Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
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This invention relates to medical equipment and supplies.
In particular, the invention concerns anatomical limb restraints. More
particularly, the invention concerns apparatus for immobilizing the
forearm, wrist and hand of a patient during intravenous treatment.
Intravenous treatment, including bLood transfusions and
intravenous feeding, is a frequent and familiar surgical procedure.
Basically, the routine consists of immobllizing the patient's lower
limb, forearm, wrist and hand and making a venipuncture near the wrist.
The needle is generally taped in place and may remain for a pe~iod of
a couple of hours to a few weeks. For the duration of the treatment,
it is imperative that the limb remain immobilized to prevent dislodge-
ment of the needle wlth possible serious consequences.
The prior art is replete with various limb restraints for
use during intravenous treatment. The original device has been
obscured by antiquity. Presumably, it was a wooden splint to which
the limb was found. The earliest attempts to improve upon the limb
restraint were obviously the result oE concern for a patient's comfort.
These efforts results in simply bonding a layer of cushiony m~terial
to a flat elongate board.
; 20 Initially, the layer of cushiony material was specified as
sponge rubber. With the development of synthetic
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materials, the cushiony layer was subsequently changed to foamed plastic.
A moisture impervious covering encasing the porous cushiony layer pre-
vented the absorption of body fluids. Bind:ing the patient's arm to the
support was accomplished either by adhesive tape or buckle-fitted straps.
More recently, the cushiony layer has been discarded in favor of
a contoured board. One type of contoured arrangement provided an elongate,
rigid member having upturned sides to receive the patientls lower limb
which was secured therein by snap-fastened straps. A future trend was
established by an elongate rectangular board having on the upper surface
thereof a large depression extending inwardly from one end thereof to re-
ceive the forearm and a series of smaller impressions extending inwardly
from the other end thereof to accommodate the three middle fingers. The
board, being symmetrical from side to side, received either the right or
left lower arm in the palm down position. The board had a substantially
flat undersurface to rest upon a table or similar surface. In a subsequent
development, a slightly flexible ball was provided for flexing the Eingers
and hand to overcome tension and boredom.
The rigid contoured member evolved to the present-day molded
plastic device which is contoured to receive the hand, including the
thumb and all fingers thereof, the wrist and the fo~earm. The device
accommodates either arm which is received in the palm down position~ The
lower limb is secured by interlocking straps which are integral with the
molded plastic unit. The patient's lower limb is wrapped in an irregularly
shaped disposable liner.
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Several criteria are paramount for effic$ent and effective
immobilization of the patient~s lower limb. While retaining the arm ln
the medically desired position, the method must be expedient and prosaic
to insure that treatment can be commenced quickly in an emergency and
that the manual manipulations are in accordance with established medical
routine. Also, since most persons become nervous and fidgety during
the tenure of the needle, the devices used should be as comfortable as
possible.
The recently developed contoured arm supports, especially the
molded plastic type, provide obvious advantages over the prior art.
However, such devices have not gained widespread medical acceptance, nor
/ commercial success, since such devices only partially fill the estab-
lished requirements.
It would be highly advantageous, therefore, to provide a limb
restraint for use in intravenous treatment which provides for patient
comfort and fulfills medical needs.
Accordingly, it is an object of a principal aspect of the
present invention to provide an improved limb restraint for securing
a patient's lower limb, including hand, wrist and forearm, in a predeter-
mined position for use during intravenous treatment.
An object of another aspect of the present invention is to
provide a limb restraint which will receive either the right or left
lower limb.
An object of still another aspect oE the present invention is
the provision of a limb restraint which will contouredly accommodate a
limb in the palm down or volar position, or in the palm ~p or supine
position.
An object of still another aspect of the present invention is
to provide a limb restraint in which the arm is secured thereto by
adhesive tape in accordance with accepted medical practice.
~ n object of yet still another aspect of the present invention
is to provide a limb restraint which retains the patient's arm and hand
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in a more natural position to reduce restlessness and discomfort.
An object of a furtiler aspect of the present invention is the
provision of an arm restraint in combination with a readily usable,
disposable, absorbent cover.
An object of a still further aspect of the present invention
is the provision of a limb restraint which is sufficiently durable for
sterilization and reuse and yet inexpensively manufactured to provide
a disposable unit at the discretion of the user.
By one broad aspect of this invention, a limb restraint is
provided for immobilizing the forearm, wrist and hand of a patient and
maintaining the limb in a cornfortable predetermined position during
intravenous treatment and for contouredly receiving the palm side or
back side of either the patient's right or left lower arm, the restraint
comprising a rigid elongate member for receiving an arm of a patient in
either of two positions during administration of intravenous feeding,
the elongate member being generally concavo-convex in cross-section and
including. (a) a substantially convex surface at its forward end and a
concave tapered section rearward of the convex Fortion, the convex sur-
face being generally contoured to receive the normal palm side of the
! 20 lower forearm, wrist and palm of the patient thereover and adapted to
h old the hand in a generally horizontal position; (b) a substantially
concave generally transverse surface generally contoured to receive the
normal back side of the lower forearm, wrist and palm of the patient
therein, the opposite lower edges thereof being coplanar; and (c) a
plurality of spaced-apart projections extending along opposite longitu-
dinal edges of the support; the convex surface and the concave surface
extending along opposite sides of the elongate member; the convex sur-
face and the concave surface having the contours thereof in general
complementary alignment whereby the elongate member is substantially
concaveo-convex in cross-section.
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In accordance with a preferred embodiment thereof, a rigid
elongate member is provided which is substantially concavo~convex in
cross-section. The convex surface is generally contoured to receive
the lower forearm, wrist and palm of a human limb thereover in the volar
position. The patient's limb in the supine position is received in the
contoured concave surface. Each contoured surface is arranged to
accommodate either the right or left limb. The patient's fingers rest
in recesses spaced along one end of the elongate member. Adhesive tape,
or other suitable medical binding, encircling the limb and the limb
10 restraint is received between projections spaced along either edge of the
elongate member. Optionally, the elongate member is encased in a resili-
ent, absorbent, disposable envelope.
By a variant of an aspect of this invention, the restraint
includes means defining a plurality of recesses extending between the
convex surface and the concave surface at the forward end of the limb
restraint and extending rearwardly therefrom along a forward portion of
the limb restraint for positionally receiving the fingers of the
immobilized limb when the limb is placed against either the convex sur-
face or the concave surface.
By another variant of an aspect of this invention, the restraint
is provided in combination with a resilient, absorbent, disposable envel-
ope sized and shaped removably to receive the elongate member therein and
having a length substantially equal to the length of the elongate member.
In the accompanying drawings,
Figure 1 is a perspective view of a limb restraint constructed
in accordance with the teachings of an aspect of the present invention,
particularly illustrated with the concave surface upwardly;
Figure 2 is a perspective view of the device of Figure 1
showing the convex side thereof;
Figure 3 is a plan view of the device as it appears in Figure 2;
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Figure 4 is a vertical cross-section taken along the line 4-4
of Flgure l;
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Figure 5 is a vertlcal cross-section taken ~long the line 5-5
of ~'igure l;
Figure 6 is a perspective view o~ a disposable cover for use
in connection with the device of an aspect of the present invention;
Figure 7 is a perspective view of the limb restraint of an
aspect of the present invention as lt would appear when supporting a
human limb in the volar position and having the venipuncture on the
back side of the wrist; and
Figure 8 i9 a perspective view of the llmb restraint of an
aspect of the present i~vention as i~ would appear when supporting
a human limb in the supine position and having the venipuncture on the
underside of the wrist.
Turning now to the drawings, in which the same reference
numerals indicate corresponding elements throughout the several views,
attention is first directed to Figure 1, which shows an elongate member
generally designated by the reEerence character 10, having a substan-
tially concave surface 11 which is generally contoured to receive a
patient's lower arm ir the supine position in accordance with the limb
restraint of an aspect of the present invention. A first section 12
of concave surface 11 extending from the rear edge 13 of elongated
member 10 to approximately the position indicated by the dashed line A
is shaped to receive the back side of the lower foresrm. A second
section 14 generally lying between the dashed lines A and B is narrowed
and curves upwardly from first section 12 generally to conform to the
patient's wrist.
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A third section 17, wider and deeper than the second section 14, extending
generally from dashed line B to forward edge 18 of elongate member 10 is
contoured to receive the bac~ of the patient's hand.
The generally convex surface 19 on the opposite side of elongate
member 10 from concave surface 11 is illustrated in Fig. 2. Convex surface
19 is generally contoured to receive the patient~s lower arm in the volar
position. First section 20 of surface 19 slopes upward from rear edge 13 to
approximately the position designated by dashed line C to rest the lower
forearm and wrist thereon. Second section 21 approximately between dashed
lines C and D is hollowed to receive the heel of the hand and the face of
the thumb. Third section 22, commencing at approximately dashed line D and
ending at the forward edge 18, is best described as spheroid to receive the
normally curved palm thereover in a natural position. Four recesses 23
are spaced along forward edge 18. Each recess 23 becomes shallow and even-
tually fades as -lt i5 traced rearwardly, upwardly upon the generally spher-
oid third section 22. Recesses 23 accommodate a patient's fingers, exclud-
ing the thumb, as will be described hereinafter~
The general shape of elongate member 10 in plan view is best
illustrated in Fig. 3. Elongate member 10 is symmetrical about the longi-
tudinal axis thereof to provide a limb restraint which will accommodateeither the left or right lower arm. A plurality of projections 24 along
each longitudinal edge 27 and substantially extending between
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concave surface 11 and convex surface 19 are spaced to receive adhesive tape
therebetween.
Fig~ 4 complements Flgs. 1 and 2 for a clearer illustration of the
contours of concave surface 11 and convex surface 19. As further seen in
Fig. 5, concave surface 11 and convex surface 19 are arranged to have the
contours thereof in gen~ral complementary aligm~ent, whereby the elongate
member 11 is substantially concavo-convex in cross-section.
The limb restraint of an aspect of the present invention, as ~
above described, is preferably fabricatèd from a lightweight, rigid, in-
expensive, molded plastic such as, for example, polyethylene. This pro-
vides a very lightweight device, yet having inherent strength and rigidity
to be thoroughly reliable for the intended purpose. The material employed
can be prepared for reuse by conventional gaseous sterilization, yet the
substantially low cost of a mass-produced molded polyethylene structure
suggests a disposable item.
Fig. 6 shows a pre-formed envelope 28 having a closed end 29 and
an open end 30 which is sized and shaped to receive elongate member 10
therein. The envelope is pre-formed of a resilient, absorbent material
such as, for example, embossed or multi-ply paper which is sealed along all
edges thereof except for the open end 30. The purpose of the envelope is
to cover elongate member 10 and absorb body fluids such as, for example,
perspiration and blood which would otherwise soak into the somewli~t porous
structure of the polyethylene.
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Being pre-formed, the envelope is immediately available for use and can be
readily exchanged during an extended treatment for keeping the treatment
area clean and dry.
Figs. 7 and ~ graphically illustrate the arm support of an aspect
of the present invention during the intended use thereof for immobili~ing
the lower portion of a human arm during intravenous treatment. Fig. 7
shows the lower portion of the limb in the volar position against convex
surface 19 of elongate member 10, while Fig. 8 depicts the lower limb re-
ceived in the concave surface 11. In each case, the venipuncture is re-
presented by surgical tube 31 which transmits the intravenous fluid there-
through to a needle properly inserted into a vein and secured with adhesive
tape 32.
The lower human arm, when unencumbered, assumes a natural position
in which the hand and wrlst are generally stralght to the forearm with the
fingers curled in a semi-grasping or clenched position. The natural curl
of the fingers is somewhat less in the supine position than in the volar
position. An object placed in the palm of the hand, especially in the
volar position, tends to cause the fingers to curl thereabout in a normal
position in which the tip of the thumb is generally perpendicular to the
fingertips. Since intravenous treatment tends to cause nervousness or
restlessness among most patients, being able to grasp and squee~e something
is of considerable benefit to the patient.
As particularly noted in Fig. 7, the patient's forearm and heel
are received upon sections 20 and 21,
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respectively, with the hand grasped over spheroid section 22. The fingers
are extended downwardly, lying in recesses 23 and curled over the end 18
of elongate member 10. The thumb, beginning in recessed portion 21, ex-
tends forwardly outward and is curled over the edge of section 22. In
this position, the entire lower limb i5 supported with the hand, including
fingers and thumb, in the natural free position. ConventLonal medical ad-
hesive tape strips 33, generally cut from the same roll thereof as adhesive
tape piece 32, encircle the patient's lower arm to immobilize the forearm,
wrist and hand~ Adhesive tape strips 33 pass between projections 27 to
prevent longitudinal slippage between elongate member 10 and the patient~s
lower limb.
The patient's lower limb in the supine position is received with-
in the concave surface 11 of elongate member lO, as depicted in Fig. 8. The
forearm and wrist are received in sections 12 and 14, respectively. The
back of the hand, with the fingers curled in the natural position, is re-
ceived in section 17. As explained in connection with Fig. 7, adhesive
tape strips 33 secured the lower limb to the elongate member. It is par-
ticularly noted in the illustrations of Figs. 7 and 8 that envelope 23 nor-
mally used to enclose elongate member 10 has been partially cut away for
purposes of clarity.
From the foregoing de'tailed description of an embodiment of an
aspect of the present invention, it will be immediately apparent to those
skilled in the art that the limb restraint disclosed therein as a single .
unit is readily available to immobilize either the right or left lower limb
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in either the volar or suplne position. The limb is secured to the re-
straint in accordance with the accepted medical practice at the specific
medical facility in which it is used. General:Ly, medical personnel prefer
to use adhesive tape, although other types of bindings such as various
straps and ties, are readily usable with aspects of the instant invention.
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