METHOD AND DEVICE FOR CONTAINING DEADLY GERMS OF A PATIENT DURING TREATMENT
20190183709 ยท 2019-06-20
Inventors
Cpc classification
B65G51/00
PERFORMING OPERATIONS; TRANSPORTING
A61B42/30
HUMAN NECESSITIES
A61B90/40
HUMAN NECESSITIES
A61G10/023
HUMAN NECESSITIES
A61G10/02
HUMAN NECESSITIES
International classification
A61G10/00
HUMAN NECESSITIES
Abstract
Methods and devices are presented for the long-term treatment of a patient infectious with deadly microbes without a risk for spread of germs to caregivers comprising a hermetically sealed human sized containment box with means for delivering medical care, for sustaining life, and for dealing with waste products, as well as providing rehabilitative care.
Claims
1. A method of containing germs, the method comprising: hermetically sealing a patient containment box; flowing air into the patient containment box; and sterilizing the air that flows out of the patient containment box, the sterilizing comprising heat sterilizing the air.
2. The method of claim 1, in which the air flowing comprises maintaining an air pressure inside the patient containment box less than an air pressure outside the patient containment box.
3. The method of claim 2, further comprising transmitting an alarm in response to the air pressure inside the patient containment box being at least equal to the air pressure outside the patient containment box.
4. The method of claim 2, in which the sterilizing is performed while the air pressure inside the patient containment box is less than the air pressure outside the patient containment box.
5. The method of claim 1, further comprising pressure testing a flexible glove extending inwardly from an opening formed through a wall of the patient containment box, the pressure testing comprising: reducing an air pressure inside the patient containment box, thereby increasingly inflating the flexible glove in the patient containment box; sealing a previously open end of the glove at the opening; and monitoring an air pressure inside the glove while the end of the glove is sealed.
6. The method of claim 1, further comprising tilting the patient containment box.
7. The method of claim 6, further comprising draining water from the patient containment box while the patient containment box is tilted.
8. The method of claim 1, further comprising enlarging an interior volume of the patient containment box by telescopingly extending opposing side walls of the patient containment box.
9. The method of claim 1, further comprising placing human waste products from an interior of the patient containment box or a room holding an infected human into a pneumatic tube transport system, delivering said waste products to an incinerator, and incinerating the waste products.
10. A method of removing and disinfecting a waste product of an infected human from a patient containment box, or a room holding an infected human, the method comprising: placing the human waste products from an interior of the patient containment box or said room into a pneumatic tube transport system, delivering said waste products to an incinerator, and incinerating said waste products.
11. The method of claim 10, further comprising flowing air into the patient containment box or a room holding the infected human, and sterilizing the air that flows out of the patient containment box or said room, the sterilizing comprising heat sterilizing the air.
12. The method of claim 11, in which the air flowing comprises maintaining an air pressure inside the patient containment box or said room less than an air pressure outside the patient containment box or said room.
13. The method of claim 12, further comprising transmitting an alarm in response to the air pressure inside the patient containment box or said room being equal to or greater than the air pressure outside the patient containment box or said room.
14. The method of claim 12, in which the sterilizing is performed while the air pressure inside the patient containment box is less than the air pressure outside the patient containment box.
15. The method of claim 10, further comprising pressure testing a flexible glove extending inwardly from an opening formed through a wall of the patient containment box, the pressure testing comprising: reducing an air pressure inside the patient containment box, thereby increasingly inflating the flexible glove in the patient containment box; sealing a previously open end of the glove at the opening; and monitoring an air pressure inside the glove while the end of the glove is sealed.
16. The method of claim 10, further comprising tilting the patient containment box or said room.
17. The method of claim 16, further comprising draining water from the patient containment box or room while the patient containment box or room is tilted.
18. The method of claim 10, further comprising enlarging an interior volume of the patient containment box or room by telescopingly extending opposing side walls of the patient containment box or room.
Description
DRAWINGS OF THE INVENTION
[0023]
[0024]
[0025]
[0026]
[0027]
[0028]
[0029]
DETAILED DESCRIPTION OF THE INVENTION
Sealed Box
[0030] Said box could be rectangular to facilitate storage of a large number of them when not in use, but could be of other dimensions to allow patients greater mobility and take different resting positions by themselves (recumbent, sitting, standing). Said box could have rounded corners. Therefore, said box can be termed a sealed vessel instead of box. Said box in a preferred embodiment is made of hard plastic, such as plexiglass or polycarbonate for greater strength, durability, and visibility.
[0031] One embodiment of said box is depicted in
[0032] If the vertical dimension of said box depicted in
[0033] Another embodiment that is within the scope of this invention is depicted in
[0034] Prior to placing a patient into said box, said box needs to be furnished with such items as a bed. There can be a doorway placed in any appropriate wall of said box, such as on the vinyl wall C, in the case of box of
[0035] Same sets of glove port means are provided onto both walls A and B, as described for the box of
[0036] The feature of the embodiment depicted in
[0037] While the dimensions described for said box are those most appropriate for an adult patient, for children, one can reduce the length in particular of said box.
[0038] While in one embodiment, said box can be entirely made of hard plastic like plexiglass, in another embodiment, some of the portions of said box, especially upper and lower portions not likely touched by said patient can be framed in metal and covered in film plastic like 20 mil (0.5 mm) vinyl to reduce the cost of said box, to make its assembly easier, and to facilitate its transport. Since the purpose of this box is to enable caregiver to provide sophisticated medical support and treatment using said glove means, it is essential that areas of the walls of said box that can provide visual information to caregivers be clear and least likely to distort the visual image of said patient to said caregivers. Vinyl type film can distort what one sees through it and is unsatisfactory for areas that are regularly used to provide visual information to caregivers. Generally, hard plastics like polycarbonate and plexiglass can provide more realistic imaging of said patient to caregivers. Such materials are called, non-image-distorting. What is also important to note is that this invention must be capable of long-term treatment and containment of an infected patient. Although possible, generally the intent of the invention is not a brief use of a few hours or a day. Construction therefore is described as durable construction.
Dual Gloved Portal Means
[0039] By the term, dual gloved portal means we mean something like depicted in
[0040] The preferred locations of dual-gloved portal means are as presented in the foregoing summary of the invention, but more specifically the following are the locations in inches, measured from the cephalad end wall nearest where the head of said patient would be placed. The specified distance is for the center of each dual-gloved portal means. The height for each dual-gloved means is the same, 8 inches (20 cm) above the surface of the bed on which said patient lies, and where the height of the bed within said box can be adjusted when said box lies on the floor and said box is at least 50 inches (127 cm) tall, height of each dual-gloved means, at center, should be 44 inches (112 cm) from the floor, to enable a comfortable working height for caregivers. Ideal work conditions can change and these recommendations should not be considered absolute. Basically, the height recommended is at the elbow of a standing caregiver reaching into the box to treat the patient.
[0041] The distance from end wall(cephalad) to the center of the dual-gloved portal means at recumbent patient's elbow level should be 27 inches (69 cm) (note there are two holes making them dual-gloved and the center is the midpoint between the two holesthat is, where the two holes are separated by 4.5 inches (11 cm), said midpoint would at a point 2.25 inches (5.7 cm) from the proximal edge of the right hole and 2.25 inches (5.7 cm) from the proximal edge of the left hole); the distance from end wall (cephlad) to the center of the hip level dual-gloved portal means should be 38 inches (97 cm); the distance from end wall (cephalad) to the center of the ankle level dual-gloved portal means should be 63 inches (160 cm). Circumstances of caregiving and anatomical dimensions of said patient can dictate some changes in above dimensions. However, portals usable for outlined tasks including intubation, nasogastric tube insertion (for the dual portal means near the skull top of said patient), intravenous catheter insertion in antecubital fossa (for the dual portal means near the elbow of said patient), urinary catheter insertion, femoral artery puncture (for dual portal means near the hip of said patient), and pedal venipuncture or ankle restraint (for the dual portal means near the ankles), are the portals within the scope of this invention.
[0042] An important requirement for the gloved portal means is durability. With anticipation of even one thousand hand insertions and extractions, the glove portals themselves must be durable, meaning generally that the portals must be based either in hard plastic material (holes made in polycarbonate, for example) or rimmed with metal that is supported in metal frame.
Interior Environment of Box
[0043] Said sealed box has means to allow flow of oxygen and/or air into the box (
[0044] Said box has means to maintain a slight negative air pressure in respect to the box's interior environment to reduce any chance of germ inside the box escaping into the outer environment. Should a leak in said box occur or at any time, the air pressure inside said box loses its negative pressure in respect to its pressure relative to air pressure outside said box, an alarm can be made to sound.
[0045] Said box has associated means for regulating interior humidity by means obvious to those skilled in the art.
Privacy
[0046] Said box is mostly transparent to facilitate patient care, but where patient is not fully gowned, means are provided to provide privacy at least to the genital area and to the breast area for female patients. Such means may be simply be a curved cover held away from direct contact with the patient. There is now light changing window glass that could be used to make areas of the box less transparent.
[0047] In the case of the embodiment depicted in
Heat
[0048] Said box has means to regulate the inside temperature of said box by such means as a heated bed surface and/or by using heated air pumped into said box.
Decubitus (Bedsore) Prevention
[0049] Said box has means to prevent bed sores by the use of standard anti-decubitus air mattresses or other similar provisions.
Physical Therapy Option
[0050] In a preferred embodiment, said box has inside a manually operated exercise bar which uses resistance to exercise the patient's major limbs. Also, as described above under Sealed Box, where the bed used inside said box is electrically powered to enable said patient to stand, said patient can receive physical therapy in standing position.
Lighting
[0051] In a preferred embodiment said box can have its own light source for patient's benefit (for example, to read a book) or caregiver's benefit although it may be preferable to provide light from outside said box.
Caregiving Features
General
[0052] Said box like depicted in
[0053] Alternatively, said box of
Waste Management
[0054] Said sealed box has efficient means to disinfect liquid or solid waste of the patient and other used products coming out of said box, by chlorine or other disinfectant, by autoclaving, or by high heat.
[0055] In one preferred embodiment, said box has incinerator means (
[0056] While disinfection by incineration is best for human wastes like feces and urine and for soiled caregiving wastes like dirty linen or gowns. Applicants in a preferred embodiment recommend against incinerating contaminated caregiving wastes like syringes and sharps with traces of chemicals, which actually would be rare anyway to end up inside the box needing to be disposed of from inside the box, because of potential of dangerous fumes resulting from incineration, even where gases resulting from incineration are cleared of toxic fumes, such clearance is never perfect.
[0057] In another preferred embodiment, said box has a hole in the bed under the buttocks of the patient to drain away fecal material into a collection container which empties into such incineration means, all ensuring that no germs are allowed to escape out of the box into the outer environment.
[0058] Another preferred embodiment of said box has means to disinfect products of caregiving by allowing such products to be passed into a container outside the box that holds chlorine or other disinfectants in such a manner as to not allow live germs on the products to escape into the environment outside said box. Provisions are provided to prevent noxious fumes of disinfectant from getting into said box holding a patient.
[0059] Another embodiment comprises in case of room sized containment device like that depicted in
[0060] To facilitate waste disposal, a large receptacle box can be provided inside said box or in space contiguous to said box (see below, adjacent Lounge Space Room,
[0061] Tube transporter systems are also known as pneumatic tube systems. Aerocom (Aerocom GmbH & Co. Pneumatic Tube System, Adam-Riese-Strasse 16, D-73529 Schwabisch Gmunde, Germany) is a supplier of such an age-old tubular system that enables items, such as paper receipts, to be transferred from one location in a warehouse to another via, typically, 4 inch diameter hard tubing that criss-cross the warehouse's ceiling to their desired destination. In an article in an internet technical encyclopedia (www.ExplainThatStuff.com/pneumatic-tube-transport.html), author Chris Woodford states, Pneumatic tubes have been used at the U.S. Library of Congress since the late 19th Century to send requests between readers and the stores where archive material are held . . . still used in parts of Library to this day. It is because of these long standing uses that Applicants feel that the description that these are age-old and are well-known is justified. In a quick search in the area local to Applicants (San Francisco East Bay), Applicants found use of pneumatic tube system at warehouses of Costco, a well-known whole-seller to general consumers, and Home Depot, a prominent supplier of building products. Although such pneumatic tube (or tube transporter) systems are known, there has been no prior suggestion to move human waste products using pneumatic tubular transport.
Providing of Food & Supplies
[0062] Said box has means to allow equipment, supplies, and medication to be inserted into the box without any significant potential of infected air inside said box from escaping into the room that holds said box.
[0063] In a preferred embodiment of said box, samples of blood, urine and other bodily excretions can be removed from said box after tubes holding such samples are dipped first in a disinfectant and passed out through an airlock chamber portal means. Said portal means (
[0064] It will be obvious to those skilled in the art how to decontaminate the interior of said chamber in-between each use, such as with disinfectant wash fluid or disinfectant gas. Food and other medical supplies can be placed into said chamber using the exterior door after which said exterior door is closed air-tight. Subsequently, an operator can reach into the interior of said box using one of the glove portal means to open the door separating said chamber from the interior of said box, grab any item placed into said chamber and place the item inside said box. The operator then closes securely the interior door to said chamber, after which said chamber is disinfected for the next use.
[0065] Said box has means to allow intravenous tubings connected to intravenous fluids hanging outside said box into said box through ports designed to not allow germs to come out of said box. Design of such port means is obvious to those skilled in the art, but can include such means as a rubber plug with a slit that allows an intravenous tubing to be passed into the interior of said box. Said box has similar means to allow respirator tubing connected to a respirator unit outside said box to enter said box through ports designed to not allow germs to come out of said box. It may be an operational provision to not permit any tubing that entered said box to not come back out of said box except through means described above under Waste Management. Similarly, said box can have means to allow a warm water hose to enter said box without allowing any germ inside the box to come outside, said hose then being usable to provide shower to the patient.
Placement of Patient into Box
[0066] Means are provided for placing a patient into said box. In a preferred embodiment, the wall of said box nearest the head of patient to be placed into said box is hinged to open to allow a patient to be slid into said box, said hinged wall serving as a door being made to close air-tight and locking it shut ensuring no accidental opening that can allow germs from inside said box to escape into the environment. Other means for insertion of patient and things like furniture has also been discussed above under descriptions of the embodiment of
Degree of Seal of Box or Containment Device
[0067] Different pathogenic germs have different characteristics for transmission. Some viruses that cause Severe Acute Respiratory Syndrome (SARS) such as SARS corona viruses are easily transmitted over the air, while other viruses like ebola viruses are less likely to transmit over the air unless an infected patient sneezes and propels infected droplets from his nose at another person. While it is obvious that the degree of air separation and sealing of patient compartment must be more complete in the case of SARS than in the case of ebola, it will be advantageous to ensure as complete a hermetic seal of the patients compartment as practical and economically possible. However, some degree of imperfection in the seal may not defeat the intent and performance of this invention when dealing with germs not considered air-transmissible and such imperfection may not be considered to have violated the scope of this invention. The intent of this invention is to enable separation between an infected patient and caregivers of the type that virtually eliminates transmission of the germs from the patient to the caregivers. Because devices such as this invention are made and stored in case of sudden occurrence of viral epidemics, since we would not know what type of virus may cause the problem, it will be advantageous to create and store units that have the highest standard for separation, which would be a hermetically sealed containment device.
Provision to Provide Lounge Space Room to Patient Held in Said Box
[0068] Some patients needing isolation from caregivers and the society are not so sick as to require full-time bed rest and even those who are very sick and require bed rest will get well and would desire more space in which to recuperate while still infectious. In one embodiment, such as depicted in
[0069] The lateral longitudinal walls of said room can have multiple glove port means at approximately 42 to 44 inches (107 to 112 cm) (center) high from the floor on each side of the length of said room so that caregivers on both sides of said room can physically support a patient as he ambulates. Said glove port means must then be placed close enough to each other to allow transfer of patient's arm on each side from one caregiver to the next down said length of said room. One way to determine the spacing between glove port means is to use the forearm length as a measure since one caregiver will transfer the arm of said patient to the next caregiver's gloved hand from the next gloved portal down said length of said room and so the distance between said gloved port means cannot exceed twice the length of a typical caregiver's forearm. Although forearm length depends on the height of a caregiver, one would prudently use, for this purpose, larger, strong caregivers to support said patient on his both sides. Therefore, a distance of two feet (61 cm) center to center of said gloved port means would provide a minimal distance between said glove port means. Since a patient can fall during ambulation, additional glove port means closer to the floor and placed with inter-glove spacing about the same as those at 42 to 44 inches (107 to 112 cm) in height should be sufficient. In a preferred embodiment, said gloves are bidirectional to allow either right or left hand to be inserted comfortably.
[0070] One can provide a wheeled flat bed means tucked under a bed used for treatment that can be wheeled out into the lounge area onto which a fallen patient can be placed, said flat bed means having the capability to raise patient all the way up to the level of his treatment bed.
[0071] As a precaution against a patient falling in said lounge room, said patient can be made to wear a body harness that is linked to a rail running along a reinforced overhead spine that runs along the length of said lounge room. The rail is preferably made of a strong metal and is supported firmly in its overhead position by such means as metal framing like shown in
[0072] The floor of said lounge room can be subject to heavy use from ambulation. In a preferred embodiment, the floor of said lounge room can be reinforced with a vinyl like runner carpet that could be 50 mil (1.3 mm) thick. Such said runner carpet can be replaced from time to time, always making sure it is disposed through means provided in this invention that prevents germs from inside to escape into the environment outside said box and lounge room.
Other Provisions
[0073] Other provisions which would be obvious to those skilled in the art may be provided in and around said box to provide better care and comfort to a patient being treated inside said box. Many embellishments and additional embodiments may be added to described invention without falling outside the scope of described invention.
[0074] Prior designs for devices for containing deadly germs during patient treatment were often insufficient in many ways, including lacking thoroughness in blocking escape of germs from inside the box, transient nature of materials others used that would not stand up to long-term needs, and insufficiency in features provided that made other designs impossible to treat patients for more than a few days. For example, in one design, air exiting the box was merely filtered, such as with a filter that would block bacterial passage because of filter porosity of 0.22 microns, but viruses would easily pass through such a filter. Also such filters, even when caring for a patient with a deadly bacterial infection, cannot be used except for a short time because such filters would begin to clog with other particles found in air. In Applicants' preferred embodiment, exiting air are sterilized by high heat. There is no prior art in which exiting air from a treatment box or room are disinfected by high heat. In some prior designs a disinfectant vapour was used to treat the air and that vapour was created using a mild heat (like from a high resistance wire) to heat and vaporize a disinfectant liquid, but this means that disinfection is by chemical means, not heat. There are numerous disadvantages to using chemicals to disinfect high volumes of air exiting a box or a room.