WRIST SUPPORT AND METHODS OF USE
20200289304 ยท 2020-09-17
Assignee
Inventors
Cpc classification
International classification
A61F5/37
HUMAN NECESSITIES
Abstract
A wrist support apparatus capable of positioning and restraining a patients wrist including an elongated base member and an adjustable means to adjust the angle of the patient's exposed wrist for insertion of a medial line such as a radial arterial line or intravenous line. The wrist support apparatus includes a first fastening means to restrain the patient's fingers, a second fastening means to restrain the patient's forearm and a third fastening means to restrain the patient's thumb. A fourth fastening means may be used to secure the wrist support apparatus to an object such as a table. A method of use includes positioning the patient's wrist at an angle during the insertion of the medical line and may include an adjustable means for such positioning.
Claims
1. A wrist support for positioning and restraining a patient's wrist comprising: an elongated base member including at least a pair of apertures on each side of a distal end of the elongated base member and at least a pair of apertures on each side of a proximal end of the elongated base member; a fastening means inserted within each aperture on the distal end of the elongated base member and secured below the elongated base member; a second fastening means inserted within each aperture on the proximal end of the elongated base member and secured below the elongated base member; a third pair of apertures on the elongated base member located closer to the center of the elongated base member from the pair of apertures located on the distal end of the elongated base member and a third fastening means inserted within one of the third pair of apertures; and an adjustable means located in the center of the elongated base member.
2. The wrist support of claim 1 wherein the adjustable means is an inflatable means.
3. The wrist support of claim 2 wherein the inflatable means is selected from a manual air system, a mechanical inflatable system, or an electronic inflatable system.
4. The wrist support of claim 1 wherein the adjustable means further compromises an air bladder, tube and pump.
5. The wrist support of claim 4 wherein the inflatable means further compromises a valve to release air within the air bladder.
6. The wrist support of claim 1 wherein the first and second fastening means are flexible straps.
7. The wrist support of claim 6, wherein the straps have hook and loop fasteners or belts.
8. The wrist support of claim 1 wherein the third fastening means is a flexible band.
9. The wrist support of claim 1, wherein the inflatable means is in the inflated position and a patient's forearm and hand are positionable, palm up, on the inflatable means for receiving a radial atrial line, with the patient's wrist extended and exposed for the radial atrial line.
10. The wrist support of claim 1 further comprising a fourth pair of apertures each located near the side edge of a center portion of the elongated base and a fourth fastening means inserted within each aperture on the center portion of the elongated base and secured below the elongated base.
11. The wrist support of claim 10 wherein the fourth fastening means is a flexible strap.
12. The wrist support of claim 11, wherein the strap has hook and loop fasteners or belts.
13. A wrist support for positioning and restraining a patient's wrist during a radial arterial cannulation comprising: an elongated base member including at least a pair of apertures on each side of a distal end of the elongated base and at least a second pair of apertures on each side of a proximal end of the elongated base, and at least a third pair of apertures on each side of a center portion of the elongated base; a fastening means inserted within each aperture on the distal end of the elongated base and secured below the elongated base configured to restrain a patient's fingers during the cannulation; a second fastening means inserted within each aperture on the proximal, end of the elongated base and secured below the elongated base configured to restrain a patient's forearms during the cannulation; a third fastening means inserted within each, aperture on the center portion of the elongated base and secured below the elongated base configured to secure the wrist support to an immobile object during the cannulation; a fourth pair of apertures on the elongated base located closer to the center of the elongated base from the pair of apertures located on the distal end of the elongated base and a fourth fastening means inserted within one of the fourth pair of apertures configured to restrain a patient's thumb during the cannulation; and an adjustable means located in the center of the elongated base configured to start in pone position and to extend the patient's wrist during the cannulation when the adjustable means is in a second position.
14. The wrist support of claim 13 wherein the adjustable means is an inflatable means selected from a manual air system, a mechanical inflatable system, or an electronic inflatable system.
15. The wrist support of claim 13 wherein the adjustable means compromises an air bladder, tube and pump.
16. The wrist support of claim 15 wherein the inflatable means further compromises a valve to release air within the air bladder.
17. The wrist support of claim 13 wherein the first, second and third fastening means are flexible straps.
18. The wrist support of claim 1 wherein the straps have hook and loop fasteners or belts.
19. The wrist support of claim 13 wherein the fourth fastening means is a flexible band.
20. A method for positioning and restraining a patient's wrist during a radial arterial cannulation comprising: providing a wrist support apparatus having (a) an elongated base member including at least a pair of apertures on each side of a distal end of the elongated base member and at least a pair of apertures on each side of a proximal end of the elongated base member, (b) a fastening means inserted within each aperture on the distal end of the elongated base member and secured below the elongated base member, (c) a second fastening means inserted within each aperture on the proximal end of the elongated base member and secured below the elongated base member, (d) a third pair of apertures on the elongated base member located closer to the center of the elongated base member from the pair of apertures located on the distal end of the elongated base member and a third fastening means inserted within one of the third pair of apertures, and (e) an adjustable means located in the center of the elongated base member; placing the patient's wrist in a palm up position on the adjustable means of the elongated base member with the patient's forearm on the proximal end of the elongated base member and the patient's fingers on the distal end of the elongated base member; adjusting the adjustable means to provide a sufficient angle of flexation of the patient's wrist to insert a radial arterial line during the cannulation; securing the first fastening means on the patient's fingers; securing the second fastening means on the patient's forearm; securing the third fastening means on the patient's thumb so that the thumb is in an extended position; locating the radial artery; and inserting a needle and catheter into the patient's a grist in the radial artery.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF THE INVENTION
[0045] The invention is a wrist support apparatus including an elongated base member with a proximal end and a distal end and a having a multitude of apertures for insertion of fastening means. The elongated base member is attached to an upper member which may be adjustable which may be adjustable in one embodiment and may also be inflatable in an embodiment and may also be non-adjustable in a sloped shape. The upper member may be an inflatable means which may be a bladder, with the inflatable means having a proximal end and a distal end coinciding to the proximal end and the distal end of the elongated base member. The proximal end of the inflatable means supports the forearm immediately above the wrist when in use. The distal end of the inflatable means supports the palm of the hand when in use. The inflatable means supports the wrist of a patient in an extended position when the hand is faced upward. The sloped member in another embodiment may have a proximal end and a distal end coinciding to the proximal end and the distal end of the elongated base member with the proximal end of the sloped member is sloped upward from the beginning of the proximal end toward the distal end and supports the forearm immediately above the wrist. The distal end of the sloped member is also sloped upward from the distal end toward the proximal end at a slope angle higher than that of the slope of the proximal end toward the distal end. The middle portion of the sloped member forms an angle similar to an inverted \/ based on the meeting of the ramped is slopes from the proximal end and the distal end of the sloped member. The middle portion of the sloped member supports the wrist of a patient in an extended position when the hand is faced upward. The distal portion of the sloped member supports the palm and fingers of the patient when in use. The distal end of the elongated base member includes at least one aperture for attachment to a fastening means so as to secure the thumb of the patient when in use. The distal end of the elongated base member may further include another aperture for attachment to a fastening means so as to secure the extended fingers of the patient when in use. The proximal end of the elongated member may include a fastening means within the at last two apertures to secure and stabilize the forearm of the patient.
[0046]
[0047] The elongated base member 110 may be a shape suitable to be stable when placed on surface such as a table or medical surface. In one embodiment as shown in
[0048] The bottom of the elongated base member 110 may optionally include, as seen in
[0049] In this embodiment of the present invention, the elongated base member 110 also includes at least two apertures 160a, 160b at the proximal end 120. A fastening means 165 is inserted within each of the apertures 160a, 160b and is looped under the bottom of the inventive inflatable wrist support 100 as shown in
[0050] The elongated base member 110 also includes at least two apertures 172a, 172b at the distal end 130. A fastening means 177 is inserted within each of the apertures 172a, 172b and is looped under the bottom of the inventive inflatable wrist support 100 as shown in
[0051] A further fastening means 175a, 175b may be used to secure the thumb of the patient when in use. The fastening means 175a, 175b may be an elastic material such as rubber constraints such as rubber bands, which are hooked individually onto each of the tabs 190a, 190b (shown in
[0052] The elongated base member 110 is attached to an inflatable means 140. The inflatable means 140 may be slightly smaller in length and width than the elongated base member 110 for stability of the inventive inflatable wrist support 100 as well as providing for the apertures (160a, 160b, 170a, 170b) as seen in
[0053] The inflatable means 140 may be a semi-rigid or a flexible material capable of supporting a patient's wrist when in use. The inflatable means 140 may be a bladder such as an air bladder. The air bladder may be realized by two plastic films that are joined together preferably by heat or RF welding to form an air chamber therebetween. The inflatable means 140 when an air bladder can be manually inflated by a pump (e.g., a standard syringe barrel) that is interfaced thereto via a valve assembly. The valve assembly may be a luer having an internal valve which allows for inflation and deflation. Alternatively, both separate inflation and deflation valves may be provided. In yet another alternative, the inflation/deflation valve(s) may be omitted and the inflatable means 140 when an air bladder is pre-filled with air at the desired pressure during manufacture.
[0054] The inflatable means 140 when an air bladder may be comprised of any material compatible to the skin of the user such as a polymer, film, laminated polymer, nonwoven or other mater or combinations thereof. The material of the inflatable means 140 when an air bladder must be flexible so as to move between an inactivated to activated state and return, as well as support the wrist being elevated such that it is partial or semi-rigid. One possible material is a polyurethane film or polymer. The inflatable means 140 when an air bladder is connected to the elongated base 110 by a connecting means (not shown). The connecting means may be any permanent fastening means such as glue, weld, or RF bonding or may be a removable fastening means such as a polymer or plastic layer connected to Velcro.
[0055] The inflatable means 140 when an air bladder further includes a plug or a tube for connection to a pump or other inflating mechanism or even a mouth for pushing of air into the inflatable means 140 when an air bladder. If the inflatable means 140 when an air bladder is to be connected to a pump via a tube 145 capable of connection to a pump such as a bulb or other manual or electronic pump or inflation means. For example, as shown in
[0056] The inflatable means 140 when an air bladder is shown in one shape of a rounded rectangle in
[0057] The upper member when adjustable, such as an inflatable means 140, must be adjusted such that the exposed and extended upward facing wrist is at an angle sufficient for the user to locate the radial artery and perform the radial arterial cannulation while reducing many of the complications to the patient.
[0058] The inflatable means 140 when an air bladder and inflated may be sloped at an angle to support, secure, restrain and stabilize the forearm of a patient when the inventive inflatable wrist support 100 is in use. The sloped angle of the inflatable means 140 when an air bladder may be between about 10 to about 60, preferably between about 30 to about 45, when measuring the angle from the proximal end 120 of the elongated base member so as to support, secure and stabilize the forearm of a patient when the inventive inflatable wrist support 100 is in use. The sloped angle of the distal end of inflatable means 140 when an air bladder may be between about 20 to about 90, preferably between about 60 to about 80, when measuring the angle from the proximal end 120 of the elongated base member (or between about 91 to about 160, preferably between about 95 to about 125, when measuring the angle from the distal end 130 of the elongated base member). The angle differences are to further extend or hyperextend the wrist for better cannulation of the radial artery.
[0059] In another embodiment of the inflatable means 140 when an air bladder may include a concave portion (not shown) to support and secure the wrist of a patient when in use. The concave portion should be wide and long enough to support and secure the anatomy of the wrist without causing additional pain to the patient when in use. In another embodiment, not shown the inflatable means 140 when an air bladder may optionally include a malleable portion placed on top of the inflation means 140, possibly within the concave portion if included. The malleable portion may be comprised of a material such as foam, woven materials, gauze, cotton, padding and the like. This malleable portion may be disposable and changed out after each use of the inventive wrist support 100. The malleable portion may be adhered within the inflation means 140 with an adhesive or other fastening means.
[0060] The inventive inflatable wrist support 100 may also include a further fastening means to further secure either the fingers or palm of the hand of the patient when in use or to secure and stabilize the inserted atrial line when in use. As noted above, any movement of the arm or hand of the patient may compromise the integrity of the cannulation and also compromise the inserted atrial line during a subsequent medical procedure or therapy. Securing and stabilizing the inserted atrial line may thus be augmented by a third fastening means 165 while restrains the forearm and the radial arterial line (600).
[0061] A further embodiment of the present invention is shown in
[0062] The inventive inflatable wrist support 100 may be used in a hospital setting, a clinic of doctors office setting or even a home setting. The inventive inflatable wrist support 100 in use may be placed onto a flat surface such as a table, examining table or operating table. In one embodiment the inventive inflatable wrist support 100 may be affixed permanently to an operating table.
[0063] In use, the inventive inflatable wrist support 100 is placed on a surface such as a table. As seen in
[0064] Another method of use is to insert an intravenous line wherein the same steps are taken but the patient's hand is placed on the wrist support 140 with the palm facing downward as shown in
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[0066] The bottom of the elongated base member 110 may optionally include, as seen in
[0067] In this embodiment of the present invention, the elongated base member 110 also includes at least two apertures 160a, 160b at the proximal end 120. A second fastening means 165 is inserted within each of the apertures 160a, 160b and is looped under the bottom of the inventive wrist support 100 as shown in
[0068] The elongated base member 110 is attached to an upper member 180. The upper member 180 is slightly smaller in length and width than the elongated base member 110 for stability of the inventive wrist support 100 as well as providing for the apertures (160a, 160b, 170a, 170b) as seen in
[0069] In the upper member 180 the middle portion 185 includes a concave portion 195 to support and secure the wrist of a patient when in use. The concave portion 195 should be wide and long, enough to support and secure the anatomy of the wrist without causing additional pain to the patient when in use. As seen in
[0070] The inventive wrist support 100 may also include a further fastening means to further secure either the fingers or palm of the hand of the patient when in use or to secure and stabilize the inserted atrial line when in use. As noted above, any movement of the arm or hand of the patient may compromise the integrity of the cannulation and the inserted atrial line. Securing and stabilizing the inserted atrial line may thus be augmented by a third fastening, means 250 as shown in
[0071] In yet another embodiment of the invention the upper member 180 may be rigid or semi-rigid or may be adjustable in height and resulting adjustable angle of the wrist when in use with the inventive wrist support 100. The upper member 180 may be comprised of any rigid material sufficient to support the arm and hand placed upon it. Suitable materials include without limitation polymers, plastics, foam, wood, metals and the like. The upper member 180 is preferably comprised of a polymer or plastic material for economic reasons and to make the inventive wrist support 100 easy to use by a medical professional when in operation. For commercialization and mass production, the inventive wrist support 100 may formed of a suitable disposable material. In other embodiments the inventive wrist support 100 may be comprised a suitable rigid material capable of being sterilized and reusable, or capable of autoclaving, and in this embodiment the fastening means 165, 175, 177 would be disposable and replaced after the sterilization of the previously used upper member 180. In another embodiment the upper member 180 may be comprised of a semi-rigid material.
[0072] In yet another embodiment of the invention the upper member 180 may be adjustable in height and resulting adjustable angle of the wrist when in use with the inventive wrist support 100. The upper member 180 may be adjusted via any known adjusting means such as a ratchet, lock, screw thread or the like. The upper member 180 when in use on a patient may be adjusted upward for a more extended angle of the wrist, such that the upper wrist forms a reflex angle and exposes the wrist for radial arterial cannulation. The upper member 180 may be adjusted downward so that the wrist is, not extended in such an angle and relaxed after the initial arterial cannulation and the line has been established and placed in the patient's wrist. The upper member 180 can thereafter be adjusted upward or downward or adjusted in angle as needed by the user for the patient's wrist extension or angle.
[0073] In other embodiments of the invention an indicator graphic may be included outlining a hand to show that the fingers are placed on the distal end 130 of the elongated base member 110 and the forearm rests on the proximal end 120 of the elongated base member 110. Other graphics such as phrases of Place Wrist Here or Place Fingers Here may be used or an arrow pointing towards the distal end 130 of the elongated base member 110 or other indicator graphics as possible. Since the inventive wrist support 100 in use is ambidextrous in that it may be used with either the left or right hand, the word graphics may be used.
[0074] The invention encompasses a kit including the inventive wrist support 100 and a catheter and needle. Other embodiments include a needle guide such as that disclosed in PCT/US14/59576 by Dr. Ravikumar (Vein Access Needle Guide Assembly and Methods of Use) which is incorporated by reference herein in its entirety, and Ser. No. 14/354,243 filed Jun. 16, 2015 which is incorporated by reference herein in its entirety, and Serial No. 14/ 886,765 filed Oct.r 15, 2015 which is incorporated by reference herein in its entirety. The method of use of the inventive wrist support 100 may further include use of the inventive needle guide as disclosed in such applications.
[0075] The present invention obviates the disadvantages associated with the traditional arm boards and/or wrist supports by providing an adjustable wrist support so as to vary the angle of flexion of the exposed wrist in order for the user to obtain a better or even optimal angle for insertion of a catheter during radial arterial cannulation and this reducing complications of such procedure.
[0076] Another embodiment of the inventive wrist support 100 includes a preformed unitary support which can be readily and inexpensively manufactured by a simple molding process.
[0077] The inventive wrist support 100 provides better access to the radial artery due to the angle of the wrist and the hyperextension of the thumb. Further, the inventive wrist support provides increased stabilization of the inserted atrial line and/or catheter when in use based on the stabilization of the forearm and the wrist and hand during use.
[0078] The inventive wrist support 100 may be adjustable (140 or 180) so that the angle of the wrist may be adjusted for insertion of either a radial arterial line or an intravenous line but then the angle is decreased so that the wrist is more relaxed during a subsequent medical procedure or therapy such as C.O.P.D therapy and chemotherapy. The adjustable wrist support 100 may then be adjusted for an increased angle of the wrist and such adjustment may be increased or decreased throughout the is medical procedure while the hand, wrist and forearm are stabilized through the various fastening means employed with the inventive wrist support 100.
[0079] The inventive wrist support 100 may be inflated so as to adjust the angel of the wrist during the arterial cannulation or intravenous line insertion. The inflation means may be adjusted so as to lower or raise the wrist and extend further or lessen the extension of the wrist and exposure of the radial artery or veins and flexion of the wrist.
[0080] The inventive wrist support 100 may reduce decannulation of the intra-arterial line and thus reduce the risk of blood to flow out of the radial artery at systolic pressure, which could lead to a large hematoma or in a worst case scenario if left undetected and untreated may cause a person to bleed to death. The inventive wrist support 100 may reduce pain and complications to the patient during the radial arterial cannulation or intravenous line insertion procedures. The inventive wrist support 100 may reduce the need for repeated cannulation and thus reduce other complications such as a hematoma, blood loss, pain, infection and extended post-operative-time and impairments.
[0081] The inventive wrist support 100 in use hyperextends the thumb separately from the remaining four fingers and upturned palm providing a better positioned radial artery which is exposed at an angle for insertion of the cannula or arterial line and may result in a better maintained and secure manner throughout the medical procedure which may reduce complications to the patient. The inventive wrist support 100 when adjustable provides a better positioned radial artery which is exposed at an angle for insertion of the cannula or arterial line and this may reduce complications to the patient.
[0082] The inventive wrist support 100 is an economic, convenient and effective wrist support apparatus for supporting a patient's wrist and forearm during radial arterial cannulation, intravenous line insertion and subsequent medical procedures or therapy.
[0083] Although the exemplary embodiments of the present invention have been is described, it is understood that the present invention should not be limited to these exemplary embodiments but various changes and modifications can be made by one ordinary skilled in the art within the spirit and scope of the present invention as hereinafter claimed. The invention has been described in terms of embodiments thereof, but is more broadly applicable as will be understood by those skilled in the art. The scope of the invention is only limited by the following claims.