US2614565A - Automatic tourniquet - Google Patents

Description

Oct. 21, 1952 J. K. PACKER 2,614,565

AUTOMATIC TOURNIQUET Filed March 17, 1951 2 SHEETS-SHEET l 061C. 21, 1952 4 PACKER 2,614,565

AUTOMATIC TOURNIQUET Filed March 17-, 1951 2 SHEETS-SHEET 2 i atenteci Oct. 21,952

AUTOMATVIQTOURNIQUET r JohnK. Packer, Norton, I' j Inmanysituations it is-necessarytoapply a tourniquet tostop blood fiow and to leave. the tourniquet in use for a considerable period of time. One example'isin warfarei where it takes considerable time to get injured men to a hospital. Similar situations-develop in many other places as for examplein the case of accidents on' ships, aircraft, etc. However if the blood flow isstopped very long at a time the consequences to the patient may be serious. Consequently, if there'is a doctor or nurseavailable, it is cus-' tomary to relieve the pressure of the tourniquet periodically to let the blood flow for brief intervals. For example the blood flow may be obstructed for twenty-five'minutes, then permitted to flow for-forty-five seconds, then obstructed again for twenty-five minutes, and, so .on. over a period of several hours Without danger from'the obstructionand'without'much bleeding. s I Objects of the present'invention are-to produc an automatic tourniquet which will alternately impede the flow of blood. and then permit it'to flow, which can readily be set for any desired periods of flow and non-flow, which will. maintain the pressure onthe patient constant during each'period ofnon-flow, which will automatically stop the cycles of flowand non-flow atthe end of a predetermined number of cycles, whichwill leave the pressure applied to the patient at: the end of the'series of cycles;- which is simple and economical in construc'tion,-which is lightand portable, and which is durable and reliable in use. According to the present invention the blood circulation is preferably controlledwith .aninfiatable'cum 'that is any devicesadapted to apply pressure on a part of the body by being: inflated, as for example a rubberbag ortube enclosed in "a fabricsleeve such as commonly'used by ,phyisiciansin taking blood pressu're. According to this invention the device comprises a; pressure regulator to control the pressure in thecufLin combination with a valve to'relieve-the pressure in the cuff and a timer for actuating the valve periodically, whereby the flow of blood'is' normally impeded but periodically permitted to flow; While any source-of gas pressure may be employed, such as an air compresson-the source preferably comprises a 'sma'll tube of carbomdioxide gas under high pressure with'a tight casing' to house the tube and' means to-puncture thetubeafter the casing is closed. The-"aforesaid valve'preferably comprises a three-way-valve in the conduit connecting the pressureregulator with the cufl, the'valve being m'ovable between-two positions, an-onf'position in which i the cuff is connected with the r'egulator andan "on" position in which this connectionisfclosed and the cufi is connected to; an exhaust' to'permit the gas in the" cuff to figwiout intdithe atmoshere; The aforesaid timer preferably comprises Thegas-container G has one 'end-closing-an opening throughvwhich a Application-May 17, 1951; SerialN 226,811

6 m... (o1.12 s-"a 2v l a rotary /-controller having ,.on and off positions; correspondingto. the aforesaid position revsp ectively;-'imeanswfor urging the controller to turn; time-controlled stop means for blocking rotation of the controller for predetermined times in thezafor'esaid positions, and means for'adjusting. each of the :predetermined times independently of the other. .1-.

Fors the purposei-of illustration a typical embodiment of the invention is shown in the accompanyingdrawing inwhic'h l Fig. -1.--is'a side1view of; the, apparatus applied toapatientp' .,1

.Fig. 2 is a full-size-gview of a portion of the apparatuswith parts broken away; I

Fig. i3 is a side elevation of thetimer viewed from the side .oppositeto that shown in Fig. 2;

Fig. 4 is a side-view; viewed from the left of Fig.2; l N

Fig. 5 is a side view of the apparatus in use,

viewed from the same'side as in Fig.4;

Fig. 3. showing the parts in Fig.6 is aview like on position;

5 Fig. '7 .isa similar view at the instant the parts :start to shift from on. to "01? position; i Fig. 8 is a similar view with the parts in off position; A

Fig. 9 is a similar view atthe instant theparts start to shift from f ofii to 0n.position;

The particular embodimentcho'sen for the purpose of illustration comprises a-cufi C ofthe type referred to, a gas container G, a pressure regulator assembly P; arthree-way valveV, a timer T and a-housing Hfor the' parts, the housing having'a clip K'adapted to hook over the-cuff when the cuff is" applied tota patient to'support the apparatus (Fig.5). a removablec'apl at cylindernf carbon' dioxidegas maybe inserted.

At theother'en'd of: the container is a pivot arm 2 having apo'intedend proj'ecting inside the housingto 'puncture the end of the cylinder'when the 2'is pulled away from theho'using by means of the pull"cord"3'. The container G communicates with the pressure regulator through the connection 4 'shownin-Figs. 1', 2 and ll.

pressure regulator assembly; which is shownfin detail infFig s, 11 and l2,"fcomprises' a icylin dricalj housingj having an open" end which H is closed by' a cap fl*cor'nprising an integral pormen ,3 which projectsunto the'hou sing, the part having a'l slot 9"rnilled therein. The cap 1 nipple -=for connection with theoutlet II is a filter I2 and a valve seat 13 of soft metal. Seating on 13 is a valve l4 actuated by a pinion l6 which in turn is actuated by a rack l1 connected to bellows t8, the parts l4, [Band I! being movably mounted in the slot 9 by means of pins bridging the slot "as shown Figs. 11 and 12. Bearing against the innerend of the bel-.

the screw 2| is set the bellows expand, moving the rack H to the right andth'e valve II to the left, thereby ad'mittinggasto the cuff from the container G. When the pressure .is restored. to the predetermined value the valveii-l is "again closed'by the pressure of the gas onthe bellows.

The valve assembly V' is mounted on the .pressure regulator by means of a connection '22 which is soldered or welded to the .pressure --re"gulator as indicated at 23 ('Fig. .1 1) Extending through the projecting end "of the :"connection .22 is a screw 24 which threads into the lower end of the valve to hold the parts together, the connection "and screw tiaving passageways connecting the valve with therefgulatbr. shown in Fig. 10 the valve is located-imabasing 26 interconnected with the-.screwi2'4 byimean'sbf a nipple 21, a :disk valve 2-8 movable back and forth between the end of the nipple 21 and a valve seat 29, a ball. 3|, bearing on the valve, a spring a 32 having one end bearingonthe balha plunger 33 having ashoulder bearing on. thezother end of the spring and projecting outside -.the casing so that it may be pressed inwardly against the action of the spring *to imove the valve from the seat. to the nipple 21. an outlet 34 for connection to the cuff, and an exhaust :port 35. With the valve in the .onWposition shown in Fig. 10 gas may'flow from-itheregulator through the nipple .-.2'! and thence through the outlet. 34 to the cuff. When the valve 28 is ShiftGdZ'fI-Om the seat 2i to thenipple21'ithegassupply is shut off and the outlet 34 communicates with theexhaust port :"36so that the .gas in the cuff :may flow out into'the :"atmosphere.

The timer T comprises clockwork similar to anordinary alarm clockdncluding: an indicator 4| visible through an opening in the'hous'mg However instead of being 'calibratedin terms of hours and minutes it is. preferably calibrated in terms of cycles, each cycle comprising an on period and an off period. The -:timer comprises the usual main spring (not shown) for driving the shaft-42 (Fig.4) which, through suitable gearing, drives inner :and outer timing disks 43 and 44 having in'their peripheries recesses 46 and 41, and aproiecting key -4. 5 for winding the main-spring. .The idisks are held in adjusted position on shaft "by means --of a collar pressed "on one-endof the shaft, the other end of the shaft havinga projectinghandle Sl'with which ,the disks may Fbemanually turned to any desired position. Engageable with the recesses 46 and 41 are iingers=52 and- 53 on arm 54 fast to the outer-endof shaft 56.. Fast to the inner end of shaft 56 is another arm 5-! having similar inturned ends 58 and 59 (Figs. 6 to 9). Adjacent the arm'51 is -a bar 6| having a slot for a screw 62 which permits-the bar to slide lengthwise. The lower-endof the -bart has a circular opening to receive an eccentric 83 which is eccentrically mounted on a shaft 64. The bar 6| has a struck-up tongue 6'! projecting at rightangles from the bar over the end of the plunger 33 of the three-way valve (Figs. 4 and 10). Fast to the shaft 64 is a controller 66 engageable with the ends 58 and 59 or arm 51. When the controller 66 is in the position shown in Fig. 6 the bar BI is moved up by the eccentric to the position shown in Figs. 6 and 10 to open the passageway from the source of gas to the cuff, and when the controller 66 is in the position shown in Fig. 8 the eccentric has moved the bar 61 down to shift the valve 28 from the seat 29 to the end of the nipple 21 (Fig. 10) thereby to close the passageway from the source to the cinfa'nd open the passageway from the cuff to the atmosphere. v v

The controller :65 is continuously urged in the direction indicatedby 'the arrow in Figs. :6 to '9 but .iS held from turning by the ends 58 and '59 in the two :positions shown in Figs. 6 and .8. Whe'nthe parts :are in the on position shown in Fig. -6 they remain in this :position until the finger =53 snaps into one .of the recesses 41 .in the outer timing disk 44, the finger being caused to snap into the recess by the pressure of the controller 66 on theend "58 of armx5-i. When finger 53:snapsinto the recess the arms :54 and .51 move -to "the :iposition shown in Fig. 7 permitting the controller 66 "to turn to the position shown .in Fig. 8. 'When the :controller reaches this position :i't .presses against the .end .59 .of arm 51, thereby yieldinglypressing the finger 52 against therp'eriphery of the inner timingadisk 43. Then when the :timing .disks :have turned .to the positio'n shown in Fig.5!) the finger 52 snaps into .a recess of the inner disk, thereby permittin the controller ifi to advance to theposition shown *in Fig. '16 to inflate the cufi.

The .rcontroller .66 :is driven independently ,-.of the timing disks 4.3 'and '44 so that the timing disks :may continue. to turn while rotation of V the controller is blocked ,by arm 51. While :this may beea'ccomplished with a separatespring, it is :pref'erably accomplished .by connecting one end :of '-the main .spring to the gearin whi h drives "the :timing disks: and the other end .to .the "gearing which drives the .controller, as in an al'arm :clock where-ione end drives;the;c1ock and thenotherend the alarm.

' The length of each.:c'ycle may :be; predetermined -inv arious waysasnfor-example -;by choice :Qf ratio of ith'exgears which drive :the timing disks .or variatiomofthe:number .of recesses in :thepearipherieszof the :timing disks; and the relative lengths of the on and off .periods :may .be varied-by angularly shifting one timing disk rela- -tive tothe-other.

In a .fportable .device where :the. source of gas is not inexhaustabie .itds desirable to :discon- -tinue the aforesaid :cycle of operation before the -gas'..is: .exhausted. For thisa'purpose the timer is Projectings from bellrcrank 13.

' From the'foregoing it will be evident that'the passageway through the regulator assembly P and the valve assemblyV constitutes a conduit having an inlet l2 (Fig. 11) for connection to the gas'source G and an outlet 34 (Fig. for connection to the cuif C, .It will also be understood that the stops 52 and 53 and associated part-s (Figs. 6 to 9) constitute time-controlled stop means and the length'of the on and off periods may be adjusted by shifting the timing ' disks 43 and 44 relatively to eachother as described above.

It should be understood that the present-disclosure is for the purpose of illustration only and 'that this invention includes all modifications and equivalents which fall within the scope of the appended claims.

I' claim:

- 1. A device for regulating blood circulation with an inflatable cuff, applied to a patient com- 1 prising a conduit having an inlet for connection to a suitable source of gas and an outlet for connection to the cuff, pressure regulating means in said conduit which opens to admit gas to the cuff when the pressure inthe cuff falls below a predetermined value, a valve communicatin with the'cuff to relieve the pressure in the cuff, and atimer associated with the valve for actuating the valve periodically, whereby the flow 'of blood is normally impeded but periodically permitted to flow.

;2.-A device for regulating blood circulation connection to the cuff, pressure regulating means in said conduit which opens to admit gas to the cuff when'the pressure in the cuff falls below a predetermined value, between the regulating means and outlet a three-way'valve movable between two positions in one of which the outlet is connected to the regulating means and in the other of which the passage from the regulating means is closed and theoutlet is connected to ,an exhaust, and a timer associated with the valve for moving the valve to said positions alternately, whereby the blood is alternately impeded and permitted to flow.

'3. A device for regulating blood circulation comprising an inflatable cuff for application to a patient, a source of gas under pressure, a con- ,tween two positions in one of which the outlet is connected to the regulating means and in the other of which the passage from the regulating means is closedand the outlet is connected to an exhaust, -and a timer associated with the valve for moving the valve to said posiv with an inflatable cuff applied to a patient comprising a conduit having an inlet for connection to a suitable source of gas and an outlet for connection to the cuff; pressure regulating means in said conduit which opens to admit gas to the cuff when the pressure in the cufi falls below a predetermined value; between the regulating means and outlet a three-way valve movable between an on position in which the outlet is connected to the regulating means and an ofi position in which the passage from the regulating means is closed and the outlet is connected to an exhaust; and a timer associated with the valve for'moving the valve to said positions alternately, the timer comprising a rotary controller havingfon and ofi? positions corre sponding to said positions respectively and time 1 controlled stop means for blocking rotation; of

thecontroller for predetermined times in said positions,-whereby the blood is alternately 'im- ,peded and permitted to flow.

prising a conduit having an inlet for connection to a suitable source of gas and an outlet for connection to the cuff; pressure regulating means in said conduit which opens to admit gas to the cuff when the pressure in the cuff falls below a predetermined value; between the regulating means and outlet a three-way valve movable between an on position in which the outlet is connected to'the regulating means and an off position in which the passage from the regulating means is closed and the outlet is connected to an exhaust; and a timer associated with the valve for moving the valve to said positions altroller having on and off positions corresponding to said positions respectively and time- '40 with an inflatable cuif appliedto a patient com- I prising a conduit having an inlet for connection to a suitable source of gas and an outlet for tions alternately,.whereby the blood is alter- I nately impeded and permitted to flow.

controlled stop means for blocking rotation of the controller for predetermined times in said positions, parts of the timer being adjustable to vary each of said predetermined times independently of the other, whereby the blood is alternately impeded and permitted to flow.

6. A device for regulating blood circulation with an inflatable cuff applied to a patient comprising a conduit having an inlet for connection to a suitable source of gas and an outlet for connection'to the cuff, pressure regulating means in REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date I 2,140,898 Collens et al. Dec. 20, 1938 1 2,339,487 King Jan. 18,1944 2,533,504 PO01 D60. 12, 1950 FOREIGN PATENTS Number Country Date 390,407 France July 28, 1908

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