A prone head rest accessory for prone positioning of patients

Abstract

A head rest for a prone patient comprises a facial cushion 200 configured to fit into a supporting mask or helmet structure 400, the cushion and supporting structure each having through-thickness cut-

Description

Background The present disclosure relates to a support mask and a face cushion for supporting the head of an anesthetized patient in prone position during surgical procedures. Some surgical procedures are performed on an anesthetized patient in a face down or prone position with breathing supported by an endotracheal tube placed in the patient's mouth. In this position much of the weight of the patient's head must be supported on the soft tissue of the face. These support masks tend to be unitary in structure and are formed of a rigid material while the prone face cushion is formed or molded of pressure relieving foam. In the current art, these support masks have sharp edges around the perimeter. These support masks are formed to accept a prone face cushion. Typically the patient is brought into the surgical suite on a gurney in the supine or face up position. The support mask holding the prone face cushion is placed on the patient’s face while they are supine with the gurney parallel and adjacent to the surgical table. The patient is then “rolled” or moved from the supine position into the prone position onto the surgical table. This is done with clinicians supporting the patient’s body including the torso, arms and head. The clinician supporting the patient’s head must hold the support mask with the prone support cushion in place on the patient’s face. Once in the prone position, the support mask is fitted onto a mounting tray or platform. The mounting tray has apertures that allow it to be mounted onto the spars of specialty surgical tables. The support mask may have adjustable legs that fit into cutouts or indentations formed into the mounting tray. The support mask and the prone face cushion may have corresponding cut outs to expose the patient’s eyes and mouth. The support platform may have a mirror which allows the clinicians to observe the patients eyes. The cutouts in the support mask and prone face cushion allows the intubation of the patient and the positioning of anesthesia tubing into the patient’s airways. Nothing in this Background section is an admission that the contents thereof is prior art. Summary When patient is rolled or moved from the supine position into the prone position onto a surgical table, the edges on the outside perimeter of the support mask into which the face cushion is placed may impinge onto the patient’s face thereby causing skin tears or other injuries. The current art requires the acceptance of this occasional resulting injury to the patient’s face when the patient is “rolled” from the supine position into the prone position.. Additionally the support mask in the current art is difficult to hold onto and to keep on the patient’s face during the “roll” which also contributes to the injury issues to the patient’s face. Thus, there is a need for a support mask and prone face cushion that is easier to hold for the clinician and that provides protection for the patient. The present disclosure provides a support mask into which a molded foam cushion may be positioned to support and protect the head and face of a patient during surgical procedures which require prone positioning. The support mask may be formed or molded of a suitable rigid material such as hard plastic or metal. The upper surface of the support mask can be formed and shaped to receive a molded face cushion upon which the patient’s face / head may be placed to reduced stress whilst the patient is undergoing surgery. The support mask and the support cushion may have corresponding horizontal or circular cutouts around where the patient’s eyes and mouth and nose may be positioned. The support mask may have receptacles formed into its bottom surface into which support legs may be fit, which may be height adjustable. These legs may be designed to fit into corresponding receptacles formed in an upper surface of a flat mirrored surface. When the support mask with face cushion described above is placed onto the mirrored surface, it allows an unobstructed view of the patient’s eyes and neither the support mask or face cushion interfere with the endotracheal tube or other apparatus that may be attached to the patient’s nose or mouth. The edges of the support mask may have a flange on at least a portion of the outer surface of the support mask that curves outward and away from the outer surface of the support mask thereby providing a gripping edge with which the clinician may easily hold or grip the supporting mask. The corresponding prone face cushion that fits into the support mask also may have an outward flange on at least a portion of the outer surface of the support face cushion that curves outward and away from the outer surface of the face cushion and fits into that correspond to the corresponding flange of the support mask. This outward flange of the prone face cushion in conjunction with the flange of the support mask prevents the patient’s face from coming into inadvertent contact with the hard features of the mask, thereby reducing the chance of facial injuries. The flanges of both the support mask and face cushion can be disposed on any portion of the outer surfaces of the support mask and face cushion, such as at a top edge of the outer surface, or at the middle of the outer surface. BRIEF DESCRIPTION OF THE DRAWINGS FIGS. 1A - IF illustrate top, side and perspective views of one embodiment of the prone face cushion. FIGS. 2A - 2F illustrate top, side and perspective views of another embodiment of the prone face cushion. FIGS. 3A - 3F illustrate top, side and perspective views of another embodiment of the support mask. FIG. 3G illustrates a cross-sectional view of the flange 306. FIG. 3H shows the support mask including two frames. FIG. 4A Illustrates a perspective view of one embodiment of the prone face cushion and support mask in combination. FIG. 4B illustrates a closeup view of the overlapping flanges. FIG. 5 illustrates the flange protruding from an upper portion of the outer surface of the support mask. FIG. 6 Illustrates a perspective view of one embodiment of the mounting tray. FIG. 7A Illustrates a perspective view of one embodiment of the prone face cushion and support mask, and mounting tray in combination. FIG. 7B illustrates the inner channel of legs of the support mask in FIG. 7A. DETAILED DESCRIPTION FIGS. 1A-1F illustrate an embodiment of a prone face cushion 100 that does not include a chin support. The prone face cushion 100 includes inner surface 105, outer surface 104 with outwardly extending flange 106 formed on an outside surface of the face cushion, mouth cut out 102 and eye cutout 101. In this particular embodiment mouth cutout 102 extends to the bottom edge of prone face cushion 100. Flange 106 can be formed on the outer perimeter edge of the prone face cushion 100, as best shown in FIGS. IC and IE. The flange 106 curves outwardly and away from outer surface of the face cushion 100 and can be formed on the entire perimeter, or on only a portion of the perimeter, of the face cushion 100. The angle of the flange relative to a plane perpendicular of the side of the face cushion 100 could be from approximately -30 degrees (i.e., bending downwards) to approximately +30 degrees from that plane (i.e., bending upwards). The dimension of the portion of the flange 106 that extends away from the side of the face cushion can be from approximately 1 / 4 inch to approximately to 2 inches. The face cushion 100 can be molded or machined from viscoelastic polyurethane foam, or polyurethane with gel beads, or phase-change materials for cooling, or polyethylene foam, or silicone-based foam. The preferred material would be Viscoelastic polyurethane foam. FIGS. 2A-2F illustrate another embodiment of a prone face cushion 200 that includes a chin support 207. The prone face cushion 200 includes inner surface 205, outer surface 204 with overlapping flange 206 formed on an outside surface of the face cushion, mouth cut out 202 and eye cutout 201. In this particular embodiment, mouth cutout 202 does not extend to the bottom edge of prone face cushion 200. Flange 206 can be formed on the outer perimeter edge of the prone face cushion 200, as best shown in FIGS. 2C and 2E. The flange 206 curves outwardly and away from the outer surface of the face cushion 200 and can be formed on the entire perimeter, or on only a portion of the perimeter, of the face cushion 200. The flange 206 curves outwardly and away from outer surface of the face cushion 200 and can be formed on the entire perimeter, or on only a portion of the perimeter, of the face cushion 200. The angle of the flange relative to a plane perpendicular of the side of the face cushion 200 could be from approximately -30 degrees (i.e., bending downwards) to approximately +30 degrees from that plane (i.e., bending upwards). The dimension of the portion of the flange 206 that extends away from the side of the face cushion can be from approximately 1 / 4 inch to approximately to 2 inches. FIGS. 3A-3F illustrate one embodiment of a support mask / structure 300 with legs 310.Support mask 300 comprises outer surface 304 and inner surface 305 with eye cut out 301, mouth cut out 302 and support mask cut-out 317. In this embodiment, mouth cut out 302 extends to the bottom edge of support mask 300. Flange 306 can be formed on the outer edges or perimeter of support mask 300, as best shown in FIGS. 3C and 3E. The flange 306 curves outwardly and away from outer edges of the support mask 300 and can be formed on the entire perimeter, or on only a portion of the perimeter, of the support mask 300, thereby providing a gripping edge with which the clinician may easily hold or grip the support mask. The angle of the flange 306 relative to a plane perpendicular of the side of the support mask 300 could be from approximately -30 degrees (i.e., bending downwards) to approximately +30 degrees from that plane. The dimension of the portion of the flange 306 that extends away from the side of the support mask can be from approximately 1 / 4 inch to approximately to 2 inches. Section 3G-3G’ shown in FIG. 3G shows a detailed view of flange 306. The support mask 300 can comprise one or more frames. FIG. 3H shows the support mask 300 including two frames. These frames could be snapped into each other using screws or pins, or can be glued together. The support mask 300 can be made of ABS (Acrylonitrile / Butadiene / Styrene) or glass-filled polycarbonate or Nylon-filled polycarbonate or fiberglass-reinforced Plastic, or a combination of these. The support mask can be molded by injection molding methods, thermoforming methods, or other molding processes, or machined. FIGS. 4A and 4B illustrate an embodiment including prone face cushion 200 and support mask / structure 400. Prone face cushion 200 is designed to fit into support mask 400. In this embodiment, prone face cushion 200 includes inner surface 205, outer surface 204 with overlapping flange 206, mouth cut out 202 and eye cutout 201. Support mask 400 includes inner surface 405, outer surface 406 and flange 406 formed on a portion of the perimeter of support mask 400. Eye cutout 401 may be formed through support mask 400, and in this embodiment, corresponds to eye cutout 201 in prone face cushion 200. Mouth cutout 402 can be formed through support mask 400, and in this embodiment, corresponds to mouth cutout 202 formed through prone face cushion 200. Flange 206 formed on the perimeter of prone face cushion 200 overlaps with flange 406 formed on the perimeter support mask 400 when face cushion 200 is fit into support mask 400. FIG. 4B shows details of the overlap of flange 206 and flange 406. This overlap of the flange of the face cushion with the flange of the support mask prevents the patient’s face from coming into inadvertent contact with the hard features of the mask, thereby reducing the chance of facial injuries. The overlap of flange 206 with flange 406 can be any amount of overlap including a total overlap, or a partial overlap. Legs 410 are formed or fitted into outer surface 404 of support structure 400. The flanges of the support mask and face cushion can be disposed on any portion of the outer surfaces of the support mask and face cushion, such as at a top edge of the outer surface (see FIG. IC and FIG. 3C], at an upper portion of the outer surface, or at the middle portion of the outer surface. For example, as shown in FIG. 5, the flange 506 protrudes from an upper portion of the outer surface 504 of the support mask 500, instead of at the top edge portion of the outer surface of the support mask. FIG. 6 illustrates an aspect of one embodiment of the device including mounting tray 700 which includes mirrored surface 703. Mounting tray 700 has a plurality of protrusions extending from it in a spaced arrangement including pins 706 with projection 704 and threads 705. In this embodiment, four pins 706 are shown, however the number of pins may vary in other embodiments. Pins 706 engage with threaded members 707 about an axial internal engagement passage (not shown). Such a threaded engagement provides an easily adjusted mechanism for lateral translation of pins 706 toward and away from the mirrored surface 703 of mounting tray 700. If threaded members 707 communicate through the mounting tray 700, adjustment can also be achieved from the bottom of the mounting tray 700 by twisting knob 708 which is fitted into the distal length of a threaded member 707. 701 spar mount brackets can be formed into the left and right edges of mount tray 700 with openings 710 formed therethrough and sized to accept spar 714 of a specialty table, thereby allowing mount tray 700 to be mounted to the specialty table. Openings 720 are formed through the surface of mounting tray 700 to allow the placement of anesthesia tubing or monitoring leads, or other medical equipment. .Reference numeral 702 shows the point where the bottom surface of the mounting tray 700 angles upward. This angle can be between approximately 30 degrees and 60 degrees. FIG. 7A illustrates another embodiment comprising a support mask 400, prone face cushion 300 fitted into the support mask 400 and mounting tray 700. FIG. 7B shows section 7B-7B’of FIG. 7 A, which illustrates the inner channel of legs 410 with threads 411. The inner channel of legs 410 are formed such that pins 706 fit snuggly therein while threads 705 are formed to interact with threads 411 of inner channel of legs 410. Pin 706 can be removably engaged into the inner channel of leg 410 by rotating knob 708 attached by threaded member 707 to pin 706. The height of the support mask 400 can be adjusted upwards or downwards by rotating knobs 708 which engage through members 707 with the inner channel (not shown) of pins 706 which in turn engage with the inner channel of legs 410. Mirrored surface 703 in combination with eye cut out 401 in the support mask 400 and eye cut out 301 in the face cushion 300 allow the clinician to observe the patient’s eyes when the patients face is placed into prone face cushion 300. Those having ordinary skill in the art will appreciate that various changes can be made to the above embodiments without departing from the scope of the invention. The above detailed description refers to the accompanying drawings. The same or similar reference numbers may have been used in the drawings or in the description to refer to the same or similar parts. Also, similarly named elements may perform similar functions and may be similarly designed, unless specified otherwise. Details are set forth to provide an understanding of the exemplary embodiments. Embodiments, e.g., alternative embodiments, maybe practiced without some of these details. In other instances, well known techniques, procedures, and components have not been described in detail to avoid obscuring the described embodiments. The foregoing description of the embodiments has been presented for purposes of illustration only. It is not exhaustive and does not limit the embodiments to the precise form disclosed. While several exemplary embodiments and features are described, modifications, adaptations, and other implementations may be possible, without departing from the spirit and scope of the embodiments. Accordingly, unless explicitly stated otherwise, the descriptions relate to one or more embodiments and should not be construed to limit the embodiments as a whole. This is true regardless of whether or not the disclosure states that a feature is related to “a,” “the,” “one,” “one or more,” “some,” or “various” embodiments. As used herein, the singular forms “a,” “an,” and “the” may include the plural forms unless the context clearly dictates otherwise. Further, the term “coupled” does not exclude the presence of intermediate elements between the coupled items. Also, stating that a feature may exist indicates that the feature may exist in one or more embodiments. In this disclosure, the terms “include,” “comprise,” “contain,” and “have,” when used after a set or a system, mean an open inclusion and do not exclude addition of other, non-enumerated, members to the set or to the system. Further, unless stated otherwise or deducted otherwise from the context, the conjunction “or,” if used, is not exclusive, but is instead inclusive to mean and / or. Moreover, if these terms are used, a subset of a set may include one or more than one, including all, members of the set. Further, if used in this disclosure, and unless stated or deducted otherwise, a first variable is an increasing function of a second variable if the first variable does not decrease and instead generally increases when the second variable increases. On the other hand, a first variable is a decreasing function of a second variable if the first variable does not increase and instead generally decreases when the second variable increases. In some embodiment, a first variable may be an increasing or a decreasing function of a second variable if, respectively, the first variable is directly or inversely proportional to the second variable. The disclosed systems, methods, and apparatus are not limited to any specific aspect or feature or combinations thereof, nor do the disclosed systems, methods, and apparatus require that any one or more specific advantages be present or problems be solved. Any theories of operation are to facilitate explanation, but the disclosed systems, methods, and apparatus are not limited to such theories of operation. Modifications and variations are possible in light of the above teachings or may be acquired from practicing the embodiments. For example, the described steps need not be performed in the same sequence discussed or with the same degree of separation. Likewise various steps may be omitted, repeated, combined, or performed in parallel, as necessary, to achieve the same or similar objectives. Similarly, the systems described need not necessarily include all parts described in the embodiments, and may also include other parts not described in the embodiments. Accordingly, the embodiments are not limited to the abovedescribed details, but instead are defined by the appended claims in light of their full scope of equivalents. Further, the present disclosure is directed toward all novel and non-obvious features and aspects of the various disclosed embodiments, alone and in various combinations and sub-combinations with one another. While the present disclosure has been particularly described in conjunction with specific embodiments, many alternatives, modifications, and variations will be apparent in light of the foregoing description. It is therefore contemplated that the appended claims will embrace any such alternatives, modifications, and 5 variations as falling within the true spirit and scope of the present disclosure.

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