SYSTHESIS OF TROLLEY CUM WHEELCHAIR FOR PATIENT HANDLING

Transcription

1 SYSTHESIS OF TROLLEY CUM WHEELCHAIR FOR PATIENT HANDLING Ehsanullah Khan Dr. C.C.Handa Dr. R.D.Askhedkar ABSTRACT Handling of patient from hospital bed to CT-Scan, MR Scan, X-Ray, Sonography centre etc is a cumbersome and tedious job. Generally from bed, the patient is moved to trolley manually. Three to four persons lift the patient and keep him on the stretcher. The trolley is moved to lift if necessary. If the lift cannot accommodate, the trolley, the patient is transferred to the ground floor by a nursing staff on a stretcher, and the stretcher is kept on the trolley. Again the trolley takes the patient to ambulance but patient is to be lifted manually with stretcher and put on ambulance platform. Again at the CT scan centre the patient with stretcher has to be lifted manually for X-Ray or CT scan. The procedure is repeated for moving the patient back to the hospital bed. The manual handling of patient is injurious to the patient as stresses are produced in the body of the patient, especially in neck, back bone, limb joints etc along with the basic medical problem he has. Improper handling may cause injuries to the patient. Also the nursing staffs who handles patients, faces some health problems like pain in the shoulder, back bone etc. For safety of the patient, the manual handling of patient should be totally eliminated. If trolley cum wheelchair,with adjustable height is available, once the patient is transferred to the trolley-cum-wheelchair from hospital bed, the patient will not be required to be handled manually till he reaches the CT Scan / X-Ray centre. The paper presents a schematic design of trolley cum wheelchair and discusses its salient features and applications INTRODUCTION Generally a person who is suffering from some kinds of medical problem and requires continues monitoring by doctor and may require external aids like oxygen, blood transformation, saline etc. is known as s patient. He is generally admitted in a hospital. The patient is confined to bed in hospital and is required to be moved to other places for taking X-ray or undergoing sonography or CT scan procedure. The handling of the patient is rather difficult and is required to be planed meticulously. In patient handling, a lot of problems are being faced by nursing staff, the people who handle the patient at home, and the patient himself. These problems consist of pain to patient, in various portions of body like shoulder, back, legs, etc; while moving him from one place to another. In the hospitals, the nursing staffs are also facing some health problems like pain in their shoulders and backbone, as they have to do the work of patient handling repeatedly. ISSN : Vol. 3 No. 8 August

2 According to a recent survey, it is found that, 38% of nursing staffs suffer work-related back injuries requiring time away from work,12% of nursing staffs consider leaving nursing due to low back pain at average age 39, Nursing staff aides have also experienced significant injury. The main objective of this research work is to reduce problems of patient handling by developing Trolley-cum-Wheelchair. [3] PRESENT METHOD OF PATIENT HANDLING Fig. No.1 shows the present method of handling the patient to move into or to transfer to CT scans, MRI scans, X-ray, Sonography etc. Patient Bed Trolley Lift/elevator Ground Floor Ambulance CT scans, MRI scans, Sonography, X-ray Back to Bed Fig. No. 1Flow chart for Present method of patient handling Various stages of patient handling to transfer patient from hospital bed to CT scan/mr machine/sonography/x-ray centre, as shown in flow chart, are. 1) Patient bed to trolley- The patient is moved from bed to trolley with the help of three to four persons. They simply lift the patient and keep him on trolley ISSN : Vol. 3 No. 8 August

3 2) Trolley to lift- The trolley with patient is then moved to lift whose size is appropriate to accommodate the trolley. 3) Trolley to ground floor- The trolley inside lift is then transferred to ground floor. 4) Ground floor to Ambulance platform-the stretcher along with patient is moved inside the ambulance and pushed on the guide ways provided inside the ambulance for stretcher. The trolley is lifted and put in ambulance. 5) Hospital to CT scan centre- The ambulance takes the patient from hospital to CT scan centre 6) Ambulance to CT scan machine- From the ambulance, the patient lying on stretcher, is lifted manually by four persons and put it on the trolley. 7) Movement of trolley to CT scan machine- The trolley with patient is moved to the CT scan machine. 8) Back to patient bed- The above procedure is repeated while moving the patient back to the hospital bed in reverse sequence. THE PROBLEMS ASSOCIATED WITH HANDLING OF THE PATIENT The patient is required to move manually on a canvas bed sheet from hospital bed to trolley, trolley to ambulance bed then ambulance bed to trolley, trolley to CT scan machine. Backward patient journey from CT scan bed to the hospital bed is similar. The various problems associated with patient handling are 1) When the patient is required to be moved on the same floor is wrapped in a canvas or cotton bed sheet and lifted and moved by three to four person / nursing staff. Due to this handling, stresses are produced, in the body of the patient as well as the nursing staff. This may result in injuries to the patient and cramps may be produced in backbone and other parts of the body. 2) During the manual handling of the patient various accessories like oxygen supply, blood transmission facility, saline facility, are not available and this may create serious problem if the patient is serious. 3) When the patient is to be moved from trolley to ambulance bed or to be move on staircase at CT scan or X- ray centre.the movement of the patient is on inclined plane. During this handling there is a chance that the patient may slip/slide down on stretcher. The nursing staff handling the patient has to be very causes to such an eventuality. The problems of manual handling of patient can be eliminated or minimized by using trolley-cumwheelchair for patient handling. CONCEPTUAL DEVELOPMENT OF TROLLEY CUM WHEELCHAIR This paper presents the synthesis of trolley cum wheelchair Fig. No. 2 and Fig. No 3 shows the photograph of trolley cum wheelchair in wheelchair position and trolley position respectively. WORKING OF TROLLEY CUM WHEELCHAIR The trolley cum wheelchair consists of backrest, hip rest and leg rest (as shown in fig. No. 4), connected together by a four bar mechanism OABC. [1, 2]OA is a fixed link of four bar mechanism and AC and OB are movable links and BC is a coupler in form of a lever which is used for changing trolley cum wheelchair from trolley position to chair position and vice versa. Link AC is connected to Backrest while link OB is connected to leg rest. The hip rest is immovable and is parallel to the ground always. The backrest and leg rest are moved by lever operated by the coupler of four bar mechanism to change trolley cum wheelchair from trolley position to wheelchair position and vice versa. The design of Trolley cum wheelchair will be based on ISSN : Vol. 3 No. 8 August

4 ergonomic considerations. The schematic drawing of trolley cum wheelchair in chair position and trolley position are shown in Fig. No. 2 and Fig. No. 3 respectively In wheelchair position, the backrest will be inclined perpendicular to hip rest to provide comfort to the patients. The hip rest will be parallel to the ground. To convert the wheelchair into trolley (stretcher), the lever is rotated in clockwise direction. When the lever is rotated in the clockwise direction, backrest slides backward (downward direction) and leg rest slides upward and the wheelchair is converted into trolley. To convert the trolley into wheelchair the lever is rotated in anticlockwise direction. When the lever is rotated in the anticlockwise direction, backrest slides upward and leg rest downward and the trolley is converted to wheelchair. Fig 2 chair position of trolley cum Fig 3 trolley position of trolley cum wheelchair Wheelchair SIMULATION OF TROLLEY CUM WHEELCHAIR The dimensions of the trolley cum wheelchair are assumed on the basis of dimensions of trolley cum wheelchair reported in literature [4]. The CAD model of the trolley cum wheelchair of these dimensions is prepared by using Pro-E software. Figure 5 shows the CAD Model of trolley cum wheelchair. To verify the dimensions of trolley cum wheelchair, it is simulated from wheelchair position to trolley position and trolley position to wheelchair position by using Pro-E. It is observed that there is an interference with backrest and link (AC). To remove the interference, the length of link AC is changed to 40cm from its original length of 25cm. Fig. No.6 shows the wheelchair cum trolley with new dimensions. To verify the modified dimensions of trolley cum wheelchair, it is simulated from wheelchair position to trolley position and trolley position to wheelchair position by using Pro-E the When the simulation was carried out it was observed that there is no interference. Therefore the final dimensions of trolley cum wheelchair are accepted as final dimension of trolley cum wheelchair. ISSN : Vol. 3 No. 8 August

5 Fig. No. 4 CAD Model of trolley cum wheelchair with links Fig. No. 5 CAD Model of trolley cum wheelchair with original dimensions ISSN : Vol. 3 No. 8 August

6 Fig. No. 6 CAD Model of trolley cum wheelchair with modified dimensions CONCLUSION The research work reported in this paper is an attempt to synthesize a trolley cum wheelchair. The production of this trolley cum wheelchair will help hospitals to improve the comfort of patient during their required movement for CT scan, X-ray etc. Trolley cum wheelchair is generally available in developed countries for patient handling but such trolley are not available even in modern hospital in our country. It is expected that production of low cost trolley cum wheelchairs for patient handling will relive patient and nursing staff from a lots of physical discomfort. REFRENCES 1. Rao J.S. Mechanism and Machine Theory -(New Age International (p) limited Publishers) Edition Sandor N.George & Erdman G.Arthur ADVANCE MECHANISM DESIGN Analysis and Synthesis (Tata Mc-Grew hills) 2002, fifth Edition. 3. Tiernan John, Leonard Conor,Gilchrist Michael & de Paor Annraoi," A Survey of the Wheelchair and Seating Market in Ireland" Assistive Technology shaping the future: AAATE conference proceedings,vol. 11, No. 1, pp , Publication Ehsanullah khan, Lecturer, Prof & Head Dept of Mech Engg Dr. R.D.Askhedkar Prof of Mechanical Engg, Dean, Central India Institute of Polytechnic Nagpur. KDK collage of Engg, Nagpur (Academic), KDK collage of Engineering, Nagpur. ISSN : Vol. 3 No. 8 August