US2481924A - Sphygmomanometer cuff - Google Patents

Description

Sept. 13, 1949. HANAFlN 2,481,924

SPHYGMOMANOMETER CUFF Filed April 24, 1948 2 Sheets-Sheet 1 P 3, 1949- B. M. HANAFIN SPHYGMOMANOMETER CUFF 2 Sheets-Sheet 2 Filed April 24, l948 llllllllllllllll I INVENTOR BERN/4RD MHfl/VHF/A/ BY [lanai- 777% n--.,( 3W

ATTORNEYS l' atented Sept. l3, 1949 SPHYGMOMANOMETER CUFF Bernard M. Hanafin, Kew Gardens, N. Y., as-

signor to W. A. Baum 00., Inc., New York, N. Y., a corporation of New York Application April 24, 1948, Serial No. 23,076

This invention relates to an inflatable cufi particularly useful in sphygmomanometer apparatus. The invention provides an improved cuff which is short and compact, which is immediately applicable to limbs of a wide variety of sizes without adjustment, and which requires no metallic or other rigid fastening elements to hold it in place upon a patients limb. The present invention represents an improvement over that disclosed in the joint application of William A. Baum and Bernard M. Hanafin (the latter being the applicant herein), Serial No. 23,108, filed April 24, 1948, and assigned to the assignee hereof.

The inflatable cuff of my invention may be made of one or more strips of flexible material which are folded and sewn, or joined if there are more than one, to form a structure having three portions or branches extending from a common line of junction. When the branches are extended to radiate in planes from their line of junction at approximately equal angles to each other, the

structure has the general shape of a Y. An inflatable bag adapted to constrict the flow of blood in the patients artery is associated with and supported by one of the branches of the Y. The cuff is applied to the patient by wrapping the three branches of the Y about the patients limb from their line of junction in successively opposite directions, beginning with the bag-supporting branch, so that the ends of the three branches overlap each other and the inflatable bag, and are stressed together in frictional contact when the bag is inflated.

Means are provided which apply to the overlappin branches of the cuff a stress normal to their surfaces, pressing them together in the region of their overlap so that they will not become disconnected or unwrapped, for example if the patient moves about. In particular this normal stress retains the outer end of the outermost branch in contact with the second branch wrapped, independently of inflation of the bag, much as if it were held down with the finger. Inflation of the inflatable bag, which underlies the three branches of the cuff in the region of their overlap, is therefore effective to stress together the second and third branches in the portion of their overlap lying between this outer end of the third branch and the end of the second branch, as well as to stress together the first and second branches throughout their region of overlap. A relatively small perpendicular stress thus applied between the second and third branches at the outer end of the latter, suffices to secure the much greater perpendicular stresses 6 Claims. (Cl. 128327) between the branches which are provided by inflation of the bag in aid of retention of the branches in overlapping relation upon the'patients limb. For, the overlapping branches so stressed together perpendicularly to their surfaces are held against lengthwise slipping with respect to each other by the large forces of friction thus made available.

A cuff so constructed is adapted to accommodate limbs of a wide range of sizes. None of the branches of the Y need be as much as a single turn about the limb in length, so that no rolling or gathering of the free ends to be wrapped is necessary, as is required by prior art cuffs consisting of a simple two-ended strip or bandage to be wrapped around and around the limb. The combined length of the branches which make up my novel cufi may be substantially less than the length of the single two-ended strip of old-style bandage'cuffs so that my improved cuff is both simpler to apply and less bulky.

Removal of my improved cuff after completion of the blood pressure measurement is correspondingly simplified since no one of the branches Of which it is composed need be unwrapped more than one complete turn in order to be entirely freed of the patients limb.

Thus the rows of hooks and eyes, interengaging bars and eyelets, and similar'interengaging positive fastening devices which have been hitherto required to be provided on the two ends of short fastener-type cuffs in order to make them applicable to limbs of various sizes may be dispensed with in cuffs constructed according to my present invention. A short eufif, speedy of application, may therefore be constructed which will retain the pliability and conf-ormability which characterized the early, long, bandagestyle cuff with which the presently accepted clinical standards of blood pressure were established. My improved cuff thus conduces to the relative comfort of the early sphygmomanometer cuffs in which along single strip of fabric was wrapped around and around the limb with attendant dif- Fig. 1 in which is shown the relation of the ele-' ments of the cuff preparatory to its application to a patient;

Fig. 3 is a perspective view of the'cufi of Fig. 1 as applied about the upper arm of a patient;

Fig. 4 is a sectional view taken on the line 4-4.

of Fig. 3;

Fig. 5 is a perspective view' similar to that of Fig. 3 but showing a modified form of cufflin which a pair of tuck-in flaps are employed to assist in holding the cuff in place preparatory to the inflation ofthebas 1Fig. .6' is a sectional View on the line 6-'6 'of Fig. '5 showing the overlapped relation of the fb'ranches'or the cuiT of Fig. 5 as they are stressed tc'gether bythe inflatable bag; and 'Fig, "7 is an exploded view of a cufi according to arurtner modification. of my invention in which a pressure-sensitive adhesive is employed ontnebranch'es off the cuff to aid in frictionally retaining the, overlapped branches of the cuff in place "Referring to Fig. 1, av cuff according to my invention is shown with the separate branches thereof extended in the form of a. Y as the cuff will appear when held preliminary to its applicati'oilt'o, the limb "Of-the patient. The cufi of Fig. :1 .-ihc1udes for support 'of the inflatable bag and its-retentionagainst the limb a single strip-like piece I of pliable material essentially rectangular in shape. The material employed may be a woven, fabric or a. plastic or other pliable material. "The strip l iisffolde'd and sewn to provide an-pocket-forining branch 5-and two. additional branches, and [2. all extending from-a line of junction 18. Alternatlythe cufi may be assembled irom'two striplikepieces, one forming. any two. of the branches. 5, -ll] and I2 and the other the third. The two. strips are joined by-sewing or otherwisefljoinihg.the strip which -frorms .a, single branch. at one of its ends to'th'e other strip transversely of the latter. ataposi- 'tioh intermediate the ehiilsfthr'tiOf.v vOr the Cliff may 'be assembledfrom three-,striplik'elpiec'esfof flexible material, one for each of the branches. .Onefend of eachfst'rip willjthen be sewn'or otherwisenjoined to one end of eachol the others along a common seam or line of junction'transverse of tnestnps. V "O'n'eeofth'e branches of the Y, numbered 5. in Fig. 1, provides support to an -inflatable bag 6 '(seFigQZ) byineans of 'a "pocket .1. In the case if a cult formed of 'a'single stri of materialtne fbra'ricn egis fcrmed byfoldihgfthestrip lba'ck on itself. alohgfa line [El/Which locates the free end or jithe'fbran'ch '5. The "edges or thejtiwo portions 'or'tne strip extending from; the line 19 are then jbinedto' i therfior :a suitable distance; as, by sewii'i'g, tofori'n a pocket 1 ihto, Whibh "an inflatable bag may be inserted. Aperturfesareprovided'in thepjocktftdper'r'riitiriser'tionand removal of the ba and? for thejafjdliiis'fsion of the tubes which communicate with an infiatingfbulbafld'af'meas- 'uri'rig' instrument-such asaniariometer.

The two layers of material formingthebranch arecbnhectedtogether'transver'slyofthestrip 4 by a seam, suitably reinforced if necessary, which produces the line of junction I8 from which radiate the three branches of the cuiT.

The second and third branches l0 and I? of the Y are formed one from each of the two ends of the strip l as they extend beyond the seam or line oi-junction I8. The branch [0. forms the first overlapping 'conta-ctwith the bag-supporting branch 5 when Wrapped around the patients limb in the direction opposite to the branch 5. Similarly the third or outside branch I2 provides the"second overlapping contact which holds the cufi in place when it is wrapped about the limb from the line i8. down over the branch 5 and the outer end of the branch in.

The second and third branches I0 and I2 are provided cooperative means which secure the, third; branch in contact with the second by holding the terminal end of the former down in contact with, the latter. These means may take various forms.

In'the cuff of Fig. 1 this "auxiliary holding means consists of affolding tab 20 afiixe'd to and extending b fydnd'ithe free end of the branch 1'2 and of an .op'entab pocket. 22 extended longi- 'tudina'lly .Of the' branch I'll on the side thereof "rating. th'ebra'ncn [2, The tab"pocket '22 -is form d by :means 'ofailarrowstripifi"of pliable material sewn or otherwise 'aflixed along "three sides to the branchv 111 as aforesaid and with the iourth side free to form a pocket open towards 'onejlater'al edge "of thefbranch 111.

"The foldin'gftab 20 is provided-with api'ojecti'onii lj racing tireflaterai ed e of tne branch :2 which is contiguous with the lateral edge ofthe branch'lt "faced by the opensi'de of the pocket 22. The tabmay be folded along a folii line '25 parallel to the lengthwise dimension of the branch "[2, iso as to permit 'its insertion into the tZZwh'en the 'cufiis applied to them-- tiIentsjlimb Tn order to permit application 'of the, cull toflinibs off a wide. variety of 'sizes the pocket 22 isjpreferably'madeto extend along a large "fraction of the .length of the branch 18. The vpocket,will then "be much longer than the tab, 2B, and theft'abimay -be inserted into 'the pocket i'egardless'oi the "extent io'fithe overlap betweenfthe brancl'ies"I'll and [2.

To 'ap iyfthe cuff torthe 'patientfit' maybe held by tn 'branieneste anti. lfl'withthe'patientfs 1mm 'litfini the ang e between/the two-as shown 2. The branchli shojuld-gprierably 'fa'cefthe's'ide of, the, limb on which the artery is located so that wlhenf'the cuff is applied .thejinflatable bagjwill overlie the artery. The branches "5, [0 and I? "of the are 'then -s ufccessiyelywrapped closely around'thelhmb. Thebranch V5, is, Wrapped "about the limb -in ione lilirection beginning at the line dijuncftion f8; and the branchltlis'next wrapped about-the lijmbinthe opposite'dire'ction so'as'to overlie the end. of the branch? and theinfiatable ba Thirdlyj'thia outside branch 3'2 'is wrapped t 'oiit. the-limb from 'theline of jl nct'ron F8 'in the same dire'ction'as thebranchisoas to pverlie theoth'er twojwithithetab'flilover the tab-pocket 22. The tab 'may'th'en be folded into the pocket to hold the "branch I 21. in contact with the branch lfl. The cufi'o'f Tig. 'l'so'appliedto-theupper' arm 'iof"a'patientfiis*showninFig."3-. By virtue-"of the "curve'd'section of the arm thetab pocket forming 's'trip 2 3 is draw'n'down' tightly over the branch 'Hl and"thetabfml foldeddnto the "tab pocket 22 is "tightly' 'lld therein.

Asa result "of "the "close wrapping of "the branches 'and'the insertion of "the tab into the tab pocket, the branches 5 and ID are stressed together perpendicularly to their surfaces upon inflation of the bag, and in turn the branches l6 and I2 aresimilarly stressed together. Friction between the branches so interleaved and overlapping retains the cuff in place against the burstingstress of the inflated bag so that the bag constricts the artery of the limb. The frictional inter-relation-of the branches of the cuff is furthershown in Fig. 4, where the tab is shown tucked into the tab pocket over the end of the inflatable bag. As appears from Fig. 4 the area of the surfaces of the branches which are frictionally engaged and which together must be brought to slip before the cuff will loosen under the expansive stress of the inflated bag is nearly twice the circumference of the arm multiplied by the width of the cuff.

The auxiliary holding down means provided by the tab and tab pocket 22 are applicable between the overlapped branches continuously around the circumference of the cuff along the length of the tab pocket 22. No discrete steps thus occur in the range of available circumferential lengths for the cuff and no adjustment to or choice between such steps is necessary for application of the cuff to limbs of various sizes as is the case where the cuff is held in place by positive fastening means having complementary interlocking elements on the two ends of a bandage sought to be secured together. By relying upon the frictional effect between the three overlapped branches to prevent loosening of the cuff under the expansive stress of the inflatable bag, the effect required of the auxiliary holding down means which the tab provides is so reduced that positive interlocking members are not necessary.

The branches 5 and Ill should have a combined length greater than the girth of the largest limb about which the cuff is to be applied in order to 1 provide an area of overlap between the two. Subject to this condition the branch 5 may be of any length, although a preferred length therefor is greater than one-half the girth of such large limb and less than one times the girth thereof. The branch It should have a length no greater than the girth of the smallest limb to which the cuff is to be applied and no less than that length which with the branch 5 will encircle the largest limb with a substantial area of overlap. A preferred length for the branch [0 is again a length somewhat greater than one-half the girth of the largest limb normally encountered in practice.

It is apparent from Fig. 4 that the outside branch I2 may be of unlimited length. I have found however that making the branches 5 and I2 longer than the girth of the limbs to which the cuff is to be applied is unnecessary and sacrifices the advantages of convenience and rapidity in application which my cuff provides.

To accommodate unusually large limbs the branch l0 may be provided at its outer end with an extension II as shown in Fig. 1. When the cuff is used on limbs of normal sizes, the extension is retained folded against the branch, for example by means of a pressure-sensitive adhesive, so that the length of the branch so folded does not exceed the girth of normal limbs. For large limbs the extension H is available to provide the branch ID with length sufficient to overlap the end of the branch 5 when the two are wrapped in opposite directions around the limb from their line of junction l8.

The cuff is made preferably of a rough-surfaced fabric so that the coefficient of friction between overlapped portions thereof may be high. By applying the three branches closely to'the limb the elasticity of the tissues in the limb is made to stretch the cuff sufficiently to provide a substantial normal stress between the overlapping portions of the branches. For increased frictional effect thefabricmay be rubber-impregnated.

- In place of the tab and tab pocket of'the cuff of Figs. 1 to 4 a pair of flaps, disposed one at either side ofthe free end of the outside branch, may be employed to hold the branches of the cuff in frictional contact so that they may be fur ther stressed together upon inflation of the bag.

A cuff employing such tuck-in flaps is shown in perspective in Fig. 5. The third or outside branch All of this cuff is shown wrapped down over the overlapped ends of the first and second branches 38 and 39. A tuck-inflap 42 is shown affixed to either side of the end of the branch 40, tucked under both of the branches 38 and 39 into contact with the patients limb. Thus between the flaps d2 andthe' free end of the outside branch it the surfaces of the branches 33, 39 and 40 he in close contact with each other and the end of the branch M) is prevented, asa result of friction between the flaps 42 and the underside of the branch 33, from losing contact with the outer surface of the second branch 39. Like the tab and pocket of the cuff of Figs. 1-4, the tuckin flaps 32 provide "an auxiliary holding down means applicable to limbs of a continuous range of sizes without preliminary adjustment of any kind.

Fig. 6 shows in section the cuff of Fig. 5 and further illustrates the large area of frictional contact provided by the Y-type of cuff. The tuck-in flaps- 42 are shown'interposed between the branches of the cuff and the patients arm where they are held in place byinflation of the inflatable bag. r

A further means for providing the auxiliary holding down stress is shown in Fig. '7. Fig. '7 shows in partially interleaved and overlapping relation the branches of a cuff according to my invention in which a tacky adhesive material is applied to the side of the third or outside branch 60 which faces the first or bag-supporting branch 58 so that when the cuff is applied the tacky area may be pressed down over the end of the second or intermediate branch 59.

My invention is not restricted to the precise details of construction illustrated in the drawings and as set forth in the accompanying description. Changes and modifications may be made therein without departing from the scope of my invention as set forth in the appended claims.

I claim:

1. An inflatable cuff comprising a structure of flexible material having three strip-like branches radiating from a line of junction in Y-like fashion, and an inflatable bag disposed adjacent the free end of one of the branches, the said cufi being adapted to be applied to a limb by wrapping a second one of the branches thereof about the limb and over the inflatable bag in one direction and by wrapping the remaining branch about the limb in the opposite direction over the inflatable bag and the extremity of the said second branch, whereby said cuff and inflatable bag are retained in a desired relation upon the limb by the combined action of the friction developed between the overlapping branches sneeze thefeqfi under the pressure exe ted b tween th opposed Wrapp d ran hes upon inflation of the has- 2-. An inf atable sphy-em m n meter cuff prising a Yi-like structureofpliablematerial having three branches each: substantially rectangular in shape; extending from a common line of iu ict c i v a inf ab ba s p ted ad acent-th free end of one of the branches, a tab-receiving ponkett rm d on aseconden o th brancb on the. surfacether-ecfi remete from the bags-sup.- portinab anch a d a e i -e t n fro the free e d t hirdfbran he-said ta be: ing dap d b folded po s l al n a ne substantially perpendicular to the free; end of the, said third branch, the; said tab-receiv in pocket having a length along the extension-oi the. second branch from the line of junction substantially greater than the parallel dimension of. the said tab, whereby upon application or the cuffv to a-v human limb by thesuccessive wrapping of. the three branches thereaboutin successively opposite directions, the free end of the, third branch may be wrapped down into overlapping frictional contact with-the seccnd branch and the tab-may be folded into the tab-receiving. pocket,

3-A1'1 inflatable-cult comprising a Y-likestructure-of flexible material having three branches radiating from a common line of junction, an

inflatable ba supported adjacent the freeend Q ne of the sa d b anches? a a ec i g: p ck t arranged on the second one ofthethree branches on th surface thereof remote from the bagsupporting branch, the said tab-receiving pocket being open towards one lateral edge of the said second branch, and a tab afiixed to and extending from the free end of the third branch, the said tab having a projection beyond the fr ee end of the third branch ext ndin transversely thereof toward the lateral edge thereof contiguous with the lateraledge of the second branch faced by the tab-receiving pocket.

4. An inflatable sphygrnemanometer .comprising a Y-like structure. of pliable material having three branches extending from a common line. of junction, an inflatable bag supported adjacent the tree and. s ne 9 said-breat es he said; iff be n ada t d o p t the eie-bee ht e l mb r h tery th r e by the rappin 9 the. bea enertinsbra h in p ir qtie e eiit h l mb: be innin at the l e 9? Net ie!!! he w a pin s anoth b ch m the: sai line r ina n about the i in t e p o it rec qeto erlap the nf atabl h s and t e est in i the hird bran t om h Sa in d u tion abou e lim in the: fi t di c to. ov leathenf atab e h s an the fr e e d o e s cond branch, nd-a a o fle l fla amx en at ithe si e o e r end of sa thi d ran h an adap ed t be ucked unde the ec .Q the aid b anches w reby the re e d o sa d third bra ch ay be; r ainedagainst he s i second bran h and the cuff'may beretained upo the limb by the force of frictionbetween adjacent overlapping branches h reof as pressed to eth r by infiaction of the bag.

5. A pneumatic sphygmomanometer cufi com: prising. a first strip of roughesurfaced flexible fabric adapted to support an inflatable; baganinfiatablebag' supported on said first, strip, a second. strip of rough-surfaced flexible fabric secured at one end thereof toan end of said first strip along a line of'junctilon transverse'to' both stripsya third strip of rough-surfaced flexible fabric secured transversely thereof-at one end thereof to said first and second strips alon the said line of junction, and a pair of tuckin flaps secured one at: each side of the free end of said third strip.

5. A pneumatic sph-ygmomanometer cuff comprising three strips of flexible fabric having one end of each sewn to. one end of each of the others along a common seam, a pocket formed on one of the said strips and adapted to contain an inflatable'bag, an. inflatable bag in the said pocket; and a pressure-sensitive adhesive material applied to the-free end of one of the strips othert-han that containing the bag.

BERNARD M.

No references cited.

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