Medical bed facilitating manoeuvring for turning a patient over, in particular in the event of prolonged mechanical ventilation

Abstract

The invention relates to a patient turning system for patients under artificial ventilation. The turning system comprises two hollow upper (1) and lower (2) hemi-cylinders, means for temporarily anchoring (3) and releasing these two hemi-cylinders from each other to form, by anchoring, a complete cylinder (4), the upper (1) and lower (2) hemi-cylinders having at each of their longitudinal distal ends a rigid tubular hemicircle (la, 2a) to form a complete tubular circle (6), the complete cylinder (4) internally delimiting a volume in the form of a free space (5) intended to receive the patient, a fixing base (7) having at each of its longitudinal distal ends two rotating pulleys (8) aligned in a plane transverse to the longitudinal axis of the complete cylinder on which one of the complete tubular circles (6) rests, the whole allowing a rotation of said complete cylinder (4).

Description

Technical field

[0001] The present invention aims to facilitate the handling of hospitalized patients, benefiting from long-term artificial ventilation and requiring a turning maneuver (transition from the position lying on the back, called dorsal decubitus, to the position lying on the stomach, called ventral decubitus.

[0002] This maneuver is painful, requires 3 to 8 people and lasts 30 minutes or more. It is sometimes dangerous for the patient and does not allow for easy care and hygiene or other ancillary tasks. It is certainly not intuitive, as evidenced by the initiative of the Besançon University Hospital to methodically train all of its healthcare staff (Coronavirus: the Besançon University Hospital trains 220 caregivers in turning patients prone, Health - Science File: Marion Streicher, France Bleu Besançon, Wednesday, April 8, 2020, 4:51 p.m.) .

[0003] The invention makes it possible to facilitate, accelerate and secure this manipulation while reducing the number of people involved in the maneuver.

[0004] In cases of severe respiratory failure, artificial ventilation (here we will speak indifferently of ventilation or respiration) becomes necessary, using oxygen administered with a mask tightly sealed to the face. At a higher degree, intubation is used and the ventilatory circuit then delivers oxygen into the trachea and bronchi. Oxygen can be supplemented with other gases, such as NO (Nitric Oxide), which is more toxic but diffuses better. As a last resort, the blood is oxygenated via an extracorporeal circuit called ECMO.

[0005] It is now accepted that position changes have a major beneficial effect in accessing and freeing the most distal level of the bronchioles and alveoli by directing the gas jet and combating the effects of gravity that cause stasis and congestion in the dependent areas. Thus, during the current Covid 19 epidemic, this turning maneuver is frequent if not systematic for patients hospitalized and ventilated in intensive care, at a minimum rate of twice a day (round trip). Other physiological mechanisms are involved to explain the improvement in hematosis function.

[0006] In any case, during this turning maneuver, the patient being subjected to major sedation to plunge him into an artificial coma, he represents a "dead weight" and the turning maneuver is made all the more difficult as particular care must be taken with the rotation of the head, encumbered by a tube that must be "turned" in perfect coordination with the mobilization of the body, trunk and lower limbs to avoid causing hemorrhage by untimely mobilization of the endotracheral intubation tube. Another delicate point are the arms encumbered with multiple perfusion tubes connected to bottles usually located at the head of the bed (more than ten), not to mention the monitoring devices and sensors (oximetry, blood pressure, continuous electrocardiogram, etc.) and the possible ECMO circuit.

[0007] The present invention can also be extended to the turning of patients in other pathological and therapeutic situations and applies to any age.

[0008] Various patient turning systems are known, in particular through document US 2002 / 0104535 A1, which describes a turning system that is extremely complex to implement from a technical point of view and to handle. Furthermore, the system described does not allow the patient's horizontal turning to be safely accompanied, in particular at the level of the patient's head and the artificial ventilation circuits. Presentation of the invention

[0009] The object of the present invention therefore aims to overcome the drawbacks of the prior art and to facilitate, accelerate and secure the operation of horizontally turning a patient, passing from the dorsal decubitus position to that of ventral decubitus, known as procubitus, and vice versa, in particular for patients subjected to a form of artificial ventilation.

[0010] Another object of the present invention is to provide a new system for horizontally turning a patient which is particularly effective, simple and economical.

[0011] Another object of the present invention is to propose a new method for horizontally turning a patient which is particularly easy to implement and substantially improves the hygiene operations to be carried out. The objects assigned to the present invention are achieved using a turning system for a patient under artificial ventilation, characterized in that it comprises: two rigid half-envelopes of substantially cylindrical shape, constituting identical hollow hemi-cylinders, upper and lower, each internally covered with at least one removable protective base mattress, means for temporarily anchoring and releasing these two hemi-cylinders from each other to form, by anchoring, a complete cylinder along a longitudinal axis and by release a complete separation of the two upper and lower hemi-cylinders, the upper and lower hemi-cylinders comprising at each of their longitudinal distal ends a rigid tubular hemi-circle to form a complete tubular circle resulting from the backing of the two tubular hemi-circles when the upper and lower hemi-cylinders are anchored, the complete tubular circle, with an axis coincident with the longitudinal axis of the complete cylinder, forming a handling member used for rotating and gripping the assembly,the complete cylinder internally delimiting a volume in the form of a free space intended to receive the patient in dorsal or ventral decubitus, protected by at least one upper and lower base mattress, a fixing base comprising at each of its longitudinal distal ends two rotating pulleys, with axes parallel to the longitudinal axis of the complete cylinder and aligned in a plane transverse to the longitudinal axis of the complete cylinder, on which one of the complete tubular circles rests to form at each longitudinal distal end of the fixing base, a rotation plate constituting a rolling line for the complete tubular circle, the whole allowing a clockwise or anti-clockwise rotation of 180° of said complete cylinder, before detachment and complete separation of the upper half-cylinder from the lower half-cylinder.

[0012] According to an exemplary embodiment, the diameter of the complete tubular circles, by placing the two tubular semi-circles against each other, is greater than the external diameter of the complete cylinder in order to more easily and manually rotate said complete cylinder.

[0013] The turning system comprises, for example, a remotely controlled and servo-controlled electric motor mounted in the fixing base and driving the rotating pulleys to perform a motorized rotation of the complete cylinder.

[0014] According to an exemplary embodiment, each upper and lower semi-cylinder comprises at least two longitudinal tubes assembled by means of at least one stiffening hoop and removable connecting elements fixed to the longitudinal tubes and / or to the stiffening hoops.

[0015] According to an exemplary embodiment, the docking means comprise locking members to prevent, when the upper and lower semi-cylinders are docked, in particular during an operation of rotation of the complete cylinder, the separation of the two upper and lower semi-cylinders during a rotation operation.

[0016] According to an exemplary embodiment, the fixing base comprises a locking system for locking the lower half-cylinder in rotation in different angular positions allowing the lower half-cylinder to be tilted.

[0017] The turning system comprises, for example, a first inflatable anti-decubitus mattress placed on the base mattress of the lower half-cylinder, the patient resting on this first inflatable mattress in a ventral or dorsal decubitus position and a second inflatable anti-decubitus mattress associated with the upper half-cylinder to carry out the turning maneuver.

[0018] The turning system comprises, for example, a set of removable foam elements, such as walls and / or wedges, at least some of which have shapes designed to adapt to any size and anatomy of the patient, a combination of various foam elements making it possible to fill the space existing between the patient's body, the first inflatable mattress and the lateral parts of the lower half-cylinder, so as to immobilize said patient in the lower half-cylinder.

[0019] According to an exemplary embodiment, the foam elements comprise two lateral elements intended to extend along each rising part of the lower semi-cylinder, two intermediate elements having on one side a flat external contour and on another side a curved internal contour, to best envelop the patient when they are arranged on each side of the patient and wedging elements in the form of asymmetrical bent pieces.

[0020] According to an example of embodiment, the base mattress is made of foam and reinforced and has fastening systems on the underside to fix it to the lower semi-cylinder.

[0021] According to an exemplary embodiment, the fixing base comprises a frame whose dimensions are chosen so that it can be placed on a medical bed or on a trolley.

[0022] According to another embodiment, the fixing base includes a base to rest directly on the ground.

[0023] The objects assigned to the invention are also achieved using a method of horizontally turning a patient under artificial ventilation, consisting of using a turning system as described above comprising the steps: using the foam elements, wedge and immobilize the patient lying in the ventral or dorsal decubitus position on the first inflatable anti-decubitus mattress in the lower half-cylinder, place the second inflatable anti-decubitus mattress on the foam elements in vertical alignment with the first inflatable mattress to cover the patient, place and secure the upper half-cylinder on the lower half-cylinder and activate the locking members, at least partially inflate the second inflatable mattress to fill the free space remaining between the second inflatable mattress and the base mattress fixed in the upper half-cylinder, deactivate the locking system of the lower half-cylinder, rotate the complete cylinder by actuating the complete tubular circle, lock the upper half-cylinder on the fixing base, deactivate the locking members and separate the lower half-cylinder from the upper half-cylinder,deflate and remove the first inflatable mattress, and extract the foam elements.

[0024] According to an exemplary implementation, the turning method consists of cleaning the removable foam elements, the first inflatable mattress, the corresponding base mattress and the lower half-cylinder, thus freed to provide the nursing staff with a new assembly comprising an upper half-cylinder usable for another turning maneuver.

[0025] The turning system according to the invention has the enormous advantage that it becomes possible to carry out the turning without touching the patient, avoiding skin or deep lesions and transmission of iatrogenic infections carried by hand. The turning system therefore makes it possible to facilitate and secure iterative, atraumatic turnings without direct manipulation of the patient in respiratory distress subjected to artificial ventilation.

[0026] Another remarkable advantage of the invention is related to the saving of nursing staff to carry out the turning operations. The turning requires only two people and this without compromising the safety of the patient.

[0027] In addition, turning can be done easily, without significant physical effort for the nursing staff.

[0028] The duration of the operation directly involving the patient (excluding preparation time) goes from several tens of minutes to a few tens of seconds, at most.

[0029] The patient can be turned over, thanks to the invention, by visually checking the absence of tension on the perfusion lines and on the extracorporeal oxygenation tubes and, consequently, avoiding any disconnections or occlusions by twisting of these different components.

[0030] Finally, the patient is held, gently but firmly, confined to the center of the cylinder during the rotation maneuver which causes the turning, like a stone in the center of a fruit, apricot, peach, etc. this absence of "rocking" prevents "lateral" transfers which generate cardio-circulatory disturbances harmful to the perfusion of vital organs.

[0031] The configuration of the turning system according to the invention makes it possible to obtain the lowest possible positioning of the center of gravity both for the complete cylinder during rotation and for the static lower half-cylinder serving as a bed for the patient. The stability of the assembly is thus improved. Brief description of the figures

[0032] Other characteristics and advantages of the invention will appear on reading the detailed description which follows, given by way of illustrative and non-limiting example, a description made with reference to the appended drawings, in which: THE Figures 1 and 2 are profile views of an exemplary embodiment of a turning system according to the invention comprising two semi-cylinders, respectively separated and moored, the figure 3 is a front view of the turning system of the figure 2 , there figure 4 is a top view of the turning system of the figure 3 , there Figure 5 is a perspective view of the turning system of the figure 3 , there figure 6 is a representation of a detail A of the Figure 5 , there figure 7 is a representation of a detail B of the figure 3 , there figure 8is a bottom and perspective view of a flat, reinforced base mattress, intended to equip each semi-cylinder to serve as support for an inflatable anti-decubitus mattress, the figure 9 is a perspective view of a semi-cylinder dressed with this basic mattress of the figure 8 , there figure 10 represents the semi-cylinder of the figure 9 , comprising an inflatable anti-decubitus mattress placed on the base mattress, the figure 11 illustrates an exemplary embodiment of flat foam side elements intended to extend on either side of the inflatable mattress to cover open spaces between cradles which support the mattresses and the patient, the figure 12 illustrates the semi-cylinder of the figure 10 , dressed with the foam side elements, the figure 13illustrates an exemplary embodiment of foam contour elements specifically adapted to the shape of the human body intended to be positioned between the foam side elements and each side of the patient's body, the figure 14 illustrates the semi-cylinder of the figure 12 , also dressed with the foam contour elements, the figure 15 illustrates an example of the production of foam cushioning elements, for example in the shape of comma, which can be deformed, flattened or folded in two as required, the figure 16 illustrates an example of the use of foam wedging elements, of good positioning of the assembly thanks to the placement in an appropriate position between the patient's body and this molding element described in figures 13 And 14 or between the latter and the lateral element described in figures 11 And 12 using an appropriate number of these comma-shaped foam wedges, the figures 17 to 20schematically illustrate an example of implementation of part of the steps of the turning method according to the invention, in which, the figure 18 presents the second inflatable mattress identical to the one on which the patient is lying, which will be placed on the patient's body and then topped with the semi-cylinder also identical to the one occupied by the patient, the figure 19 shows the assembly secured together and indicates by the arrow the 180° rotation maneuver, a stabilizing pin of a locking system located at six o'clock, at the slope point being temporarily removed, and the figure 20 shows that the patient is in an inverted position by the orientation of the feet. Detailed description of the invention

[0033] In the following, elements shown in several figures, which are structurally and functionally identical, have the same numerical or alphanumeric references.

[0034] THE Figures 1 and 2are profile views of an exemplary embodiment of a turning system, which comprises two upper 1 and lower 2 semi-cylinders, respectively separated on the figure 1 and moored on the figure 2 .

[0035] The turning system comprises means for temporarily mooring 3 and releasing these two upper 1 and lower 2 semi-cylinders from each other, to form, by mooring, a complete cylinder 4 along a longitudinal axis and by releasing a complete separation of the two upper 1 and lower 2 semi-cylinders.

[0036] The temporary mooring means 3 advantageously comprise locking members to prevent, when the upper 1 and lower 2 semi-cylinders are moored, in particular during an operation of rotation of the complete cylinder, the separation of the two upper 1 and lower 2 semi-cylinders.

[0037] The upper 1 and lower 2 semi-cylinders comprise at each of their longitudinal distal ends, respectively a semi-circle 1a and 2a, tubular and rigid to form a complete tubular circle 6 resulting from the backing of the two tubular semi-circles 1a and 2a, when the upper 1 and lower 2 semi-cylinders are moored.

[0038] The complete tubular circle 6, with its axis coincident with the longitudinal axis of the complete cylinder 4, forms a handling member used for rotating and gripping the assembly. The diameter of the complete tubular circles 6, by placing the two tubular semi-circles 1a and 2a against each other, is preferably greater than the outside diameter of the complete cylinder in order to more easily and manually rotate said complete cylinder.

[0039] According to another exemplary embodiment, in a motorized variant of the system, the turning system comprises a servo-controlled and remotely controlled electric motor, mounted in the fixing base 7 and driving the rotating pulleys 8 in rotation to carry out a motorized rotation of the complete cylinder.

[0040] The complete cylinder 4 thus delimits, internally, a volume in the form of a free space 5 intended to receive the patient in dorsal or ventral decubitus, protected by at least one upper and lower protective mattress, it being understood that the patient must be held firmly but without deleterious pressure in the center of the system during rotation by opposing the effects of gravity by optimal wedging of the side of the body which would naturally come into a declive position, in the absence of a wedging system.

[0041] The turning system also comprises a fixing base 7 comprising at each of its longitudinal distal ends two rotating pulleys 8, with axes parallel to the longitudinal axis of the complete cylinder 4. The rotating pulleys 8 are aligned in a plane transverse to the longitudinal axis of the complete cylinder 4.

[0042] On each pair of rotating pulleys 8 rests one of the complete tubular circles 6 to form at each longitudinal distal end of the fixing base 7, a rotation plate 9 constituting a rolling line for the complete tubular circle 6.

[0043] There figure 3 is a front view of the turning system of the figure 2 , with the upper 1 and lower 2 semi-cylinders moored to each other.

[0044] There figure 4 is a top view and the Figure 5 a perspective view of the turning system of the figure 3The upper semi-cylinder 1 comprises longitudinal tubes 10 assembled by means of stiffening hoops 11 and removable connecting elements 12 and 13 fixed to the longitudinal tubes 10 and / or to the stiffening hoops 11. The removable connecting elements 12 and 13 are advantageously clipped or fixed to the longitudinal tubes 10 and / or to the stiffening hoops 11 by any rapid fixing means.

[0045] Advantageously, the longitudinal tubes 10 extend to the lateral ends of the upper 1 and lower 2 semi-cylinders and carry the temporary mooring means 3.

[0046] The longitudinal tubes 10 and the stiffening hoops 11 are advantageously made partially of steel, aluminum and / or carbon. The connecting elements 12 and 13 are made for example of PSA or PMMA.

[0047] The connecting element 12, in the form of a rigid or semi-rigid strip, extends longitudinally and connects together stiffening bars 1b each secured to a different semi-circle 1a.

[0048] The connecting elements 13, for example two in number for the upper semi-cylinder 1, in the form of a rigid or semi-rigid strip, have a U shape whose ends are fixed or clipped onto the longitudinal tubes 10. The connecting elements 13, for example, rest on the longitudinal connecting element 12.

[0049] The construction of the lower hemi-cylinder 2 is strictly identical to that of the upper hemi-cylinder 1. Each hemi-circle 2a therefore has a stiffening bar 2b.

[0050] There figure 6 is a representation of an enlarged detail A of the Figure 5. The fixing base 7 comprises a locking system 14 for locking the lower hemi-cylinder 2 in rotation in different angular positions. The locking system 14 comprises a plate secured to the fixing base 7 and extending over the rolling path of the complete tubular circle 6. The tubular hemi-circle 2a comprises radial bores 15 over a determined angular extension, so as to allow a locking pin 16 passing through the plate to engage in one of the radial bores 15 and thus lock the hemi-circle 2a and consequently the lower hemi-cylinder 2 in rotation. The locking pin 16 advantageously comprises a handling handle 16a. The latter makes it possible to remove the locking pin 16 from the radial bore 15 and thus release the tubular hemi-circle 2a and consequently also the lower hemi-cylinder 2 in rotation.Once the correct inclination relative to the horizontal has been obtained for the lower half-cylinder 2, the locking system 14 must be reactivated by engaging the locking pin 16 in the appropriate radial hole 15.

[0051] There figure 7 is a representation of an enlarged detail B of the figure 3 . Each rotary pulley 8 is mounted on an axle 8a by means of ball bearings 8b. The axle 8a is mounted on a pulley support 7a secured to the fixing base 7. The pulley 8 advantageously has an external rim 8c higher than an internal rim 8d, thus contributing to the longitudinal locking of the semi-circle 2a in the rotation plates 9.

[0052] There figure 8is a bottom and perspective view of a base mattress 17, made of foam, reinforced by a plate and intended to equip the upper half-cylinder 1 and the lower half-cylinder 2. The base mattress 17 has a rectangular shape and is fixed to the connecting elements 12 and 13 and to the stiffening bars 1b and 2b. The base mattress 17 comprises, for example, fastening systems 17a, for example braided nylon strips, adjustable in length and so-called quick plastic fasteners. Another means of fastening, of the VELCRO type, can also be envisaged.

[0053] There figure 9 is a perspective view of the lower hemi-cylinder 2 dressed with the base mattress 17.

[0054] The turning system further comprises a first inflatable anti-decubitus mattress 18 arranged on the base mattress 17 inside the lower semi-cylinder 2. The patient rests on this first inflatable mattress 18 in a horizontal position.

[0055] There figure 10 represents the lower semi-cylinder 2 in which the first inflatable mattress 18 is arranged.

[0056] The turning system also includes a set of removable foam elements for immobilizing the patient in the lower hemi-cylinder 2. The foam elements include side elements 19, illustrated for example in figure 11 and intended to be positioned along the rising parts of the lower semi-cylinder 2, on either side of the first inflatable mattress 18.

[0057] There figure 12 illustrates the semi-cylinder of the figure 10 , dressed with the 19 foam side elements.

[0058] The foam elements also include two intermediate elements 20, illustrated in figure 13 , the shape of which is designed to adapt to the size and morphology of the patient. The two intermediate elements 20 advantageously have a flat external contour 20a and a curved internal contour 20b, to best envelop the patient when they are arranged on each side of the patient on the first inflatable mattress 18.

[0059] The intermediate elements 20 advantageously have lower ends 20c intended to extend as well as possible around the patient's feet and upper ends 20d, opposite each other, but having a sufficient gap intended for the passage of the patient's head. The intermediate elements 20 are intended to be positioned, each, between a lateral element 19 and a side of the patient, as illustrated in figure 14 .

[0060] The foam elements also include wedging elements 21, for example in the form of commas or asymmetrical bent pieces, illustrated in figure 15 . These are intended to be inserted between the patient and the intermediate elements 20 and / or between the lateral elements 19 and the intermediate elements 20. The number and position of the wedging elements 21 used depend on the size and morphology of the patient. An example of positioning of wedging elements 21 is illustrated in figure 16 .

[0061] The foam elements therefore make it possible to best fill the space existing between the patient's body, the first inflatable mattress 18 and the lateral parts of the lower semi-cylinder 2, so as to immobilize the patient in the horizontal plane.

[0062] According to an exemplary embodiment, each upper 1 or lower 2 hemi-cylinder is advantageously flattened over its entire length according to a chord “10:00 - 14:00” which would be calculated on an upper 1 or lower 2 hemi-cylinder placed on its base with the top of the corresponding hemi-circle 1 or 2 appearing at noon. This defines a “useful” cylinder (flattened at two levels) which will contain protective mattresses delimiting the patient space, which can be adjusted by removing or not secondary nesting mattresses.

[0063] The aim is to reduce the internal volume and therefore the weight and mass of protective foam which will serve as a bed for the patient.

[0064] The (temporary) mooring of the two upper 1 and lower 2 hemi-cylinders is done on the longitudinal reinforcement elements by means of male-female interlocking, hole-pin, or any other system favoring simplicity for assembly-disassembly and access for cleaning.

[0065] To allow the rotation of the assembly, the rotary pulleys 18 have concave grooves and external cheeks or rims with a diameter greater than the internal cheek, receiving the complete tubular circles 6 peripheral with round section formed by the junction of the two semi-circles 1a and 2a which slide in the groove of said pulleys with adequate dimensions. The larger diameter of the external cheek of the pulley is a safety device to prevent the complete tubular circle 6 from coming out of the groove of the pulleys, in particular during the rotation maneuver.

[0066] This is done alternately either clockwise ( figure 19), or counter-clockwise, depending on the device settings and the caregivers' choice, but it is imperative to reproduce the strictly reverse path on the return in a "from 0° to 180° then from 180° to 0°" mode, to return to the starting position in order to avoid unwanted traction on the entire pipework connected to the patient.

[0067] After placing the two upper 1 and lower 2 hemi-cylinders, one on top of the other, which requires two people, a member of the nursing staff can then manually rotate the complete cylinder 4, which a single person can do with ease. A doctor will be concerned that all the tubes and pipes, in particular the ventilation device, harmoniously follow the patient's turning movement without exerting any traction, bending, axial torsion or risk of tearing. Four hands will again be necessary to release and store the lower 2 hemi-cylinder once it has reached the upper, high position, freed from the presence of the patient, which will be found in the opposite position to that preceding the turning maneuver.

[0068] Inside, each of the two hollow upper 1 and lower 2 half-cylinders is, according to another embodiment, lined with a hollow mattress rising up on the sides, made of foam with or without shape memory, intended to accommodate the patient placed alternately on the back or on the stomach. Depending on the build of the individual, one or two of the pre-cut nesting mattresses which fit together perfectly may be left in place, in order to adapt to the morphology of the patient and to add, optionally, an additional protective mattress, either with tubes with temporary and alternating inflation or a mattress filled with water or silicone gel as additional protection, optional with the shape memory foam.

[0069] At the end of the rotation maneuver, over 180°, a rotation stop system can be provided. Such a rotation stop system, conveniently placed on the "foot" or "head" side or in the middle of the length of the fixing plate 7 to the plane of the bed or trolley to which it is secured, is engaged in order to protect the assembly from any unwanted excessive rotation. It would be possible to add electrical assistance to the rotation, without this being in any way essential and at the cost of a significant increase in complexity.

[0070] Likewise, choosing to block the bed, i.e. the lower half-cylinder 2 occupied by the patient, on intermediate rotation positions inclined at 15°, 30°, 45° from the horizontal is possible.

[0071] The turning system must be securely fastened (permanently) to the base of the hospital bed on which it may be placed. The turning system then comprises a strap device of the type used to hold truck tarpaulins with a notched locking system, which has the advantage of flexibility and simplicity when dealing with beds of different widths. Other means of securing are possible, such as lashing pads fixed to the internal edges of the fixing plate 7.

[0072] As an example, the rotation or turning maneuver is described starting with a patient lying on their back on the first inflatable mattress 18 or on a foam mattress lightened or not by one or two (or more) nesting foam mats depending on their morphology. The patient is assumed to be subjected to sedative therapy or artificially asleep ("plunged into an artificial coma"). The objective is that the patient is not compressed or that, conversely, they "float" in the space they occupy, during this rotation.

[0073] When the decision is made to turn the patient from the dorsal position (precubitus dorsal) to the ventral position (procubitus), the staff installs side cushions if necessary, particularly on both sides of the head, which remains controlled throughout the operation by a caregiver who accompanies the movement. Other cushions / pads, for example all or part of the foam elements 19, 20, 21, block the flanks and lower limbs.

[0074] It is possible to immobilize the patient with Velcro-type straps. In practice, appropriate wedging will eliminate the need to strap the patient down.

[0075] Then, ensuring that no pipe is stuck, bent or twisted, the second hemi-cylinder (upper hemi-cylinder 1) is placed on the first (lower hemi-cylinder 2) to form the complete cylinder 4, the two being centered and fixed to each other with the temporary mooring means 3, such as hooking / unhooking means, hole / pin, to make them perfectly integral and form the complete rigid cylinder 4, ready for rotation.

[0076] In any event, at the end of this maneuver which lasts a few seconds or tens of seconds at most depending on this method linked to the invention, the patient is in the opposite position to that of the start in the upper half-cylinder 1 added extemporaneously before the rotation.

[0077] According to an exemplary embodiment, a stop with the softest possible stop will avoid any "hyper-rotation" beyond 180° and the return to the initial position taking the same path in the opposite direction, has the main reason to avoid causing all the tubes, in particular respiratory and perfusion lines, in a particularly harmful axial torsion. Different methods are possible for maintaining good ventilation, some being based on the use of a specially designed facial support element, which is outside the scope of this document, the essential thing being to be able to ensure complete compatibility with the foam elements and mattresses on which the patient rests.

[0078] Then the lower hemi-cylinder 2, initially in the low position and which is now facing "ceiling", is detached and separated from the upper hemi-cylinder 1, cleaned, sanitized for its metal part, while the inflatable mattress 18 and where appropriate the basic foam mattress 17, protected by sheets which envelop them or directly placed in a non-woven fabric bag, is removed to allow cleaning or disinfection by appropriate means (jet of disinfectant air and / or antiseptic spray for example) before being covered with clean material, pending its reuse. Bacteriological or more generally microbiological samples will be taken systematically. These interventions can be repeated as many times as necessary.

[0079] Saving time, reducing physical effort, gentle handling and reducing the number of operators are therefore obtained with a ventilated patient turning system, in accordance with the invention.

[0080] According to an exemplary embodiment, one can imagine an additional specific device for managing the piping connected to an artificial ventilation device and to allow a degree of lateralization of the patient's head, in particular when lying prone.

[0081] According to the above description, it appears that the work of medical personnel is greatly facilitated, the number of caregivers can be considerably reduced and, in addition, they are no longer subjected to painful or traumatic physical efforts. For the patient, the safety which is the desired objective is guaranteed.

[0082] Many variations are possible compared to this precise description. They will have in common the simplification of the architecture of the bed to facilitate its industrialization and reduce the cost of production. For example, to save weight, thermoformed, rotomolded or injected plastic materials can be used.

[0083] Aluminum or carbon can also be used for all or part of the turning system parts. Different configurations of material choices are therefore possible for the metal parts, including perforating them, in order to optimize the stability - ease of rotation couple while maintaining the rigidity of the upper 1 or lower 2 hemi-cylinder serving as the patient's bed.

[0084] It will also be possible to make the turning system completely autonomous by placing it on a dedicated structure taking the rectangular shape of a medical bed plan.

[0085] THE figures 17 to 20schematically illustrate an example of implementation of part of the steps of the turning method according to the invention. In order to perform a horizontal turning of a patient under artificial ventilation, the following steps are implemented using the turning system described above.

[0086] In a first step, using the foam elements 19, 20, 21, the patient resting in the supine position on the first inflatable mattress 18 in the lower half-cylinder 2 is wedged and immobilized.

[0087] In a second step, a second inflatable anti-decubitus mattress 22 is placed on the foam elements 19, 20, 21 in vertical alignment with the first inflatable mattress 18 to cover the patient.

[0088] In a third step, the upper half-cylinder 1 is positioned and secured to the lower half-cylinder 2 and the locking devices are activated. Reference may be made to Figure 17 and 18 .

[0089] According to a fourth step, the second inflatable mattress 22 is inflated, at least partially, to fill the free space remaining between the second inflatable mattress 22 and the base mattress 17 fixed in the upper semi-cylinder 1.

[0090] In a fifth step, the locking system 14 of the tubular semicircle 2a is deactivated and the complete cylinder is rotated by actuating the complete tubular circle 6, for example over an angular stroke of 180°. Reference may be made to a figure 19 .

[0091] In a sixth step, the tubular hemi-circle 1a is locked onto the fixing base 7 using the locking system 14. The patient now lies in the ventral decubitus position in the upper hemi-cylinder 1, as illustrated in figure 20 .

[0092] In a seventh step, the locking members are deactivated and the lower half-cylinder 2 is separated from the upper half-cylinder 1, the latter now being locked in rotation on the fixing base 7.

[0093] In an eighth step, the first inflatable mattress 18 is deflated and removed, and the foam elements 19, 20, 21 are extracted from the upper semi-cylinder 1.

[0094] According to an example of implementation, once the turning maneuver is carried out, the bed can be placed from the horizontal starting plane in an oblique position in the sagittal direction of more or less 25° or even 35° for a limited duration with the possibility of varying the inclination to help improve pulmonary ventilation. In this case, the various foam elements and / or cushions for wedging the patient, used during the turning phase, will be used as much as necessary.

[0095] According to an exemplary implementation, the turning method consists of cleaning the foam elements 19, 20, 21, the first inflatable mattress 18, the base mattress 17 and the lower half-cylinder 2, to make it available to the care staff in the form of a new upper half-cylinder 1, usable for another turning maneuver.

[0096] Obviously, the invention is not limited to the preferred embodiment described above and shown in the various figures, the person skilled in the art being able to make numerous modifications and imagine other variants, within the framework of the protection defined by the claims.

Claims

1. A patient turning system, characterised in that it comprises: - two rigid half-shells of substantially cylindrical shape, constituting identical hollow semi-cylinders, upper (1) and lower (2), each clad internally with at least one removable protective base mattress (17), - means for temporary mooring (3) and releasing these two semi-cylinders (1, 2) from each other to form, by mooring, a complete cylinder (4) along a longitudinal axis and by releasing a complete separation of the two upper (1) and lower (2) semi-cylinders, - the upper (1) and lower (2) semi-cylinders comprising, at each of their longitudinal distal ends, a tubular semi-circle (1a, 2a) which is rigid so as to form a complete tubular circle (6) resulting from the abutment of the two tubular semi-circles (1a, 2a) when the upper (1) and lower (2) semi-cylinders are moored, the complete tubular circle (6), the axis of which coincides with the longitudinal axis of the complete cylinder (4), forming a handling member serving to rotate and grip the assembly, - the complete cylinder internally delimiting a volume in the form of a free space (5) intended to receive the patient, protected by at least two upper and lower base mattresses (17), - a fixing base (7) comprising at each of its longitudinal distal ends two rotary pulleys (8), with axes parallel to the longitudinal axis of the complete cylinder and aligned in a plane transverse to the longitudinal axis of the complete cylinder, on which one of the complete tubular circles (6) rests to form at each longitudinal distal end of the fixing base (7), a rotation plate (9) constituting a rolling line for the complete tubular circle (6), - all allowing a clockwise or counterclockwise rotation, of 180° of said complete cylinder (4), before unhooking and complete separation of the upper (1) semi-cylinder from the lower (2) semi-cylinder.

2. The turning system according to claim 1, characterised in that the diameter of the complete tubular circles (6), by abutting the two tubular semi-circles (1a) and (2a), is greater than the outside diameter of the complete cylinder to more easily and manually perform the rotation of said complete cylinder (4).

3. The turning system according to claim 1 or 2, characterised in that it comprises a remotely controlled and servo-controlled electric motor, mounted in the fixing base (7) and driving in rotation the rotary pulleys (8) to perform a motorised rotation of the complete cylinder (4).

4. The turning system according to any one of claims 1 to 3, characterised in that each upper (1) and lower (2) semi-cylinder comprises at least two longitudinal tubes (10) assembled by means of at least one stiffening arch (11) and removable connecting elements fixed to the longitudinal tubes and / or to the stiffening arches.

5. The turning system according to any one of claims 1 to 4, characterised in that the mooring means comprise locking members to prevent, when the upper (1) and lower (2) semi-cylinders are moored, in particular during a rotation operation of the complete cylinder (4), the separation of the two upper (1) and lower (2) semi-cylinders during a rotation operation.

6. The turning system according to any one of claims 1 to 5, characterised in that the fixing base (7) comprises a blocking system (14) for blocking the lower (2) semi-cylinder in rotation in different angular positions allowing the lower (2) semi-cylinder to be inclined.

7. The turning system according to any one of claims 1 to 6, characterised in that it comprises a first anti eschar inflatable mattress (18) arranged on the base mattress (17) of the lower (2) semi-cylinder, the patient resting on this first inflatable mattress (18), and a second anti eschar inflatable mattress (22) associated with the upper (1) semi-cylinder in order to perform the turning maneuver.

8. The turning system according to claim 7, characterised in that it comprises a set of removable foam elements (19, 20, 21), such as walls and / or wedges, at least some of these elements have shapes designed to adapt to any size and anatomy of the patient, a combination of various foam elements (19, 20, 21) making it possible to fill the space existing between the body of the patient, the first inflatable mattress (18) and the lateral parts of the lower (2) semi-cylinder, so as to immobilise said patient in the lower (2) semi-cylinder.

9. The turning system according to claim 8, characterised in that the foam elements (19, 20, 21) comprise two lateral elements (19) intended to extend along each rising part of the lower (2) semi-cylinder, two intermediate elements (20) having, on one side, a plane external contour (20a) and, on another side, a curved internal contour (20b), in order to best envelop the patient when they are arranged on each side of the patient, and wedging elements (21) in the form of asymmetrical bent parts.

10. The turning system according to any one of claims 1 to 9, characterised in that the base mattress (17) is made of foam and reinforced and has underside fastening systems (17a) for fixing it to the lower (2) semi-cylinder.

11. The turning system according to any one of claims 1 to 10, characterised in that the fixing base (7) comprises a frame the dimensions of which, are chosen so as to be able to be placed on a medical bed or on a trolley.

12. The turning system according to any one of claims 1 to 10, characterised in that the fixing base (7) comprises a base for resting directly on the ground.

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