US1546813A - Portable obstetrical bed table - Google Patents

Description

July 21, 1925.

J. H. THOMSEN PORTABLE OBSTETRICAL BED TABLE 2 She@es-Sheet l Filed Aug. 16, 1924 Jb. THOMJEN.

July 21,1925.

J. H. THOMSEN 'PORTABLE OBSETRICAL BBD TABLE Filed Aug. 16, 1924 2 Sheets-Shoot 2 S 'll Jenn H. macias-niv, or OMAHA, NEBRASKA.

PORTABLE OBSTETRICALFBED TABLE:

Application filed August 16, 1924. Serial No. 732,496.

To all whom t may concern.'

lie it known that l, [lo-HN ll. Trroiisnii, a citizen oit the United States, residing;` at (.lniaha, in the county ot Douglas and @tate of Nebraska, have invented certain nen7 and useful Improvements in Fortable Obstet? rical Bed Tables, oi which the following,l is a specification. y

My invention relates to surgical tables, beds and the lilre, and particularly to devices of this character adapted for use in obstetries. 1t is the object or my invention to provide an obstetrical `bed so constructed that its parts may be disconnected and formed into a compact bundle, oi such small size and Weight that the obstetrician may readily convey the same into the `hoine of the patient, and there quickly assemble the parts to 'form a practical and efficient ap-V pliance which, in connection with the usual and ivell-lrnoivn accessories, will afford siibstantially the same facilities in the home or residence as are available'in Well-equii ped maternity hospitals. My appliance may be used also :tor general surgical purposes, a table :For genital, rectal, and vperinlal operations and examinations, but is 'especially designed and suited tor obstetrical uses, being; adapted for constraining the patient, either While conscious or under anesthesia, to maintain the position or positions best adapted tor facilitating' delivery, eitherl natural lor by the aidof forceps or other instruments; for enabling` the attendantto maintain eilicient drainage and complete yiasepsis; and facilitating; post-delivery attentions, siich as repairs et perineal lacerations and the like. The gieneial purposes and functions oli my improved appliance are substantially the same as that disclosed in my coi-pending' application, tiled (lctober 8, 1921, Serial No.1

506,443, of which the present application is in part a continuation; My improved structure, however, pro-vides an appliance which is lighter, stronger, and neater in appear-V ance, and which 'may be carried in a more compact form When its "partsare disconnected. 'i'

In the accompanying drawings Fig. 1 is a side vieiv of my improved appliance, Fie', 2. is a plan view of tliesainefpartly in section-` on the horizontal plane ofthe line 2-2 ol' Fig. l, Fig. 3 is a detail partial transverse' section on the vertical plane of the line 7 -7 of Fig. 1 and 2, Fig. 4L isa detail side view of' one of the posts or standards, with a foot-holding'- boot carried thereon, Fig. 5 is a detail section on the veru tical plane of the lines 5-5 oi Fig. 2, Fig. (i is a bottom view oi the appliance, and Fig. 7 is a complete transverse section on the ver tical plane oi the line '7-7 of F 1 and 2.

In carryingl out my invention the pri- 'marily essential structure is a substantially rectangular, flat, thin and rigid base-portion, havingl rigidly affixed thereto at one by the 'straps end a pair of transversely spaced vertice.. ly

strength and rigidity proportional to the Weight of the parts, and also to avoid sharp edges and corners upon the traine-members. The tubular Vframe-elements comprise the longitudinal or side-members 11 oia the base, the front and rear transverse end- members 12 and 13 ci the base, and the vertical standards or posts 1a Which are connected with the base at "thejfront end adjoining, the transverse end-member 12. The end-portions of the side-members 11 are flattened to form bar- like terminals 15 and 16 which are 'disposed vertically edgeivise, each olf said flattened terminal portions being` rounded vat their ends, and each having therein a transverse opening for receiving` the clamp-rods 17. The clampnrods 17 have rounded loops or eyes 18 at one end, the opposite ends being'coiiircally pointed, and adjoining' 4said 'pointed ends the rods being threaded to receive the Winggniits 19. The ends ot the transverse tubular members 12 and 13 are threaded, and upon said threaded ends are screwed the caps 20, said caps havingl axial openings to receive the clamprods, which pass through the members 1Q and 13 from end to end thereof. The open-` ings .through the caps 20 are flared or countersunk at the inner ends, as shown clearly atQl in Fig. 3, saidjtlared portions'oi the openings facilitating the insertion of the pointed-ends 'oii the clamp-rods When the structure is being,` assembled. The ends of' abut the flat terminals .1.6 at the rear CTI of the side-members 11, and said parts are' held together by one of the clamp-rods 1'?, of which the terminal loop 18 and the wingnut 19 may be grasped and manipulated by hand to securely clamp the parts, without the use of a wrench or other tool` The front end-member 12 is slightly shorter than the member 18, said member 12 being disposed between the flat front terminals 15 of the side-members 11, but its caps 2O being` spaced therefrom, and the end-portions 22 of the posts 14 being interposed between said caps and flat terminals. Said end portions 22 of the vertical posts are flattened similarly to the terminals of the side-members 11, and are preferably turned in horizontally so that their ends are offset from the transverse vertical plane of the posts, the amount of t-he offset being slightly nore than the diameter of the posts. Said flat tened, inturned ends 22 have openings therein for the clamp-rod which extends through the end-member 12, the clarnp-rod holding the parts together transversely of the base. Each of the posts 14 is connected with the transverse base-member 12 by a short diagonally extending braee-bar 23, of which the lower end is pivotally connected with said base-member by a rivet 24 extending through the outer side only of the tubular member, as shown in Fig. 5, the opposite or inner side of the tube having an opening 25 therein to enable convenient insertion of the rivet. rlhe upper ends of the brace-bars 28 are detachably connected with the posts 14 by means of bolts 2G, provided with wingnuts 27, as shown. rlhe posts 14 are connected with the longitudinal base-men'ib-ers 11 by brace-bars 28 of which thelower ends are pivotally connected with said members 11 by means of rivets 29, and the upper ends detachably connected with the posts by bolts 30 and wing-nuts 31. rlhe upper ends of the posts are threaded and have the caps screwed the-reen, and in the upper portions of the posts are a series of vertically spaced horizontal holes for receiving the eye-bolts 84. laid eye-bolts are provided with wing-nuts 85, whereby the bolts may be readily removed and transferred to any of the holes 83, being thereby disposed at the desired height upon the posts. Rings 8G are connected with the eye-bolts 34 by links 87, said rings 36 being detaehably engaged by the snaps 38 of the foot-straps 89. Eye-bolts 4() extend transversely through the longitudinal base-members 11 near the front ends thereof, said eye-bolts being se cured to said members by wing-nuts 41 screwed upon the inner ends of the bolts. The snaps 42 of the hand-straps 43 are detaehably engaged with the said eye-bolts 40.

In the` rectangular space between the side and end members of the base-frame is disposed a flexible cover 44, preferably of strong fabric, such as canvas, which is connected with the frame so as to be held under tension thereby. At the front end the cover has a wide hem 45 which is looped about the tubular end-member 12, the cover being made narrower at said end, so as to engage only that portion of the frame-member intermediate the lower ends of the braces 23. At the sides the cover is provided with pairs of straps 46 which are passed around the longitudinal frame-members 11 and their ends secured together by buckles 47. At the rear end of lthe cover straps 48 are secured thereto, said straps being passed about the end-member 13, and their free ends connected by buclrles 49 with short straps 50 secured beneath the cover near said end. A separate or free strap 51 is also provided, said strap being looped about the end-meni ber 13, and being employed for the purpose hereinafter mentioned.

It will be seen that in the described structure the frame may be readily disjointed l merely withdrawing the clamp-rods 17, after removing the wing-mits 19 tl'ierefrom, and disconnecting the upper ends of the brace- bars 23 and 28 from the posts 14, by removal of the bolts 26 and 80. The cover 44 is removable, of course, by unbuclrling the attaching- straps 46 and 48. After the upper ends of the brace-bars are disconnected from the posts, the longitudinal braces may be folded down parallel with the side-members 11, and the braces 28 folded down parallel with the end-member 12, so that the entire frame is reduced to group of elongated members which may be formed into a bundle and the cover 44 wrapped about the same, thereby producing a compact package which may be placed in a bag or other suitable container for convenient transportation,

In assembling the described structure, the end-meinber 12 is first passed through the hem 45 of the cover 44, then the terminals 22 and 15 of the posts 14 and side-members 11 are juxtaposed to the ends of the member 12, and said parts scoured together by passing one of the clamp-rods 1T through them and tightening the wing-nut 19 on the threaded end of the cla.n'1p-rod. Then the. end-member 18 is placed between the terminals 1G of the side-members 11, and said parts secured together bythe other clamprod. Then the braces 23 and 28 are` raised and connected with the posts 14 to retain the same in position perpendicular to tl e base-frame, and finally the straps 46 and 45) are passed around the sideanembers and the end-member 13 of the base-frame, drawn taut, and buckled, to hold the cover under suitable tension. Under cert-ain conditions, it may be desired to have the appliance in a. fairly compact form, but so that it may be very quickly set up for use, and in such case the ends of the longitudinal braces 28 lnay be disconnected from the posts lll, after which both posts maybe swung pivotally about the iront clamp-rod to posit-ions above and parallel with theside-ineinbers ll oit the base-traine. The appliance is thus reduced to a substantially flat forni which may be transported with reasonable convenience, and which may be made ready tor useV by merely raising the posts to the perpendiculan position and attaching' the braces 28 thereto, to hold thein in said position. While the appliance is in actual use, `and at tiines when the posts are not beingemployed for holding` the l'eet oit the patient in elevated position, the braces 28 inay be disconnected `troni the posts and the latter then swung;v down to a reversed position, at which they hang troin the end of the base-traine adjoining the bed, table or other support on which the appliance is sustained.

` ln a typical or characteristic use of iny appliance in obstetrical cases, the base-frame is disposed transversely upon an ordinary .sleeping-bed, with the front end of the traine (on which the posts lll are carried) at one slideV of the bed and projecting slightly over said side oiE the bed. rlhe rear end oit the frarneuis connected with the rail at the opposite side of the bed by inea-ns of the strap 5l, which is passed about the traine-member 13 and the bedrail, drawn taut, and buckled, to thereby prevent slidingr or shitting of the appliance toward the side oli the bed at which it is placed. The base-iraine may be tilted Vor inclined toward the front end, it' desired, by placingpillows or other suitable and available articles beneath the rear end olf the lranie. The upper surface of the base is padded by placing 'folded blankets .or the like over the flexible cover lL-l, and the padding' is preferably covered over with a sterile sheet. A Kelly pad is placed upon the front portion oi the padded base oit the appliance, with the open side of the inflated annular cushion thereof at the liront end of the base, so that the drainage apron. of the pad extends between the posts and down at the side oli the bed to discharge into a suitable receptacle dis posed upon the floor.

It preferable `that, be'liore the patient is placed upon the appliance, the hand-straps 43 and Jfoot-straps 39 be detached by releasing the snaps 4.9, and 3S from the eye-bolts 4:0 and rings 3G; the handestraps .being socured about the hands and wrists of the patient, and the iootstraps secured about the 'feet and ankles. ln order that the feet may be secured without drawing the straps too ti lfrhtly, l 'may employ in connection with the :toot-straps the foot-holders or boots V52, of which one is shown in Fig. l,and which are made of flexible material, having .secured thereto the loops or guides 53 through which the straps 39 are passed, as shown. After the hand-straps and foot-straps have been secured to the patient, said straps inay be connected with the appliance at the proper time by inerely engaging the snaps 38 and l2 with the rinn's 3G and eye-bolts /l-O. When the patient is placed upon the appliance,the trunk is disposed supine upon the padded base, so that the entire weight oit the body is supported thereon, and the pelvic portion of the body is adjacent to the posts, wherebythe natural discharges and the antiseptic fluids used for cleansing and sterilif/iingl the parts inay be received upon the Kelly pad and conveyed by theapron thereor into the receptacle provided, without soiling or wetting'the bedding. The patient is usually irst placed uponthe appliance after labor has progressed to* `a s yage at which it is desirable that muscular exertions of the patient `be employed to assist in the descent olf the fetus, F or this pnrpose, both the handstraps and foot-straps areI attached to the base and posts, respectively, and the patient is required to pull forcibly upon the handstraps, balancing' the pull thereon by` inshino; against the foot-straps, sothat the appliance remains in equilibrium. ll or the pulling7 phase oft the delivery, the length and points of connection oi.E the straps to the appliance are so arranged that the` arras and legs will be only slightly flexed at the elbows and knees, there being` seine flexure at the hips, so that the thighs extend at an obtuse angle to the axis ot the trunk. Should it be desired that the patient assun'ie the W'alcher77 delivery position, the foot-straps may be detached from the posts, and iii this position is to beeinployed for a consid Jrable tinie the braces 28 inay be disconnected from the posts and the latter swung down to the reversed position before mentioned. It is usuallyv prete able'at the beginninge,v el the actual delivery to place the patient in a lithotoiny position, and in this position the length o'l the straps and the points ot' connection with the applian are. so proportioned that the thighs are cwended upwardly from the plane ot the trunk, the knees being; flexed so th. the lor-vcr legs are approximately horizontal. ln the norinal lithotoiny position the this, is extend in a plane perpendicular to the axis the trunk., but in soine cases an extreme litliotoniy postion inay be desirable, in which the tlexure atthe hips is greater than in the nornial lithotoniy posi tion, so that the thighs extend at au acute angle with the axis ol the trunk. The pulling position first above mentioned niay be regarded as a niodilied lithotoniy position. By suitable adjustments ot the straps, either the normal or extreme lithotoiny position may be established, and movements of the patient inhibited to the extent required for maintaining the desired position. The atlll) fill

tendant is thus enablet to cleanse, shave. and sterilize the external parts, establishing thereby an aseptic lield, which may be maintained throughout the delivery by Flushingv away with antiseptic fluids any septic discharges and excretions as the same are voided` rEhe maintaining` ot the desired position tor delivery is fully eiiiective, either when the patient is conscious or under anesthesia, and the obstetrician is thus enabled to carry out any measures that may be required, either surgical or manipulative, unhampered by interi'ference from the patient, and with the assurance ot surgical asepsis througliont the period of partui'ition, and extending;I to 'he post-delivery attentions, such as repairs olI perineal lacerations and the like. est the conclusion of the operative period, when the patient .is released 'from the app lance, it is merely necessary to .swing the body about to a position longitudinal of the bed, removing the appliance therefrom, and thus avoiding', entirely the laborious and often hazardous transference of the patient which is required at this time when the delivery is effected elsewhere than upon the sleeping-bed which is to be occupied after delivery, or when the delivery is accomplished in the bed by methods and means which permit wetting or soiling ot the bedding, so that the latter must be renewed or replaced before the bed can be occupied by the patient.

New, having described my invention, what l claim and desire to secure by Letters Patent is:

l. An obstetrical appliance comprising a relatively thin and iiat base-portion adapted to receive thereon the supine runk of a patient so that the pelvic portion oit the trunk adjoins the front end of' the base and the entire weight ot the body rests upon said base to stabilize the same, said baseportion having' a rigid trame, upright posts rigidly connected .vith said rigid base-traine at the sides ot th 'liront end thereot, Ylootstraps det-urhably connected with the upper` portions ot said posts and adapted to secure the lie/ct ot the patient at such an elevation and lo gritudinal relation to the trunk vas to maintain a lithotomY position ot the thighs and legs, and hand-straps detachably enadjoini' to secure trie it lonthe longitudinal bes one ot the transverse members, braces (le,-

tachably connected at their upper ends with said posts and connected at their lower ends with said loi tudinai base-members, and a flexible cover dctachably connected marginally with said base-members and held under tension thereby.

3. An obstetrical appliance comprising' a substantially tlat and rigid base member adapted to be disposed transversely upon a sleeping bed so that one end et the base member is at one side of the bed, said base member being of suiiicient length to receive and completely support the trunk of a patient, rigid posts connect-ed with the base member at one end near the corners thereo't and adapted to fold longitudinally ot the base member upon the same, diagonal braces at the sides of the base member and connected with the posts intern'iediate the upper and lower ends ot the latter to secure the same rigidly in position perpendicular to the base member, toot straps connecteiil with said posts adjacent the upper ends thereof and adapted 'tor lifzedly securingr in ele 'ated position both the feet and legrs o'l' a patient whose body lies upon the base member, and hand straps connected t-o the base member at the sides thereof adjacent the lower ends of the posts for lixedly securingv the hands of the patient to thi lrse member at said points and at the saine ti A1e permit the patient to grasp the rigid posts directly at points below the lect.

JOHN El. THMS @ffl

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