WO2000045768A1

WO2000045768A1 - Individual confinement chamber for transporting immunodeficient or contagious patient

Info

Publication number: WO2000045768A1
Application number: PCT/FR2000/000246
Authority: WO
Inventors: Michel Perraud
Original assignee: Universite Claude Bernard Lyon I
Priority date: 1999-02-02
Filing date: 2000-02-02
Publication date: 2000-08-10
Also published as: FR2788966B1; FR2788966A1

Abstract

The invention concerns the confinement of patients. More particularly, it concerns an individual mobile chamber for a patient, defined by an outer casing (1) consisting at least partly of a soft layered material, characterised in that the outer casing comprises: means (10) for being connected to a forced breathing mixture ventilation system (11); substantially sealing means (15) for passing through perfusion or breathing assisting tubes and/or electric cables (17) for medical equipment or the like; channels (20) for intake or discharge of ventilated gases; and an orifice (18) provided with closure means (19): The invention is applicable to confinement under excess pressure of an immunodeficient patient.

Description

INDIVIDUAL CONTAINMENT ENCLOSURE FOR THE TRANSPORT OF IMMUNODEPRESSED OR CONTAGIOUS PATIENTS

TECHNICAL AREA :

The present invention relates to the technical field of confining individuals with a view to either protecting them from the outside environment or, on the contrary, protecting their environment.

The invention relates more particularly to the individual confinement of patients in hospitals in particular.

PRIOR TECHNIQUE:

The prior art knows, for example, individual containment enclosures such as spacesuits for interventions in a contaminated environment. These spacesuits consist of a flexible suit connected to forced ventilation means such as for example a pulsed source of decontaminated air.

However, such spacesuits or full suits, used in the context of intervention in a radioactive environment for example, are not at all suitable for the individual transport of patients in a hospital environment.

Indeed, it may appear necessary to have to transport patients requiring rigorous isolation measures to bring them from one department to another or from one establishment to another in order to carry out medical examinations such as on example of x-rays or subjecting them to special treatment. During this transport, it is imperative to be able to provide eflBcient medical monitoring of the patient by, for example, monitoring his vital functions using suitable instrumentation. Likewise, during this transport, it may be necessary to inoculate various drugs, in particular by means of an infusion placed on the patient. It should be noted that such a need for isolation is particularly acute for the transportation of patients who have AIDS at an advanced stage of the development of the disease and who must be protected from opportunistic infections. This need for isolation is also encountered for patients undergoing immunosuppressive treatment following an organ transplant, for example.

It therefore appears the need to be able to have a confinement enclosure which is particularly suitable for the individual transport of patients in a medical environment while the prior art does not, to the knowledge of the applicant, offer any really suitable solution. PRESENTATION OF THE INVENTION:

In order to meet this objective, the invention relates to a confinement enclosure, individual and mobile, for a patient, of the type delimited by an envelope made up at least in part of a flexible sheet material.

According to the invention, the enclosure is characterized in that the envelope comprises:

- means of connection to a forced ventilation system with breathable gases,

- substantially sealed passage means for perfusion and / or respiratory assistance tubing, and / or for electrical cables for medical or other instruments,

- ventilation or exhaust gas extraction or evacuation routes,

- And an opening equipped with closing means.

Furthermore, the Applicant has had the merit of highlighting that one of the safety factors for carrying out an optimal medical follow-up of the patient transported and isolated in the confinement enclosure, resides in the fact of having rapid access to the different parts of the patient's body in order to be able to practice the emergency procedures that his condition is likely to require.

To meet this need, according to another characteristic of the invention, the confinement enclosure is characterized in that the envelope has means for rapid tearing of the flexible material constituting it.

Another safety factor may lie in being able to observe the patient's condition at any time. To this end, according to another characteristic of the invention, the confinement enclosure is characterized in that the envelope is made at least in part from a substantially transparent material.

Various other characteristics will emerge from the description given below with reference to the appended drawings which show, by way of nonlimiting examples, embodiments of the subject of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS:

Fig. 1 is a front view of a confinement enclosure according to the invention delimited by an envelope forming a diving suit.

Fig. 2 is a side view of the enclosure according to FIG. 1. Fig.3 is a rear view of the enclosure according to Fig. 1.

Figs. 4 and 5 are partial sections showing a detail of embodiment of means, arranged on the enclosure according to the invention, for the passage of pipes. Fig. 6 is a schematic view of a detail of embodiment of a diving suit according to the invention.

Fig. 7 illustrates another embodiment of the confinement enclosure according to the invention.

BEST WAY TO IMPLEMENT THE INVENTION:

According to a preferred embodiment, more particularly illustrated in FIGS. 1 to 3, the confinement enclosure according to the invention is delimited by an envelope which forms a diving suit and which is designated as a whole by the reference 1. The diving suit 1 comprises a combination 2 formed from a flexible material in sheet form such as for example a plastic film preferably but not exclusively air and water tight, made of polypropylene, vinyl acetate, or any other suitable material. The combination 2 is preferably shaped to completely wrap the trunk, the lower and upper limbs of the patient, but it could also include a jacket and pants intended to be connected to each other in a waterproof manner to the belt level for example.

The combination 2 is, moreover, supplemented with a pair of gloves 3 and a pair of boots or overshoes 4 adapted in a waterproof manner on the combination. To this end, the gloves 3 and the boots 4 can be an integral part of the suit 2. Finally, the spacesuit 1 includes a helmet 5 also fitted to the suit 2 in a sealed manner. The helmet 5 has at least one transparent visor which has a surface in relation to the size of the face of the patient wearing the diving suit 1 forming the confinement enclosure. As for gloves 3 and boots 4, the helm 5 can be an integral part of the combination 2 or be independent and connected to the latter by watertight fixing means. Preferably, the helmet 5 is rigid to define a non-deformable volume around the head of the patient wearing the diving suit. According to an essential characteristic of the invention, the enclosure 1 has means 10 for connection to a system 11 of forced ventilation with breathable gas. Preferably, the connection means 10 consist of a bayonet fitting on which is fitted a flexible pipe 12 for connection between the forced ventilation system 11 and the confinement enclosure 1. Preferably but not necessary, the pipe 12 is made from a plastic tube, corrugated to resist crushing. According to another essential characteristic of the invention, the envelope 1 has passage means 15, substantially sealed, for various pipes with a medical function such as, for example, tubes 16 for perfusion and / or respiratory assistance, or else electrical cables 17 for medical or other instruments. The passage means 15 may for example be constituted by buttonholes arranged in an elastically deformable material attached to the envelope 1 or even buttonholes arranged in combination 2 and closed by means of adhesive strips. The passage means 15 are preferably but not necessarily arranged on the envelope 1 so as to be located in relation to the different parts of the patient's body on which the various medical devices above are usually placed.

Preferably, the passage means 15 consist of a kind of flexible sleeve, called a "thimble", forming an integral part of the combination as illustrated in FIG. 4. Before use, the sleeve 15 is closed at its free end 15ι. When it is necessary to pass a tubing 16 or a cable 17 towards the interior of the enclosure 1, the free end 15ι is first of all sectioned and then the tubing 16 is introduced through the opening thus formed. Finally, the sleeve 15 is pressed around the tubing 16 by a ligature 15 ₂ , as shown in FIG. 5, to seal the passage. In order to allow the patient to put on or be covered with the envelope or diving suit 1, the latter has an opening 18 of sufficient size to allow the boots and the lower part of the combination 2 to be put on first. , then the upper part and finally the helmet 5. To complete the isolation of the patient wearing the diving suit, the opening 18 is equipped with closing means 19. Preferably but not necessary, the opening 18 is placed on the before the spacesuit 1 and the closure means 19 are reversible and consist of a zipper. Of course, the closure means 19 could also consist of an adhesive strip bordering the opening of the diving suit 1.

Finally, in accordance with another essential characteristic of the invention, the enclosure 1 has paths 20 for suction or evacuation of the ventilated gases depending on whether the enclosure is maintained under vacuum or over pressure.

When the patient wearing the diving suit 1 has an immunocompromised state, it is necessary to isolate it from the external environment and therefore for this purpose to maintain the enclosure 1 under overpressure. The ventilation system 11 then injects into the enclosure 1, breathable air having a quality compatible with the condition of the patient. Given the injection of air by the system 11, the channels 20 must be capable of allowing air to be evacuated when the overpressure inside the spacesuit 1 has reached a certain value. Preferably, the evacuation paths 20 consist of one or more active or passive filters, the flow rate of which varies as a function of the pressure of the air to be evacuated.

The evacuation paths 20 can also be constituted by ventilation valves oriented in the direction of evacuation of the ventilated gases towards the outside of the enclosure 1, so as to prevent any air intake which would not have been treated by the forced ventilation system 11.

In order to maintain, as much as possible, a film of air between the whole body of the patient and the diving suit, the exhaust air channels 20 are preferably located near the ends of the sleeves and the legs. of the spacesuit 1.

In the same direction, so as to ensure good diffusion of the ventilated air within it, the confinement enclosure 1 may include distribution channels 21 as shown in dotted lines in FIG. 1. These channels 21 extend in particular in the parts of the diving suit 1 corresponding to the upper and lower limbs of the patient. These channels are, for example, constituted by porous flexible pipes and are preferably arranged towards the front face of the diving suit 1 to allow the patient to sit or lie down, without risk of ventilation malfunction.

According to another characteristic of the invention, in order to allow visual observation of the patient's condition at any time, the combination 2 is at least partly and, preferably, completely transparent.

In addition, in order to authorize, in an emergency, rapid access to the different parts of the patient's body, the diving suit 1 preferably has means 25 for rapid tearing of the flexible material of which the suit 2 is made. Such means are for example formed by a zone of initiation of tearing arranged on the combination 2 in relation to a tongue on which it suffices to pull to cause, without undue effort, a rapid tearing of the combination 2. According to another variant embodiment, the tearing means 25 are constituted by a metal wire bonded to the internal face of the combination 2 and connected, on the external face, to a gripping tab which it suffices to pull to cause rapid cutting of the envelope 1. FIG. 1 shows, in phantom, an example of implantation of a wire 25 constituting such tearing means and drawing the shape of a U, oriented upside down, the branches of which extend in relation to the legs of the combination 2. The diving suit 1 according to the invention was presented in the context of use for an immunocompromised patient. However, the diving suit 1 can also be used for the overpressure confinement of a contagious patient. In this case, the material constituting the enclosure or spacesuit 1 is necessarily waterproof and the channels 20 for evacuating the ventilated air are connected to air treatment means so as to neutralize, before being discharged into the atmosphere, any source of infection that it may contain. The processing means can then consist of appropriate active or passive filters. When the pressure drops are too great, it can be envisaged to assist the evacuation of the air by motorized means of forced evacuation. In this case, the ventilation system 11 and the forced evacuation means are designed and controlled to maintain an overpressure in the enclosure and to ensure a relative swelling thereof. To this end, the flow of blown air may, for example, be, at the start of operation, greater than the flow of exhaust air.

It appears that the confinement enclosure 1 according to the invention, and the mobile installation comprising the enclosure 1 and the ventilation system 11 advantageously make it possible to provide transport for patients who are both immunocompromised and contagious for route to examination or treatment rooms, in good health security conditions and while guaranteeing optimal comfort.

In addition, the fact of maintaining the enclosure in overpressure, on the one hand, provides respiratory comfort for a patient suffering from respiratory insufficiency and, on the other hand, ensures a kind of inflation of the diving suit which combats a phenomenon of sauna, by interposing a film of air between the patient's body and the wall of the spacesuit.

In the example above, the confinement of the patients is ensured by placing the enclosure 1 under overpressure, however the confinement of a contagious patient can also be ensured by placing the enclosure under vacuum. To this end, the ventilation system 11 sucks in air to maintain the enclosure 1 under vacuum and the channels 20 allow the suction of the ventilated gases. The channels 20 are then preferably formed by valves oriented in the direction of suction of the gases ventilated towards the inside of the enclosure so as to prevent any escape, towards the outside, of gas coming from the 'pregnant. It should be noted that, in this case, the ventilation system 11 treats the gases before they are released into the atmosphere so as to neutralize any source of infection that they may contain. Preferably, in the context of this application to the confinement of a contagious patient, the aspiration by the system 11 is carried out at the helm 5 of the diving suit 1. The helm 5 then has means of connection 10 to the system 11 and suction paths 20 for the admission of air. According to an alternative embodiment of the diving suit constituting the enclosure according to the invention, the helmet 5 comprises a half-mask 26 shaped to wrap the nose and the mouth of the patient as shown in FIG. 6. The half-mask 26 has, on the one hand, at least one orifice 27 for communication with the interior of the helmet, which is controlled by a non-return valve allowing air to be drawn in from the helmet which is supplied with fresh air. The half-mask 26 is, on the other hand, connected to at least one channel 28 for evacuating the exhaled air towards the outside of the helmet 5 and of the enclosure 1. This channel 28 is then either controlled by a non-return valve authorizing expiration, is connected to means for forced evacuation of the exhaled air. This arrangement of the invention avoids confinement, inside the spacesuit 1, of expired water vapor and carbon dioxide. According to another alternative embodiment, the half-mask 26 is directly connected to the ventilation system 11 and only the volume part of the enclosure delimited by the half-mask 26 and the user's face is in forced ventilation.

In order to ensure better comfort for the patient wearing the diving suit constituting the confinement enclosure 1, the diving suit may comprise, at the level of the helmet 5, means 29 for broadcasting sound and / or music information. Such means

29 can be constituted by a loudspeaker arranged inside the helmet or by disposable pneumatic earphones connected to an appropriate sound source.

According to another embodiment of the enclosure according to the invention more particularly illustrated in FIG. 7, the casing 1 defines a partially at least transparent box supported by a rigid frame 30 formed from arches. This box can for example be adapted on a stretcher or a stretcher for the transport of patients in the lying position. Of course, the envelope 1 includes all the essential elements of the invention and may also have means of rapid tearing. Given the presence of the rigid frame, the casing 1 thus produced is particularly suitable for confining depression of a contagious patient.

According to yet another embodiment of the enclosure 1 according to the invention, the passageways for the ventilated air are made of a material, in sheet form, flexible and porous.

In the context in particular of an enclosure for the confinement of an immunocompromised patient, it could be envisaged to produce the entire envelope of the enclosure in such a porous material, the confinement of the patient being completed by the overpressure of the 'pregnant.

Claims

CLAIMS:

1 - Containment enclosure, individual and mobile, for a patient, of the type delimited by an envelope (1) made at least in part by a flexible sheet material, characterized in that the envelope comprises: means (10) for connection to a ventilation system (11) forced into breathable gases, substantially leaktight passage means (15) for infusion tubes and / or respiratory assistance and / or for electric cables (17) of medical or other instrumentation, paths (20) for suction or evacuation of ventilated gases, an opening (18) equipped with closing means (19), and means (25) for rapid tearing of the flexible material.

2 - Containment enclosure according to claim 1 characterized in that the tearing means (25) consist of at least one tear initiation zone arranged in the envelope.

3 - Containment enclosure according to claim 1 characterized in that the paths (20) of suction or evacuation of the ventilated gases consist of at least one ventilation valve. 4 - Containment enclosure according to claim 1 or 2 characterized in that the envelope (1) is made in part at least in a substantially transparent material.

5 - Containment enclosure according to one of claims 1 to 4 characterized in that it is intended to be maintained in overpressure by the system (11) of forced ventilation and in that the channels (20) are intended to ensure a evacuation of ventilated gases outside the enclosure.

6 - Containment enclosure according to claim 5, characterized in that the channels (20) are constituted by at least one ventilation valve oriented in the direction of evacuation of the ventilated gases to the outside of the enclosure. 7 - Containment enclosure according to claim 5, characterized in that the channels (20) are intended to be connected to means for the forced evacuation of ventilated gases.

8 - Containment enclosure according to one of claims 1 to 4 characterized in that it is intended to be maintained in depression by the system (11) of forced ventilation and in that the ventilation valves (20) are oriented in the direction of aspiration of the ventilated gases towards the interior of the enclosure. 9 - Containment enclosure according to one of claims 1 to 8, characterized in that it is produced in the form of an integral spacesuit comprising a helmet (5).

10 - Containment enclosure according to claims 6 and 9 characterized in that the ventilation valves (20) are arranged near the ends of the parts of the spacesuit corresponding to the members of the human body.

11 - Containment enclosure according to claim 8 characterized in that the envelope (1) defines a box and in that it comprises a rigid frame (30) supporting the envelope. 12 - Containment enclosure according to one of claims 1 to 11 characterized in that it comprises means (26) for the dissemination of music and / or sound information.

13 - Containment enclosure according to one of claims 1 to 12 characterized in that it comprises channels (21) for distributing the ventilated gases within the envelope (1).

14 - Application of an enclosure according to claim 1 or 5 for the transport of an immunocompromised patient.

15 - Application of an enclosure according to claim 1, 7 or 8, to the transport of a contagious patient. 16 - Mobile installation for transporting a patient, characterized in that it comprises a confinement enclosure (1) according to one of claims 1 to 13 and a forced ventilation system (11).