REFERENCE TO RELATED APPLICATIONS

[0001] The present patent document claims priority to German Application Serial No. DE 10211081.6, filed Mar. 13, 2002, which is hereby incorporated by reference.

BACKGROUND

[0002] The invention relates to a system for medical emergency care and monitoring of a patient.

[0003] In the diagnosis and treatment of critically injured patients, severely injured patients, or patients with multiple traumas, there is a need to be able to perform clinical processes within a very short time in order to minimize lasting damage to the patient and thus to minimize clinical follow-up and health care costs.

[0004] Typically, the patient is taken by emergency technicians to a so-called trauma room, where he is first physiologically stabilized by life-support measures. In some places, the first information on possible internal injuries is also collected using an ultrasound apparatus. After that, the patient is taken to radiology, for instance to take top views of the skull, cervical spine, chest, abdomen, and anterior-posterior and/or lateral views of the pelvis. Depending on how the hospital is equipped, these views are taken either with a conventional x-ray unit, partially supplemented by images from a computed tomography (CT) scanner, or the views are taken only with a CT scanner. If both a conventional x-ray unit and a CT scanner are used, the patient must as a rule be transferred from one table to another and moved to a different examination room. After his stay in radiology, the patient often returns to the trauma room for remaining stabilization, before finally being taken to an operating room or to a room in an intensive care unit. The numerous routes between different rooms and/or units of the hospital, and moving the patient from one table to another in every room are both time-consuming and not always wise for the health of the patient in view of his extremely severe injuries. Also, during the examinations and along the way there, it is not always possible to monitor the patient's vital functions continuously and to care for him adequately.

[0005] Various systems have become known in which various imaging equipment has been fused or combined into one joint system. From German Patent Disclosure DE 197 11 499 A1, for instance, a radiological diagnostic unit with a CT scanner and an x-ray unit have a common holding device. The holding apparatus is adjustable along a guide rail from a first position, associated with the CT scanner, to a second position, associated with the x-ray unit.

[0006] In German Published, Nonexamined Patent Application DE 198 53 463 A1, a plurality of multiple examination systems with many imaging systems have been disclosed; the imaging systems are disposed on a common support and can be associated with the patient's bed by moving the carrier relative to the bed of one of the imaging systems in succession.

[0007] U.S. Pat. No. 5,822,814 discloses a diagnosis and/or treatment system that has a C-arm device. The associated table can be pivoted outward 90° to allow a mobile “ring arm CT scanner” to be taken to the table. With this diagnostic and/or treatment system, a full-body scan of the patient is not possible.

[0008] German Patent DE 199 21 280 C1 shows a radiological diagnostic unit in which a CT scanner can also be operated as a conventional radiological diagnostic unit, in that the beam emitter that is present for the sake of the computed tomography can be associated with both a row detector for the computed tomography and a further beam receiver.

[0009] In a Siemens AG brochure entitled “SOMATOM Emotion, Balance, Esprit-Sliding Gantry”, No. A91001-M2120-G151-01-7600, a system comprising a CT scanner and an x-ray unit is also described for angiography. Here, the patient holding apparatus has a table that protrudes past a base on one side. By moving the CT scanner, which is movable along a guide rail on the floor, the protruding part can be introduced into the patient opening of the CT scanner, so that CT images are possible. The angiography device can also be positioned in the region of the protrusion, to take corresponding images.

SUMMARY

[0010] These known systems are all oriented toward simplifying examination of the patient but are not suitable for simultaneous treatment, especially for treating patients with multiple traumas, and/or they do not permit full-body scans of the patient.

[0011] The object of the invention is a system for medical emergency care and monitoring of a patient that is suitable for both examining and for monitoring and caring for extremely severely injured patients in such a way that the number of times the patient has to be moved from table to table and the travel distances can be kept low, and in which nevertheless a full-body scan is possible.

[0012] This object is attained by a system having the following components:

[0013] a) a patient holding apparatus with a fixed base and a table mounted on it, and the table protrudes past the base on the head end with a radio transparent first region and on the foot end with a radio transparent second region,

[0014] b) a CT scanner, which is movable on the floor along a guide element in such a way that the second region of the table can be brought, by moving the CT scanner, into the patient opening of the CT scanner;

[0015] c) an x-ray unit, which is arranged for taking x-ray images in the first region of the table; and

[0016] d) a guided patient board that can slide on the table in the longitudinal direction.

[0017] An examination and/or treatment region is created on both sides of the base of the patient holding apparatus, to improve the functional capabilities in terms of care, examination and/or monitoring of the patient. For instance, in the first region that protrudes on the head end, which is also arranged for taking x-ray images, stabilizing the patient is done with life support measures. The patient is accessible there on three sides. As soon as it is found, during the care done there, that a computed tomography image is necessary, the patient is moved, lying on the patient board, along the table to the second region that protrudes on the foot end. By moving the movable CT scanner toward it, the second region can be introduced into the patient opening of the CT scanner, so that corresponding computed tomography images can be made. In a reversal of the usual procedure, the patient is introduced into the computed tomography opening feet first. By means of the guide element of the CT scanner, a slice-by-slice advancement can be performed in such a way that a full-body scan of the patient is possible.

[0018] These actions can be done quickly. Transferring the patient from one table to another, which might harm him, is unnecessary. Equally quickly and without being transferred, once the examination has been done in the CT scanner, the patient can be returned to the first region of the table by displacement of the slidable patient board, so that life support actions can be continued there, and/or to take a view of the skull, for instance, by means of the x-ray unit.

[0019] The patient board is embodied as slidable on the table, since in this way metal components, which when the patient board is introduced into the patient opening of the CT scanner can cause artifacts in the image, can be largely avoided.

[0020] Preferably, the guide rail of the CT scanner and the table are disposed parallel to one another, particularly in a linear arrangement.

[0021] In a further feature, the system has a life support unit that can be attached or mounted to the first region of the table and that, in particular, includes at least one respirator and one monitoring device that records vital functions of the patient. A life support unit of this kind can be embodied as a movable trolley (“life support trolley”), for instance. With the life support unit, there is the advantage that both the physiological stabilization of the patient and the diagnostic and treatment work on the severely injured patient can be done without transferring him, with permanent monitoring and care, and in an ergonomically flexible way.

[0022] To further shorten the time required caring for the patient (processing time), it is expedient that the patient holding apparatus, the CT scanner, the x-ray unit, and optionally the life support unit are disposed jointly in one room. A trauma room of this kind, for instance in a hospital building, is also the subject of the invention.

[0023] Preferably, the second region of the table has at least the length of an adult patient, in particular at least a length of 1.8 meters, or is at least adjustable to such a length. It is thus advantageously possible to examine the patient over his full body length (“height”) using the CT scanner. The length of the guide rail of the CT scanner can also be designed for a full-body scan.

[0024] For the first region of the table, it is expedient that it has at least half the length of an adult patient, and in particular at least a length of 0.9 meters, or is at least adjustable to such a length. Such a length suffices for instance to take images of the patient with the x-ray unit in the region from his head to approximately his pelvis.

[0025] In a preferred refinement, one component of the system is also a patient trolley, which is embodied for receiving the patient board in a fixed way, in particular by positive engagement or coupling. As a result, in situations in which the patient must be brought to or taken away from the system of the invention for medical emergency care and monitoring, it is possible to leave the patient lying on the patient board, and to transfer him along with the patient board gently to the patient trolley.

[0026] Especially advantageously, the patient trolley is embodied with support elements for the patient board that are open at the sides in such a way that the table of the patient holding apparatus can be moved underneath such that the patient board received on the patient trolley can be positioned above the table. It is then possible to transfer the patient from the patient trolley to the patient holding apparatus or vice versa by means of slight vertical motions—either by muscle power or driven by a motor—without having to transport the patient sideways or even lift him in a way that is uncomfortable for him and inconvenient for the staff. For this purpose, the support elements of the patient trolley can be adjustable in height, in particular by motor, to make it easier for the staff to work.

[0027] The table and/or the patient board are preferably made from carbon-fiber-reinforced plastic. Especially advantageously, the x-ray unit of the system is ceiling-mounted, to keep the first region of the table, especially the region on the floor around the first region, freely usable for the medical staff in the event that the x-ray unit is not needed just at that time. As a result, it is possible for up to four or five persons (anesthesiologist, IV infusion nurse or doctor, radiologist, surgeon, medical record personnel, and so forth) of the medical staff, optionally together with the movable life support unit, to be present near this region all at once. The x-ray unit can be mounted in the ceiling via a rail system, for instance, and can then be movable in the longitudinal direction and/or laterally. For the vertical adjustment, a telescoping stand can be secured to the rail system and carry and x-ray emitter and/or receiver on its end.

[0028] The x-ray emitter and the x-ray detector of the x-ray unit are preferably mounted to the ends of two legs of a U-shaped or C-shaped arc, preferably in such a way that views can be taken both from above and below the table.

[0029] A work method can be performed, in particular, with the system above. The work method has the following steps:

[0030] 1) transporting the patient from the ambulance door of a hospital to a trauma room, lying on a patient trolley that has a removable patient board, the patient board being mounted on a rolling frame with support elements that are open at the sides;

[0031] 2) positioning the patient board above a table of a stationary patient holding apparatus by running the rolling frame under the table with the patient trolley;

[0032] 3) lowering the patient board onto the table;

[0033] 4) moving the patient trolley away;

[0034] 5) to the extent necessary, sliding the patient board with the patient along the table into a radio transparent first region of the table;

[0035] 6) beginning life-support measures in the first region;

[0036] 7) optionally, x-ray examination with an x-ray unit associated with the first region;

[0037] 8) sliding the patient board, with the patient, along the table into a radio transparent second region of the table, preferably with the patient feet first;

[0038] 9) performing a CT examination in the second region;

[0039] 10) sliding the patient board with the patient along the table from the second region to the first region, or to an optional third region of the table.

[0040] Optionally, in other phases, life support can be continued with further measures in the third region of the table. The third region preferably overlaps a radiopaque, but mechanically stable region, which is supported indirectly or directly by the base of the patient holding apparatus. The first and second regions are located in particular on opposite sides of the third region.

[0041] For further preferred features of the patient holding apparatus, and in particular its first region, second region, and third region, as well as of the x-ray unit, CT scanner, or patient trolley, see the remarks made regarding the system in the detailed description below and in the summary above. Also in the work method, a life support unit as described above can be used. In transporting the patient on the patient trolley, the life support unit can preferably be docked—preferably at the head end—to the patient trolley and then in the stationary mode can be moved independently of the patient trolley along the patient holding apparatus. Transporting the patient away from the trauma room can be done analogously, again using the patient trolley.