SPECIFIC IMMOBILISATION DEVICE
20180333287 · 2018-11-22
Inventors
Cpc classification
A61F5/3715
HUMAN NECESSITIES
International classification
Abstract
A specific immobilisation device for use in rescue services, pre-hospital medical emergencies services and patient transport services, has (i) a rigid guide having a telescopic structure, the lower distal end of the guide having a T-shaped ankle band, (ii) a system for securing two padded anatomical bands having a longitudinal multi-tunnel system containing a viscoelastic layer on a rigid laminar endoskeleton to the rigid central guide of the device; (iii) a series of straps with quick-action fastening that complete the function of the bands into which they are inserted, allowing both opposite ends to remain duly connected and secured; and (iv) an internal mechanism for facilitating the mechanical retraction and extension of the telescopic or mobile element of the guide and the consequent adaptation of the ankle band of the device to the specific anatomy of each injured person.
Claims
1-6. (canceled)
7. A specific immobilisation device (SID), for immobilisation of a pelvic area and affected lower limb of the injured subject in cases in which a femoral neck fracture is suspected, comprising: (i) a rigid guide having a telescopic structure configured for stabilizing the pelvic area and aligning the affected lower limb, and having at a lower distal end a T-shaped ankle band; (ii) two sets of anatomical bands or wings connected to a longitudinal multi-tunnel system containing a viscoelastic layer on a rigid laminar endoskeleton that runs parallel to the limb to be immobilised, confers vertical rigidity and horizontal flexibility, and allows fixing the telescopic rigid guide to the body of the injured subject, encircling the body, and completing immobilization of the pelvic area with both extremities en bloc; (iii) a series of straps inserted into the bands or wings, the straps having quick fastening which complete the function of the bands or wings, allowing both opposite ends to remain duly adjusted and connected; (iv) an internal parallel-axis, straight tooth gear mechanism having gears that mesh with one another and with millimetric indentations of an inner side of the guides, facilitating, by manual operation of pulling on and releasing the outer handle, in cases of femoral neck fracture, mechanical extension and retraction of the telescopic or mobile element of the guide and subsequent adaptation of the ankle band of the device to the specific anatomy of each injured subject.
8. The specific immobilisation device (SID) according to claim 1, wherein the internal gear mechanism is operable by manual rotary operation of the outer handle, allowing the millimetric extension and retraction of the telescopic element of the guide and subsequent millimetric mechanical traction of the affected lower limb in cases of femoral fracture and fracture from a proximal tibia to a knee.
9. The specific immobilisation device (SID) according to claim 1, wherein the two sets of anatomical bands or wings form an upper set and a lower set, and wherein the device has a set of central wings or bands reinforcing the function of the upper set and lower set.
10. The specific immobilisation device (SID) according to claim 2, wherein the two sets of anatomical bands or wings form an upper set and a lower set, and wherein the device has a set of central wings or bands reinforcing the function of the upper set and lower set.
11. A specific immobilisation device (SID), for immobilization of a pelvic area and affected lower limb of the injured subject in cases in which a femoral neck fracture is suspected, comprising: (i) a rigid guide having a telescopic structure configured for stabilizing the pelvic area and aligning the affected lower limb, and having at a lower distal end a T-shaped ankle band; (ii) a single anatomical band or wing connected to a longitudinal multi-tunnel system containing a viscoelastic layer on a rigid laminar endoskeleton that runs parallel to the limb to be immobilised, confers vertical rigidity and horizontal flexibility, and allows fixing the telescopic rigid guide to the body of the injured subject, encircling the body, and completing immobilization of the pelvic area with both extremities en bloc; (iii) a series of straps inserted into the band or wing, the straps having quick fastening which complete the function of the band or wing, allowing both opposite ends to remain duly adjusted and connected; (iv) an internal parallel-axis, straight tooth gear mechanism having gears that mesh with one another and with millimetric indentations of an inner side of the guides, facilitating, by manual operation of pulling on and releasing the outer handle, in cases of femoral neck fracture, mechanical extension and retraction of the telescopic or mobile element of the guide and subsequent adaptation of the ankle band of the device to the specific anatomy of each injured subject.
12. The specific immobilisation device (SID) according to claim 11, wherein the internal gear mechanism is operable by manual rotary operation of the outer handle, allowing the millimetric extension and retraction of the telescopic element of the guide and subsequent millimetric mechanical traction of the affected lower limb in cases of femoral fracture and fracture from a proximal tibia to a knee.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0027] To complement the description of the immobilisation device at hand and for the purpose of helping to better understand the features thereof, a set of drawings of a selected preferred practical embodiment is attached as an illustrative and non-limiting integral part of said description. It must be borne in mind that identical or duplicate or equivalent or similar structures, elements, or parts appearing in one or more of the drawings are generally designated with the same natural reference number, optionally with an additional letter or additional letters to distinguish between objects or variants of similar objects, and they may not be named and/or described repeatedly. The dimensions of the components and features shown in the drawings are also chosen for the sake of convenience or clarity of presentation and are not necessarily shown to scale or in actual perspective. Finally, for the sake of convenience or clarity, some elements or structures are not shown or are shown only partially and/or with a different perspective or from different viewing points.
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[0036]
DETAILED DISCLOSURE OF A PREFERRED EMBODIMENT
[0037] In view of the mentioned drawings and according to the adopted numbering, a preferred embodiment of the immobilisation device at hand, which comprises the parts and elements that are indicated and described in detail below, can be seen therein. Said description relates to one or more non-limiting examples of preferred variants of a practical embodiment of the immobilisation device (SID). This invention is not limited by the variants described or by the drawings shown, where it can be carried out to practice in different ways with different configurations, variations, and with variable dimensions. The terminology used herein must not be construed as limiting, unless otherwise specified. Likewise, the titles of the section used herein are for the sake of convenience and must not be interpreted as limiting the scope of the specific immobilisation device (SID) shown herein.
[0038] As discussed above, the immobilisation device (SID) constitutes a newly developed specific immobilisation device which allows a perfect en bloc immobilisation of the site of injury and the affected lower limb in cases of femoral neck fracture, the main purpose of which is to enable the efficacious, efficient, and effective, and particularly pain-free, rescue of the injured subject, all without requiring the administration of medication to the patient, and accordingly without requiring the intervention of physicians and/or nurses during the rescue process. This device can also be used with the same efficacy, efficiency, and effectiveness as a specific immobilisation device in cases of pelvic fracture, femoral fracture, knee fracture, and fracture from the proximal tibia to the knee.
[0039] The present specific immobilisation device (SID) comprises the following elements, all of them roughly shown in the attached
[0040] Central Guide (100)
[0041] This is a central component which, like a spinal cord, performs the function of a backbone and a support for the assembly of the immobilisation device, said component being in the form of a rigid central guide having an adjustable telescopic structure (100). This structure in turn has the following elements:
[0042] Central Casing (200): Fixed Rigid Element
[0043] This constitutes the first of the two segments making up the mentioned central guide having a telescopic structure (100). The casing (200) represents the main support element of the central guide (100) and of the assembly of the device.
[0044] As can be seen in detail in
[0045] Cover: the entire immobilisation device (SID), i.e., both the central casing (200) and the so-called upper bands or wings (600), lower bands or wings (800), and where appropriate, intermediate bands or wings (700), are covered by respective thin polyvinyl chloride layers (or another material having similar characteristics or properties). As indicated in
[0046] Interior of the central casing (200): the interior of the central casing houses the second segment (300) of the telescopic structure of the central guide (100) which, when extended using the gear mechanism (500) that can be seen in detail in
[0047] Rails: The two solid guides (301) and (302) having a rectangular section that have been described and form the structure of the mentioned extendable segment (300) of the telescopic central guide (100) are always kept in place and aligned as a result of U-shaped rails (208) that run along the entire length of the inner side of the smaller faces (203) and (204) of the casing (see
[0048] Cut-out: The lower half of the outer face (202) of the casing (200) has a cut-out (210) which enables the connection of the gear system (500) housed therein with a lever or handle in the form of an outer wheel (501) through which the aforementioned mechanism (500) is manually operated (see
[0049] Lid: As mentioned above, the upper side (205) of the casing (200) is blocked off forming a closed structure with the same physical characteristics as the rest of the structure of the casing (200). In contrast, the lower end (206) of said casing (200) is open in principle. However, this lower end (206) will be depicted as being sealed by a lid (211) [see
[0050] Accordingly, the central casing (200), as a fixed element of the central guide (100), allows performing the following functions: (i) the function of a backbone and support, like a spinal cord, for the assembly of the device (SID), the function of a casing, housing the extendable or telescopic element, as well as the mechanism regulating same, allowing access through the structure thereof to operate it from the outside; (ii) the function of supporting and stabilizing the affected lower limb with the injured subject in a vertical, horizontal, or titled situation; (iii) the function of aligning the affected lower limb; (iv) the function of preventing the body of the patient from sliding when he is in a tilted or vertical position on the spine board during evacuation; (v) and finally, it is a key piece that enables the integral function of the device, which is to provide a perfect and specific immobilisation which allows pain to be maximally reduced during the handling and movement of the patient in a pre-hospital rescue operation (made up of the three mentioned phases: evacuation, transport, and reception) without requiring the presence of a physician and nurse, and without the administration of medication to ease the pain.
[0051] Telescopic Segment (300): Rigid Extendable Element
[0052] As discussed above and as can be seen in
[0053] These guides (301) and (302) have a solid tubular structure with a rectangular section, where they can be manufactured from aluminium (or another material having similar characteristics/properties). Additionally, both guides are maintained as a rigid equidistant assembly by respective tubular elements welded (preferably) in a perpendicular manner (to the guides) at both ends of the segment [upper section (304) and lower section (305)] forming a rectangular tubular structure with a closed perimeter (300). The mentioned four sections comprise the two long sections and the two short sections, where the two opposing long sections are identical to one another and the two opposing short sections are identical to one another, and they (preferably) have an identical tube section. The observer will not be able to see the two short sections given that the upper end of the extendable segment of the guide (300) is always inside the casing (200), with the stop in the form of a flange (209) mentioned above assuring that this is the case; and the lower end is embedded in what is referred to as an ankle band (400) for descriptive purposes, making the observer feel like the structure is only made up of an independent double tubular guide. Said structure is therefore extremely robust and compact, being resistant to deformations that may be caused by rough and unpractised use of the immobilisation device (SID).
[0054] As discussed, the extendable segment (300) of the telescopic central guide (100) provides support at its lower distal end (305) to the so-called ankle band (400), forming a T-shaped structure (seen clearly in
[0055] The casing (401) is completely covered by a layer of polyvinyl chloride (or another material having similar characteristics/properties) and has two rectangular metal washers (or washers made of another material having similar characteristics/properties), being arranged around the perimeter of both guides (301) and (302), performing the function of protecting the cover material from possible friction and wear due to the intensive use of the central guide (100).
[0056] The extendable element (300) of the central guide (100) allows achieving the following functions: (i) the function of aligning the affected limb in cases of femoral neck fracture; (ii) the function of enabling the traction of the affected limb by means of using the millimetric gear mechanism provided for the use thereof in the case of femoral fracture or fracture from the proximal tibia to the knee; (iii) the function of reducing haematomas and the worsening of the injury or fracture in the preceding cases; (iv) the function of reducing pain when resetting the bone in the affected limb; and in any case (v) the function of specifically immobilising the affected limb and both lower limbs en bloc.
[0057] Lower Ankle Band (400)
[0058] This band (400), referred to as ankle band for descriptive purposes (as it performs the function of fixing the central guide (100), securing the lower end (102) thereof to the ankle of the injured subject) is secured to the distal end (305) of the rigid extendable component (300) of the central guide (100) arranged perpendicular to the backbone (103) of the telescopic central guide (100), forming a T-shaped structure therewith (
[0059] The casing (401) made of high-density polyethylene (or another material having similar characteristics or properties) housed therein constitutes the base on which there is adhered (with industrial contact adhesive) a larger trapezoidal central element (402) made of high-density polyester foam (or another material having similar characteristics or properties) (
[0060] The assembly is covered by two sheets, i.e., an inner sheet in contact with the patient and covering the padded face (405) (see
[0061] Two short straps: two straps (411) and (412) extending perpendicular to the backbone (103) of the immobilisation device (SID) in the same direction of the bands (403) and (404) are sewn on the outer face (406) of the cover layer by means of seams (415) sewn with a nylon thread (or another material having similar characteristics or properties). These straps will be manufactured from a mixed fabric of nylon and polyester (or another material having similar characteristics or properties) and incorporate a contact-type quick fastening and unfastening system, i.e., VELCRO (414), that is fixed to the straps by means of perimetral seams (416) sewn with a nylon thread (or another material having similar characteristics or properties), said straps surrounding the ankle of the affected leg, and completing and enabling the holding of the described ankle bands (403) and (404) (see
[0062] Long strap: additionally and as can be seen in
[0063] */*/ Velcro-type fasteners: both short straps (411) and (412) have a female (or smooth) fastening side (designated with the letter F in the corresponding
[0064] Padded band: finally, reference is made to a small padded band (417) on which the patient's foot rests and the purpose of which is to prevent chafing. The band will be sewn forming a seam (418) with a nylon thread (or another material having similar characteristics or properties)] along the lower edge of the ankle band (400); it will be padded with a high-density polyester foam (or another material having similar characteristics or properties), and it will be covered with polyvinyl chloride material (or another material having similar characteristics or properties) identical to the one used for the cover of the rest of the immobilisation device (SID).
[0065] This element (ankle band) allows performing the following functions: (i) complete fastening of the device (SID) to the ankle of the injured subject (which will be placed at a different height depending on the particular anatomy of the subject); (ii) enables perfect en bloc immobilisation and alignment of both limbs in conjunction with the telescopic element (300) of the guide (100), and therefore a safe and pain-free evacuation.
[0066] Operating Mechanism (500)
[0067] The central guide (100) of the SID having, as mentioned, a telescopic structure consisting of two segments (200) and (300) can be adjusted by means of an internal mechanism (500). As can be seen in
[0068] The upper section of the shaft of the larger gear or gear ring (504a) is fixed to the handle in the form of a wheel (501). This wheel is manufactured from high-density polyethylene (or another material having similar characteristics or properties) and enables manually operating the internal gear mechanism. It must be pointed out that said handle is covered with a rough anti-slip material (or another material having similar characteristics or properties) to make it easier to grip same in all types of conditions. When said upper section of the shaft of the larger gear or gear ring is manually operated (by pulling it outward), the lower end of the shaft (506) comes out of the notch (510) provided for that purpose at the central point of the larger gear or gear ring. When said handle (501) is no longer operated, said lower end of the shaft (506) again rests in said notch (510). The lower section of the shaft (507a) of the larger gear and the lower portion (507b) of the shaft of the smaller gear remain in place as a result of the notches (510a) and (510b) with a high border (see
[0069] There is a need to highlight that although the millimetric bite marks marking almost the entire inner face of both guides (301a) and (302a) are identical (in the sense that they have the same dimensions), they are not placed in a symmetrical manner, one in front of another. In other words, in order to allow both guides [(301) and (302)] to be extended or withdrawn in unison, they are synchronized, in a manner of speaking, in an asymmetrical position, one with respect to the other. Likewise, it should be borne in mind that the bite marks depicted in
[0070] In this manner, through the described manual operation [pulling on the lever or handle (501)], the internal mechanism of the immobilisation device (SID) performs three functions: (i) on one hand, it keeps the extendable telescopic segment (300) of the guide (100) held inside the casing (200) when it is withdrawn or in standby; (ii) on the other hand, it allows extending the telescopic or extendable segment (300) of the guide (100), aligning the affected limb and holding it securely in place once the ankle band (400) has been placed at the level of the ankle of the injured subject; (iii) finally, in cases of femoral fracture and fracture from the proximal tibia to the knee, the millimetric gear mechanism (500) described above is designed to allow the mentioned telescopic segment (300) of the guide (100) to be extended millimetre by millimetre by means of rotating the wheel, which allows a delicate and precise traction of the affected lower limb.
[0071] Upper Bands or Wings (600), Intermediate Bands or Wings (700), and Lower Bands or Wings (800)
[0072] Once again, these elements of the immobilisation device (SID) are referred to as bands or wings only for mere descriptive purposes and without having any limiting character whatsoever. As can be seen particularly in
[0073] The bands or wings emerge from both sides of the segment of the central guide (100) referred to as central casing (200) and extend in a perpendicular line in the direction opposite the vertical backbone (103) of the central guide (100). The aforementioned bands or wings provide the device (SID) with both vertical rigidity and horizontal flexibility as a result of the unique longitudinal equidistant arrangement of a series of sheets which together form a type of semi-rigid endoskeleton (900) shown in
[0074] Endoskeleton Made of Cut-Out Sheets (900)
[0075] Each of the side bands or sections extending on each side of the guide (601) and (602), (701) and (702), as well as (801) and (802) has an endoskeleton (900) formed by a series of rigid independent sheets (901) that run parallel to the central casing (200), along the entire interior of the device, in a continuous and longitudinal manner (see
[0076] This type of inner longitudinal infrastructure is formed by sheets (901) made of rigid high-density polyethylene (or another material having similar characteristics or properties) with cut-outs (907) [
[0077] The aforementioned cut-outs (907) have a variable configuration, the central point of which coincides with the imaginary longitudinal axis (908) of each of the sheets (901) at hand [see
[0078] Each of the sheets (901) has adhered (with industrial contact adhesive) [depicted in
[0079] Function: The described endoskeleton (900) allows simultaneously combining the functions of (i) providing vertical rigidity to the assembly, extending the patient stabilization and alignment function fundamentally carried out by the central guide (100), and (ii) enhancing the flexibility and horizontal anatomical adaptation function of the bands or wings of the immobilisation device (SID) (or parallel symmetrical sections) with respect to the body of the patient. Combining both functions described above is what ultimately allows the pain-free handling, evacuation, and transfer of the patient without any medicinal products and without the intervention of any professional practitioner in pre-hospital stage of the patient's care.
[0080] Covering or cover of the device (910) and (911): As can be seen mainly in
[0081] Longitudinal multi-tunnel (semi-cylindrical channel) system (914): The longitudinal assembly of the sheet of rigid high-density polyethylene (901) and the strip or layer of superimposed viscoelastic material (906) is covered by respective layers of polyvinyl chloride [on its outer or non-padded face (911) and the inner or padded face (910)], being perfectly fixed in a equidistant manner as a result of the parallel longitudinal seams (912) attaching or fixing both sheets or inner cover layer (910) and outer cover layer (911) separating same, creating in an alternating manner a design consisting of padded semi-cylindrical channels (914) containing the assembly of the sheet (901) and viscoelastic material (906) and longitudinal notches in the form of a seam (912) parallel to the preceding ones [see
[0082] The alternating arrangement of semi-cylindrical channels (914) [with the sheet (901) and the viscoelastic material (906) therein] and vertical longitudinal notches (seams) (912) gives the inner face of the immobilisation device (SID) a padded appearance [see
[0083] Outer face of the device (911): In contrast and as can be seen in
[0084] Function: The bands (600), (800), and where appropriate (700) perform two simultaneous functions: (i) they extend from the central casing (200) and provide the necessary longitudinal or vertical rigidity as a result of the assembly of parallel equidistant sheets (901) forming the endoskeleton (900) thereof; (ii) said bands in turn provide the necessary flexibility and horizontal adaptability to go around the body of the injured subject, moulding itself to the unique and specific anatomical contour of the individual at hand (without compression).
[0085] Borders of the Bands of the Device (913)
[0086] The assembly formed by the central casing (200) of the guide (100) and the described sections, i.e., the set of wings/bands (600), where appropriate the set of wings/bands (700), and the set of wings/bands (800), has a band or border (913) running uninterrupted along the perimeter thereof, fixing the two layers of polyvinyl chloride (or another material having similar characteristics or properties) forming the cover of the entire device, i.e., of the padded face (910) and of the non-padded face (911) [
[0087] Fastening Straps with Anchoring in the Form of Velcro (or the like)
[0088] The six mentioned sections, i.e., the upper sections (601) and (602) [
[0089] In terms of the anchoring system, the immobilisation device (SID) has a Velcro-type quick fastening and unfastening system. The straps of the bands or wings of the device (600), where appropriate (700), and (800) always have the Velcro side of the fastener on the outer face (604), (704), and (804) of the corresponding strap. Both straps in each of the bands or wings, such as (605/606), (705/706), and (805/806), for example, have two female sections in the inner portion of the strap followed by a male section at the end farthest away therefrom (designated with the letter F (for female) and M (for male), respectively, in
[0090] The described fastening and unfastening system has an additional element, i.e., the sliding rings or arcs [designated as (609) [
[0091] 3. Complementary Elements. Cushions
[0092] The cushion (920) depicted in
[0093] Method of Using the SID
[0094] The basic phases of a method of using the present device are described below, said method comprising the following steps:
[0095] The emergency team (which is made up in Spain, by law, of two or three professionals) or rescue team goes to where the injured subject is located, regardless of whether he is on a public street, inside a building, in a rural area, etc.
[0096] The emergency team or rescue team performs a quick assessment of the injured subject to establish the extent of his injury/injuries. In the event that the injured subject shows signs and symptoms suggesting a femoral neck fracture injury, the emergency professional (paramedic, physician, nurse, or emergency medical technician) or rescue professional will use this new immobilisation device (SID) in the manner described in detail below.
[0097] The immobilisation device (SID) at hand will be placed, open or extended, resting on its outer or non-padded face, on a spine board, parallel to the injured subject at the height of his hip.
[0098] One of the health professionals or rescuers will slide the immobilisation device (SID) under the injured subject while his teammate holds the patient in the lateral decubitus position, with the affected limb held in place.
[0099] So while one of the professionals places and holds the patient in the lateral decubitus position and the other holds the affected lower limb, they will both proceed to slide the spine board along with the immobilisation device arranged thereon under the patient at the suitable height together and at the same time using their free hands (i.e., this action will be performed depending on the height of the site of the injury or fracture).
[0100] Once the patient is moved back to the supine decubitus position, the professional assures that the patient is suitably located on the immobilisation device (SID).
[0101] For the purpose of assuring a suitable venous return, rescuers will proceed to adjust the fastening straps from the bottom up, first adjusting the straps of the lower bands or wings (at the tibial level), then the straps of the intermediate bands or wings (at the femoral level) if they are included in the configuration of the specific immobiliser (SID), and finally the straps of the upper bands (at the hip and/or pelvic level).
[0102] In the exceptional case where the anatomy of the injured subject so requires, the emergency staff or rescuer will place during the preceding process cushions which are provided and which the staff or rescuer believes are necessary in order to fill the anatomical gaps left by the particular anatomy of the injured subject, thereby assuring perfect immobilisation of the patient.
[0103] Once the patient has been immobilised at the indicated height, the telescopic or movable section of the guide is placed and adjusted with respect to the height of the ankle of the patient. The guide will be extended depending on the length of the affected limb of the patient, so that the ankle band and its straps are aligned parallel to the ankle (or ankles) of the injured subject.
[0104] The straps of the ankle of the affected limb are then adjusted.
[0105] Traction: In the case of a hip fracture, a femoral fracture, and a fracture from the proximal tibia to the knee, traction is applied (downward or upward, depending on the case) to the affected lower limb with the guide to align the fracture, thereby minimizing pain and compensating for the lack of medication. In the case of a pelvic or knee fracture, traction would not be necessary.
[0106] Distal pulse: Once traction is applied to the limb, the distal pulse is taken to check for the existence of blood flow and thereby distal tissue oxygenation.
[0107] For the patient to form a block making his evacuation easier, the second strap of the device in the ankle band is adjusted. The strap is long enough to go around both extremities, the one affected by the injury and the one not affected, forming a block which completely stabilizes and immobilises the extremities en bloc, minimizing movements, vibrations, and accordingly pain.
[0108] Finally, the patient is fastened to the spine board on which he rests already immobilised using the provided fastening straps, and he is then evacuated to the vehicle used in the corresponding rescue service or operation.
[0109] In contrast with the current technique described above, the use of the immobiliser (SID) allows the patient to be transferred directly to the hospital, without having to be moved to the vacuum mattress, i.e., the use of the immobiliser (SID) allows the patient to be transferred to the hospital centre using the same resources [spine board and immobiliser (SID)] with which he has been evacuated.
[0110] The type of material used in the design and manufacture of the immobilisation device (SID) allows subjecting the patient to x-rays upon reaching the hospital without having to remove the immobilisation (under normal circumstances, i.e., using the current technique, the patient must first be moved from the vacuum mattress to a stretcher or bed). The patient is finally transferred from the x-ray department to be cared for by the traumatologist of an emergency department without any need to remove the immobiliser (SID) on which the patient is placed during evacuation and without any need to repeatedly move the patient. This results in an excellent quality of patient care throughout the entire process, i.e., patient handling and movement at the scene of the accident, evacuation and transfer, reception, and initial hospital care.
[0111] General: The present device has been described using descriptions of variants thereof that are provided by way of example and do not intend to limit the scope of the utility model or preclude other variants. The variants that have been described comprise various features that are not all necessarily required in all the variants of the invention. Some variants of the invention use only some of the features or possible combinations of features. Alternatively and additionally, parts of the variants that are described or illustrated as a unit can be housed in two or more separate entities which act together or otherwise carry out the described or illustrated function. Alternatively or additionally, parts of the variants that are described or illustrated as two or more separate physical entities can be integrated in a single entity for carrying out the described or illustrated function. Variations relating to one or more variants can be combined in all possible combinations with other variants. In the specifications and claims, unless otherwise particularly specified, when the operations or actions or steps are listed in a certain order, the order may vary in any practical manner. The terms used in the following claims must be interpreted, without limitation, as being characterized or described in the specification.