg.
10. The device of claim 1 wherein the device is capable of a range of compression times between 0.2 to 1.0 second.
11. The device of claim 1 wherein the device is capable of between about 1 to about 5 seconds for periods between successive compressions.
12. The device of claim 1 wherein a hardware fail-safe allows for maximum air pressure of less than 130 mm Hg and a maximum compression time of less than about 1 second.
13. The device of claim 12 wherein the hardware fail-safe for maximum air pressure is a consequence of the use of a centrifugal blower used to create the air pressure.
14. The device of claim 1 wherein the patient wears a disposable extremity glove under an inflatable cuff.
15. The device of claim 1 further comprising: an inflatable cuff for an intermittent pneumatic compression device comprising: a pneumatically inflatable cuff with a hook-and-loop fastener positioned thereon to allow the fixing of an adjustable dimension of said cuff; a closed zipper positioned on said cuff to maintain said fixed adjustable dimension; and wherein the zipper can be opened to remove said cuff while preserving the hook-and-loop fastener relationship so that when the cuff is placed back into position, the zipper can be closed and the fixed adjustable dimension will be restored.
16. An intermittent pneumatic compression device having lockable parameter settings comprising: an intermittent pneumatic compression device that has adjustable treatment parameters including at least two of the following: Duration of each pulse, Time between each pulse or total cycle time, and Pressure of each pulse; a user interface allowing selection of a specific value or a narrowed range of values from a wider range of values for each of at least two of said treatment parameters, a lockout mechanism for preventing the patient from changing said selected specific values or narrowed ranges of values for said at least two parameters, wherein said lockout mechanism requires an access device in order to make further changes to said specific values or narrowed range of values of said at least two parameters; whereby only an authorized setup person may unlock the parameter selection function to further modify said permitted values or narrow ranges of values and while remaining locked, the patient's use of the device following selection is more limited than otherwise would be within said wider range of values.
17. The device of claim 16 further comprising a USB connector coupled to a component of said lockout mechanism and through which the lockout function can be disabled.
18. The device of claim 16 further comprising a component of said lockout mechanism connecting remotely through a wireless pathway.
19. The device of claim 18 in which said component of said lockout mechanism connects through a wireless pathway that is cellular data.
20. The device of claim 18 in which said component of said lockout mechanism connects through a wireless pathway that is either bluetooth or wi-fi.
21. The device of claim 16 in which said component of said lockout mechanism connects through an internet pathway.
22. The device of claim 16 additionally including a two factor authentication mechanism function to permit unlocking.
23. The device of claim 16 in which said user interface allows only selection of a specific value and not a selection of narrowed ranges of values.
24. An inflatable cuff for an intermittent pneumatic compression device comprising: a pneumatically inflatable cuff with a hook-and-loop fastener positioned thereon to allow the fixing of an adjustable dimension of said cuff; a closed zipper positioned on said cuff to maintain said fixed adjustable dimension; and wherein the zipper can be opened to remove said cuff while preserving the hook-and-loop fastener relationship so that when the cuff is placed back into position, the zipper can be closed and the fixed adjustable dimension achieved by the hook-and-loop fastener will be restored.
25. The apparatus of claim 24 wherein the inflatable cuff is formed to cover the foot of the wearer.
26. The apparatus of claim 25 wherein either the heel or the toes portion of the cuff is made with a see-through material.
27. The apparatus of claim 26 in which both the heel and the toes portion of the cuff is made with a see-through material.
28. The apparatus of claim 24 wherein the zipper is operable without adjusting the hook-and-loop fastener.
29. The apparatus of claim 24 wherein the hook-and-loop fastener is operable without adjusting the zipper.
30. An inflatable cuff for an intermittent pneumatic compression device comprising: a hook-and-loop fastener for adjusting the tension of the inflatable cuff; and a zipper for releasing said tension without altering the hook-and-loop fastener; wherein when in an operable configuration the hook-and-loop fastener and the zipper is jointly provide compression in a radial direction.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0013]
[0014]
[0015]
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[0020]
[0021]
DESCRIPTION OF THE SELECTED EMBODIMENTS
[0022] For the purpose of promoting an understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended. Any alterations and further modifications in the described embodiments, and any further applications of the principles of the invention as described herein are contemplated as would normally occur to one skilled in the art to which the invention relates. Some embodiments of the inventions are shown in some degree of detail, although it will be apparent to those skilled in the relevant art that some features not relevant to the present invention may not be shown for the sake of clarity.
[0023]
[0024] As shown, minor portions of the inflatable cuff 104 are see-through portions 106 and 108 permitting visibility of the wearer's toes and heel during operation of the device for enhanced safety considerations. See-through portions 106 and 108 may for example be formed of a 4 mm clear flexible plastic material. The inflatable cuff 104 shown is a single-chamber bladder design adapted to treat arterial flow insufficiencies. The IPC device 100 may also be adapted to have a multi-chambered bladder for sequential inflation/deflation of the chambers such as may for example be desired to treat venous or lymphatic conditions.
[0025] For sanitation purposes, patient 102 may preferably wear a glove 105 on the extremity receiving treatment. The term glove as used herein is intended to encompass, for examples, a sock when used on a foot or a hand glove or mitten when used on a hand or arm. This may reduce the need to clean or replace the cuff 104 after every treatment, especially in a clinical setting. The patient may receive one washable, reusable glove 105 when they begin treatment or the glove 105 may be disposable after a one-time use. The glove 105 may be made of a thin and flexible material so as to not interfere with the treatment's effectiveness. As one example, the glove 105 may be made of nitrile, which can be relatively incompressible in this application. The glove 105 optionally may be lined with a sufficiently thin layer of felt or felt like material that it does not interfere with the treatment's effectiveness yet improves patient comfort. The glove 105 may come in various sizes to meet patient needs. As illustrated in
[0026] Extending from the bottom of the cuff 104 on the underside of the wearer's foot is a 1.5 inch diameter flexible hose 110 forming the passageway 112 that communicates between the cuff 104 and low air pressure source contained within housing or console 114. The flexible hose 110 may be connected to the inflatable cuff 104 by a quick-disconnect swivel coupling 116. The swivel coupling 116 may come in an L-shaped configuration. Alternatively to the underside of the foot, other points of attachment of hose 110 may be chosen if desired, so as to enable standing or limited walking while in use. The housing 114 is preferably designed to be portable for home use, although larger professional and clinical versions are also contemplated. In order to make the IPC device 100 portable, a handle 128 and wheels 130 were added to the device. The handle 128 and wheels 130 make the IPC device 100 easier to maneuver and store. The patient may wheel the IPC device 100 and place it in the corner, in a closet, under the bed, etc. when not in use. The handle 128 may be preferably retractable or it may be fixed.
[0027] Suitable operator controls (e.g., power switch, pressure selector control), indicators, gauges, and/or other operator information and controls are conveniently provided on the top of the housing 114. As an alternative, these functions may simply be programmed to be part of an input/output (I/O) device or user interface 118 that is a touch screen display located on top of the housing 114. Applicant envisions these controls may be placed anywhere on the housing 114 A user interface 118 could include a keyboard, mouse, trackball, and/or touch sensitive pointing device, etc. In one preferred embodiment, the user interface 118 is a touchscreen integrated into an electronic visual display. Alternatively, if designed as an at-home device for a specific affliction such as for example arterial insufficiency, it may help avoid operator error to provide only an on/off power control 122 and thus require no control changes/adjustments on the part of the home patient. While shown here with a user interface 118 associated with the housing 114, is applicants' also envision an alternative embodiment that puts controls and displays of operating parameters and settings additionally or alternatively on a wireless, hand-held remote control. A key port 120, power control 122, indicator light 124 and speaker 126 are included on top of the housing 114. The key port 120 allows for an authorized user to program the device for use. In a preferred embodiment, the key 121 used with key port 120 is a Universal Serial Bus (USB) device. Power control 122 allows the patient to turn the IPC device's 100 power on or off. Although depicted as a power toggle, the power control 122 can be a button, dial, knob, etc. Indicator light 124 shines when power is being provided to the IPC device 100. Additionally, speaker 126 is included to provide various commands or updates to the patient. The speaker 126 helps patients that have poor eyesight operate the IPC device 100.
[0028]
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[0030] In
[0031]
[0032]
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[0034]
[0035] The following table shows the IPC device's 100 preferred software controlled ranges for each treatment parameter in the preferred embodiment:
TABLE-US-00001 Air Pressure (mm HG) 30-120 (hardware cap at 130) Pulse Duration (seconds) 0.2-.8 (hardware cap at 1) Total Cycle Time (seconds) 1.2-5
[0036] The IPC device 100 preferably has a built in hardware fail-safe that allows for a maximum air pressure of less than 130 mm Hg and a maximum compression time of less than 1 second. The hardware fail-safe for maximum pressure is inherently the result of the use of a centrifugal blower used to create the air pressure, and the time fail safe is built into the controlling software. The hardware fail-safe helps prevent injuries to the patient during treatment.
[0037] The following table shows the treatment parameter ranges for each category of circulation insufficiency:
TABLE-US-00002 Arterial Venous Lymphatic DVT Air Pressure 80-120 60-100 30-60 30-60 (mm HG) Pulse Duration .35-.55 .45-.6 .6-.8 .6-.8 (seconds) Total Cycle Time 1-5 1-5 1-5 1-5 (seconds) Periodic Pauses No No No Yes
[0038] The second table provides the default treatment parameter settings for each category of circulation insufficiency:
TABLE-US-00003 Arterial Venous Lymphatic DVT Air Pressure 100 80 46 46 (mm HG) Pulse Duration .45 .52 .7 .7 (seconds) Total Cycle Time 2 2 3 3 (seconds) Total Treatment 1:00 2:00 3:00 3:00 Time (hours) Periodic Pauses No No No Yes
[0039] The treatment of deep vein thrombosis requires repeating the total cycle three times in a row and then pausing for a period of time longer than the combined time of the three repeating cycles. Preferably the period is five times longer than the combined time of the three repeating cycles. During the pause, the IPC device's 100 blower may turn off to lower the ambient noise level.
[0040]
[0041] After an authorized setup person has unlocked the device, the person is able to select a specific value or a narrow range of values for each treatment parameter 504. In some embodiments, after the range or category limiting the range is selected the authorized setup person can then select specific values for the treatment parameters. In other embodiments, the user interface 118 allows only selection of a specific value for each treatment parameter without selecting a category. A Bluetooth keyboard may be wirelessly connected to the IPC device100 to assist with the at-home setup. Any suitable input device may be employed.
[0042] Once the treatment parameters have been set, a lockout mechanism engages preventing the patient from changing the treatment parameter values 506. As described above, an access device is necessary in order to unlock the device and make further changes to the treatment parameters. With the lockout mechanism engaged, the patient starts the device operations and begins treatment 508.
[0043]
[0044] As described above, the inflatable cuff 104a is lined with one or more inflatable bladders 604 inflated during treatment to provide pressure to the afflicted extremity. The inflatable cuff 104a may have a single-chamber bladder or multi-chambered bladder such as may be desired to treat the given condition. The inflatable cuff 104a includes see-through portions 106 and 108 permitting visibility of the wearer's toes and heel during operation of the device for enhanced safety considerations. The swivel coupling 116a for attaching the flexible hose 110 is depicted on top of the inflatable cuff 104a. This orientation allows the patient to lightly walk on the inflatable cuff 104a, thus, providing the patient with mobility during treatment. Applicant envisions other embodiments where the swivel coupling 116a is located on the underside or on the calf region of the inflatable cuff 104a.
[0045] Many circumferential portions of the cuff 104a around the patient's leg include at least a portion of the hook-and-loop fasteners 600 and the zipper 700. The hook-and-loop fasteners 600 and the zipper 700 preferably both operate independently of one another. This design allows the patient to adjust the hook-and-loop fasteners 600 to adjust the cuff 104a to fit the patient's extremity and adjust the tension or rigidity of the cuff 104a. If the patient has finished treatment or pauses treatment, perhaps to use the restroom, they may unzip the cuff 104a for removal without affecting the tension of the cuff 104a that will again be applied when the cuff 104a replaced and zipped back up. Therefore, when they return to begin another treatment, the patient may simply zip up the cuff 104a and begin treatment without any need to readjust the hook-and-loop fasteners 600. When the hook-and-loop fasteners 600 and zipper are in an operable configuration, they jointly provide radial compression to the extremity.
[0046] In addition to all of the features laid out above, the applicant has developed software to help ensure patient compliance. Applicant's website is secured with one or more passwords and contains unidentifiable patient data using patient IDs. The website is an intermediate database that can be queried by authorized individuals. Prescriber and payer, such as Medicare, may retrieve compliance data through the website by using the patient's ID number. A clinician may be provided with a number, and by entering this number into the website can retrieve the data for all of their patients.
[0047] The device's software includes an overlay preferably on a Raspberry Pi brand computer so data on the operating system is not corrupted by an improper shut down. This allows the device to save volatile temporary operating system (OS) data to an internal memory drive instead of long-term storage. Therefore, an unforeseen event such as a power failure will not corrupt the treatment data. This overlay is capable of storing volatile memory for approximately a year of home use without turning off the device. Once the IPC device 100 is nearing capacity, it will enter a fail-safe mode informing the patient to turn off the machine. Once off, the IPC device 100 will automatically erase and restart the operating system with clean memory. This fail safe can be in a variety of forms, including but not limited to, the device beeping, a flashing message on the user interface 118, a message to prescriber, a message to authorized user, a voice command, etc.
[0048] After each use, the device will attempt to upload the data obtained during operation. An automatic upload can be scheduled within the software of the device. In one embodiment, the device will upload the operating data at ten minute intervals during treatment. However, when the upload is not possible, the device will save the data to an internal non-volatile memory. This circumstance may arise with an elderly at-home patient whom does not have internet access. If the PCD cannot upload compliance data over a thirty day period, the device will regularly alert the patient to insert a USB flash drive or some other storage device. The alert may be in the form of a noise (i.e. beeping), a message on the user interface 118, a voice command, etc. After two months without uploading the compliance data, the device will go into a fail-safe mode and not operate until the data is uploaded or transferred to another memory device. Once the data has been transferred and with the IPC device's 100 memory cleared, the device will resume normal operation. The device will upload all data when it is turned off as long as it is still plugged into a power source. When the power control 122 is turned off, the computer will remain on for approximately five seconds to upload the data and close all files properly so no data is lost or corrupted. To help prevent the patient from unplugging the device immediately after turning off the power, a screen may provide a message requesting the device remain plugged into a power outlet until the transfer of data is complete. In another embodiment, the speaker 126 may issue a command to leave the device plugged in until the upload is complete.
[0049] While the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character, it being understood that only the preferred embodiment has been shown and described and that all changes, equivalents, and modifications that come within the spirit of the inventions defined by following claims are desired to be protected.