WO1991018571A1

WO1991018571A1 - Disposable multi-use pressurized bandage system

Info

Publication number: WO1991018571A1
Application number: PCT/US1991/003792
Authority: WO
Inventors: Richard Crangle
Original assignee: Richard Crangle
Priority date: 1990-06-01
Filing date: 1991-05-28
Publication date: 1991-12-12
Also published as: AU8008291A

Abstract

A novel bandaging system for uses comprising serious lacerations, surgery, burns, and non-wound injuries. This invention eliminates disadvantages of tourniquets, field dressings, and absorbent bandages, providing initial cooling and pressure at the wound site, compression and contraction of the wound, maintenance of optimum clotting temperature, maintenance of blood circulation, protection from contamination, and antihemorrhagic, anesthetic, and antiseptic agents applied to wound site in a disposable biomedical bandage. Comprising an inflatable bladder (20) and pressure application aparatus (80) the bandaging system is totally self-contained and inhibits body fluid loss while improving blood clotting time and permitting replenishment of blood supply to body parts distal to the heart beyond an intervening injury.

Description

DISPOSABLE MULTI-USE PRESSURIZED BANDAGE SYSTEM Field of Invention

This invention relates generally to bandages and related methods for use in severe cases of trauma and particularly to a bandaging system used to treat wounds to control severe bleeding and to treat burns, removing excess heat and controlling fluid loss. Background and Prior Art

Injury to civilians comprising serious lacerations number nearly 10% of the over 60,000,000 injuries recorded in the United States each year. In requesting for research proposals to help solve related military injury problems, information extracted from current U. S. Government publications indicate that research efforts are needed into the principles and techniques of self-aid and buddy aid, including enhancements in techniques, methods, and materials for basic and advanced life support for severely injured persons. The principal cause of death among soldiers who are not killed outright by an injury is hypovolemia secondary to exsanguination. Burns constitute a major contributor to battlefield morbidity and mortality and are of the greatest concern. The high incidence, prolonged healing time, and propensity for infection in the battlefield environment constitute a special problem. Infection in injuries, wounds and burns sustained in combat or under battlefield conditions remains a major perceived cause of morbidity despite the relative control of this problem in the civilian sector. Because the urgency of controlling bleeding in a broad range of injury situations, an effective, inexpensive and convenient way to ste bleeding is being continuously sought by health care professionals. The current state-of-the-art comprising cloth dressings, bandages, and tourniquets have proved to be seriously inadequate, and, in the case of the tourniquet, ofttimβs dangerous to use. As an example, with deep laceration wounds which produce a large volume of blood, the normal clotting mechanisms involving the prothrombin, thrombin, fibrinogen, and fibrin process often cannot form the necessary reticulum or thread-like web to control or prevent excessive blood loss even with standard cloth dressings and bandages applied. Head wounds are particularly troublesome since massive bleeding often occurs from serious cuts or puncture wounds because of the dense vascularization of this area.

The majority of deaths and tissue damage from wounds and burns is caused from fluid loss. Fluid loss from burns is largely due to "plasma weeping" from the burn site in which vascular permeability occurs. This condition allows the vessels to open up thereby expressing fluid contents in an uncontrolled manner. Burns from second to third degree require immediate treatment to prevent loss of fluid from plasma "weeping" which causes shock and death if not properly managed and irreparable skin damage due to tissue anoxia. These problems are compounded by intense pain and the probability of infection.

There are various types of bandages in use by physicians and paramedic personnel to control and manage external bleeding from serious wounds, lacerations and burn injuries. These typically comprise tourniquets, field dressings, and absorbent bandages. The dressings are absorbent and readily become saturated with shed blood, thereby sharply reducing their usefulness and thus becoming a source of infection and contamination. Tourniquets are dangerous in emergency situations even when used by well trained physicians and technicians because application of the tourniquet requires severely restricting blood circulation between the heart and the injury in order to stem the flow of blood from the wound. If improperly applied or attended, the tourniquet application can cause acute toxicity in the patient resulting in loss of life or limb. In practice, treating serious lacerations and wounds is difficult even under hospital conditions, and the currently used tourniquet, bandages and dressings for field treatment are often inadequate.

BRIEF SUMMARY AND OBJECTS OF THE INVENTION In brief summary, this novel invention comprises a bandaging system which overcomes or alleviates known problems related to treatment of wounds or burns, especially in field and surgery environments, which system provides the following advantgageβ: an inflatable bladder contained in an expandable and distensible housing which is facilely attached to a patient with flexible, stretchable straps and a bladder inflation system whereby controlled pressure is applied to an injury while maintaining critical blood circulation to a distal extremity; adjustable orientation of the housing relative to positioning of the straps to provide conformable application of the bandage over the injury; specially treated injury contacting and covering material releasibly affixed to the patient side of the housing which provides a medicating agent which accellerates clotting to aid in the reduction of bleeding, an antiseptic agent to reduce infection, and an anesthetic agent to reduce pain; thermal insulation characteristics which permit the temperature of the wound to rise to near body temperature to aid blood clotting; and use of the bladder inflating system for localized cooling of an injury site whereby the radii of blood vessels are decreased surrounding the injury, thereby sharply reducing fluid loss from the wound or burn. With the initial cooling, clotting accelerant, and pressure adjustment to control bleeding and other fluid release from the injury, adequate management of the trauma is provided while maintaining critical blood circulation distal to the bandage application site.

A principal object of the present invention is the provision of novel bandage structure, and related method, which overcomes or alleviates problems of the prior art.

Accordingly, it is a primary object to provide a bandaging system by which severe bleeding is controlled without cutting off blood flow distal to the trauma site.

It is a further primary object to provide a bandaging system by which "plasma weeping" from a burn site is controlled without cutting off blood flow distal to the trauma site.

It is a key object to provide a bandaging system which is light in weight, portable, and usable in field applications for treatment of lacerations, burns, and non-laceration injuries comprising sprains and broken bones.

It is a principal object to provide a bandage system comprising an inflated bladder compressively applied to an injury site by which fluid flow from the injury is suppressed without cutting off blood supply to parts distal from the injury site.

It is a further principal object to provide a bladder inflation and deflation controller such that the pressure within the bladder is adjusted for best therapeutic results.

It is a main object to provide a contact surface which interfaces between the bladder and the injury and which adheringly attaches to the bladder during bandage application and separably remains on the injury site when the bandage is removed " to provide a protective surface which is later removed as part of surgical treatment.

It is a further main object that the contact surface comprises antihemorrhagic agents to hasten blood clotting, anesthetic agents to reduce injury related pain, and antiseptic agents to retard infection.

It is a chief object to provide a housing for the bladder to which straps are attached by which the bandage is releasibly secured to the patient.

These and other objects and features of the present invention will be apparent from the detailed description taken with reference to accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 is a perspective drawing of a bandaging system comprising an Inflatable bladder bandage and a gaβ cylinder bladder inflating device.

Figure 2 is a drawing showing an attached and secured bandage comprising a deflated bladder with a top accessible valve stem and a gas cylinder bladder inflating device in position to inflate the bladder.

Figure 3 is a drawing showing the bandage of Figure 2 comprising a filled bladder.

Figure 4 is a drawing demonstrating the separability of a surface contacting interface layer, which interfaces between the bandage bladder and the injury, releasing from adhesion to the bladder and remaining affixed to the injury site as the bandage is removed.

Figure 5 is a graph which plots blood clotting time in minutes versus the time for each of the prothrombin, thrombin, fibrinogen, and fibrin cycles.

Figure 6 is a graph which plots blood clotting time in minutes versus wound temperature.

Figure 7 is an exploded perspective drawing of a bandage comprising straps, bladder housing, bladder, and injury interface layer.

Figure 8 is a perspective drawing of gas cylinder and flow control device with portions cut away for clarity.

Figure 9 is a perspective drawing of a bladder deflation device .

Figure 10 is a side view of a galeiform housing with a portion cut away to show a scalp bandage.

Figure 11 is a rear view of a galeiform housing with a portion cut away to show a scalp bandage.

Figure 12 is a side view of a bandaged hand with a bladder inflated.

Figure 13 is a back view of a patient with a neck injury showing a bandage with a bladder inflated to hold the patient's head securely in place to prevent neck movement.

Figure 14 is a back view of a patient with a broken collar bone showing a bandage with an inflated bladder placed directly between the shoulder blades and held in place by straps wrapped and secured in figure 8 orientation.

DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS In this description when referring to a device or apparatus attached to a patient, the term "proximal" is used to indicate the segment of the body normally closer to the heart. The term "distal" refers portion of the body farther from the heart. When referring to a device as used by an operator or technician, the term "near" is used to indicate the segment closer to the operator and the term "distant" is used to indicate the segment farther from the operator. Reference is now made to the embodiments illustrated in figures 1-14 wherein like numerals are used to designate like parts throughout. As seen in figure 1 and 7—9, this novel invention is a bandaging system which comprises a inflatable bladder bandage 20, pressure delivery apparatus 80, and bladder deflation apparatus 60.

From the inferior to superior layers of the bandage, as best seen in Figures 1 and 7, inflatable bladder bandage 20 comprises injury surface contact layer 120, optionally at least one ridge member 290, inferior bladder housing layer 116, inflatable bladder 170, superior bladder housing layer 112, and bandage strap 130.

The surface contact layer 120 comprises non-absorbent material such that there is no passageway for flow of fluid from the injury through surface contact layer 120. Surface contact layer 120 is attached to the bottom of inferior bladder housing 116 such that, during application of bandage 20 to an injury site, surface contact layer 120 and inferior bladder housing 116 apply as a unit. However, after application and upon removal from the injury site surface contact layer 120 separates from inferior bladder housing 116 such that only surface contact layer 120 adhesively remains at the injury site when bandage 20 is removed. The material of surface contact layer 120 comprises a hemostatic or antihemorrhagic agent which sharply reduces clotting time, an anesthetic agent which reduces pain, and an antiseptic agent which reduces the likelihood of infection.

When used in bandage system 100, each ridge member 290 is captured between surface contact layer 120 and the bottom of inferior bladder housing 116 forming ridge 190 and comprises a long flexible plastic tube made of TYGON or similar compilable ridge producing material. In its captured state, each ridge member 290 is disposed longitudinally along the longitudinal midline of surface contact layer 120. When surface contact layer 120 is compressed against soft tissue comprising an injury, ridge 190 derived from the interposed relation of ridge member 290 between contact layer 120 and bladder housing 110 provides an increase in pressure along the length of ridge 190 improving the localized restriction in fluid flow, thereat.

Enclosed between inferior bladder housing 116 and superior bladder housing 112 is inflatable bladder 170. Inflatable bladder 170 comprises a valve stem 140 which, for different applications, is attached at different places on inflatable bladder 170 as illustrated in Figures 1 and 7. In Figure 1, valve stem 140 is positioned at an end of the inflatable bladder which is an expedient site for insertion of an inflation needle for treating some injuries; while, in Figure 7, valve stem 140 is disposed superiorly at the top center 146 of inflatable bladder 170. In this latter case, valve stem 140 comprises a swivel connection in addition to providing access to inflate bladder 170. As seen in Figure 7, valve stem 140 comprises a disc shaped flange 142 above stem neck 144. Valve stem 140 is made from pliable synthetic resinous material or rubber such that disc shaped flange 142 compliably fits through a hole 136 in superior housing 112 and through a hole 138 in bandage strap 130 to form a swivel attachment which allows superior housing 112 to rotate freely relative to bandage strap 130. Valve stem 140 comprises a normally closed valve similar to that found in inflatable sporting balls, such as footballs and basketballs. So made, valve stem 140 comprises an access port 148 for an inflation needle 40 (see Figure 8) which inserts into valve stem 140 opening the normally closed valve and providing a pathway for free fluid flow.

In the case of an inflatable bladder 170 top center 146 connection of valve stem 140 to inflatable bladder 170, inferior bladder housing 116 and superior bladder housing 112 are joined at respective edges 114 and 118 adhesively or by βtitching to fully enclose inflatable bladder 170 except for valve stem access such as hole 136 for access port 148 for valve stem 140. Thus joined inferior bladder housing 116 and superior bladder housing 112 form bladder housing 110. In the case where valve stem 140 is positioned at a bladder end 152 as seen in Figure 1, an access port (not shown) is provided in bladder housing 110 at end 152 rather than top center 146. In place of swivel connection between strap 130 and valve stem 140 for the embodiment shown in Figure 7, a hook and loop attachment is provided between strap 130 and bladder housing 110 for the embodiment in Figure 1 (not shown). Bladder housing 110 is made from extensible, stretchable material such as neoprene.

Each strap 130 is likewise made from expandable and distensible materials such as neoprene and comprises at least one set of hooks 134 and loops 132, such as VELCRO materials, placed on the proximal and distal side of strap 130, respectively, to provide adjustable but secure compressive attachment of inflatable bladder bandage 20 to a patient 160, as shown in Figures 2-3.

Filling of inflatable bladder 170 is accomplished using a pressure delivery apparatus. In the field application of the currently preferred embodiment, pressure delivery apparatus 80 is packaged with each bandage to provide bandaging system 100. Pressure delivery apparatus 80 comprises at least one gas cylinder 10, a control valve 30, and inflation needle 40 permanently attached to control valve 30. Gas cylinder 10 comprises cylinders, cartridges, and canisters which contain pressurized gas which is accessible by the turning of a valve or breaking a seal. Such pressurized gas sources are known and available in the art. In the preferred embodiment, gas cylinder 10 comprises a carbon dioxide gas cylinder which further comprises a breakable seal on threaded end 12 of gas cylinder 10 as shown in Figure 8. A control valve 30, comprising female threaded lumen 34, flow control surface 38, and fluid communication hole 42, packaged in the form of a large hex nut, for facile handling and manual rotation, threadably attaches to gas cylinder 10. Flow control surface 38 is a frustrum of a cone comprising fluid communication hole 42 at the base of the cone providing access for fluid flow from gas cylinder 10 to inflation needle 40. At the top of the frustrum 28 is seal piercing member 36 which breaks a seal on gas cylinder 10 as gas cylinder 10 is threadably rotated into threaded hole 34. Continued rotation of gas cylinder 10 tightens the broken seal orifice of gas cylinder 10 against flow control surface 38 providing a releasible seal.

Counter rotation of gas cylinder 10 releases the seal between gas cylinder 10 broken seal orifice and allows gas to flow from gas cylinder 10 into chamber 48 inside control valve 30 and formed by threaded hole 34 and control surface 38, outward through fluid communication hole, and into a connected bladder 170 through inflation needle 40 and valve stem 140. As shown in Figures 8 and 9, inflation needle 40 comprises at least one side port 44 and end port 46 for fluid communication with the interior of inflatable bladder 170 and for spraying cooling gas upon an injury which will be described in more detail hereinafter. The term "fluid" has been carefully selected and used to include the use of pressurized liquids to fill inflatable bladder 170 as well as gases, as described for this preferred embodiment, although cooling is best accomplished as the result of gas expansion.

As pressure delivery apparatus 80 with pressurized gas cylinder 10 attached and punctured is used to inflate bladder 170, pressure delivery apparatus 80 without gas cylinder 10 attached, but with inflation needle in valve stem 140 deflates a filled inflatable bladder 170. Better controlled deflation is accomplished using bladder deflation apparatus 60, shown in Figure 9, which comprises a plastic tube 62 comprising, first, an inflation needle 40 sealably inserted into one end and, second, sufficient length such that, with inflation needle 40 inserted into valve stem 140 of prefilled bladder 170, plastic tube 62 is manually kinked and partially released to restrict and permit controlled bladder 170 deflation. In the preferred embodiment, bladder deflation apparatus 60 is made by selecting a length of compliant plastic tubing 62 made from tubing sythetic resinous tubing material comprising materials such as TYGON. Tubing 62 iβ long enough to be manually kinked to restrict air flow and of such inner diameter that a threaded end 66 of inflation needle 40 provides a sealed connection when inserted into an end 64 of tubing 62. With inflation needle 40 and tubing 62 so joined, inflation needle 40 is inserted into valve stem 140 of an overfilled bladder 170 with tubing 62 first kinked to restrict escape of air from bladder 170 and then carefully released to controllably permit a regulated release of excess fluid and pressure .

To reduce blood flow in the case of a wound or laceration, prior to applying bladder bandage 20, pressure delivery apparatus 80 comprising gas cylinder 10, control valve 30, and inflation needle 40 is used as a nozzling system to spray expanding gas onto the injury. Inflation needle 40 is held one-half inch from the injury site and gas cylinder 10 is turned in control valve 30 to release a spray of cool expanding gas to reduce the temperature of the injury and surrounding tissue cooling the tissue around the laceration and causing vascular spasming to momentarily reduce blood flow to the area of the wound.

When using bandaging system 100 to compressively cover an accident or surgery caused laceration in place of a tourniquet or other bandage form, the bandage 20 is removed from a package and placed over the wound area as shown for a leg wound in Figure 2. When bandage 20 comprises at least one ridge member 290, surface contact layer 120 is placed upon the injury such that ridge 190 lies directly over the line of the injury as closely as possible. Strap 130 is tightly drawn around patient 160 limb or torso, without resticting blood flow distal to the wound, and secured by compressing hooks 134 into loops 132. A gas cylinder 10 is threadably joined with control valve 30 and rotated clockwise until gas cylinder 10 seats tightly into control valve 30 whereby the gas seal is broken and gas release is restricted by flow control surface 38 forming a releasible seal against the broken sealing orifice of gas cylinder 10. Inflation needle 40 associated with control valve 30 and gas cylinder 10 is inserted into valve stem 140. Gaε cylinder 10 is rotated counter¬ clockwise to release gas which flows into inflatable bladder 170 whereby inflatable bladder 170 is slightly over-inflated. Inflation needle 40 associated with control valve 30 is removed from valve stem 140 and bladder deflation apparatus is employed to reduce the pressure in over-inflated bladder 170. If the pressure in bladder 170 requires readjustment for reasons comprising changes in tissue tension, seepage or other injury caused fluid flow, and discovered anoxia in distal tissue, the inflation/deflation steps previously described are repeated as necessary. When an effective stable and controlled state is achieved, pressure delivery apparatus and bladder deflation apparatus are removed from valve stem 140 attachment and set aside, as shown in Figure 3.

In addition to pressure and closure brought about by initially securing bladder bandage 20 about the wound, at least three other processes aid in bringing bleeding under control. Massive bleeding is stopped without saturation of the bandage with whole bloodm by applying necessary additional pressure on the wound side by inflating bladder 170 to increase the pressure without cutting the circulation, thereby affording the benefits of the tourniquet without the negative aspects of tourniquet application. Unlike absorbent bandages and dressings which become saturated with shed blood, wound produced fluid containment by bladder bandage 20 comprises directed pressure to the wound site to suppress bleeding and materials configured to contain rather than absorb shed blood. With deep laceration wounds which produce a large volume of blood, the normal clotting mechanisms involving the prothrombin, thrombin, fibrinogen, fibrin process often cannot form the necessary reticulum or thread-like web to prevent excessive blood loss. To augment this clotting process surface contact layer 120 which directly contacts the wound is impregnated with an antihemorrhagic agent known and available in the art to promote surface blood clotting. A graph, as seen in Figure 5, graphically demonstrates the clotting time 50 for clotting under conditions of a cloth pressure bandage versus shorter clotting time 52 for a bladder bandage 20 comprising a surface contact layer 120 treated with an antihemorrhagic agent. Also, an injury covering bladder bandage 20 insulates the area of the area around the injury allowing the injured site to modify toward body temperature. Curve 54, in Figure 6, is a plot of clotting time versus wound temperature over a temperature range of 29-45° centigrade. Other than a condition of hypothermia (i.e. below 31° centigrade, the optimum clotting temperature occurs at normal body temperature, 37 centigrade.

Fluid loss in the case of burns is also critical. However, fluid loss in the case of burns is substantially due to "weeping" of the tissue, the permeability of which has been affected by burn trauma. Loss of fluid from plasma "weeping" can cause shock and death if not properly managed and can cause irreparable skin damage to the victim due to fluid loss in the tissues. To reduce blood and other fluid flow in the case of a burn, prior to applying bladder bandage 20, pressure delivery apparatus 80 comprising gas cylinder 10, control valve 30, and inflation needle 40 is used as a nozzling system to spray expanding gas onto the injury. Inflation needle 40 is held one-half inch from the injury site and gas cylinder 10 is turned in control valve 30 to release a spray of cool expanding gas to reduce the temperature of the injury and surrounding tissue taking residual heat out of the burned tissue and causing vascular spasming to momentarily reduce blood flow to the area of the burn.

Bandaging system 100 then is placed to compressively cover the burn site. The bandage is removed from a package and placed over the wound area as shown in Figure 2. Strap 130 is drawn tight around patient 160 limb or torso and secured by compressing hooks 134 into loops 132. If gaε cylinder 10 has been fully depleted by the spraying and cooling process described earlier, an unused, sealed gas cylinder 10 is threadably joined with control valve 30 and rotated clockwise until gas cylinder 10 seats tightly into control valve 30 whereby the gas seal is broken and gas release is restricted by flow control surface 38 forming a releasible seal against the broken sealing orifice of gas cylinder 10. Inflation needle 40 associated with control valve 30 and gas cylinder 10 is inserted into valve stem 140. Gaε cylinder 10 is rotated counter-clockwise to release gas which flows into inflatable bladder 170 whereby inflatable bladder 170 is slightly over-inflated. Inflation needle 40 associated with control valve 30 is removed from valve stem 140 and bladder deflation apparatus 60 is employed to reduce the pressure in over-inflated bladder 170. If the pressure in bladder 170 requires readjustment for reasons comprising changes in tissue permeability, seepage or other injury caused fluid flow, and discovered anoxia in distal tissue, the inflation/deflation steps previously described are repeated as necessary. When an effective stable and controlled state is achieved, the in-use pressure inflation/deflation apparatus is removed from valve stem 140 attachment and set aside, as shown in Figure 3.

At a time when injury access is required for further treatment, bladder bandage 20 is partably removed from the injury. As shown in Figure 4, strap 130 is unhooked and ends separated, releasing bandage 20 from pressure contact against the injury. Strap 130, bladder housing 110, and ridge member 290 are separated from surface contact layer 120 and set aside for disposal. Surface contact layer 120 is removed from the reticulum of the wound as part of related surgical procedures. All of the parts of bandaging system 100 are disposable using accepted human waste and medical instrument disposal procedures.

Head wounds are typically troublesome because of dense vascularization and resultant high volume of blood flow. As it is imperative that effective pressure be applied to the scalp to radically limit bleeding, anov.her preferred embodiment of bandaging system 100 comprises a special galeiform housing to apply pressure to a laceration with appropriate fluid control connections and head attachments to provide a pressure bandage to a skull area. Within the scope of this invention bandaging system 100 comprises galeiform housing 198 as seen in a side view in Figure 10 and a rear view in Figure 11, inflatable bandage 20 comprising a remote valve stem 140, and fluid delivery tubing 182. Galeiform housing 198 further comprises a skull covering helmet 180 comprising mounting hole 188 for valve stem 140, chin straps 184 and dorsal neck straps 186. In this embodiment, valve stem 140 is disposed away from bandage 20, mounted in a fixed position 188 in helmet 180 and βxtβnβibly connected to bandage 20 through extension tubing 182 allowing bandage 20 to be variously positioned across a headwound. Helmet is made from compilable, nonelastic resinous synthetic material or other material which maintains a compreεεive relationship against an expanding bladder residing between helmet 180 and patient head 162.

To dress a wound, inflatable bladder bandage 20 is laid along the laceration such that ridge 190 lies directly over the wound. Galeiform housing 198 is placed over patient head 162 to hold bladder bandage 20 in place. Adjustable chin straps 184 are releasibly tightened as are dorsal neck straps 186 with hooks 134 and loops 132 to firmly secure galeiform housing 198 to patient head 162. Inflation needle 40 first connected into previously prepared pressure delivery apparatus 80 is inserted into valve stem 140 which protrudes accessibly through valve stem exit portal 188 in galeiform housing 198 and communicates with bladder 170 through valve stem extension tubing 182. Gas cylinder 10 is turned counter-clockwise in control valve 30 to inflate bladder 170 and apply pressure to the wound. The initial injury cooling contact from gas expanding into bladder 170 initiates immediate vascular spasming which aids rapid blood clotting in conjunction with hemostatic contact with surface contact layer 120. Insulating properties of bladder bandage 20 allow the wound site to promptly rise to body temperature which is optimum for blood clotting. In this embodiment, ready access to the injury site is provided by removal of all applied parts of galeiform housing 198 and partable removal of bandage 20 except surface contact layer 120 which is left in place over the injury site for later removal as part of the related follow-on surgical procedure.

Bandaging system 100 is also used in multiple emergency medical applications for injuries not specifically associated with wound or burn care. These applications comprise emergency treatment of severely sprained or broken necks, knees, ankles, elbows, backs, shoulders, and hands, plus immobilization of broken collar bones. Use in these applications is appropriate due to the efficacy of the invention and preciousness of storage space in field support transportation equipment. As shown in Figure 13, bladder bandage 20 is used as a medical collar to immobilize the neck and upper spine by placing the bladder housing 110 directly on the affected area and securing strap 130 around the neck. Bladder 170 is then inflated to the desired pressure to hold patient head 162 securely in place and prevent neck movement which can cause severe spinal cord injuries to patients with a broken neck.

Figure 14 shows the position of bladder bandage 20 used in a case of a broken collar bone. Bladder housing 110 is placed directly between the shoulder blades and flexible holding straps 130 wrapped in a figure eight under the armpits and around the shoulders and secured before inflating bladder 170 to a desired pressure, thereby holding the upper body in the most favorable position for a patient with a collar bone break or shoulder separation.

A broken, or sprained, hand or finger injury is treated effectively by placing bladder housing 110 on the palm area of a hand 164 and securing flexible strap 130 around hand 164. As shown in Figure 12, inflated bladder 170 creates a firm convex support to immobilize the hand and fingers. In all cases, applications of bladder bandage 20 provides pressure to an injury without impairing patient circulation.

As demonstrated in the limited number of applications described herein, bladder 170, bladder housing 110, and straps 130 are variously configured to meet needs of the many different types and sizes of injuries treatable by bandaging system 100. The invention may be embodied in other specific forms without departing from the spirit or essential characteristics thereof. The present embodiment is therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein.

What is claimed and desired to be secured by Letters Patent is:

Claims

1. A bandaging system for application of a pressure bandage in emergency and extemporaneous treatment of a patient for trauma comprising surgery, accidental lacerations, burns, and non- lacerating sprains and bones, said system comprising: pressure application means comprising an inflatable bladder means, an expandable, distensible housing means for the bladder, and a normally closed valve means which provides a connection between the inflatable bladder and an external fluid port; bandage securing means whereby the bandage is secured to the patient such that, by expanding the bladder means, pressure is applied directly to a trauma site without cutting off the supply of blood to a body segment distal to the heart of the patient; injury contact surface means adheringly, but separably applied to the injury side of the housing means such that the distensible housing means and injury contact surface means are applied to the injury as a unit but readily parted when the housing means is removed for medical treatment; bladder inflation and deflation means by which a medical attendant can reεponsively change pressure to the bandage application site.

2. A bandaging system according to claim 1 wherein the bladder means comprise swivel attachment means whereby the pressure application means is rotatably affixed to the bandage securing means such that angular orientation of the pressure application means is independent of the position of the bandage securing means.

3. A bandaging system according to claim 2 wherein the swivel attachment means comprise a hollow stem means which provides access to the normally closed valve means.

4. A bandaging system according to claim 2 wherein the swivel attachment means are manually releasible such that the pressure application means is manually detachable from a first bandage securing means and manually affixable to a second bandage securing means such that when necessary for the treatment of a patient, said parts are interchangeable.

5. A bandaging system according to claim 1 wherein the pressure application means comprises thermal insulation mean which cause the temperature of the injury site to rise to body temperature (37° centigrade) whereat the highest rate of clotting occurs.

6. A bandaging system according to claim 1 wherein injury contact surface means comprise antihemorrhagic means to hasten blood clotting, anesthetic means to reduce injury related pain, and antiseptic means to retard infection.

7. A bandaging system according to claim 1 wherein, in combination, the injury contact surface means and the bladder means comprise non-absorbent materials which provide no material pathway for leaking body fluids comprising "weeping" fluids from burn affected tissue and blood and other fluids from lacerated organs.

8. A bandaging system according to claim 1 wherein said securing means comprise extensible, flexible strap means comprising hook and loop fastener means which provide manually releasible and adjustable attachment of said strap means around limbs and torso of the patient.

9. A bandaging system according to claim 8 wherein the extensible, flexible strap means comprise neoprene material.

10. A bandaging system according to claim 1 wherein said bladder inflation and deflation means comprise a pressure source means and a pressure release means.

11. A bandaging system according to claim 10 wherein pressure release means comprise a valve opening and fluid delivery means whereby the valve is opened and fluid is transferred from the pressure source means to the bladder means when the valve opening and fluid delivery means interconnect the pressure source means and normally closed valve means.

12. A bandaging system according to claim 11 wherein valve opening and fluid delivery means when connected only to the normally closed valve means provides bladder fluid egress means.

13. A bandaging system according to claim 10 wherein said pressure source comprises an expandable gas means.

14. A bandaging system according to claim 13 wherein, in combination, the expandable gas means and pressure release means are used to flood the area of the injury with expanding gas to cool the injury before the bandage is applied, whereby the cooled tissue and vessels experience vascular spasming which reduces fluid loss through lacerated or burned tissue.

15. A bandaging system according to claim 13 wherein said expandable gas means comprises a hand portable carbon dioxide cylinder means.

16. A bandaging system according to claim 16 wherein pressure release means comprise perforation means to break a seal on the carbon dioxide cylinder means, fluid insertion means which bypass the normally closed valve means to provide for bladder filling gas egress and ingress, and control means to control the flow of gaε from the cylinder means to the bladder means.

17. A bandaging system according to claim 1 further comprising aseptic packaging means wherein all presterilized parts of the bandaging system are antisβptically stored until opened for use.

18. A bandaging system according to claim 1 wherein all parts of the bandaging system are disposable after a single use.

19. A bandaging system according to claim 1 wherein the inflatable bladder means and housing means are the same means.

20. A bandaging system according to claim 1 wherein the housing means covers are made from neoprene.

21. A bandaging system according to claim 1 wherein the pressure application means comprise various shapes and sizes to provide a variety of bandage forms for more specific treatment for injury to body parts comprising scalp, torso, and limb.

22. A bandaging system for application of a pressure bandage in emergency and extemporaneous treatment of a patient for trauma to the scalp comprising surgery, accidental lacerations, and burns, said system comprising: galeiform securing means comprising a galeiform means comprising at least one fluid delivery port means whereby the bandage is secured to the patient such that, by expanding an inflatable bladder means through the port means, pressure is applied directly to the scalp trauma site; pressure application means comprising the inflatable bladder means, an expandable, distensible housing means for the bladder, and a normally closed valve means which provides extended fluid access to the bladder means through the port means in the galeiform means; injury contact surface means adheringly, but separably applied to the injury side of the housing means such that the distensible housing means and injury contact surface means are applied to the injury as a unit but readily parted when the housing means is removed for medical treatment; bladder inflation and deflation means by which a medical attendant can responsively change pressure to the bandage application site.

23. A bandaging system according to claim 22 wherein galeiform securing means comprise strapping means by which a tight fitting adjustment is made to the head of the patient.

24. A bandaging system according to claim 23 wherein the strapping means comprise hook and loop fasteners for rapid fitting, securing, and removing of the galeiform securing means.

25. A bandaging apparatus for application of a pressure bandage in emergency and extemporaneous treatment of a patient for trauma comprising lacerations, burns, and non-lacerating sprains and bones, said apparatus comprising: pressure application means comprising an inflatable bladder means, an expandable, distensible housing means for the bladder, and a normally closed valve means; bandage securing means whereby the bandage is secured to the patient such that, by expanding the bladder means, pressure is applied directly to a trauma site without cutting off the supply of blood to a body segment distal to the heart of the patient; injury contact surface means adheringly, but separably applied to the injury side of the housing means such that the distensible housing means and injury contact surface means are applied to the injury as a unit but readily parted when the housing means is removed for medical treatment;

26. A bandaging apparatus according to claim 25 wherein the normally closed valve means comprise valve access means through which the valve is opened for passage of pressurized fluid from a bladder inflation and deflation means by which a medical attendant can responsively change pressure to the bandage application site.

27. A method for applying a presterilized compressible bandage to a laceration on the body of a patient comprising the following steps: providing a prepackaged inflatable bladder bandage system; debriding and cleaning the injury as much as possible; unpackaging the bandaging system being careful to maintain sterility in all parts which contact the wound; placing the injury surface contact means, oriented to cover the injury; securing the bandage by a bandage securing means which compressively holds the bandage against the injury and surrounding tissue; inflating the bladder means until the pressure against the injury is sufficient to stop or control the flow of blood from the laceration; adjusting the pressure as needed to maintain control of fluid flow from the injury and maintain blood flow to distal segments of the body of the patient.

28. A method for treatment of an injury comprising applying and removing a compressible bandage to and from a laceration on the body of a patient comprising the following steps: providing a presterilized, prepackaged inflatable bladder bandage system comprising pressure application means, securing means, and injured surface contact means; debriding and cleaning the injury as much as possible; unpackaging the bandaging system being careful to maintain sterility in all parts which contact the wound; placing the injury surface contact means, oriented to cover the injury; securing the bandage by a bandage securing means which compressively holds the bandage against the injury and surrounding tissue; inflating the bladder means until the pressure against the injury is sufficient to stop or control the flow of blood from the laceration; adjusting the pressure as needed to maintain control of fluid flow from the injury and maintain blood flow to distal segments of the body of the patient. before treating the laceration, deflating the bladder and remove all parts of the bandage except the injured surface contact means; as part of attending surgical procedures, removing the injured surface contact means; properly discarding all parts of the bandage system after use.

29. A method for applying a presterilized compressible bandage to a laceration on the body of a patient comprising the following steps: providing a prepackaged inflatable bladder bandage system; debriding and cleaning the injury as much as possible; cooling the lacerated region by spraying expanding gas about the surface of the injury to reduce the temperature to reduce blood flow through vascular spasming; unpackaging the bandaging system being careful to maintain sterility in all parts which contact the wound; placing the injury surface contact means, oriented to cover the injury; securing the bandage by a bandage securing means which compressively holds the bandage against the injury and surrounding tissue; inflating the bladder means until the pressure against the injury is sufficient to stop or control the flow of blood from the laceration; adjusting the pressure as needed to maintain control of fluid flow from the injury and maintain blood flow to distal segments of the body of the patient.

30. A method for treatment of an injury comprising applying and removing a compressible bandage to and from a laceration on the body of a patient comprising the following steps: providing a presterilized, prepackaged inflatable bladder bandage system comprising pressure application means, securing means, and injured surface contact means; debriding and cleaning the injury as much as possible; cooling the lacerated region by spraying expanding gas about the surface of the injury to reduce the temperature to reduce blood flow through vascular spasming; unpackaging the bandaging system being careful to maintain sterility in all parts which contact the wound; placing the injury surface contact means, oriented to cover the injury; securing the bandage by a bandage securing means which compressively holds the bandage against the injury and surrounding tissue; inflating the bladder means until the pressure against the injury is sufficient to stop or control the flow of blood from the laceration; adjusting the pressure as needed to maintain control of fluid flow from the Injury and maintain blood flow to distal segments of the body of the patient. before treating the laceration, deflating the bladder and remove all parts of the bandage except the injured surface contact means; as part of attending surgical procedures, removing the injured surface contact means; properly discarding all parts of the bandage system after use.

31. A method for applying a presterilized, compressible bandage to a burn on the body of a patient comprising the following steps: providing a prepackaged inflatable bladder bandage system; debriding and cleaning the injury as much as possible; unpackaging the bandaging system being careful to maintain sterility in all parts which contact the wound; cooling the burned region by spraying expanding gaε about the surface of the injury to reduce the temperature of the burned region and reduce tiεsue weeping through vascular spasming; placing the injury surface contact means, oriented to cover the injury; securing the bandage by a bandage securing means which compressively holds the bandage against the injury and surrounding tissue; inflating the bladder means until the pressure against the injury is sufficient to stop or control "weeping" from the burn site; adjusting the pressure as needed to maintain control of fluid flow from the injury and maintain blood flow to distal segments of the body of the patient.

32. A method for applying and removing a presterilized, compressible bandage to a burn on the body of a patient comprising the following steps: providing a prepackaged inflatable bladder bandage system; debriding and cleaning the injury as much as possible; unpackaging the bandaging system being careful to maintain sterility in all parts which contact the wound; cooling the burned region by spraying expanding gas about the surface of the injury to reduce the temperature of the burned region and reduce tissue weeping through vascular spasming; placing the injury surface contact means, oriented to cover the Injury; securing the bandage by a bandage securing means which compressively holds the bandage against the injury and surrounding tissue; inflating the bladder means until the pressure against the injury is sufficient to stop or control "weeping" from the burn site; adjusting the pressure as needed to maintain control of fluid flow from the injury and maintain blood flow to distal segments of the body of the patient. before treating the laceration, deflating the bladder and remove all parts of the bandage except the material in direct contact with the burn; as part of attending surgical procedures, removing the material in contact with the burn; properly discarding all parts of the bandage system after use.

33. A method for applying a compressible support bandage to body of a patient comprising the following steps: providing an inflatable bladder bandage system comprising placing the injury surface contact means, oriented to cover the injured body part; securing the bandage by a bandage securing means which compressively holds the bandage against the injured and surrounding tissue; inflating the bladder means until the preεεure against the injury is sufficient to provide compreεsive support; adjusting the pressure as needed to maintain supporting pressure while maintaining blood flow to distal segments of the body of the patient.