WO2009132843A1

WO2009132843A1 - Controllable hospital bed

Info

Publication number: WO2009132843A1
Application number: PCT/EP2009/003114
Authority: WO
Inventors: Martin Teschner
Original assignee: Martin Teschner
Priority date: 2008-04-29
Filing date: 2009-04-29
Publication date: 2009-11-05
Also published as: EP2273962B1; DE102008021503B4; EP2273962A1; DE102008021503A1

Abstract

The invention relates to a controllable hospital bed which has a plurality of positions and functions. Functions comprise, for example, a bedsore prophylaxis function, a vibration function, extremity movement functions and/or a weight-monitoring function. The positions and functions of the bed are controlled via a control unit and can also be configured. The bed can also have a sensor arrangement which transmits measured data to the control unit. The controllable hospital bed thus provides a multiplicity of functionalities which can relieve the burden on the hospital staff and which serve for the well-being of the patient.

Description

Steerable hospital bed

The invention relates to a controllable hospital bed, a method for controlling a controllable hospital bed and a computer program product which implements a control for a controllable hospital bed.

For example, hospital beds are known for inpatient hospitalization. Such a hospital bed has a bedstead on which a mattress is located. By mechanical adjustment of the bed frame, for example, the headboard of the bed can be raised, which allows leaning of the upper body. Likewise, for example, the foot part of the mattress can be raised by the bed frame so that blood can flow from the lower extremities, the legs, slightly towards the upper body. This can, for example, be medically useful after an injury to one leg. Such a mechanical bedside requires that a person, such as a carer or a nurse, make the adjustment of the hospital bed. For example, it is desirable here for the time that the hospital staff to hire a mechanical bedside needed to shorten. Furthermore, it is desirable to reduce the effort required for the adjustment.

Seriously ill patients, especially patients with paralysis due to stroke or paraplegia, are often extremely restricted in their mobility in the hospital bed. The fact that they lie mostly motionless in bed has the consequence that the contact points of her body do not change on the surface of the bed. For a change of the support points would be an external force by, for example, the hospital staff required. At the support points of the body, a bone presses on the skin so that it is compressed and thus restricts or prevents the blood flow in this area. As a result, these support points are no longer supplied with sufficient oxygen. This can lead to the death of tissue parts. This is known as pressure ulcers. The pressure ulcer can become infected and can even lead to death in seriously ill and thus immunocompromised patients. In order to prevent decubitus ulcers, patients at risk must be moved by the hospital staff in bed, so that the support surfaces change more frequently and so a continuous oxygenation of all tissue parts is guaranteed. It would be desirable to automatically carry out a high-quality precaution for the prevention of decubitus. DE 100 01 687 A1 discloses a hospital bed for decubitus prophylaxis. It is exploited that moving the bed frame in different positions reduces the probability of a decubitus. The bed frame is mounted on four hydraulically actuated working cylinders. With these cylinders, the bed frame is movable to reduce the likelihood of pressure sores.

In the treatment of comatose patients, maintaining vital signs is a priority. The comatose patient is in an immobile state and experiences reduced sensory stimulation. Movement, however, is a fundamental factor in many functions of the human body. The functions are not only related to the musculature, but may also include, for example, organ functions. Longer-term real estate In particular, in patients with comatose disease, osteoarthritis, inactivity osteoporosis, changes in cartilage and the ligament / capsule apparatus, or muscle atrophy can all result. In this context, compression, tension, bending and torsion are important mechanical stimuli with structure-preserving effect for the patient. Further consequences of the immobility of the comatose patient are, for example, the increase in risk of thrombosis as well as the tendency to edema or the elimination of movement. It would be desirable to improve the treatment of comatose patients by providing appropriate engineering means.

Based on the cited prior art, it is an object of the present invention to provide a controllable hospital bed that can relieve and support the hospital staff as extensively as possible. In particular, a variety of functionalities should be provided.

The object is achieved with a controllable hospital bed, comprising a bed frame, which has movable parts, at least one drive unit for moving the movable parts and / or for driving the movable parts in certain positions, at least one control unit for controlling the at least one drive unit and at least one storage unit for storing a plurality of particular positions and functions, the determined positions comprising a shock position, a cardiac position, a cerebral position, a sitting position, a back position, a resuscitation position, and / or a horizontal position, the functions including continuously moving extremities and / or a trunk, a vibration function, a pressure ulcer prophylaxis function, a selection of different positions by means of a quick and direct adjustment and / or a weight control function, wherein the control unit comprises a Meh provides the number of specific items and functions for selection.

A bed frame is understood to be a frame which, for example, holds a mattress but may also comprise other devices which are provided, for example, for holding the extremities of a patient. For example, the To move mattress or said devices, the bed frame on movable parts. Such a movable part may for example be a movable headrest. The movable parts of the bed frame can be moved by drive units and / or moved into certain positions. The drive unit or the drive units can be designed electrically and / or hydraulically. For example, a bed frame can have joints in the area of the knee and in the hip area and thus divide the bed frame into three movable parts. Moving the lower part by a certain angle and moving the upper part by a certain angle can move the bed from a lying position to a sitting position. Such a defined setting of the movable parts can be stored as a specific position, here for example the sitting position. For example, to make decubitus prophylaxis, for example, a bed frame according to a predetermined movement profile can be moved. Such a movement profile can be defined by predetermined positions and times at which the bedstead moves to the predetermined position. Such a definition of pressure ulcer prophylaxis function can also be stored. A control unit can then move the drive units in such a way that the controllable hospital bed moves to a defined position or performs a defined function. In this case, the control unit accesses a memory unit on which a plurality of positions and functions can be stored. Through a user interface, the control unit provides a user with a plurality of specific positions and functions. The control unit is preferably an electronic controller. In addition to the positions and functions that utilize moving parts via drive units, the controllable bed can also provide other functions, such as a weight control function. With this weight control function, the weight of a patient who is on the controllable bedside can be measured. Then, a corresponding sensor supplies the measured weight information to a central control unit. The measured weight is stored by the control unit, for example, or forwarded to a screen display. It is also conceivable to record a weight measurement series and thus to determine the weight development of the to reproduce patients. The shock position describes a position in which the legs of a patient are higher than the trunk and the trunk is higher than the head. The arms preferably have slightly upwards. A cardiac position, for example, describes a position in which the angle between the upper body and thigh is greater than 90 °, and the angle between thigh and lower leg, measured at the popliteal fossa, is greater than 90 °. The sitting position differs from the heart position in particular in that the upper body is further erected. The cerebral position describes a position in which the patient lies substantially, but the popliteal fossa is slightly angled and the thigh is slightly angled relative to the upper body. The horizontal position describes a position in which the patient lies substantially completely outstretched. The back position describes a position in which the patient is lying with his back straight, the legs are angled and the lower legs are substantially parallel to the back. The resuscitation position is a position in which the bedstead extends the patient lying on his back as far as possible to the ground. The plurality of specific positions and functions comprises at least two positions and at least one function, preferably at least four positions and at least two functions, more preferably at least five positions and at least four functions.

For decubitus prophylaxis, the controllable hospital bed may have, for example, chambered air cushions which are each filled with alternating pressure. The pressure of the chambered airbags can then be controlled via the control unit.

The vibration function can be adjusted by the controller so that a separate vibration value can be set for the right hand, the left hand, the right foot and the left foot. The controllable hospital bed can be adjusted so that individual joints such. As the hip joint, the knee joint, the elbow, the shoulder joint to certain angles that are adjustable, to be moved. Such a controllable bedside can be used for therapeutic purposes, diagnostic purposes and measurement and control purposes on the patient. It can thus increase the comfort of the patient, relieve the burden on hospital staff and support or carry out therapies. For example, such a steerable bedside can impart sensory stimuli to a comatose patient, such as tactile stimuli, movement stimuli or auditory stimuli, thus assisting or improving the treatment of comatose patients. Specific movements or specific movement patterns for the extremities as well as the time duration or temporal sequence of the movement patterns for the extremities may be defined for the control unit, or the corresponding movement patterns and time periods may be input to the control unit. The latter allows an individual setting of the motion functions. Similarly, the movements of the trunk and neck are adjustable with respect to a movement pattern and the associated movement time. The time duration of the respective movements including start time and end time of a movement pattern can also be set. A movement pattern can be specified more precisely, for example, by specifying a maximum flexion of a joint. In a further development of the invention, the bed frame of the controllable hospital bed has a first movable part for holding and moving a head and trunk area of a patient and a second, a third, a fourth and a fifth movable part for holding and moving in each case a limb of the patient , With a corresponding controllable hospital bed a continuous passive movement of the four extremities and the trunk is made possible. In this way, tactile stimuli can be taught.

In a development of the invention, the controllable hospital bed has at least one sensor unit. The sensor units can be used to transmit control information such as bed data, weight measurements and / or result data to the control unit via performed movements. This control information may also be provided to other monitoring units or computer units. If, for example, a measuring unit or an external monitoring unit, the If blood pressure, heart rate or oxygen saturation is detected, an emergency is detected, then this emergency signal can be transmitted to the control unit, whereupon the control system carries out an immediate standstill of the movement of the patient bed and a positioning of the patient in emergency situation. For example, extremities and / or the torso can be fastened to mobile parts of the bedstead with hook-and-loop fasteners. In this case, the Velcro fasteners on sensors that indicate a faulty closure, if the hook and loop fastener is not properly closed. This sensor signal is then provided to the control unit, for example, which can then output a warning signal.

In a development of the invention, the controllable hospital bed has an acoustic system for emitting acoustic stimuli. In addition to tactile signals, acoustic signals are also suitable for stimulating a comatose patient. By way of example, the control unit can control the duration of audible signals as well as the volume of audible signals emitted by the audible system by the control unit and adjust it at the control unit. The acoustic system has, for example, a headphone and a memory for sound data. The control unit may provide the headphone with the sound data via a wireless connection, for example. On the control unit can also be made volume controls and time settings.

In a development of the invention, the controllable hospital bed has a thermosystem for regulating a body temperature. The thermal system can be controlled for example via the control unit. The control unit can then be informed via a communication interface of individual settings or standard settings that are necessary for the regulation of the body temperature of a patient. The thermosystem may, for example, also comprise a thermoprobe which can be applied rectally to a patient for measurement of body temperature. The measurement of body temperature is then provided to the control unit which controls the thermosystem. On this way, a body temperature control loop has been created. The temperature of the thermo system can also be set manually.

In a development of the invention, the controllable hospital bed has at least one emergency stop switch. Such an emergency stop switch serves the patient or, for example, the hospital staff in order to be able to switch off or stop the controllable bed immediately in the event of unforeseen emergencies. In this way, the security of a corresponding controllable bed is increased.

According to a development of the controllable hospital bed according to the invention, the positions and / or the functions are individually configurable. The positions are defined, for example, by the position of the various moving parts. So that the drive units can drive the moving parts into the defined positions, the control unit accesses a storage unit in which the corresponding positions are stored. It may now make sense, for example, depending on the size of the patient or other peculiarities of the patient to change the definition of the position. Similarly, it may be useful to add more defined positions. Changing and adding the positions are described here by configuring the positions. Likewise, definitions of the functions can be changed or new functions can be added. Both are in the term "Configure functions" included.

In a further development of the invention, the controllable hospital bed according to the invention provides an alarm function. For example, body parts of the patient or the patient can be fixed to the controllable bed itself. The release of a fixation can be measured via a corresponding sensor, and this measurement signal can be provided to the control unit. If the fixation dissolves unintentionally, the control unit can trigger an alarm on the basis of the received measurement signal which indicates this state. Other alarm functions may be based on the principle that control mechanisms or measuring units supply signals to the control unit, these signals from the Control unit are evaluated and then a corresponding alarm is triggered.

In a further development of the controllable hospital bed according to the invention, the control unit can be operated via a touch screen. In principle, any user interface, for example mouse, keyboard, voice control, etc., is conceivable for the control unit. In particular, the use of a touchscreen operable with a touch pen is particularly advantageous because hygienic requirements can be well met in a hospital. The user interface may be configured such that for many of the positions and functions whose definitions are stored in the memory unit can be individually selected with a separate button, i. H. a single press on a user interface is sufficient to drive the controllable bed to a selected position or to perform a selected function.

In a development of the controllable hospital bed according to the invention, the controllable hospital bed has at least one communication interface. This communication interface can be used to forward recorded measured values, such as the weight of the patient, to a computer unit at different times. The communication interface may be, for example, a USB interface or an interface for a printer.

In a development of the invention, the drive units are individually controllable. This makes it possible, for example, that the moving parts in any position that is desired by the user, can be driven.

In a development of the invention, the control unit provides a timing function. By means of a timing function, for example, functions can be performed only at certain times of the day, or after a certain time functions can be turned off automatically. In one development, materials are used in a fuselage area of the controllable hospital bed which essentially do not impair an X-ray measurement.

In particular, in X-ray measurements in the trunk area of people who can not or only partially move, it is desirable that for the X-ray measurement, no move of the patient from his bedside to another couch is needed. By using o. G. Materials can be X-ray measurements performed without the patient having to leave his bed.

According to a further aspect of the invention, a method for controlling a hospital bed according to the invention comprises at least one of the following steps:

Moving the steerable bed to a selected position after the selected position is configured and selected, - performing a selected function of the steerable bed after the selected function is configured and selected;

Performing control functions and providing an alarm signal.

The control functions may mean, for example, measuring the weight of a patient or checking a fixation. The configuration of functions or the configuration of functions can be done by having certain positions already stored in a memory that the controller can access. It may also mean that certain positions or functions are entered by a user, for example, a patient or a hospital employee, in the control unit and stored by this on a memory.

According to a further aspect of the invention, a controller for a hospital bed according to the invention is implemented in a computer program product. The control unit may, for example, be implemented as software in a processor. Such a computer program product can be loaded, for example, via a communication interface at the controllable hospital bed on a processor which belongs to the controllable hospital bed.

In the following the invention with reference to embodiments with reference to Figures 1 to 4 will be explained in more detail.

1 shows a schematic illustration of an inventive controllable hospital bed 1. A control unit 4 can be operated via a touch screen 7. The control unit 4 can access a memory unit 5. With an emergency switch 6, the controllable bed 1 can be switched off immediately at any time. The control unit 4 can control a drive unit 3. The drive unit 3 is used to move moving parts of a bed frame 2. Measuring units 9 are provided on the bed frame, which supply measured values to the control unit 4. Measured values can be, for example, weight measurements. Receives the control unit 4 via the touch screen 7 command to drive the bed 2 in a predetermined position, for example, in a sitting position, then it loads the corresponding data to the desired position from the memory unit 5. Based on the loaded data control unit 4 the drive unit 3 so that the parts of the bedstead drive in the predefined and selected position. Likewise, a position can be selected via the touch screen. The data of the selected function is loaded on the storage unit 5 by the controller. According to the loaded data, the drive units are controlled so that the bed frame 2 or the controllable hospital bed 1 performs the desired function. Likewise, the measured values of the measuring unit 9 in the control unit 4 can be processed. A result of this processing is output, for example, via the communication interface 8 to a computer or a printer.

Fig. 2 shows a touch screen 7 which is used as the user interface of the controllable hospital bed. It has functionalities by touching a correspondingly marked part of a contact surface The touch surface has a selection area for a movement device 11, for a vibration device 12, for current settings 13, for pressure ulcer prophylaxis 14, for an acoustic system 29, for a thermosystem 30 and for a system control 16 to a loss of a fixation displayed in an alarm area 15 These selection areas are used to select a dwell function. Further selection areas are a selection area for an emergency stop 17, for a shock position 18, for a heart position 19, for a cerebral position 20, for a sitting position 21, for a jerk position 22, for a resuscitation function 23 and for a horizontal position. Furthermore, there is a selection area for a weighting function 25 and an OK area 26. Manual control of a controllable hospital bed is enabled via arrows 27 and 28 for adjusting the bed position By touching the Au When a control panel of a controllable hospital bed executes the selected functionality, if an indoor functionality is selected, the touch screen will display a corresponding menu for entering further entries

3 shows a patient 35 lying on or fixed to movable parts of a bed frame. The movable parts are a first movable part 36 for moving a head and trunk area of a patient 35 and a second movable part 31, a third movable part 32, a fourth movable part 33 and a fifth movable part 34 The movable parts 31 to 34 serve to move the four extremities of the patient The five illustrated movable parts can be moved by drive units By suitable control of the anti-taching units certain functions can be performed and movement patterns are performed. Thus, for example, by appropriately moving the movable member 33, bending of the right elbow can be achieved by a certain angle

FIG. 4 schematically shows some parts of the controllable hospital bed. The diagram shows a shell 41 made of ultralight material, for example glass fiber, on which an anti-bacterial

Decubitus element 42, which has chambered air cushion, is arranged Em Thermosystem 43 is arranged laterally on the anti-decubitus element. A waterproof mattress pad 44 serves to prevent liquids from getting from a mattress to the thermal system 3 or the anti-decubitus element. A telescoping arm system 5 adjusts dimensions of the bed so that the bed can accommodate different patient sizes. Below the first movable part 30 for moving a head and trunk area, a cassette holder is slidably disposed. This cassette holder is used to record x-rays of the lungs or abdomen.

Furthermore, FIGS. 5 to 62 show screen shots of the system according to the invention.

In contrast to prior art systems, the subject-matter of claim 1 determines that it is a hospital bed - and not, as in WO 2006/061834 A2, a wellness device. It is further defined according to claim 1 that the positions and the functions are individually configurable. The user of the hospital bed is not the person lying in bed, but the medical specialist who treats the bedside patient who uses the bedside for the fulfillment of his medical order for the patient. The feature "bedside" thus reflects (i) that medical-therapeutic purposes are in the foreground and (ii) that the treatment of a medical patient requires an individual presetting of the sickbed by medical professionals, and not automatically or as in WO 2006/061834 A2 and (iii) that this adjustment is to be carried out by a healthcare professional In WO 2006/061834 A2, the person lying in bed (the user there) can only himself from a large number of predetermined exercises , Positions and functions call him appear appropriate to increase his wellness state.

The subject matter of claim 1, on the other hand, is directed to the special medical requirements of a controllable hospital bed, which assisted with the therapy and medical treatment of the patient. In fully or substantially immobile patients, and especially coma patients, a task of the medical bed is to help maintain vital signs and prevent (or at least reduce) storage damage that may otherwise occur as a result of the patient's immobile storage. Thus, the controllable bedside according to claim 1 is particularly suitable to assist patients in artificial or disease-related coma by the patient is not rigid and motionless in bed, but with the aid of the present invention controllable hospital bed (i) optimized storage, (ii) different movement therapies, (iii) different sensory therapies with tactile, olefaktorischen or akustischn stimuli and (iv) rehabilitation measures can be obtained, whereby the medical staff is relieved accordingly. As a result, all neurological and motor functions are supported and thus promoted even with prolonged immobility of a patient and in coma. The controllable hospital bed according to the invention ensures a largely natural status of essential body functions to ensure even in the situation of the coma, the essential body functions are those that are used day after day and without which no normal life would be possible. The controllable hospital bed not only allows the application of numerous therapeutic and rehabilitative functions on the patient, but also allows their programmed time sequence in a rhythm comparable to the natural processes. This means, for example, adhering to a day / night rhythm of movement, taking into account sleep and rest periods, recovery phases after (passive) physical exertion and thus avoiding overloading and observing resting periods after meals. The use of the controllable hospital bed takes into account the natural rhythm of life and the natural, subconscious or hidden reactions in everyday life.

The same applies to the neurological functions of humans. The coma patient is not alone capable of perception, movement and complex Linking neurophysiological functions, so that the controllable hospital bed supports him, even this passively convey. For this purpose, the controllable hospital bed provides a number of possible sensor modules for tactile, olfactory or acoustic stimuli.

Due to the medically highly complex relationships between the different body functions of mobility-impaired patients, and in particular coma patients, an individualized treatment of patients is required. Thus, the system according to WO 2006/061834 A2 is in no way suitable for meeting the complex requirements of medical treatment of patients whose mobility is limited or of coma patients. WO 2006/061834 A2 relates only to support for the independent wellness treatment of elderly or otherwise movement-restricted people, in particular to motivate them to train their body. However, the standardized programs and functions of the document WO 2006/061834 A2 would not be suitable for the medical treatment of mobility impaired or even of coma patients, but such a self-application of automated processes would entail the danger of serious medical damage, since they would be without any medical supervision and individualization to the patient - "automatically" - be used.

Also document DE 196 03 318 A1 does not disclose that positions and / or functions are individually configurable. Rather, it is explicitly determined that only predetermined bed positions and bed type-specific operating modes can be retrieved by means of the nurse control box. The stored data are thus bed type-specific, but not patient-specific. Likewise, there is no safeguarding of the change in setting, which ensures that only the settings prescribed by the medical staff are taken into account and that potentially harmful functions of the sickbed are not called up by the patient or by third parties for accidental or intentional manipulative adjustments. The system of DE 196 03 318 A1 is therefore also not suitable for a Komapatien- to be used. The positions and functions disclosed in DE 196 03 318 A1 are not suitable for promoting and maintaining the essential vital functions of a coma patient therapeutically and in rehabilitation.

An individualization of the control program, which is configurable by a physician, is not disclosed in DE 83 04 560 U1. DE 83 04 560 U1 merely discloses that a control element with multiple or single lever operation can also be operated by a therapist. However, this does not correspond to the embodiment of a controllable hospital bed in which the positions and / or the functions of the (electronic) control unit are individually configurable. DE 83 04 560 U1 also lacks the focus on a therapy individually arranged for the support, therapy and rehabilitation of vital functions by a medical specialist for the respective patient who is ever limited in his mobility. Also missing in DE 83 04 560 U1 the special sensors for coma patients.

Hereinafter, embodiments of the invention will be described:

Medical robot bed system

The robotic medical bed system consists of three components:

1. The information / software component 2. The electronic component

3. The hardware.

The basis of the system consists of five components, which can be extended or shortened like a telescope. Each component consists of several moving elements like a caterpillar.

The material is lightweight, for example fiberglass or hard synthetic plastic (a metal is not used for the trunk component to preserve the possibilities of X-rays). A maximum body length of 210 centimeters and a maximum body weight of 180 kilograms should be considered.

monitor

A touch screen monitor with a touch pen (not by a finger due to clinical hygiene issues); Fixation of the pin on the right side of the monitor housing.

- On one side of the monitor housing: On / Off switch

- Connection for a printer

- USB connection

- Circuit breaker

- Hard disc (for example, 20 megabytes)

- in general: change the button color by pressing or activating

- "Back" means to return to the previous picture

- "menu" means to go back to the main screen

- The color of the buttons and the monitor can of course be changed

- In case of an alarm: popup and different acoustic sounds

- Voice feedback of a selected content (like a navigation system)

- Screensaver

- Animation intro

Add a "help" function wherever it is needed. See Figure 5

"Medical Robot Bed System":

Login Name: Username

Language: English, Chinese, German, French, Spanish, Russian, Greek, Turkish, Polish ...

Date: automatic dating by turning on the monitor; automatic time (radio time) in the background

Main monitor image

O. K. button only for

- emergency stop

- Shock position, heart position, cerebral position, sitting position, back position, resuscitation position and horizontal position, weight.

The main functions of the bed system are shown on the main monitor:

1. Continuous movement of the extremities and the trunk

2. "vibration" function to prevent the deep perception

3. The Decubitus Prevention: System for preventing a decubital ulcer

4. Different positions are selected with the possibility of a quick and direct adjustment

5. Weight control with the possibility of daily documentation.

Add an LED control light system "On", "Off", "Standby", "Battery", "AC power".

See Figures 51 and 52 "Individual Setup" leads to a setup of a defined joint movement

"Standard Setup" - "Information" leads to the standard setup values of motions, - "Activation" middle! To activate the standard movement program (all joints);

See Figure 53

The fields: "Individual Setup" and "Information: Standartsetup" without a push function: All the other fields with a push function.

See Figure 6

Navigate the adjustments by using the stylus.

"Stop" means: no movement in the arms, legs or torso, the position that the arm and so on will take is then the neutral zero position.

"Reset" means: a new possibility or start of adjustment to adjust the movement.

"Standard": The movement automatically follows the standard program for the selected joint.

"Current setting" returns to the "Current setting" item in the main menu.

"Fixation in this position" Medium: Movement stop in the selected setup joint position.

Both sliding regulators can be moved separately.

See Figures 7 to 13

To demonstrate the joint movement, for example, it could be filled in by a moving human (as an animated figure)

See FIGS. 14 to 17 "Standard" means as a middle position (point 5) of all areas.

"Stop" means: Stop all vibrations.

"Off" means: Stop the separate function.

See Figure 18

"Weight": actual wiped

"Date": actual date

See Figure 19

"Standard": all areas on

See Figure 20

"Date": Date of loss of a fixation

"Loss of fixation": hour and minute of a lost fixation

"Reset": time and hour of re-fixation

Automatically registered actions.

Adding all the necessary files / points of interest to a central system; for example, there are two figures shown (see FIGS. 22 and 23)

Optionally the file "Standby, shutdown, new start" is shown in the picture: "Main menu".

See Figures 21 to 23

The following positions are accompanied by a voice that says "emergency stop", "shock position" and so on.

In the case of selected positions: Automatic standard and individual movement "off"

In the case of Selected Positions:

Vibration function off.

See Figure 24

Automatic time and period of emergency stop registration.

See Figures 25 to 31

"Register" for information, see next view, automatically registered.

See Figures 32 and 33

"Selected patient weight": initial weight.

"Actual Weight": shows the automatically registered and automatically measured weight value of the patient.

"Month": shows the first to the twelfth month of the year, for example by starting the measurement on 2 February.

Diagram "Weight": shows the initial weight in the middle of the vector.

Clicking on the weight in the diagram automatically displays the date;

"Add a Chart": Add a new chart, each chart is saved.

See Figure 34

And so on unlimited.

"Overall view": a diagram showing the development of a weight during the entire measuring time. See Figure 35

Of course, the design shown here is just a suggestion.

Medical robot bed system

Life support in a coma

"Continuous moving and sensory intensive care bed system" (CMSI) - a new intensive care strategy for the adjuvant treatment of comatose patients

1 Introduction

The main focus in the treatment of comatose patients is the preservation of vital signs. The receipt resp. the restoration of complex nervous and muscular functions, however, receives little attention.

The sedated, relaxed and controlled ventilated patient is in a largely immobile and hyposensory state. The naturally existing complex feedback mechanisms between motor, sensory and psychological functions as the basis of homeokinesia (2) are interrupted. Passive movements and tactile resp. Sensory stimuli only occur in the context of changes of position during personal hygiene, storage and prophylactic measures (3,4). Sensory stimuli primarily act as acoustic phenomena of the surrounding background noise and as tactile stimuli through incontinent touches of persons such as the responsible caregiver, physiotherapist or relatives who are in direct contact with the patient. In addition, there are low thermo-, olfactory and nociceptive as well as difficult-to-detect proprioceptive stimuli.

In summary, the comatose patient is reduced in a nonphysiological immobility and a pathological hyposensory state Sensory stimulation and therefore also poor signal processing and reaction, with iatrogenic and disease-related effects interacting.

The consequences of the immobility of the long-term ventilated intensive care patients are still generally underestimated in terms of both the effects on the musculoskeletal apparatus and the required rehabilitative recovery phase after the coma has ended, as well as the complex interaction of the somatic musculature with the organ functions during the coma ,

There are various cooperative interactions between the somatic musculature and the internal organ metabolism as well as the energy metabolism. Limited or absent motor activity therefore results in a disruption of the integration of molecular, cellular, physiological, organic, and neutral mechanisms, and thus the efficiency of energy metabolism and internal organ metabolism, with far-reaching consequences (3). Thus, moving for the functionality of the human body means a fundamental and at the same time regulative factor and, conversely, immobility is a crucial pathomechanistic factor in the genesis of complex organ disorders.

1.1 Consequences of immobility on the musculoskeletal apparatus

Prolonged immobility leads to

muscular atrophy; Actin and myosin filaments lose their ability to contract

Joint contractures with

a. Changes in hyaline cartilage and

b. Changes to the ligament and capsule apparatus with shortening and reduced tensile strength of tendons and ligaments - Inactivity osteoporosis with reduction of bone salt content and bone mass (9)

and

- Arthrosis.

The effects of immobility on the capsular / ligamentous apparatus are i.a. examined for the cruciate ligaments of the knee joint (10). According to this, the reduced load capacity of the bands must be attributed to a loss of the band-specific parallel fiber structure. This manifests itself in the connective tissue cells a synthesis disorder, which is accompanied by a reduced content of Glykosaminog- lykanen, proteoglycans or collagen. The regeneration capacity of the bands is clearly limited.

Pressure, traction, bending and torsion are important mechanical stimuli with a structuring or structure-preserving effect. In addition, the tensile or compressive effect of the musculature has a decisive influence on the maintenance of the balance between bone cultivation and bone destruction (9). For the degree of inactivity of the inoperative osteoporosis the age, the duration of the movement loss and the degree of movement restriction are of crucial importance. Inactivity osteoporosis occurs after just a few weeks, beginning in the area of the cancellous bone perifocal of the epiphyseal plates. The atrophy of the bone shaft with reduction in the thickness of the compact is observed only after a few weeks. In the case of bedridden patients, generalized osteoporosis causes 4-5% loss of bone mass per month (9). Muscular and bone atrophy can not be avoided despite adequate parenteral nutrition or enteral tube feeding (1).

According to Noack (11), immobilization results in the development of osteoarthritis, which is based on malnutrition of the cartilage. The supply of the articular cartilage with nutrients follows exclusively via the synovial fluid, wherein the physiologically changing pressure load of the cartilage in the sense of a pumping mechanism is a decisive factor. Depending on the duration and extent of immobility, rehabilitative measures with integration into the occupational resp. Everyday life is aggravated and prolonged because rehabilitation, in addition to the consequences of the underlying disease, is decisively determined by the secondary effects of immobility on the musculoskeletal apparatus. Especially in the elderly, immobility often leads to a later need for care, with the risk increasing more than βO times at a 4-week immobility period (13).

1.2 Other somatic consequences of immobility

- Disorders of neutral mobility

- Cerebral-mediated impairments of perception with impaired coordination by "unlearning" movement guidance and movement sequences

- Disorder of the vasomotor with increased thrombosis risk as well

Barren slope. Prolonged immobility leads to a disturbance of the external lubricity or internal elasticity of the nerves (1).

After just four days of immobility, significant orientation and coordination disturbances of movement can be detected (6,7,8). Prolonged immobility also means a pathomechanically relevant factor in the development of intestinal atony, from which a bacterial migration of the intestinal wall can result with consecutive sepsis (5).

Consequences of hyposensorics

The short-, medium- and long-term consequences of the hyposensory state of the comatose patient are unclear. The physiological perception as the sum of the steps of recording, selection, cognitive processing and interpretation of sensory information is more or less completely interrupted depending on the depth of the comatose state. The reaction possibilities of the comatose patient are limited to the input of one compared to analytical, differentiated function of waking consciousness at the primitive level of consciousness. Nevertheless, sensory stimuli of the surrounding world are recorded even if only singular sequences of stimuli can be registered. Perception then presents itself primarily through the largest sense organ, the skin, as being immediate and body-related (12).

2. Continuous moving intensive care bed (CMICB)

2.1 Technology and objectives

The CMICB system is a kinetic therapy system based on a robotic technique that allows continuous passive movement of the four extremities and the trunk and provides sensory tactile and auditory signals.

The primary goal is to avoid contractures, muscle atrophy and thrombosis and thereby achieve a shorter phase of rehabilitation. to avoid a permanent immobility. The mediation of sensory signals in the context of an extended basal stimulation aims at a faster postcomatous restitution of neurological perception disorders.

The CMICB system consists of two main components: on the one hand a computer-assisted module with special software for controlling the electronic and sensory individual functions was developed, on the other hand a bed mechanism was designed, which consists of 5 movable functional elements.

2.1.1 Computer module

With the computer unit, the bed has a fail-safe computer module with an ergonomically easy-to-use input and output panel. The system setup, the user administration and the administration of the pa- rameter-specific basic data and movement instructions, i. E. all parameters of the motion and signal functions.

This panel activates or deactivates the motion sequences when the options are selected. After activation, the computer unit controls the corresponding movement and signaling functions of the bed. Control information - eg data from the bed, weight measurements and result data on the movements performed - are also returned to this computer unit. It also provides connectivity to the other computer units / monitors that provide up-to-date intensive care monitoring data, such as blood pressure and heart rate or oxygen saturation, to promptly and automatically prevent immediate movement and emergency positioning in the event of an emergency. The data of the CMSI system can be printed out centrally. Alternatively, a printer can also be connected to the CMSI computer.

2.1.1.1 Calculator

Basic module of the computer unit is a computer with a hard disk storage capacity for data documentation of all selected basic and individual functions over time. The size of the hard disk depends on the volume of the software to be installed and a storage capacity to be calculated for data of the CMSI system in a usage period of 6 months. There are still available:

- Connection for printer

- USB ports (3)

sound card

- CD-ROM drive.

2.1.1.2 Monitor

The (Fiat) monitor of the computer unit is located as a touch screen monitor with a touch pen in the area of the fixed components of the bed system. From medical For hygienic reasons, operating the monitor functions by means of finger touch is not an option.

The monitor is equipped with

On / off switch

- Color change of the buttons when activated

In case of an alarm function: pop up and different, differentiated acoustic signals

- Voice feedback when selecting a function (according to a navigator system)

- Screen Saver

- Animation intro.

2.1.2 Software and Features

General functions:

- "return" means: going back to the last monitor picture

- "menu" means: going back to the main menu.

See Figure 5

First view of the system

Login Name: Username

Language: English, German.

Date: Date

Clock (radio clock) on each monitor picture (under ok button); from View 2 additionally the date

A. Main monitor picture

o.k.- button only for

- emergency stop

Shock position, cardiac position, cerebral position, sitting position, back position, resuscitation position and horizontal position, weight.

The main functions of the CMIS are shown on the main monitor and can be activated here:

1. Movement: Continuous movement of the extremities and trunk in standard or individual selection of

a. Choice of extremity

b. Range of motion in the joints resp. in the spine

c. time duration and

d. timing;

2. Acustic Signals: Function for the basic stimulation by hearing impressions in standard or individual selection of

a. Duration of the hearing impressions

b. Volume of the audio impressions

3. Vibration: Function for obtaining resp. Restitutio of depth sensitivity in standard or individual selection of

a. localization b. time duration and

c. Intensity of vibration.

4. Decubitus prophylaxis: system for the prevention of decubital ulcers in standard or individual selection of

a. Localization and

b. time duration.

5. Thermo System: system for regulating body temperature in standard or individual setting.

6. Current settings: Overview of the current settings of the system.

7. System control: Administrator functions etc.

8. Choice of different preset positions with the option of fast direct setting in combination with specific functions:

a. emergency stop (emergency stop of bed movements)

b. shock position (shock with stop of anti-decubitus function)

c. cardiac position (cardiac support with stop of the anti-decubitus function)

d. cerebral position (storage in case of injuries and diseases of the brain)

e. sitting position (seated position, for example at the beginning of mobilization with stop of the anti-decubitus function)

f. back position (box storage for back diseases and injuries)

G. horizontal position (flat storage)

as well as emergency storage 7. resuscitation position (storage for resuscitation with automatic back support, stop of the anti-decubitus function, lowering of the bed, thermo-regulation with hypothermia 25 degrees Celsius)

9. Weight control (weight control with daily documentation of the measurements, graphical representation of the course).

7. up and down bed position (raising and lowering the bed)

Add a LED controllight system "on", "off, stand by", "battery", "AC power".

See Figure 2

Main monitor picture.

A. Setting the Moving

See Figure 36

Moving setup: adjusting the movement of extremities and trunk with the choice of "individual" and "standard",

"individual setup" leads to the setup of defined movements and to the adjustment of the movements of the duration "

"Standard setup" - leads to already defined settings of the movement as well as the duration

See Figure 37

Moving individual setup: Individual adjustment of the movement functions

See Figure 6 Adjustment of the movements in the joints of the right arm and the left leg. Adjustment of the range of motion by means of a pen. Both sliders for one joint can be adjusted separately.

"stop": no movement in the arm or leg; the adjustment then takes place automatically in the neutral O position.

"reset": reset to the range of movement specified by the manufacturer;

"Standard": when selecting the joint and activating the standard function, the range of motion in the selected joint corresponds to the values in the standard function.

"current settings": Leads to the "current setting" area in the main menu.

"fix in this position": Movement stop in the selected setup of the joint function.

See Figure 7

Adjustment of the movements in the joints of the left arm and the right leg.

See Figure 8

Adjustment of the movements of the trunk and the neck.

See Figure 39

Definition of the duration of the movements.

The activation takes place by means of a pen by clicking on the light blue dot markings of the clocks.

See Figure 38

Standard setup for the movements of the extremities, the trunk and the neck. See Figure 54

Defined range of motion in the joints of the arm.

See Figure 55

Defined range of motion in the joints of the leg.

See Figure 13

Defined range of motion of the trunk and neck. The graphical representation of the demonstrator could be considered as moving according to the defined number of degrees moving male i.S. an animation graphic done.

See Figure 39

Defined timeframe of the continuous movements of the trunk and extremities.

It takes into account the day / night rhythm and the nutrition time.

See Figure 56

Individual or standard setting of the acoustic signals for basal stimulation.

The system consists of a recorder and soft (wireless) headphones for the patient. After oral and written instructions take the family members of the patient at home characteristic noise phenomena according to the daily routine (eg in the morning ringing the alarm, brushing teeth, coffee machine, in the morning noises of working life, at noon the bell of a nearby church tower, in the evening noises from the TV such as the Intro music of the Tagesschau etc.) as well as his often heard music.

The calculator offers the option of digitization, via sound card the data is transferred to the headphones. The recorder can also be connected directly to the headphones. See Figure 40

Individual volume control of the acoustic signals by means of sliders operated by the pen.

See Figure 41

Individual adjustment of the duration of the acoustic signals. To activate the light blue buttons are marked by Pen.

B. Setting the acoustic signals

See Figure 42

Standard setting of the duration and volume of the acoustic signals for basal stimulation.

C. Adjusting the vibration effect

See Figure 16

Individual or standard adjustment of the vibration effect to obtain the depth sensitivity, vibration pads are in each case in the area of the palmar and the dorsal -. by Velcro - attached. The technique of vibration corresponds to that of e.g. Mobile phones.

See Figure 43

Individual adjustment of the vibration effect in the area of the hands and back of the foot.

"Standard" means a middle position of the intensity (point 5) of all regions,

"stop" means stop the vibration of all areas,

"off means stop the single function.

See Figure 45: Individual time adjustment of the vibration effect in the area of the hands and back of the foot.

To activate the light blue buttons are marked by Pen.

See Figure 46:

Standardized time adjustment of the vibration effect on the hands and back of the foot.

D. Adjustment of the anti-decubitus function

See Figure 47

Regions of decubitus prophylaxis. Technically, these are chambered air cushions, each filled with alternating pressure. The function is activated by clicking in the defined areas and indicated by "o.k." approved. When activated, the color of the selected field changes. With "Standard" selection all regions are activated.

E. Setting the thermo system

See Figure 57

Thermosystem for the regulation of body temperature. Technically, a feedback setting is made via a e.g. rectally inserted thermoprobe; the thermo system regulates the body temperature to the preselected number of degrees.

Without feedback setting, the temperature of the thermo system can be controlled manually via the "individual setup" function.

See Figure 48:

Individual adjustment of the temperature of the thermo system via a pen to be operated slider.

See Figure 49: Standard Individual setting of the temperature of the thermo system via a pen-operated slider. Standard setting of the thermo system to 37 degrees Celsius; on feedback: reaching the body temperature of 37 degrees Celsius, with no feedback on the thermosystem temperature.

F. Current settings

See Figure 58

Current settings for movement, acoustic signals, vibration effect, decubitus prophylaxis, documentation of the emergency stop, position and weight.

"weight": current weight

G. System control

See Figure 50

Overview of the functions "system control". Here are all necessary files / points of interest for the system control included, "stand by, shut down, new start" additionally in the "main menu" (see figure 2).

See Figure 22

Administrator controlling.

See Figure 23

Registry of the user. The individual user rights are to be defined.

H. Defined functions

The following defined bed positions are complemented when activated by voce functions that name the respective functions - such as shock position, emergency stop. Individual or standardized motion functions, vibration effects, acoustic signals and anti-decubitus effects are automatically switched off when the following positions are selected.

See Figure 24

Emergency stop of all movement functions. Automatic registration of the time and duration of the function.

See Figure 25

(Volume deficit) shock position.

See Figure 26

Cardiac position (e.g., pulmonary edema, myocardial infarction).

See Figure 27

Cerebral position (for example in cranial-brain trauma).

See Figure 28

Seated position (for example, at the beginning of mobilization). Acoustic signals and vibration effects possible.

See Figure 29

Back support (for example, to bed the patient).

See Figure 30

Box layer (for example in the case of disc prolapse).

See Figure 31

Resuscitation position. Accompanying alarm sound.Automatic stop of the vibration effects, the anti-decubitus function as well as the acoustic signals. The bed moves automatically to a lower position, the starting position changes early in supine position. Automatic thermal function during resuscitation: Cooling to 25 degrees Celsius.

"register": retrieve automatic registration from the moment the activation of the function "reanimation function"

See Figure 38

Registration of the resuscitation phase / position.

I. Weight measurement

See Figure 59

Weight measurement. Digital and graphical representation, "select patients weight": Initial weight of the patient.

"actual weight": shows the current weight of the patient, which is automatically graphically and digitally registered via data memory.

The current date (see Figure 5) is shown and registered in the footer. Diagram "weight": the initial weight of the patient is shown in the vector center. If the diagram is clicked, the date will be displayed automatically, "add diagram": Add another diagram.

See Figure 34

Continuous daily automatic weight measurement and registration. The following graphics with the same representation without limitation.

"overall view"; The graph shows weight gain at 1 week, 1 month, and throughout the weighting period.

J. Alarm function: release the fixation

See Figure 20 Documentation of the loss of the fixation with acoustic alarm, "reset": time documentation of the refixation. The extremities and the trunk are fixed to the movable modules by means of padded velcro straps. Sensors indicate the defective closure.

See Figure 60

Impressun

2.2 Function module

The bed consists of 5 movable modules (Fig.3):

1. Hull-I head unit

2. 2 units each for the upper extremities

3. 2 units each for the lower extremities.

The dimensions of the bed are designed for patients with a body length of up to 2.10m and a weight of 180kg.

see FIG. 3

The 5 basic modules of the MRBS. Each component consists of several movable bowl-shaped individual elements made of lightweight, durable and easy-to-clean material. For example, fiberglass is considered. Metallic substances are not suitable for X-ray imaging.

On the trays the individual modules for decubitus prophylaxis are applied (interchangeable, for example in case of repair). Fabric covers are available for the purchase of the 5 bed components. The fixation of the extremities and the trunk is done by means of Velcro fasteners in which sensors are present, indicating a poor closure

"Loss of fixation alarm". See Figure 61

Model for the movable elements of the 5 basic modules. The shells are not flat, but curved bowl-shaped to counteract falling out. Under the shells, the coherent, computer-controlled movement system is installed, consisting of the computer-controlled movement elements for the joint area and of telescopically extending metallic tubes. The telescopic modules for the 4 extremities are slidably attached to the central (trunk) module so that individual body sizes can be taken into account.

See Figure 4

Schemes for the movable individual shell elements of the 5 basic modules.

1: shell of ultralight material (e.g., fiberglass)

2: anti-decubitus element

3: thermosystem

4: Waterproof mattress pad, available

5: Telescopic arm system.

The unit of telescopic tube and hinge system and shell elements is mounted on a base module that the bed easily movable resp. mobile and can be controlled by computerized height. For the production of X-ray images of the lung, a standard-sized cassette holder, slidable, is installed under the thorax module. For the production of radiographs of the abdomen (abdominal cavity) there is an analogous support at the level of the abdominal module. Additional brackets are used to insert a shell in the head area for hair washing and a toilet bin. The light and at the same time mechanically strong materials used in the bed system ensure easy maneuvering of the bed for transport. Laterally mounted rails make this possible Attachment of infusion pumps and at the head of a mobile oxygen device. An integrated scale allows daily, computer-aided weight documentation

2.3 Indications and contraindications to the use of the Medical robot bed system

2.31 indications

1. General: Long-term ventilation patients of all medical disciplines between the ages of 15 and 90 years

2. Neurological patients for early rehabilitation (2nd bed version with reduced functions possible)

3. Accident and neurosurgical patients for early rehabilitation

4. Domestic care of patients with chronic neurological diseases

5. Nursing home care of immobile patients with underlying neurological disorders (eg, waking coma patients)

2.3.2 contraindications

Currently no known.

The receipt resp. the stabilization of vital functions has priority in every case. The extent of the movements in terms of time duration and extent of movement depends on the underlying diseases, the cardiovascular reactions, the respiratory situation and the requirements for an operation (for example, required immobilization of a limb after osteosynthesis of a fracture).

2.4 Various technical versions of the MRBS Depending on the use of the bed system, various technical versions are available as modifications of the full version.

Examples:

A. Intensive Medicine: Full Version

B. Neurological early rehabilitation: full version without "thermo system"

C. Domestic Supply: Full version without "acustic signal", "vibration", "thermo system", "weight".

D. Nursing home care: Full version without "acoustic signal", "vibration", "thermo system.

In the following, further detailed embodiments will be described.

Continuous moving intensive care bed (CMICB)

medical record

computer module

With the computer unit, the bed has a fail-safe computer module with an ergonomically easy-to-use input and output panel. The system setup, the user administration and the administration of the patient-specific basic data and movement specifications, i. E. all parameters of the motion and signal functions.

After activation, the computer unit controls the corresponding movement and signaling functions of the bed. At the same time, control information - eg data from the bed, weight measurements and result data on the movements performed - are returned to this computer unit. In addition, a connection to the other computer units is provided to surveillance monitors which provide the current monitoring data of the intensive care patients, such as blood pressure and heart rate or oxygen saturation to be able to immediately and automatically ensure an immediate stoppage of movement and positioning in an emergency situation in the event of an emergency. The data of the CMSI system can be accessed centrally; Alternatively, a printer can be connected to the CMSI computer.

computer

Basic module of the computer unit is a computer with a hard disk storage capacity for data documentation (for example, a medical record) of all selected basic and individual functions over time. The size of the hard disk depends on the volume of the software to be installed and a storage capacity to be calculated for data of the CMSI system in a usage period of 6 months.

Further documentation for the medical record is contained in the individual functions.

See Figure 32

Registration of the resuscitation phase / position.

See Figure 59

Weight measurement. Digital and graphical representation,

"select patients weight": Initial weight of the patient.

The current date (see FIG. 5) is shown and registered in the footer.

Diagram "weight": the initial weight of the patient is shown in the vector center. If the diagram is clicked, the date will be displayed automatically.

"add diagrarn": Add another diagram.

See Figure 35

Continuous daily automatic weight measurement and registration. The following graphics with the same representation without limitation, "overall view": The diagram shows the weight development in 1 week, 1 month and during the entire time of the weight measurement.

Embodiment for the administration of pointed or blunt tapping, stroking, brushing or pressure stimuli at different body sites.

The control elements for tactile stimulation are described explicitly: a distinction is made between a "standard setup" and an "individual setup".

See Figures 46, 43 and 45.

ventilation unit

The monitor picture shows the control function "thermo system".

See Figure 62

See Figure 57

Thermosystem for the regulation of body temperature.

Technically, a feedback setting is made via a e.g. rectally inserted thermoprobe; the thermo system regulates the body temperature to the preselected number of degrees.

Without feedback setting, the temperature of the thermo system can be controlled manually via the "individual setup" function. See Figure 48

See Figure 49

Standard setting of the thermo system to 37 degrees Celsius; with feedback: reaching the 37 degrees Celsius body core temperature, in the absence of feedback Thennosystem- temperature.

See Figure 4

Schemes for the movable individual shell elements of the 5 basic modules.

1: shell of ultralight material (e.g., fiberglass) 2: anti-decubitus element 3: thermosystem

4: Waterproof mattress pad, available 5: Telescopic arm system.

Decisive for the technique of the thermosystem are the patient-related individual regulation possibilities.

In the system according to the invention preferably English-language terms are used (as exemplified in the screenshots), with the following translations:

Claims

claims

A controllable hospital bed (1), comprising a bed frame (2) having movable parts, at least one drive unit (3) for the movement of the movable

Parts and / or for driving the movable parts in certain positions, at least one control unit (4) for controlling the at least one drive unit (3) and at least one memory unit (5) for storing a plurality of specific positions and functions, wherein the determined positions Shock position, a heart position, a cerebral position, a sitting position, a back position, a resuscitation position and / or a horizontal position, the functions include a continuous movement of extremities and / or a trunk, a vibration function, pressure ulcer prophylactic function, a selection of different positions a fast and direct adjustment and / or a weight control function, wherein the control unit (4) provides a plurality of the determined positions and functions and wherein the positions and the functions are individually configurable and stored in the memory unit (5).

A steerable bedside according to claim 1, wherein the bed frame (2) comprises a first movable part for holding and moving a head and trunk area of a patient, and second, third, fourth and fifth movable parts for holding and moving, respectively, a limb of the patient ,

3. Controllable hospital bed (1) according to one of the preceding claims, wherein the controllable hospital bed has at least one sensor unit.

4. Controllable hospital bed (1) according to one of the preceding claims, wherein the controllable hospital bed has an acoustic system for the output of acoustic stimuli.

5. A controllable hospital bed (1) according to one of the preceding claims, wherein the hospital bed has a thermo-system for regulating a body temperature.

6. Controllable hospital bed (1) according to one of the preceding claims, wherein the at least one drive unit (3) is configured electrically and or hydraulically.

7. Controllable hospital bed (1) according to one of the preceding claims, wherein the taxable hospital bed (1) provides an alarm function.

8. Controllable hospital bed (1) according to one of the preceding claims, wherein the control unit (4) via a touch screen (7) is operable.

9. Controllable hospital bed (1) according to one of the preceding claims, wherein the controllable hospital bed (1) has at least one communication interface (8).

10. Controllable hospital bed (1) according to one of the preceding claims, wherein the drive units (3) can be controlled individually.

11. Controllable hospital bed (1) according to one of the preceding claims, wherein the control unit (4) provides a timing function.

12. Controllable hospital bed (1) according to one of the preceding claims, wherein in a trunk area of the controllable hospital bed (1) materials are used, which do not affect an X-ray measurement substantially.

13. A method for controlling a controllable hospital bed (1) according to one of the preceding claims, comprising at least one of the following steps:

Driving the steerable hospital bed (1) to a selected position after the selected position is configured and selected; Performing a selected function of the steerable hospital bed (1) after the selected function is configured and selected, and

Performing control functions and providing an alarm signal, wherein the positions and the functions are individually configurable and stored in a memory unit (5).

14. A computer program product implementing a control for a steerable hospital bed (1) according to any preceding claim.

A controllable hospital bed (1) for the storage, care, therapy and rehabilitation of, and the prevention of immobility in, limited mobile or immobile patients, comprising a bed frame (2) having movable or interchangeable parts or modules, at least one drive unit (3) for the movement or adjustment of the movable parts or modules and / or for driving the movable parts or modules in positions or movements stored by the storage unit (5) or individually set by the control unit (4) or for sensory stimuli at least one control unit (4) with interfaces or regulators for controlling the at least one drive unit (3), the set positions, the individual movement sequences, the ventilation and air conditioning unit (6), the sensory (tactile, olefaktorischen or acoustic) stimuli and at least a memory unit (5) with interfaces or regulators for

Inputting, storing, processing, transmitting and reproducing (i) data for (aa) storage or movement therapies, (bb) sensory (tactile, olfactory or acoustic) stimuli, (cc) temperature and ventilation settings, and / or (ii) for the documentation (medical records) resulting data and / or (iii) from a variety of pre-stored basic positions and basic functions, a ventilation and air conditioning unit (6) for providing required heat, cold and ventilation

Vibrating modules with different Befestigungselementeπ for administering vibration stimuli at different body sites, sensor modules with different fasteners for the administration of sharp or blunt Knock-, stroking, brushing or pressure stimuli at different body sites, olefaktorische modules for recording or generating or reproducing odors and their administration the patient, acoustic modules for recording or producing or reproducing human and animal voices, music, natural or artificial - even mechanical - noises,

wherein the control unit (4) and the memory unit (5) are designed to be fail-safe and by suitable customization measures (such as PIN input and / or by iris scan and / or skin scan and / or by RFID tag and / or by magnetic stripe card and / or by other measures) against unwanted manipulation or against unintentional change of the adopted setting are securable and / or a connection to non-hospital bed intensive care monitoring systems and their alarm functions may have to ensure an immediate shutdown of the kinetic modules of the hospital bed in case of alarm wherein the determined positions of the hospital bed comprise a shock position, a cardiac position, a cerebral position, a sitting position, a box position / back position, a resuscitation position and / or a horizontal position, wherein the individually adjustable functions include a continuous or periodic movement egen with different speed, intensity, different radii of each selectable limbs and / or the hull, a vibration function, the therapeutic import and control of sensory and tactile stimuli, a different body sections for adjustable temperature and ventilation of the patient, a selection of ver - various positions by means of a quick and direct adjustment and / or a weight control function, the olefaktorische module possibilities for recording, generating, reproducing and amplifying odors and their supply to the face and / or mouth and / or nose area of the patient may include; wherein the sensor module for tactile stimuli inter alia (i) vacuum and / or compressed air controlled and / or magneto-controlled and / or electric motor-driven drive parts with uniform recording and / or (ii) different therapy pieces for different forms of therapy each fit into the uniform recording and / or (iii) on the patient side of the therapy pieces differently shaped and made of therapeutically useful materials existing surfaces for vibration and / or for pressure stimuli and / or for petting and / or for knocking and / or for needle stimuli and / or for brush stimuli and / / or (iv) can be attached to appropriate locations of the hospital bed by means of different attachment harnesses at different body locations and / or with suitable attachment devices; wherein the acoustic module may comprise a data memory and a recording / playback device and amplifiers and / or loudspeakers and / or headphones (including suitability for human or animal voices, for natural or artificial sounds as well as for music). wherein the control unit (4) provides a plurality of the determined positions and functions, and wherein the positions and the functions are individually configurable and stored in the securable storage unit (5).

A steerable bedside according to claim 15, wherein the bed frame (2) comprises a first movable member for holding and moving a head and trunk region of a patient and a second, third, fourth and fifth movable member for holding and moving one or more members each having a limb of the patient and / or (i) these parts are adjustable according to the height of the respective patient and / or (ii) these parts movement of the respective body parts (torso, head / neck area, limb) (aa) in adjustable Radii and / or (bb) with adjustable frequency and / or (cc) in adjustable planes and / or (dd) in extended motion and / or (ee) in bulk gender and stretching movement and / or (ff) in a combination of several types of movement in different radii and / or on different levels and / or in different frequencies and / or (gg) with an adjustable maximum resistance (maximum movement force) to the moving body part. leaves.

17. Controllable hospital bed (1) according to claims 15 or 16, wherein the controllable hospital bed has at least one sensor unit.

18. A controllable hospital bed (1) according to any one of claims 15 to 17, wherein the controllable hospital bed has an acoustic system for the output of acoustic stimuli.

The controllable hospital bed (1) according to any one of claims 15 to 18, wherein the hospital bed has a thermosystem for regulating a body temperature and for ventilating the skin with locally different climatic zones for different body parts.

20. Controllable hospital bed (1) according to one of claims 15 to 19, wherein the at least one drive unit (3) is configured electrically and or pneumatically and or hydraulically.

21. Controllable hospital bed (1) according to any one of claims 15 to 20, wherein the controllable hospital bed (1) provides its own alarm function and / or recognize alarm functions of connected intensive care monitoring systems and / or can respond.

22. A controllable hospital bed (1) according to any one of claims 15 to 21, wherein the control unit (4) via a touch screen (7) and / or via a connected input unit (such as a laptop) is operable.

23. Controllable hospital bed (1) according to one of claims 15 to 22, wherein the controllable hospital bed (1) has at least one communication interface for setting or data transmission (8).

24. Controllable hospital bed (1) according to one of claims 15 to 23, wherein the drive units (3) and / or the functions can be controlled individually.

25. Controllable hospital bed (1) according to any one of claims 15 to 24, wherein the control unit (4) provides a timing function (timer) for starting and stopping individual functions at different times and / or for the general distinction between daily program and night program.

26. A controllable hospital bed (1) according to any one of claims 15 to 25, wherein in the lower trunk area, a mattress module can be exchanged for a laterally or downwardly removable module for receiving excretions of a patient.

27. Controllable hospital bed (1) according to any one of claims 15 to 26, wherein in the head area a mattress module can be exchanged for a laterally or downwardly removable module with shell and / or drip grid for shampooing.

28. A controllable hospital bed (1) according to any one of claims 15 to 27, wherein for the support areas of the torso and the extremities of the patient for the controllable hospital bed (1) materials are used, which does not substantially affect an X-ray measurement and / or at in the thorax region and in the abdomen region of the patient lying cushion module (s) can be exchanged for laterally or downwardly removable modules with X-ray film cassette.

29. A controllable hospital bed (1) according to any one of claims 15 to 28, wherein the construction and structure of the controllable hospital bed (1) does not significantly exceed the dimensions of simple hospital beds and the materials used simplify the weight of the controllable hospital bed compared to the usual weight easier Do not double hospital beds more than double.

30. A method for controlling a controllable hospital bed (1) according to one of claims 15 to 29, comprising at least one of the following steps:

Driving the steerable hospital bed (1) to a selected position after the selected position is configured and selected;

Performing a selected function of the steerable hospital bed (1) after the selected function is individually configured and selected, and

Performing control functions and providing an alarm signal,

- Protection of the settings made against unintentional adjustment or against unwanted manipulation by unauthorized persons. wherein the positions and the functions are individually configurable and stored in a memory unit (5) both for documentation and for repetition.

A computer program product implementing a steerable bed control (1) as claimed in any one of claims 15 to 30.