Compression Device With Simulator

The present invention relates to therapeutic and prophylactic devices, and more particularly to devices for applying compressive pressures against a patient's limb.

It is known that the velocity of blood flow in a patient's extremities, particularly the legs, markedly decreases during confinement of the patient. Such pooling or stasis of blood is particularly pronounced during surgery, immediately after surgery, and when the patient has been confined to bed for extended periods of time. It is also known that stasis of blood is a significant cause leasing to the formation of thrombi in the patient's extremities, which may have a severe deleterious effect on the patient, including death. Additionally, in certain patients it is desirable to move fluid out of interstitial spaces in extremity tissues, in order to reduce swelling associated with edema in the extremities.

Devices have been disclosed in U.S. Pat. Nos. 4,013,069 and 4,030,488, incorporated herein by reference, which develop and apply the desired compressive pressures against the patient's limbs. Such devices comprise a pair of sleeves which envelope the patient's limbs, and a controller for supplying fluid pressure to the sleeves. On certain patients only one sleeve is used, such as a patient with only one leg or a patient on whom use of the device is contraindicated on one limb. If the device is designed for use with two sleeves, the proper pressures will not normally be produced by the device when utilized with a single sleeve.

A principal feature of the present invention is the provision of an improved device for applying compressive pressures against a patient's limb from a source of pressurized fluid.

The device comprises a first elongated pressure sleeve for enclosing a length of the patient's limb, with the sleeve having a plurality of laterally extending separate fluid pressure chambers progressively arranged longitudinally along the sleeve from a lower portion of the limb to an upper portion of the limb proximal the patient's heart relative to the lower portion. The device has conduit means for establishing communication between the fluid source and the sleeve chambers. The device also has means for intermittently inflating and deflating the pressure chambers through the conduit means. The device has means for simulating a second elongated pressure sleeve of the type having a plurality of laterally extending separate fluid pressure chambers progressively arranged longitudinally along the sleeve from a lower portion of the limb to an upper portion of the limb proximal the patient's heart relative to the lower portion, with the simulating means communicating with the inflating means.

A feature of the present invention is that the simulating means simulates the second sleeve which is not utilized on the patient during operation of the device.

Another feature of the invention is that the simulated device, which is designed for normal operation with two sleeves, develops proper pressures when the device is utilized only with the single first sleeve.

Thus, a feature of the invention is that the simulating means permits use of the two-sleeve device on only one limb of the patient.

Further features will become more fully apparent in the following description of the embodiments of this invention and from the appended claims.

In the drawings:

FIG. 1 is a fragmentary perspective view of a compression device of the present invention;

FIG. 2 is a front plan view, partly broken away, of a compression sleeve for the device of FIG. 1;

FIG. 3 is a back plan view, partly broken away, of the sleeve of FIG. 2;

FIG. 4 is a front plan view of fluid impervious sheets defining chambers in the sleeve of FIG. 2;

FIG. 5 is a back plan view of the fluid impervious sheets of FIG. 4;

FIG. 6 is a fragmentary sectional view taken substantially as indicated along the line 6--6 of FIG. 4;

FIG. 7 is a fragmentary sectional view taken substantially as indicated along the line 7--7 of FIG. 4;

FIG. 8 is a fragmentary sectional view taken substantially as indicated along the line 8--8 of FIG. 4;

FIG. 9 is a perspective view illustrating the sleeve during placement on a patient's leg;

FIG. 10 is a sectional view of a connection member for conduit sets in a conduit system in the device of FIG. 1;

FIG. 11 is a sectional view taken substantially as indicated along the line 11--11 of FIG. 10;

FIG. 12 is a sectional view of attachment members for connecting the conduit system to a controller in the device of FIG. 1;

FIG. 13 is an elevational view of a connection device for releasably connecting conduit sections of the conduit sets together;

FIGS. 14 and 15 are elevational views taken from opposed sides of the connection device of FIG. 13;

FIG. 16 is an upper plan view of the connection device of FIG. 13;

FIG. 17 is a lower plan view of the connection device of FIG. 13;

FIG. 18 is an elevational view, partly broken away, of a sealing member for the connection device of FIG. 13;

FIGS. 19 and 20 are fragmentary plan views illustrating use of a pair of the connection devices of FIG. 13 for releasably connecting conduit sections in the conduit sets together, with the connection devices being separated in FIG. 19, and with the connection devices being releasably attached in FIG. 20;

FIG. 21 is a fragmentary sectional view taken through the attached connection devices of FIG. 20;

FIG. 22 is an elevational view of a simulation device of the present invention;

FIG. 23 is a lower plan view of the device of FIG. 22;

FIG. 24 is a sectional view taken substantially as indicated along the line 24--24 of FIG. 23;

FIG. 25 is a top plan view of the device of FIG. 22; and

FIG. 26 is a fragmentary perspective view illustrating use of the simulation device on the conduit system.

Referring now to FIG. 1, there is shown an intermittent compression device generally designated 20 having a controller 22, and a pair of elongated compression sleeves 26 and 27 for enclosing a length of the patient's extremities, such as the legs as shown. The controller 22 supplies pressurized fluid through a conduit system 30 to the sleeves 26 and 27. The controller 22 may be of any suitable type, such as the controllers described in U.S. Pat. Nos. 4,013,069 and 4,030,488.

With reference to FIGS. 2 and 3, the sleeve 26 has an outer cover sheet 36 covering the entire outer surface of an outer fluid impervious barrier sheet 38. Also, the sleeve 26 has an inner cover sheet 40 covering an inner surface of an inner fluid impervious barrier sheet 42. The outer cover sheet 36 may comprise a relatively inelastic fabric with a brushed matte or napped finish of nylon or polyester, such as a fabric sold under the trademark Flannel/Flannel II, No. 11630, by Guilford Mills, Greensboro, N.C., which provides an attractive outer surface for the sleeve, and also defines brushed or napped fibers across the entire outer surface of the sleeve for a purpose which will be described below. In suitable form, the fabric of the sheet 36 may be warp knit from polyester yarns on a tricot machine after which the fabric is dyed to a suitable color, and the fabric is brushed or napped on a suitable machine to raise loops from the fabric. The inner cover sheet 40 may comprise a suitable nonwoven material which provides a comfortable inner surface of the sleeve for the patient. The barrier sheets may be formed from a suitable flexible plastic material, such as polyvinylchloride. If desired, a segment of the brushed nylon fabric may be formed into a tube 44 to cover the conduits which extend from the sleeve to the controller. As shown, the conduits and covering tube 44 may extend through an opening 46 in the inner cover sheet 40.

The sleeve 26 may have a pair of side edges 48a and 48b, and a pair of end edges 50a and 50b connecting the side edges 48a and b, with the side edges 48a and b being tapered toward a lower end of the sleeve. The sleeve 26 may also have an elongated opening 52 extending through a knee region 53 of the sleeve, and defined by peripheral edges 54 extending around the opening 52. In addition, the sleeve 26 has an elongated opening or cut-out 56 in the knee region 53 extending from the side edge 48a toward a lateral central portion of the sleeve, with the opening 56 being defined by peripheral edges 58 extending from the side edge 48a around the opening 56. As shown, the inner end of the opening 56 is spaced from the opening 54, and the opening 56 defines an upper flap 60 and a lower flap 62 of the sleeve which are separated by the opening 56. Further, the sleeve 26 may have a pair of lower fastening strips 61, such as a hook material sold under the trademark Velcro, secured to the inner cover sheet 40 along the side edge 48b.

With reference to FIGS. 4-8, the inner and outer fluid impervious barrier sheets 38 and 42 have a plurality of laterally extending lines 64, such as lines of sealing, connecting the barrier sheets 38 and 42 together, and longitudinally extending lines 66, such as lines of sealing, connecting the sheets 38 and 42 together and connecting ends of the lateral lines 64, as shown. The connecting lines 64 and 66 define a plurality of longitudinally disposed chambers 68a, 68b, 68c, 68d, 68e, and 68f, which for convenience will be termed contiguous. As shown, the chambers 48 extend laterally in the sheets 38 and 42, and are disposed in the longitudinal arrangement between the end edges 50a and 50b. When the sleeve is placed on the patient's leg, the lowermost chamber 68a is located on a lower part of the leg adjacent the patient's ankle, while the uppermost chamber 68f is located on an upper part of the leg adjacent the midthigh.

As shown, the longitudinal line 66 nearest the side edge 48b is separated intermediate the chambers 68b and c, 68c and d, and the chambers 68e and f. The lateral lines 64 define ventilation channels 70a, 70b, and 70c extending laterally in the sleeve from the longitudinal line 66 adjacent the side edge 48a toward the longitudinal lines 66 adjacent the side edge 48b, with the ventilation channels 70 being positioned at spaced locations longitudinally along the sleeve intermediate different pairs of adjoining chambers. Thus, the ventilation channel 70a is located intermediate the chambers 68b and 68c, the ventilation channel 70b is located intermediate the chambers 68c and 68d, and the ventilation channel 70c is located intermediate the chambers 68e and 68f. Moreover, the ventilation channels 70 have a width substantially less than the width of the chambers 68 such that the channels 70 do not detract from the size and volume required for the compression chambers 68. The inner and outer barrier sheets 38 and 42 also have a longitudinally extending line 72 which defines a connecting channel 74 intermediate the line 72 and the adjacent longitudinal line 66. As shown, the connecting channel 74 extends along the sides of the chambers 68c, 68d, and 68e, and communicates with the ventilation channels 70a, b, and c, such that the channel 74 connects the spaced ventilation channels 70. Further, the inner barrier sheet 42 has a plurality of openings or apertures 76 which communicate with the channels 70. Thus, when the sleeve 26 is placed on the patient's leg, the openings 76 face toward the leg.

With reference to FIGS. 4-7, the longitudinal lines 66 and 72 adjacent the side edge 48b define a pair of flaps 78a and 78b of the barrier sheets 38 and 42 which extend between the respective lines and the side edge 48b. As shown, the sheets 38 and 42 have a longitudinally extending line 79 which defines a directing channel 80 intermediate the lines 79 and 72, with the opposed longitudinal ends of the channel 80 being open. The sleeve 26 has a first connecter 82a which is commonly connected in fluid communication to the two lowermost chambers 68a and 68b, and which is connected to a first conduit in the conduit system 30. As shown, the first conduit passes through an opening 84a in the upper barrier sheet flap 78a which retains the first conduit at the desired position in the sleeve 26. The sleeve 26 also has a second connecter 82b which is commonly connected in fluid communication to the second pair of adjoining chambers 68a and 68d, and which is connected to a second conduit in the conduit system 30. The second conduit passes through an opening 84b in the upper flap 78a which retains the second conduit at the desired position. The sleeve 26 has a third connecter 82c which is commonly connected in fluid communication to the uppermost chambers 68e and 68f, and which is connected to a third conduit in the conduit system 30. As shown, the third conduit passes through an opening 84c in the upper flap 78a, with the third conduit extending through the directing channel 80 in order to retain the third conduit at the desired position in the sleeve. The sleeve 26 also has a fourth connecter 82d which is connected in fluid communication to the connecting channel 74 in order to permit passage of air to the ventilation channels 70. As shown, the connecter 82d is connected to a fourth conduit in the conduit system, with the fourth conduit passing through an opening 84d in the upper barrier flap 78a. Thus, the first, second, and third conduits are separately connected to pairs of adjoining chambers, while the fourth conduit is connected to the connecting channel 74. Of course, the other sleeve 27 associated with the conduit system may be constructed in a similar manner. It will be apparent that the barrier flaps 78a and 78b, the directing channel 80, and the openings 84 cooperate to retain the conduits at the desired position within the sleeve. Further, the sleeve 26 has suitable securing means 86, such as regions of heat sealing or adhesive, bonding the flaps 78a and 78b to opposed sides of the conduits adjacent the opening 46. Thus, in the event that forces are applied to the conduits exterior the sleeve 26, the forces are transmitted to the flaps 78a and b rather than the connectors 82a, b, and c, in order to relieve possible strain from the connectors and prevent severance of the connectors from the sleeve.

In use, the sleeve 26 may be placed below the patient's leg preparatory to securement about the limb, as illustrated in FIG. 9. Next, the upper flap 60 and lower flap 62 may be independently passed around the patient's leg at locations above and below the knee, respectively. Thus, the opening 56 separates the flap portions of the sleeve in the region of the knee to permit independent wrapping of the upper and lower portions of the sleeve about the leg and simplify placement of the sleeve, as well as provide an improved fit. After both the upper and lower flaps 60 and 62 have been suitably wrapped about the patient's limb, the remaining part of the sleeve adjacent the side edge 48b may be wrapped over the flaps 60 and 62, and the fastening strips 61 may be pressed against the outer cover sheet 36. Thus, the hook fastening strips 61 engage with the brushed fibers of the outer cover sheet 36, such that the strips 61 and sheet 36 interegage and retain the sleeve in the wrapped configuration. Since the sheet 36 extends entirely across the outer surface of the sleeve 26, the sleeve may be readily adjusted as necessary for the desired fit according to the size of the patient's leg. Thus, the sleeve 26 may be placed in a simplified manner while accomplishing an improved fit on patients having varying leg sizes. In addition, the openings 52 and 56 greatly reduce the amount of material and bulk for the sleeve in the region of the patient's knee. Accordingly, the sleeve provides flexibility in the knee region in order to prevent binding and permit flexation of the knee during the extended periods of time while the sleeve is secured about the leg.

After placement of the sleeves on the patient's limbs, the controller 22 may be initiated in order to supply air to the sleeves 26 and 27 through the conduit system 30. The controller 22 intermittently inflates the chambers 68 during periodic compression cycles, and intermittently deflates the chambers 68 during periodic decompression cycles intermediate the compression cycles The inelastic cover sheet 36 of the placed sleeve restricts the size of the inflated chambers, and greatly enhances the compressive action of the chambers to permit lower fluid volumes during the compression cycles. Further, the controller 22 supplies air through the conduits to the connecting channels 74 in the two sleeves. The air then passes from the common connecting channels 74 to the spaced ventilation channels 70 and through the openings 76 onto the patient's legs. In this manner, the device 20 ventilates a substantial portion of the patient's legs to prevent heat buildup and provide comfort for the patient during extended periods of time while the sleeves are retained in a wrapped condition about the patient's limbs. In a preferred form, the controller 22 supplies air to the ventilation channels 70 during the periodic decompression cycles.

With reference to FIG. 1, the conduit system 30 of the device 20 has a first set 90 of conduits 90a, 90b, 90c, and 90d communicating with the chambers of the sleeve 26 in a manner as previously described. The conduit system 30 also has a second set 92 of conduits 92a, 92b, 92c, and 92d in communication with chambers in the second sleeve 27 in a manner as previously discussed in connection with the sleeve 26. The conduit system 30 also has a third set 94 of conduits 94a, 94b, 94c, and 94d in communication with the controller 22.

The conduit system 30 has a connection member 96 which separately connects the conduits of the first and second sets 90 and 92, respectively, to the conduits 94 of the third set, and which may be made from a suitable material, such as plastic. With reference to FIGS. 10 and 11, the connection member 96 has a housing 98 having a plurality of tubular sections 100 spaced along the housing within a pair of opposed flanges 102a and 102b, with the tubular sections 100 defining associated ports 104a, 104b, 104c, and 104d. The tubular sections 100 are received in the conduits of the third conduit set 94, with the ports 104a, b, c, and d communicating respectively with the conduits 94a, b, c, and d, and with the ends of the conduits 94 being located intermediate the tubular sections 100 and the flanges 102a and b. The housing 98 also has a plurality of spaced tubular sections 106a, 106b, 106c, and 106d spaced beneath a pair of opposed flanges 108a and 108b, with the tubular sections 106a, b, c, and d defining respective ports 110a, 110b, 110c, and 110d. The conduits 90 in the first conduit set are attached to the tubular sections 106 with the conduits 90a, b, c, and d respectively communicating with the ports 110a, b, c, and d, and with the ends of the conduits 90 being located intermediate the tubular sections 106 and flanges 108a and b. The housing 98 also has a plurality of tubular sections 112a, 112b, 112c, and 112d spaced beneath opposed flanges 114a and 114b, with the tubular sections 112a, b, c, and d defining associated ports 116a, 116b, 116c, and 116d. The conduits 92 of the second conduit set are attached to the tubular sections 112 with the conduits 92a, b, c, and d respectively communicating with the ports 116a, b, c, and d, and with the ends of the conduits 92 being located intermediate the tubular sections 112 and flanges 114a and b.

The housing 98 also has a plurality of internal partitions 118a, 118b, and 118c and a pair of opposed end walls 120a and 120b which define a plurality of separate cavities 122a, 122b, 122c, and 122d, such that the port 104a communicates with the ports 110a and 116a through the cavity 122a, the port 104b communicates with the ports 110b and 116b through the cavity 122b, the port 104c communicates with the ports 110c and 116c through the cavity 122c, and the port 104d communicates with the port 110d and 116d through the cavity 122d. Thus, in this manner the connection member 96 separates fluid flowing through the third conduit set 94 and separately distributes the fluid to the first conduit set 90 and the second conduit set 92, with the conduits 94a, b, c, and d communicating respectively with the conduits 90a, b, c, and d and 92a, b, c, and d. In a preferred form, the tubular sections 106 are generally aligned with the tubular sections 112, while the tubular sections 100 are orientated generally perpendicular to the aligned tubular sections 106 and 112.

With reference to FIGS. 1 and 12, the controller 22 has a connection device 124 for releasably attaching the third conduit set 94 to the controller. The connection device 124 has a first connection member 126 of suitable material, such as plastic, having a plate 128 and a retaining flange 130 secured to the plate 128 by suitable means, such as screws 132, and with the connection member 126 defining a recess 134. The first connection member 126 has a plurality of tubular sections 136a, 136b, 136c, and 136d extending through the plate 128 and defining associated ports 138a, 138b, 138c, and 138d, with end portions of the tubular sections 136 extending on opposed sides of the plate 128. The outer end portions of the tubular sections 136a, b, c, and d have associated O-rings 140a, 140b, 140c, and 140d, constructed from a suitable material, such as rubber, for a purpose which will be described below. The connection device 124 also has a second connection member 142 of suitable material, such as plastic, having a housing 144 retaining a plurality of spaced tubular sections 146a, 146b, 146c, and 146d, with the tubular sections 146a, b, c, and d being received in upstream ends of the respective conduits 94a, b, c, and d of the third conduit set 94, such that the third conduit set 94 is attached to the second connection member 142. The housing 144 of the second connection member 142 also has a plurality of openings 148a, 148b, 148c, and 148d communicating with the respective tubular sections 146a, b, c, and d.

The second connection member 142 is releasably received in the recess 134 of the first connection member 126 with the outer ends of the tubular sections 136a, b, c, and d of the first connection member 126 being received in the associated openings 148a, b, c, and d of the second connection member 142, with the O-rings 140 providing sealing engagement between the tubular sections 136 of the first connection member 126 and the openings 148 of the second connection member 142. In this manner, communication is established between the ports 138a, b, c, and d of the first connection member 126 and the conduits 94a, b, c, and d of the third conduit set 94 when the second connection member 142 is attached to the first connection member 126. The controller 22 forms fluid pressure pulses which are separately connected inside the controller 22 to the ports 138a, b, c, and d during periodic inflation cycles, while the controller periodically exhausts fluid through the ports 138a, b, c, and d during periodic decompression cycles between the inflation cycles. In this manner, communication is established between the controller 22 through the ports 138 and the connection device 124 to the sleeves 26 and 27 through the third conduit set 94, the connection member 96, and the first and second conduit sets 90 and 92, respectively. Also, the second connection member 142 may be readily disconnected from the first connection member 126, in order to remove the controller 22 from the conduit system 30, as desired.

The first and second conduit sets 90 and 92, respectively, also have connection devices of identical design intermediate their lengths, and, for convenience, these connection devices will be discussed in connection with the first conduit set 90. Thus, with reference to FIG. 19, the first conduit set 90 has a connection device 150 comprising first and second connection members 152 and 154, respectively, which may be constructed of suitable material, such as plastic, which releasably connect downstream end portions of conduit sections 90a', 90b', 90c', and 90d', communicating with the controller 22, with upstream end portions of conduit sections 90a", 90b", 90c", and 90d", communicating with the chambers of the sleeve, with the conduit sections 90a', b', c', and d' and the sections 90a", b", c", and d" being, of course, sections of the respective conduits 90a, b, c, and d of the first set 90.

As will be discussed below, the first and second connection members 152 and 154 are identical in construction, although used in different orientations, and will be described in connection with the first connection member 152. Thus, with reference to FIGS. 13-17, and 21, the connection member 152 has a housing 156 having a laterally extending plate 158. The connection member 152 has a plurality of laterally spaced tubular sections 160a, 160b, 160c, and 160d extending through the plate 158, with the tubular sections 160a, b, c, and d having associated first end portions 162a, 162b, 162c, and 162d being located on one side of the plate 158, and second end portions 164a, 164b, 164c, and 164d being located on the opposed side of the plate 158. The housing 156 has an elongated first cover section 166 of reduced dimensions having a pair of opposed spaced walls 168a and 168b, with the first cover section 166 extending peripherally around the first end portions 162a, b, c, and d of the tubular sections 160a, b, c, and d. The first cover section 166 has a pair of opposed locking members 170a and 170b comprising outwardly biased flanges having tapered protuberances 172a and 172b at the outer ends of the locking members 170a and b, and a pair of outwardly directed bosses 174a and 174b spaced inwardly from the protuberances 172a and b and being located intermediate ends of the locking members 170a and b.

The housing 156 also has an elongated second cover section 176 of enlarged dimensions having a pair of opposed spaced walls 178a and 178b and a pair of opposed sidewalls 180a and 180b connecting the walls 178a and b, with the walls 178a and b and the sidewalls 180a and b defining a cavity or recess 182 which is sufficiently large to receive the first cover section 166 within the second cover section 176. As shown, the opposed sidewalls 180a and b of the second cover section 176 have a pair of associated apertures 184a and 184b spaced from an outer edge of the second cover section 176, and a pair of associated notches 186a and 186b extending inwardly from the outer edge of the second cover section 176. As shown, the second cover section 176 extends peripherally around the second end portions 164a, b, c, and d of the tubular sections 160a, b, c, and d, respectively.

With reference to FIG. 18, the connection device 150 has a sealing member 188 of elastic and flexible material, such as polyvinylchloride, 70 durometer, having a laterally extending plate 190 and a plurality of spaced annular sections 192a, 192b, 192c, and 192d extending on opposed sides of the plate 190 and defining associated bores within the annular sections 192a, b, c, and d. As shown, one or both ends of the annular sections 192a, b, c, and d may have internal annular sealing rings 194.

The internal structure of the locked connection members 152 and 154 is illustrated in FIG. 21, and since the connection members 152 and 154 are identical in structure, although inverted, identical reference numerals will be utilized in the connection members 152 and 154 for convenience in discussion and under the belief that it will not create confusion. Thus, with reference to FIGS. 19-21, the first end portions 162a, b, c, and d of the associated tubular sections 160a, b, c, and d are received in the respective conduit sections 90a', b', c', and d' in order to secure the conduit sections to the first connection member 152. Conversely, the second end portions 164a, b, c, and d of the tubular sections 160a, b, c, and d of the connection member 154 are received in the conduit sections 90a", b", c", and d" in order to secure these conduit sections to the connection member 154. The sealing member 188 may be secured on the connection member 154 with the first end portions 162a, b, c, and d of the tubular sections 160a, b, c, and d in the connection member 154 being received in the associated annular sections 192a, b, c, and d of the sealing member 188, and with the sealing rings 194 being located in the annular sections 192a, b, c, and d on the side of the plate 190 facing toward the connection member 152. The configuration of the connection members 152 and 154 and sealing member 188 with the connection members 152 and 154 and associated conduit sections detached is illustrated in FIG. 19.

With reference to FIGS. 20 and 21, when it is desired to connect the conduit sections together, the first cover section 166 of the connection member 154 is positioned in the cavity 182 defined by the second cover section 176 of the connection member 152, such that the second end portions 164a, b, c, and d of the tubular sections 160a, b, c, and d in the connection member 152 are received in the annular sections 192a, b, c, and d of the sealing member 188, with the sealing member 188 providing a seal between the tubular sections 160a, b, c, and d of both the connection members 152 and 154. In this manner, communication is established between the conduit sections 90a', b', c', and d' and the conduit sections 90a", b", c", and d" through the respective tubular sections 160a, b, c, and d of the connection member 152, the sealing member 188, and the respective tubular sections 160a, b, c, and d of the connection member 154.

During placement of the first cover section 166 of the connection member 154 within the second cover section 176 of the connection member 152, the protuberances 172a and b of the associated locking members 170a and b of the connection member 154 are received in the respective apertures 184a and b of the connection member 152, with the locking members 170a and b being biased outwardly to lock the connection members 152 and 154 in place with the conduit sections in fluid communication. At the same time, the bosses 174a and b of the respective locking members 170a and b in the connection member 154 are received in the associated notches 186a and b of the connection member 152. Thus, when it is desired to disengage the connection members 152 and 154, the bosses 174a and b of the locking members 170a and b in the connection member 154 are depressed sufficiently to remove the associated protuberances 172a and b of the connection member 154 from the associated apertures 184a and b of the connection member 152, such that the connection member 154 may be withdrawn from the connection member 152.

Thus, the connection members 152 and 154 may be readily attached together in sealing engagement while the connection members 152 and 154 and automatically locked in the engaged configuration. Also, the connection members 152 and 154 may be readily detached from each other by pressing the locking members, as previously described. In this manner, the sleeves may be readily attached to the conduit system when desired, or a given sleeve may be removed from the conduit system, for example, in the case of an emergency, or after completion of use of the system. Also, it will be seen that the controller, conduit system, and sleeves may be supplied and stored separately, as desired. Moreover, the connection members 152 and 154 are of identical construction, thus simplifying the manufacturing procedures and reducing the cost of the connection members.

With reference to FIGS. 16 and 17, the first cover section 166 has a plurality of longitudinally extending internal flanges 200, and the second cover section 176 has a plurality of external longitudinal recesses 202 to receive the flanges 200 when the connection members 152 and 154 are locked together. The flanges 200 and recesses 202 facilitate alignment of the attached cover sections 166 and 176 of the connection members 152 and 154, and also assure correct orientation of the connection members 152 and 154 relative each other to assure correct connection of the tubular sections together. Also, with reference to FIGS. 19 and 20, the connection members 152 and 154 may have suitable indicia, such as arrows A, which serve to guide the user for proper orientation of the connection members 152 and 154 with the arrows aligned when the connection members 152 and 154 are attached together. With reference to FIGS. 16 and 17, the first cover section 166 also has a plurality of external longitudinally extending ribs 204 which serve to stabilize the first cover section 166 within the second cover section 176 and limit relative movement when the connection members 152 and 154 are attached together.

The compression device 20 has been previously described in connection with normal use of the device with two sleeves 26 and 27. However, in certain instances only one sleeve is used, such as on a patient with one leg. Since the device is calibrated for use with two sleeves, the proper pressures will not normally be produced if one sleeve is removed from the device.

However, as will be discussed below, a simulation device generally designated 210 as illustrated in FIGS. 22-26 may be utilized to obtain proper pressures when a sleeve is removed from the device 20. The simulation device 210 comprises an elongated elastic wall or plate 212 having a plurality of aligned hollow tubular sections 214a, 214b, 214c, and 214d extending from the wall 212 and defining associated lumens 216a, 216b, 216c, and 216d. As shown, the tubular sections 214a, b, c, and d may have internal annular sealing rings 218. Also, the wall 212 has a plurality of slits 220a, 220b, and 220c extending through the wall 212 and communicating with the lumens of the tubular sections 214a, b, and c, respectively. The wall 212 may also have an opening 222 communicating with the lumen 216d of the tubular section 214d. The simulation device 210 may be made of any suitable elastic material, such as natural rubber or silicone rubber.

With reference to FIGS. 13-17, 19-21, and 26, one of the sleeves 26 or 27 and the associated second connection member 154 may be removed from the corresponding first connection member 152. Next, the simulation device 210 may be placed in the cavity 182 of the first connection member 152, and the tubular sections 214a, b, c, and d may be attached to the second end portions 164a, b, c, and d of the tubular sections 160a, b, c, and d with the sealing rings 218 of the simulation device 210 sealingly engaging against the outer surface of the tubular section second end portions 164a, b, c, and d. In this configuration, the opening 222 of the simulation device 210 permits free passage of air from the associated conduit downstream end portion, with the opening 222 corresponding to the conduit normally connected to the ventilation channels 70 of the removed sleeve 26 or 27. Also, in this configuration, the three slits 220a, b, and c, of the simulation device are associated with the three conduits normally connected to the sleeve chambers, with the slits widening somewhat responsive to an increase of pressure in the conduits associated with the slits 220a, b, and c. Thus, the slits 220a, b, and c close and prevent passage of air when the pressure in the associated conduit is relatively small, while the pressure-responsive slits widen in the presence of a relatively large pressure to permit passage of a relatively large quantity of air through the slits. Accordingly, when the pressure is moderately low in the conduits, the simulation device 210 passes a relatively small amount of air through the wall 212, while the simulation device 210 passes a relatively large volume of air when the pressure in the associated conduits is relatively large.

In this manner, the simulation device 210 simulates the sleeve chambers of the removed sleeve through use of the slits in the wall 212. Accordingly, since the simulation device 210 results in simulation of the removed sleeve, the desired pressure characteristics are still obtained in the single sleeve which remains connected to the system. Thus, due to the simulation device 210 the device 20, which is designed for use with two sleeves 216 and 217, may be utilized while only connected to one sleeve. The pressure flow characteristics of the simulator slits 220a, b, and c, may be modified through selection of the thickness of the wall 212, the length of the slits 220a, b, and c, or the width of the slits 220a, b, and c in the wall 212.

The foregoing detailed description is given for clearness of understanding only, and no unnecessary limitations should be understood therefrom, as modifications will be obvious to those skilled in the art.