JP2016522042A - Pneumatic tourniquet - Google Patents

Abstract

To provide a pneumatic tourniquet in which a strap for applying a hemostatic force can expand to a controlled pressure. The compressed gas container and flow control unit are held in a rigid housing of a control device that is locally attached to an inflatable strap of a pneumatic tourniquet. When triggered, the flow control unit selectively delivers a predetermined amount of pressurized gas discharged from the gas container to the strap internal cavity to achieve a predetermined pressure in the cavity to apply the necessary hemostatic force to the limb. Configured to supply. The strap restraining unit allows the free end to displace without resistance until the free end of the strap is long enough to apply hemostatic force, and is sufficiently tight with the strap to restrain the strap. It corresponds so that a restraint element may be arrange | positioned in the place which becomes a press relationship. The tourniquet can be placed by engaging the buckle frame with the protruding member. [Selection] Figure 3

Description

  The present invention relates to the field of inflatable tourniquets. More particularly, the present invention relates to a tourniquet that applies a hemostatic force that can be inflated by a control device attached to the strap.

  A tourniquet is a well-known device for hemostasis. Bandages wound tightly with tools such as sticks have long been used to apply pressure to the arteries and stop the flow of blood from the limbs.

  In the event of an emergency, if an injured person with massive blood loss is alone, the blood flow cannot be blocked unless the hemostatic force can be applied by himself. However, injured persons are generally physically restricted and cannot always provide the necessary hemostatic force. The actual force required for hemostasis will, of course, depend on the thickness of the limb and the depth of the artery in the limb. If too much force is applied, the bones, eg, the ribs and tibia of the legs, may break and soft tissue may be damaged, such as late soft tissue complications.

  An important consideration for the physician or any other person applying hemostasis is an appropriate record of the time at which hemostasis began to be applied. As a result of prolonged arterial occlusion, ischemia occurs in the limb. Physiological and anatomical studies have shown that irreversible muscle damage begins 3 hours after ischemia and is almost complete at 6 hours following arterial occlusion. Because the injured person is at risk of amputation when ischemia occurs, it is essential to indicate the start time of the hemostatic force so that the injured person can be dispatched to the hospital for treatment and release of the hemostatic force It is. An injured person is usually not cool enough to write on the strap the time at which he started applying the hemostatic force himself, and in general, he cannot apply the required constant hemostatic force.

  US Pat. No. 7,892,253 discloses an emergency tourniquet that can be applied using only one hand. The tourniquet includes an outer sleeve, a buckle coupled to one end of the outer sleeve, an inner strap slidably engaged with the outer sleeve, and a windlass rod coupled to the inner strap. The buckle has a raised intermediate bar and teeth for contact with the outer sleeve. The outer surface of the outer sleeve passes through the buckle through the other end of the outer sleeve, secures it around the limb, and then removes the first and second portions of the outer surface together while adjusting for the limb of different dimensions Includes a hook and room structure for possible interlocking. The windlass are rotated to apply a tensile force to the inner strap and apply a compressive force that is applied circumferentially to the limb to inhibit blood flow.

  Such tourniquets have several drawbacks. First, it takes a relatively long time to secure the outer sleeve through the buckle to the injured limb. Second, it is not easy to quickly place the tourniquet on the unmovable limb. In order to be placed in a non-movable limb, the outer sleeve must be disengaged from the buckle by hand and then re-engaged with the buckle before being wrapped around the limb and tightened. In addition to the limited stress and dexterity of the injured person during one-handed placement in high stress conditions, especially those who are trying to stop hemostasis, even a few seconds delay as a result of this placement procedure May cause fatal blood loss.

  Third, there is no control over the instantaneous hemostatic force applied. If the hemostatic force is less than required, the bleeding artery will not be fully occluded. On the other hand, if excessive force is applied, the soft tissue, muscles, nerves and bones of the injured limb may be damaged, especially by the thin straps of about 2.5 cm digging into the skin. is there. The pain from the thin strap prevents the injured person from applying a sufficiently high hemostatic force himself. Thus, prior art tourniquets can only be reliably placed by experienced physicians or any other medical personnel.

  In addition, the hook and loop structure required to adjust for limbs of various dimensions is not effectively interlocked in harsh environments such as mud and water, and the structure can be viewed well. It is difficult to interlock in the dark.

  Various pneumatic tourniquets are known from prior art including GB713132, US Patent Application No. 2013/0245673, TW201311204 and CN2875336.

  WO2014 / 023960 includes an unprotected pressurized gas bottle coupled to the inlet and protruding from the edge of the cuff, a movable piston disposed between the inlet and the outlet, and the piston relative to the inlet in cooperation with the piston. An inflation system for a tourniquet is disclosed that includes a spring disposed in the back of the chamber that resists relative retraction. Disengagement of the piston from the inlet occurs when the gas pressure in the bottle is greater than the combination of the bladder internal pressure and the biasing force exerted by the spring.

  This inflation system is not suitable for use in a battlefield environment because gas bottles are unprotected and susceptible to damage. In addition, gas bottles cannot be used more than once for hemostasis treatment in practice. This is because the gas pressure in the bottle is generally significantly greater than the combination of the bladder's internal pressure and the biasing force exerted by the spring, so that most of the compressed gas is exhausted in the course of a single hemostasis procedure. Because it ends up.

U.S. Patent 7,892,253 GB713132 US Patent Application No. 2013/0245673 TW201311204 CN2875336 WO2014 / 023960

  It is an object of the present invention to provide a pneumatic tourniquet in which a strap that applies a hemostatic force is inflatable to a controlled pressure.

  It is a further object of the present invention to provide a pneumatic tourniquet that can be placed much more quickly than prior art devices.

  It is a further object of the present invention to provide a pneumatic tourniquet that can be self-placed.

  It is a further object of the present invention to provide a pneumatic tourniquet that can be reliably placed even in harsh environments such as in mud or underwater.

  It is a further object of the present invention to provide a pneumatic tourniquet having a fully reusable flow control unit.

  Other objects and advantages of the present invention will become apparent as the detailed description proceeds.

  The present invention comprises a control device that is locally attached to an inflatable strap having an internal cavity and that achieves a predetermined pressure within the cavity, thereby applying the necessary hemostatic force to the limb with which the strap is engaged. Provide a pneumatic tourniquet.

  The control device includes a compressed gas container, a flow control unit in fluid communication with the container and the internal cavity, and a rigid housing in which the compressed gas container and the flow control unit are held. The flow control unit is configured to selectively supply a predetermined amount of pressurized gas discharged from the gas container to the internal cavity when triggered.

  The flow control unit ensures that a substantially constant controlled hemostatic force is applied to the limb with which the strap is engaged, so as to prevent further injury to the injured while continuing sufficient hemostasis. To do.

  The flow control unit can preferably be triggered by a starting force applied by the strap restraint unit. The strap restraining unit allows the free end to be displaced without resistance until the free end of the strap is long enough to apply a hemostatic force, and also restrains the strap using a force derived from the strap. Configured as follows.

  In one aspect, the strap restraining unit is configured to control the pressure in the internal cavity for maximum pull of the strap, puncture of the gas container thin film, and maintenance of a predetermined pressure in response to a single motion of the user, for example, one-handed motion. Cooperates with the flow control unit to facilitate adjustment.

  In one aspect, the strap restraint unit cooperates with the flow control unit to facilitate time adjustment of maximum strap pull, gas container thin film puncture, and initiation of hemostatic treatment in response to a single user action. Work. To avoid irreversible muscle damage from ischemia in subjects undergoing hemostasis treatment, the elapsed time of the hemostasis treatment can be viewed with a digital timer mounted within the housing of the control device.

  In one aspect, the control device comprises a circuit board for supporting the function of one or more electronic devices intended to assist the injured.

  The tourniquet can be compactly housed in a small enough package to be carried in a pocket or in a lifesaving kit for use in ambulances, lifesaving emergency agencies, hospitals and military applications. The package can also be attached to a soldier's military uniform, a construction worker's harness, or a person's clothing.

  The invention further comprises a strap restraining unit equipped in a tourniquet, a guide element for the introduction of a strap adapted to apply a hemostatic force to the wounded limb, and the strap restraining unit. A strap restraining unit comprising a restraining element capable of moving in response to a strap-derived force resulting from displacement of the strap passed through the unit, the free end of the strap being predetermined enough to apply a hemostatic force It is configured to allow the free end to be displaced without resistance until the length is reached, and the restraining element is arranged in a sufficiently close pressing relationship with the strap to restrain the strap. Target strap restraint units corresponding to

  The strap restraining unit can also further comprise a starting element that is also movable in response to a force derived from the strap. The strap is a pneumatically expandable strap and the triggering element is displaceable to a position where a force can be applied to the trigger that triggers the strap expansion.

  The present invention is further a method for indwelling a tourniquet, a strap, a wide area member locally attached to the first end of the strap and projecting outward therefrom, and a first of the strap. Providing a tourniquet comprising a buckle frame attached to the end of the two and having a strap free end portion extending therefrom and movably engageable thereto; and Placing the first end of the strap in contact with an injured limb to which hemostasis is to be applied, and wrapping the strap around the limb until the buckle frame is adjacent to the protruding member; Engaging the unattached end of the buckle frame with the projecting member and applying sufficient circumferential pressure to the limb to cause hemostasis. Comprising the steps of extending the strap free end portion such until tensioned, a method to target.

1 is a perspective view of a tourniquet according to an embodiment of the present invention. FIG. FIG. 2 is a cross-sectional perspective view of the tourniquet of FIG. FIG. 2 is a perspective view of the tourniquet of FIG. 1 when the buckle frame is separated from the control device. FIG. 2 is a diagram showing one of five stages in which the tourniquet of FIG. 1 is placed on the limb of a subject in order to apply a hemostatic force. FIG. 2 is a diagram showing one of five stages in which the tourniquet of FIG. 1 is placed on the limb of a subject in order to apply a hemostatic force. FIG. 2 is a diagram showing one of five stages in which the tourniquet of FIG. 1 is placed on the limb of a subject in order to apply a hemostatic force. FIG. 2 is a diagram showing one of five stages in which the tourniquet of FIG. 1 is placed on the limb of a subject in order to apply a hemostatic force. FIG. 2 is a diagram showing one of five stages in which the tourniquet of FIG. 1 is placed on the limb of a subject in order to apply a hemostatic force. FIG. 2 is a perspective view of the tourniquet of FIG. 1 being introduced onto a subject's hand with a buckle frame pre-engaged with a control device. FIG. 3 is a schematic view of a flow control unit connecting a compressed gas container and an internal cavity of a pneumatically inflatable strap. FIG. 11 is a cross-sectional view of the flow control unit of FIG. FIG. 5 illustrates one of three stages of a strap restraint procedure according to an embodiment of the present invention. FIG. 5 illustrates one of three stages of a strap restraint procedure according to an embodiment of the present invention. FIG. 5 illustrates one of three stages of a strap restraint procedure according to an embodiment of the present invention. FIG. 6 shows one of two stages of a strap restraint procedure according to another embodiment of the present invention. FIG. 6 shows one of two stages of a strap restraint procedure according to another embodiment of the present invention. 1 is a schematic diagram of a circuit board for supporting the functions of various electronic devices intended to assist an injured person. FIG. 6 is a perspective view of a control device disposed in a tourniquet according to another embodiment of the present invention. It is a perspective view of the tourniquet according to another embodiment of the present invention. FIG. 6 is a perspective view of a flow control unit according to another embodiment of the present invention. FIG. 21 is a vertical cross-sectional view of the flow control unit of FIG. 20 along a plane coinciding with the longitudinal axis of the gas container, showing the state prior to puncturing. FIG. 21 is a horizontal cross-sectional view of the flow control unit of FIG. 20 along a plane that coincides with the longitudinal axis of the gas container in a pre-puncture state. FIG. 21 is a vertical cross-sectional view of a piston assembly used in conjunction with the flow control unit of FIG. 20 shown in a normal, unrestricted position. FIG. 21 is a vertical cross-sectional view of the flow control unit of FIG. 20 along a plane coinciding with the longitudinal axis of the gas container, shown after being punctured and achieving a predetermined pressure. FIG. 21 is a vertical cross-sectional view of a piston assembly used in conjunction with the flow control unit of FIG. 20 shown in a restricted position.

  The present invention is an intelligent pneumatic tourniquet that rapidly inflates a strap for applying a hemostatic force to a controlled constant pressure. The control device is locally attached to a strap configured to include an inflatable sleeve. The control device includes a flow control unit that ensures that the required amount of pressurized gas is expelled into the sleeve when triggered, and hemostasis to avoid irreversible muscle damage resulting from prolonged ischemia. And a timer for indicating to the physician the exact time when the force began to be applied. The discharge of pressurized gas is controlled to produce a common predetermined force suitable for rapid and reliable hemostasis in all limbs without causing physical damage.

  FIG. 1 shows an intelligent tourniquet, indicated generally by the numeral 10, according to one embodiment of the present invention. The tourniquet 10 includes an inflatable strap 3, a closed self-contained control device 5 configured as a protruding member, for example rectangular, for inflating the strap 3 to a control pressure, and the upper side of the control device 5 Visible digital timer 8 mounted inside, removable buckle frame 11 for triggering hemostatic force, which is the same shape as the outer periphery of control device 5 and can be engaged with it, and is formed integrally with buckle frame 11 And a strap release lever 14 for selectively releasing the hemostatic force.

  The strap 3 is an elongate flexible material, such as a fabric, that is substantially puncture resistant to be suitable for use by soldiers and is preferably provided with an absorbent material that absorbs exudates from the injured artery. Made with. The strap is generally formed with a cavity into which pressurized gas for inflating the strap can be injected. The dimensions of the strap are preferably, but not essential, relatively wide and at least 4.5 cm, for example 5 cm, thereby ensuring that, in contrast to prior art tourniquets with fairly thin straps, Even when a relatively high hemostatic force is applied, the strap does not bite into the skin. The wider strap contributes to applying an effective but reduced pressure to the body part while achieving blood flow control.

  The strap 3 can comprise two sleeves such that an inner sleeve that receives pressurized gas is inserted along the entire length of the outer protective sleeve. Alternatively, the sleeve may consist of two members that are attached together at their common ends to define a cavity.

  A pressure relief valve 22, shown schematically, is in fluid communication with the internal cavity and may be operably coupled to the strap 3 proximate to the control device 5. The pressure relief valve 22, which is generally manually operated but is also within the scope of the present invention, can be removed from the subject as needed at the end of the hemostasis procedure by removing the tourniquet 10 from other subjects. It is used to sufficiently reduce the gas pressure in the internal cavity to a level that can be indwelled. Alternatively, the pressure relief valve 22 may be operably connected to the flow control unit.

  As shown in the cross-sectional view of FIG. 2, the free end 4 of the strap 3 passes through an opening in front of the strap adjustment chamber 6 that can abut the control device 5, i.e. under the wall 8 accessible to the user. And wrapped around a pin 9 that is rotatably mounted in the side wall of the strap adjustment chamber 6. The free end 4 of the strap 3 can come out of the top wall 8 of the strap adjustment chamber 6 and contact a detent 17 with a narrow and narrow end, for example, to prevent further extension of the free end 4. it can. The detent 17 is rotatably attached to the strap release lever 14 by a pin 18 and moves away from the free end 4 when the lever 14 is released to adjust the length of the free end 4.

  FIG. 3 shows the control device 5 and the buckle frame 11 in more detail. A substantially flat base 1 located inside the control device 5 is fixedly attached to one longitudinal end 13 of the strap 3 along one side of the strap 3. The housing of the control device 5 protrudes from the base 1. The front wall 2 of the control device 5 from which the trigger protrudes is substantially perpendicular to the base 1, while the rear wall 12 of the control device 5 is in contact with the outer flat surface 28 of the control device. The joint extends obliquely away from the front wall 2 so as to define an engageable portion 27 for engagement with the unattached end 26 of the buckle frame 11. The side wall of the buckle frame 11 may be configured to include a plurality of ribs 31 to facilitate engagement with the edges and side walls of the control device 5.

  An apparatus for controllably generating the hemostatic force is housed in the control device 5 and is shown schematically in FIG. 2, for example a replaceable compressed gas container 15 containing compressed carbon dioxide and a compressed exhaust It includes a flow control unit 17 through which gas passes and a trigger 19 that controls the gas dispenser 17 in a controllable manner.

  As shown in FIGS. 4 to 8, the tourniquet 20 can be placed quickly due to its novel structure, and even self-placement can be performed quickly. The tourniquet 20 may be an intelligent pneumatic tourniquet or a tourniquet for manually applying a hemostatic force.

  FIG. 4 shows a tourniquet strap 23 in an undeployed state extending from an unengaged projecting member 25 to the buckle frame 11. After placing the projecting member 25 over the injured limb 21 to which the hemostatic force is schematically illustrated, a buckle frame 11 from which a short strap free end portion 24 extends, as shown in FIG. The strap 23 is wound around the limbs 21 until the projection member 25 approaches. Next, as shown in FIG. 6, the unattached end 26 of the buckle frame 11 is arranged to engage with a projecting member 25 having a large area that can be easily engaged, and thereafter, as shown in FIG. 7, A strap adjustment portion including the strap connection end 29 is arranged to engage with the protruding member 25. At this stage, the strap 23 loosely surrounds the limb 21 and can be adjusted for subjects of various dimensions. As shown in FIG. 8, when the strap free end portion 24 is extended, sufficient tension is applied to the strap 23 to apply circumferential pressure to the limb 21 and cause hemostasis.

  The ability to easily engage the buckle frame 11 with the projecting member 25, which is very noticeable, makes it possible to interlock it in harsh environments such as in mud or water, or even in the dark. In contrast to the conventional technique using a hook and room structure that deteriorates the characteristics, the protruding member 25 can be easily touched and confirmed, which facilitates reliable placement and adjustment.

  If the tourniquet 20 is an intelligent pneumatic tourniquet, the control device is automatically triggered after the strap free end portion is fully extended, as described herein below.

  This structure wraps the strap around a non-movable limb and then engages the buckle frame with an easily accessible protruding member so that its hand or other limb is covered with debris or inaccessible Rapid placement in a non-movable limb is encouraged.

  In anticipation of an injury situation, if the buckle frame of the tourniquet 20 is pre-engaged with the protruding member so as to define the loop-shaped structure 30 as shown in FIG. 9, the hemostasis force can be applied quickly. Immediately, the tourniquet can be introduced over the hand 34 of the injured person and placed on the injured limb 21. Thereafter, the strap is tensioned in the same manner as shown in FIGS.

  With reference now to FIGS. 10 and 11, an exemplary flow control unit 34 is schematically illustrated. The flow control unit 34 comprises an integral block structure 37 formed with a recess in which the conduit and flow control element are mounted. A hollow puncture pin 41 is attached in the recess 39. The puncture pin 41 extends into the threaded cavity 43. When the compressed gas container 15 is maximally threadedly engaged into the cavity 43, the sealing element 16 is punctured so that the exhaust gas flows through the flow control unit 34 into the internal cavity 7 of the strap 3. It becomes possible to flow in.

  In the block structure 37, an inlet fitting portion 42 that guides exhaust gas to the strap cavity, an outlet fitting portion 43 that communicates with the strap cavity, and a control that receives the gas flowing from the outlet fitting portion 43. A valve 44 and an actuator valve 45 terminating in a flange 47 functioning as a trigger are housed.

  The first longitudinal conduit 52 extends from a recess 39 in communication with the puncture pin 41 to the control valve 44, and the second longitudinal conduit 54 extends from the control valve 44 to a stopper element 56 at the outer edge of the block structure 37. Extend to. A vertical conduit 53 connects the first conduit 52 and the second conduit 54 together. Another vertical conduit 59 extends from the inlet fitting 42 across both the actuator valve 45 and the second conduit 54 to a stopper 61 on the outer surface 64 of the block 37.

  The actuator valve 45 has a slidable stem 48 attached to a closure element 49 to which a spring is connected. When the abutment head 47 of the actuator valve 45 is in the retracted position, the conduit 59 is occluded and no compressed gas is discharged into the strap's internal cavity. When the abutment head 47 is triggered, it is displaced towards the outer edge of the block 37 as shown, thereby releasing the conduit 59 from being blocked by the closure element 49 and aligning the intermediate port 46 with the conduit 59. The This allows compressed gas to enter the strap's internal cavity via conduits 52, 53, 54 and 59. When the cavity is sufficiently pressurized, for example to a pressure of 5 psi, the pressure in the cavity applies a force suitable for closing the conduit 52 to the spring actuated control valve 44.

  2 and 3, the strap free end 4 so that the strap adjustment chamber 6 of the buckle frame 11 abuts against and applies a force to the trigger protruding from the front wall 2 of the control device 5. When fully extended, the actuator valve can be triggered.

  In other embodiments, the force is applied to the trigger by the starting element of the strap restraint unit. A strap restraining unit located in front of the control device is quickly pulled without resistance until the strap free end is pulled to a predetermined length sufficient to apply a hemostatic force. The element and the strap are configured to be restrained from being displaced. The strap is subjected to varying frictional forces, such as gradually increasing frictional forces, thereby ensuring a reliable, normally unreleasable locking performance. Therefore, placement with one hand is facilitated by the strap restraining unit.

  The strap restraining unit 62 shown in FIGS. 12-14 comprises a cylindrical arm member 63 extending between two side elements 64. Each side element 64 is rotatably attached to one of two appendages 66 located laterally in front of the buckle frame by a corresponding pivot connection 69. Side element 64 is also interconnected with a rotatable initiating-restraining member 68. The start restraint and combination member 68 serves to restrain the strap in cooperation with the relatively wide start portion 72 and the arm member 63 located rearward, which may be arcuate for an angle of about 30 degrees. It has a constriction 74 which defines a sawtooth edge 76 and is located in front of the swivel connection 69.

  The start restraint combined member 68 further includes two shoulder elements 75 that are spaced apart in the lateral direction. The upper flat edge 76 of the corresponding shoulder element 75 is releasably engaged from above with a thin cantilevered head element 78 having a forward beveled edge 79 and spaced laterally from the trigger 67. obtain.

  In the initial stage of the strap restraint procedure shown in FIG. 12, the strap 3 is located between the sawtooth edge 76 and the arm member 63, and each shoulder element 75 is exposed to the arm member 63 inadvertently. Also, the starting restraint and combination member 68 is engaged with the corresponding head element 78 so that it does not move, and the starting portion 72 is located in front of the trigger 67 at a distance.

  When the free end portion 5 of the strap is extended, a force is applied to the arm member 63, as shown in FIG. 13, thereby causing the arm member 63 to rotate clockwise around the pivoting connection 69 according to the illustrated arrangement. As a result, the distance between the sawtooth edge 76 and the arm member 63 is reduced. This applied force is large enough to disengage each shoulder element 75 from the corresponding head element 78, thereby allowing the starting portion 72 to rotate. The distance from the center of the swivel connecting portion 69 to the outer edge of the starting portion 72 is longer than the distance to the outer edge of the trigger 67 when the trigger 67 is in the normal stationary position. Accordingly, the trigger 67 is pushed down by the clockwise rotation of the starting portion 72, thereby discharging a predetermined amount of compressed gas into the cavity of the strap 3.

  In the final stage shown in FIG. 14, the strap free end 4 is further extended so that the starting portion 72 is spaced from the trigger 67 and the sawtooth edge 76 is It is supported on the arm member 63 so as to restrain the strap 3 located between it and 63 to prevent its further movement.

  The strap restraint unit 82 shown in FIGS. 15 and 16 includes a rotatable start restraint and combination member 88 that cooperates with a stationary triangular element 84. The triangular element 84 projects laterally from the inner surface of the appendage 66 located laterally spaced in front of the buckle frame. The triangular element 84 has a vertex pointing downward. The upper side of the triangular element 84 may coincide with the upper edge of the appendage 66.

  The integral start restraint and combination member 88 has opposite side surfaces 91 adjacent to the corresponding appendages 66. A V-shaped notch 93 for cooperating with the stationary triangular element 84 is formed in the middle region of the side surface 91. The elongated restraining portion 97 may be oval and is located in front of the notch 93. The pin holding section 92 is located behind the notch 93. The opening O through which the strap 3 is passed is provided under the notch 93 at the center of the member 88.

  The restraining portion 97 has a laterally oriented tubular cavity in the middle. A mandrel 99 that is rotatably attached to the buckle frame appendage 66 is fitted into the cavity, thereby enabling rotation of the start restraint and combination member 88. The restraining portion 97 further has a strap-contactable protrusion P with a limited thickness located at the rear. The protrusion P has a curved outer surface that is tangential to the edge of the adjacent constraining portion 97, and extends laterally between the two side surfaces 91. A rounded edge 95 at the rear of the pin retaining section 92, which is thickened and has a radius that is relatively larger than the radius of the constraining portion 97 and extends between the two side surfaces 91, constitutes the starting part.

  In the initial stage of the strap restraining procedure shown in FIG. 15, the start restraining and combining member 88 is disposed obliquely so that the strap abutable protrusion P points away from the triangular element 84. As a result of this arrangement, the strap 3 passes through the space between the triangular element 84 and the strap-contactable protrusion P, and further between the guide surface 94, eg, a convex surface of the pin holding section 92, and the strap-contactable protrusion P. So that the strap is advanced according to the curved path.

  While the free end 4 of the strap 3 is being pulled, the strap path is curved, so that a moment is applied to the strap abutable protrusion P, so that the start restraint member 88 is shown around the mandrel 99. According to the orientation, it is rotated clockwise to reach the orientation shown in FIG. 16, whereby the triangular element 84 is received in the V-shaped notch 93 and the strap abutable protrusion P points toward the triangular element 84. As a result of this arrangement, the gap between the triangular element 84 and the strap-contactable protrusion P is reduced, so that the strap-contactable protrusion P is supported on the strap 3, while the strap 3 is attached to the triangular element 84. Pressed against the proximity surface. The strap 3 is constrained by a combination of the pressing action and the gap reduction, thereby preventing the user from further displacing the strap.

  At this final stage, since the distance from the center of the mandrel 99 to the edge of the starting portion 95 is longer than the distance to the outer edge of the trigger 67 when the trigger 67 is in a normal rest position, the starting portion 95 is Rotate enough to push down.

  As a further precaution to prevent reverse movement of the strap 3, a spring-mounted pin (not shown) extends laterally outward from the pin holding section 92 towards the corresponding appendage 66. can do. After the starter restraint member 88 is fully rotated, the pin is received in a hole 83 (FIG. 15) formed in the appendage 66, thereby locking the starter restraint member 88 in place. When a release element accessible from the outer surface of the appendage 66 is activated, the spring connected to the pin is compressed and the pin can be disengaged from the hole 83.

  20 to 25 show another embodiment of the automatic adjustment flow control unit 144. FIG. Here, to reduce costs, all of its components except the spring are made of an inexpensive material such as a polymer material.

  As shown in FIG. 20, the flow control unit 144 includes a rigid puncture pin carrier 148 that is displaceable with respect to the compressed gas container 15, a piston assembly 153 that controls the flow of compressed gas discharged, and a piston assembly 153. And a swivel valve member 159 having a closure element that is driven and fitted into a bore 141 formed in the carrier 148. The carrier 148 has a cylindrical body, but part of it may be removed to save material, and the trigger 147 engages and protrudes from the body of the carrier 148 by the start element of the strap restraining unit. In response to the applied force, it can be displaced.

  FIG. 21 shows a longitudinal section of the flow control unit 144. To control the pressure in the strap's internal cavity, the carrier 148 allows the exhausted compressed gas to flow into the strap's internal cavity through an inlet 152 formed in the fitting 151. Thus, it is configured to include a connection fitting portion 151 that is compactly inserted into the internal cavity of the strap. An outlet is formed in the coupling fastener 154 of the piston assembly 153 that is compactly inserted into the internal cavity of the strap, through which pressurized gas from the internal cavity of the strap can flow. When the pressure in the inner container rises above a predetermined level, the piston of assembly 153 causes the closure element to stop the flow of compressed gas from container 15.

  The carrier 148 is configured to include a cylindrical body portion 143 that faces the container and a truncated body portion 149 that faces the lower trigger than the portion 143.

  A cylindrical cavity 161 is formed coaxially within the cylindrical body portion 143 facing the container. Cavity 161 receives a stationary annular adapter 167. The gas container 15 can be releasably engaged with the adapter 167, for example, in a screw manner. The adapter 167 can be prevented from moving relative to the carrier 148 by being coupled to the housing of the control device. Alternatively, the gas container 15 may be releasably secured to the housing of the control device so that the adapter 167 is stationary relative to the carrier 148 when engaged with the gas container. A central opening 168 is formed in the adapter 167.

  A hollow puncture pin 164 projects from the body portion 149 facing the trigger into the cavity 161 and is aligned with the longitudinal opening 168 of the adapter 167 and the longitudinal axis of the threaded portion 169 or releasable to the gas container 15 Aligned with any other annular engagement means adapted to be engaged with the fixed portion in the projection 166, and when the projection 166 is engaged with the annular engagement means, the length of the gas container 15 Aligned to the direction axis. A small bore 165 aligned with the puncture pin 164 is formed in the protrusion 166 and extends to the outer edge of the bore 141.

  Cylindrical closure element 173 is in contact with the outer wall of bore 141. Cylindrical closure element 173 is formed with two bores 176, 177 that are in fluid communication with each other and extend to the outer wall of bore 141, for example at an angle that is perpendicular to each other. In the illustrated arrangement of the closure element 173, the bore 176 is aligned with the bore 165, and the bore 177 is aligned with a passage 156 formed in the body portion 149 facing the trigger and extending from the inlet 152 to the outer wall of the bore 141. Thereby, when the thin film M of the container 15 is punctured as shown in FIG. 24, the pressurized gas discharged can flow into the internal cavity of the strap.

  FIG. 22 shows the valve member 159 functioning as a ball valve in more detail. The rotatable closure element 173 is slightly shorter than the bore 141 formed in the body portion 149 facing the trigger. The diameter of the closure element 173 is substantially equal to the diameter of the bore 141 but slightly smaller. The closure element 173 is maintained in sealing engagement with the wall of the bore 141 by a spaced apart sealing element 179 received in a corresponding circumferential seat. Bore 176, 177 may be formed at the longitudinal centerline of closure element 173 in alignment with puncture pin 164.

  The angled connecting arm 182 has two portions, for example, arranged at an angle of about 90 degrees to each other and extends from the end 184 of the closure element 173 facing the piston assembly 153. The free end 186 of the connecting rod 182 is coupled to a holding element 155 that projects from the upper side of the housing of the piston assembly 153. The holding element 155 is formed with an intermediate groove 158 that movably receives the angled arm 182.

  Referring now to FIG. 23, the piston assembly 153 has an annular housing 157 that defines an internal cavity 171. An upper surface 178 of the housing 157 is formed with an opening 181 (FIG. 25) that coincides with the groove of the holding element and is normally covered by the free end of the angled arm 182. The outlet fitting portion 154 extends downward from the central portion of the fitting portion holder 163 fixed to the bottom end of the housing 157. A passage 175 aligned with the opening 181 is formed in the outlet fitting portion 154 and extends from the outlet 174 to the upper side surface of the fitting portion holder 163.

  A piston 188 that is sealingly engaged with the inner surface of the housing 157 has a central head portion 189 that is aligned with an opening 181 formed in the upper side 178 of the housing 157 and has a smaller dimension. A spring 192 that surrounds the head portion 189 is connected to an adjacent portion of the housing 157, and is normally biased so that the piston 188 is in contact with the fitting portion holder 163, as shown. The compressed gas flowing through the passage 175 can act on the piston 188.

  Referring now to FIG. 24, the carrier 148 is displaced relative to the adapter 167 in the cavity 161 after a force is applied to the trigger 147 by the starting element of the strap restraining unit. A carrier element 148 is moved in a linear displacement by a sealing element 162 located between the body portion 143 facing the container and the adapter 167. As a result of the linear displacement limited by the contact between the body portion 149 facing the trigger and the adapter 167, the puncture pin 164 punctures the thin film M. As a result, compressed gas is expelled from the container 15 through the piercing pin 164 and passage 156 into the strap's internal cavity, as shown by the arrow extending downward in FIG. 21, and again the arrow extending upward in FIG. Flows through the outlet fitting 154 as indicated by.

  As the compressed gas is exhausted, the pressure in the internal cavity gradually increases continuously. At the same time, the piston 188 is gradually displaced upward in the cavity 171 by the compressed gas flowing through the passage 175, as shown in FIG.

  As piston 188 is displaced upward, spring 192 is compressed and head portion 189 protrudes through opening 181. As a result, the upwardly displaced head portion 189 contacts the free end of the arm 182 so that the free end of the arm 182 is pivoted about the retaining element 155 (FIG. 22), causing the closure element 173 to move up to, for example, 20 degrees. A moment is generated that slightly rotates about the longitudinal axis of the bore 141 in the clockwise direction in accordance with the illustrated orientation of rotation. The free end of the arm 182 functions as a lever so that the necessary force applied by the piston 188 required to counter the high pressure of the gas exhausted from the gas container can be reduced. As a result of this rotation, the bore 176 is no longer aligned with the piercing pin 164 and the outer edge 187 of the closure element 173 blocks the bore 165 so that no further compressed gas is expelled. With this construction, a predetermined pressure, typically 5 psi, which is generally the resistance action of the spring 192, is quickly achieved within the strap's internal cavity without exceeding, and a correspondingly constant hemostatic force. Will be added to the limb with which the strap is engaged. Furthermore, since the gas container is separated from the strap's internal cavity to prevent additional discharge of compressed gas, the remaining compressed gas can be used for further hemostasis procedures.

  If the internal pressure of the strap cavity drops, for example due to leakage, the piston 188 is displaced downward and the free end of the arm 182 returns to its original position shown in FIG. Therefore. The closure element 173 is rotated counterclockwise to achieve the bore alignment shown in FIGS. 21 and 22, so that an additional amount of compressed gas is added to the strap's internal cavity until the predetermined pressure is again achieved. It will be discharged inside.

  A button 172 or any other switch device for activating the digital timer may be connected to the circuit. Thus, the force applied to the trigger 147 by the triggering element of the strap restraining unit results in tension on the strap and the gas container membrane is punctured to adjust the pressure in the internal cavity in response to the discharge of pressurized gas Not only will this be done, but also the start time of the hemostatic treatment will be set. The doctor treating the subject can check the elapsed time from the start of applying the hemostatic force with a timer in order to avoid irreversible muscle damage resulting from prolonged ischemia.

  It will be appreciated that other configurations of the flow control unit housed within the control device are also within the scope of the present invention. The target control pressure can be adjusted, such as by manually or electrically applying a force to the spring to change the spring resistance, and the resulting hemostatic force can be applied to subjects of various sizes, such as infants or obese people Can be adapted.

  In other embodiments of the present invention, the control device includes a microprocessor that is disposed within the circuit board 102 schematically illustrated in FIG. 17 and supports the functions of various electronic devices that can assist the injured. Including.

  The following are: (1) a battery 103 or any other power source for energizing various components and modules; (2) a microphone 107 for recording messages or talking with others, for example for help. (3) A speaker 108 for listening to messages or instructions recorded by a microphone 107 or imported from a database, or for conversation with others, (4) a global positioning system for locating an injured person ( (GPS) 109, (5) Global System for Mobile (GSM (registered trademark)) for transmitting GPS data or communicating with hospitals, such as by voice based communication channel, text message or emergency signal 111, and (6) a continuously generated pattern, for example using a patch means applied to the skin, to prevent him or her from fainting or distant consciousness. Electronic pulse generator (EPG) 113 for providing the scan to injuries are those of some of the components and modules may be located in the circuit board 102.

  In the embodiment of FIG. 18, the control device 115 comprises further means for assisting the injured person. For example, the lighting device 127 that functions as an in-field detection light that can be activated by electrical or chemical means to easily locate the injured person It can be mounted in a centrally located opening 128 and positioned under the digital timer.

  The tubular connection 117 of the luer lock 118 can be inserted into a port 121 located near the rear wall 12, thereby quickly connecting with hospital devices and equipment to reduce the risk of bleeding and ischemia. Will be able to.

  Around the tubular connection 117 is a printable surface 124, for example a card or a sticker, on which instructions for general treatment of the injured person or detailed treatment of a particular injured person are written. Yes. An emergency call telephone number may be printed on the printable surface 124. The doctor can also receive such instructions by playing a recorded message and listening to the message from the speaker.

  The tourniquet 130 shown in FIG. 19 is an additional feature for assisting the injured person, (1) a limb diameter scale printed on the free end 4 of the strap showing the diameter of the limb to which the hemostatic force is to be applied 132, (2) a packaged morphine capsule or any other powerful analgesic capsule to be inserted into a dedicated cavity 134 formed at the front end of the strap, (3) a drug transfer patch applied to the inner surface of the strap ( drug transfer patch) 135, (4) Hydrophobic coating 137 applied to the strap to prevent drainage liquids such as blood from sticking to the strap and sticking to the skin, especially for the benefit of burn injuries (5) Cardiopulmonary resuscitation (CPR) guidelines are engraved above, for example in the form of a sticker, or in the form of a media card in which audio information relating to CPR guidelines can be recorded and played back by a speaker Cardiopulmonary resuscitation aid card 139 brought to the outer surface of the wrap, and (6) the identity of the injured, details of the injury or details of the surgery performed by the doctor, or purchase of a tourniquet at the store, e.g. One or more identification display areas.

While several embodiments of the invention have been described by way of example, the invention may be practiced in many modifications, variations and adaptations without departing from the scope of the claims. It will be understood that many equivalents or alternative solutions within the purview of the vendor can be implemented.

Claims (13)

Intelligent pneumatic hemostasis comprising a control device locally attached to an inflatable strap having an internal cavity, which achieves a predetermined pressure within the cavity and thereby applies the necessary hemostatic force to the limb with which the strap is engaged A belt,
The control device comprises a compressed gas container, a flow control unit in fluid communication with the container and the internal cavity, and a rigid housing in which the compressed gas container and the flow control unit are held;
The flow control unit is configured to selectively supply a predetermined amount of pressurized gas discharged from the gas container to the internal cavity when triggered.
Intelligent pneumatic tourniquet.   The tourniquet of claim 1, wherein the flow control unit can be triggered by a starting force applied by a strap restraint unit.   A slidable actuator valve that, when triggered, releases a blockage of the conduit and allows exhausted compressed gas to flow through the conduit and into the internal cavity of the strap. The tourniquet according to claim 2, comprising.   The flow control unit comprises a slidable puncture pin carrier and an abutment projecting from the carrier, and a trigger force is transmitted from the abutment to the carrier, thereby causing the compressed gas container The tourniquet of claim 2, wherein a thin film puncture occurs, resulting in the compressed gas being discharged into the internal cavity of the strap.   The flow control unit further comprises a valve having a closure element in fluid communication with the puncture pin, wherein the closure element is a flow extending from the puncture pin when the pressure in the internal cavity of the strap exceeds a predetermined level. 6. The tourniquet of claim 4, wherein the tourniquet is operable to block a tract. The strap restraining unit allows the free end to be displaced without resistance until the free end of the strap is of a predetermined length sufficient to apply the hemostatic force, and using the force from the strap, Configured to restrain the strap,
The tourniquet according to claim 2.   The strap restraining unit adjusts the pressure in the internal cavity for maximum pull of the strap, puncture of the gas container thin film, and maintenance of the predetermined pressure in response to a single movement of the user. 7. The tourniquet of claim 6, wherein the tourniquet cooperates with the flow control unit to facilitate.   The strap restraint unit cooperates with the flow control unit to facilitate time adjustment of maximum pull of the strap, puncture of the gas container membrane, and initiation of hemostasis treatment in response to a single user action. 7. The tourniquet of claim 6, which works.   9. The tourniquet of claim 8, further comprising a digital timer mounted within the housing of the control device and capable of displaying an elapsed time of hemostasis treatment.   The tourniquet of claim 1, wherein the control device comprises a circuit board to support the function of one or more electronic devices intended to assist the injured.   A strap restraining unit equipped in a tourniquet, a guide element for introduction through the strap adapted to apply a hemostatic force to the wounded limb, and the strap passed through the strap restraining unit A strap restraining unit comprising a restraining element capable of moving in response to a strap-derived force resulting from strap displacement until the free end of the strap is of a predetermined length sufficient to apply the hemostatic force A strap configured to allow the free end to displace without resistance and corresponding to placing the restraining element in a sufficiently close pressing relationship with the strap to restrain the strap. Restraint unit.   Further comprising a starting element movable in response to a force derived from the strap, wherein the strap is a pneumatically inflatable strap, and the starting element applies a force to a trigger that triggers the expansion of the strap 12. The strap restraining unit according to claim 11, wherein the strap restraining unit is displaceable to a possible position. A method of placing a tourniquet,
a) a strap; a wide area member locally attached to and projecting outwardly from the first end of the strap; and a buckle frame attached to the second end of the strap, the strap free end Providing a tourniquet comprising a buckle frame from which a portion extends and is movably engageable;
b) placing the first end of the strap in contact with the injured limb to which hemostasis is to be applied;
c) wrapping the strap around the limb until the buckle frame is adjacent to the protruding member;
d) engaging the unattached end of the buckle frame with the protruding member;
e) applying circumferential pressure to the limb and extending the free end portion of the strap until the strap is sufficiently tensioned to cause hemostasis.

Images