System and method for controlling pressure in a surgical tourniquet

• US 6,605,103 B2
• Filed: 09/19/2001
• Issued: 08/12/2003
• Est. Priority Date: 03/29/1999
• Status: Expired due to Term

• Current Assignee: Stryker Corporation
• Original Assignee: InstruMed, Inc.
• Inventors: Hovanes, Michael E., Schmitt, Don S.
• Primary Examiner(s): TRUONG, KEVIN THAO
• Application Number:
  US09/955,763
• Publication Number:
  US 20020016610A1
• Time in Patent Office: 692 Days
• Field of Search: 606/202, 606/201, 606/203, 128/681, 128/327, 128/680, 128/686
• US Class Current: 606/202
• CPC Class Codes: A61B 17/1355 Automated control means therefor

Abstract

A system and method of controlling the pressure within a pressure cuff of a surgical tourniquet so as selectively to occlude blood flow within a portion of a limb of a patient, wherein a sensor determines when flow past the tourniquet is occurring so that corrective action may be taken, such as by increasing the pressure in the tourniquet or by notifying an operator of the flow past the tourniquet. The present invention may use an acoustic sensor to detect Korotkoff sounds indicating incipient blood flow past the tourniquet. When such signals are detected, the tourniquet controller may either incrementally increase the pressure in the tourniquet, or if a threshold would be exceeded by such an increase, signal an alarm indicative of the blood flow.

Claims

1. A surgical tourniquet controller, said controller comprising:

a pressure source, said pressure source supplying a pressure medium at a sufficient pressure to pressurize a pressure cuff being used as a surgical tourniquet;

a pressure port, said pressure port allowing a pressure medium to be supplied to a pressure cuff;

a source valve, said source valve interposed between said pressure source and said pressure port;

an occlusion sensor, said occlusion sensor detecting pressure variations in the pressure medium indicative of blood flow past a pressure cuff, said occlusion sensor further generating a flow signal indicative of blood flow past a pressure cuff; and

a processor, said processor communicably connected to said occlusion sensor, said processor further communicably connected to said source valve;

wherein said processor instructs said source valve to increase the pressure in a pressure cuff when blood flow is detected past the pressure cuff.

2. A surgical tourniquet controller according to claim 1, further comprising a pressure threshold value, wherein said processor instructs said source valve to increase the pressure in a pressure cuff only when the increased pressure would not exceed the pressure threshold value.

3. A surgical tourniquet controller according to claim 1, further comprising a pressure relief valve, said pressure relief valve having a pre-determined pressure threshold value, said pressure relief valve being connected to said pressure port such that if a pressure in said pressure port exceeds said pressure threshold value, said pressure relief valve vents said pressure port.

4. A surgical tourniquet controller according to claim 1, wherein said occlusion sensor senses Korotkoff sounds.

5. A surgical tourniquet controller according to claim 4, wherein said surgical tourniquet controller further comprises an analog to digital converter and a digital signal processor, said analog to digital converter converting an analog output from said occlusion sensor into a digital signal, said digital signal processor analyzing said digital signal to identify flow past a pressure cuff.

6. A surgical tourniquet controller according to claim 5, further comprising an input/output interface.

7. A surgical tourniquet controller according to claim 6, further comprising a heart rate sensor, said heart rate sensor generating a heart rate signal indicative of a heart rate associated with a patient to whom a surgical tourniquet has been applied, said heart rate sensor further communicating said heart rate signal to said surgical tourniquet controller, said surgical tourniquet controller using said heart rate signal to provide feedback for flow detection.

8. A surgical tourniquet controller according to claim 7, wherein said heart rate sensor is an EKG monitor.

9. A surgical tourniquet controller according to claim 1, wherein said occlusion sensor senses oscillometric indications of blood flow past a pressure cuff.

10. A surgical tourniquet controller according to claim 1, further comprising an input/output interface.

11. A surgical tourniquet controller according to claim 10, further comprising a heart rate sensor, said heart rate sensor generating a heart rate signal indicative of a heart rate associated with a patient to whom a surgical tourniquet has been applied, said heart rate sensor further communicating said heart rate signal to said surgical tourniquet controller, said surgical tourniquet controller using said heart rate signal to provide feedback for flow detection.

12. A surgical tourniquet controller according to claim 11, wherein said heart rate sensor is an EKG monitor.

13. A surgical tourniquet controller according to claim 10, further comprising a blood pressure sensor, said blood pressure sensor generating a blood pressure signal indicative of a patient'"'"'s blood pressure said blood pressure sensor further communicating said blood pressure signal to said surgical tourniquet controller, said surgical tourniquet controller using said blood pressure signal to set an initial cuff pressure value.

14. A surgical tourniquet controller according to claim 10, further comprising a blood pressure sensor, said blood pressure sensor generating a blood pressure signal indicative of a patient'"'"'s blood pressure said blood pressure sensor further communicating said blood pressure signal to said surgical tourniquet controller, said surgical tourniquet controller using said blood pressure signal to verify that a cuff pressure value exceeds said blood pressure signal.

15. A surgical tourniquet controller according to claim 1, further comprising a graphical display, said graphical display graphically displaying an iconic indicator when blood flow past a pressure cuff is detected.

16. A surgical tourniquet controller according to claim 1, further comprising a graphical display and a maximum pressure threshold, said graphical display graphically displaying an iconic indicator when blood flow past a pressure cuff is detected and when said cuff pressure is equal to or exceeds said maximum pressure threshold.

17. A surgical tourniquet controller, said controller comprising:

an occlusion sensor, said occlusion sensor detecting blood flow past a pressurized pressure cuff, said occlusion signal further generating a signal indicative of detected blood flow; and

a means for increasing the pressure in a pressure cuff in response to a signal indicating detected blood flow.

18. The surgical tourniquet controller of claim 17, wherein said occlusion sensor comprises a sensor which measures flow sounds associated with blood flow past a pressure cuff.

19. The surgical tourniquet controller of claim 17, wherein said occlusion sensor comprises a sensor which measures pressure fluctuations in a pressure cuff associated with blood flow past a pressure cuff.

20. The surgical controller of claim 17, further comprising a heart sensing means, said heart sensing means sensing a heart beat signal associated with a patient to whom a pressure cuff has been applied, said heart beat signal being communicated to said means for sensing occlusion, wherein said means for sensing occlusion further uses said heart beat signal for identifying flow past a pressure cuff.

21. A method for controlling a surgical tourniquet, said method comprising the steps of:

inflating a pressure cuff to an initial pressure;

detecting blood flow past a pressure cuff;

incrementally increasing pressure in the pressure cuff in response to detected flow past the pressure cuff;

determining whether the increased pressure in the surgical tourniquet has occluded blood flow past the tourniquet;

when blood flow has not been occluded, continuing to incrementally increase pressure in the pressure cuff until blood flow past the tourniquet is occluded or a maximum pressure threshold is reached.

22. A method for controlling a surgical according to claim 21, further comprising the steps of:

receiving a desired inflation duration;

starting a timer when the pressure cuff is initially inflated; and

deflating the pressure cuff when the desired inflation duration has occurred.

23. A method for controlling a surgical according to claim 21, further comprising the steps of:

receiving a desired inflation duration;

starting a timer when the pressure cuff is initially inflated;

informing an operator when the desired inflation duration has occurred; and

deflating the pressure cuff upon command by an operator.

24. A method for controlling a surgical according to claim 21, further comprising the steps of:

determining a threshold pressure above which the pressure cuff should not be inflated;

ceasing incremental pressure increases when the threshold pressure is achieved; and

informing an operator that the threshold pressure has been achieved.

25. A method for controlling a surgical according to claim 21, further comprising the steps of:

receiving a threshold pressure above which the pressure cuff should not be inflated from an operator;

ceasing incremental pressure increases if the threshold pressure is reached; and

informing an operator that the threshold pressure has been reached.

26. A computer readable medium tangibly embodying instructions which, when executed by a computer, cause a surgical tourniquet controller to:

inflate a pressure cuff to an initial pressure;

receive indications from a sensor of blood flow past a pressure cuff when blood flows past the pressure cuff;

incrementally increase pressure in the pressure cuff when blood flow past a pressure cuff is detected;

determine whether the increased pressure in the pressure cuff has occluded blood flow past the pressure cuff; and

when blood flow has not been occluded, continuing to incrementally increase blood pressure until blood flow past the pressure cuff is occluded.

27. A computer readable medium tangibly embodying instructions according to claim 26, wherein the instructions when executed further cause a surgical tourniquet controller to:

receive a desired inflation duration;

start a timer when a pressure cuff is initially inflated; and

to

deflate the pressure cuff when the desired inflation duration has occurred.

28. A computer readable medium tangibly embodying instructions according to claim 26, wherein the instructions when executed further cause a surgical tourniquet controller to:

receive a desired inflation duration;

start a timer when a pressure cuff is initially inflated;

signal an operator when the desired inflation duration has occurred;

receive a deflate command from an operator; and

deflate the pressure cuff upon receipt of the command from an operator.

29. A computer readable medium tangibly embodying instructions according to claim 26, wherein the instructions when executed further cause a surgical tourniquet controller to:

determine a threshold pressure above which the pressure cuff should not be inflated;

cease incremental pressure increases when the threshold pressure is achieved; and

inform an operator that the threshold pressure has been achieved.

30. A surgical tourniquet system, including a pressure cuff that may be closed around a patient'"'"'s limb so as to exert pressure on blood vessels within a portion of the limb, comprising:

an inflatable cuff containing a first quantity of gas having a first internal pressure;

an inflatable bladder containing a second quantity of gas having a second internal pressure;

a first conduit between said inflatable cuff and said inflatable bladder;

a first valve within said first conduit;

a controller connected to said first valve; and

a flow sensor connected to said first conduit, said flow sensor between said first valve and said inflatable cuff,

wherein, when the pressure in said inflatable cuff is greater than that in said inflatable bladder, said controller decreases the pressure in said inflatable cuff by opening said first valve;

wherein, when the pressure in said inflatable cuff is less than that in said inflatable bladder, said controller increases the pressure in said inflatable cuff by opening said first valve; and

wherein when the flow sensor detects flow past the inflatable cuff, the second internal pressure in the inflatable bladder is incrementally increased.

31. The surgical tourniquet system of claim 30, further comprising:

a pump connected to said controller;

a second conduit between said pump and said inflatable bladder;

a second valve within said second conduit and connected to said controller,

wherein said controller increases the pressure in said inflatable bladder by opening said second valve and pumping gas from outside the surgical tourniquet system into said inflatable bladder; and

wherein said controller decreases the pressure in said inflatable bladder by opening said second valve, thereby equalizing the pressure in said inflatable bladder with that of the atmosphere.

32. A method of controlling the pressure within a surgical tourniquet system so as selectively to occlude blood flow within a portion of a limb of a patient, comprising the steps of:

(a) decreasing the pressure within an inflatable cuff surrounding a portion of a limb of a patient by automatically opening a first valve connected to a controller and located within a first conduit between an inflatable bladder and the inflatable cuff, when the pressure in the inflatable cuff is greater than that in the inflatable bladder;

(b) increasing the pressure within an inflatable cuff surrounding a portion of a limb of a patient by automatically opening a first valve connected to a controller and located within a first conduit between an inflatable bladder and the inflatable cuff, when the pressure in the inflatable cuff is less than that in the inflatable bladder; and

(c) when flow past an inflatable cuff is detected, incrementally increasing the pressure within an inflatable bladder.

33. A surgical tourniquet system, comprising:

an inflatable cuff;

a controller connected to said inflatable cuff;

a flow sensor; and

a display connected to said controller,

wherein a user controls the surgical tourniquet system by means of a graphical user interface displayed on said display.

34. The surgical tourniquet system of claim 33, wherein the graphical user interface comprises a plurality of icons, at least one of said icons being a flow detected indication icon.

35. The surgical tourniquet system of claim 33, wherein the graphical user interface comprises a plurality of icons, at least one of said icons being a threshold pressure achieved flow detected indication icon.