text:
Justia Patents Upper Body Portions Of User Supported By Adjustable SectionUS Patent for Positional feedback system for medical mattress systems Patent (Patent # 6,353,950)
Positional feedback system for medical mattress systems
Jul 12, 1996 - Kinetic Concepts, Inc.
An apparatus adjusts the pressures of a therapeutic mattress surface in accordance with the angular position of that surface. The apparatus comprises an angular position sensor and a rotation sensor which are housed together in an enclosure having a top surface in the form of a circular plate. The circular plate mounts either on the surface of the mattress or on the bottom of a bed frame supporting the mattress. The angular position and rotation sensors measure the horizontal plane referenced perpendicular to the direction of the force of gravity. The apparatus further comprises a controller blower valve assembly which processes data received from the angular position and rotation sensors to maintain, increase, or decrease the pressures within the mattress.
Latest Kinetic Concepts, Inc. Patents:
Negative pressure treatment system with heating and cooling provision
Bariatric treatment system and related methods
Pneumatic compression device and methods for use in the medical field
Pneumatic pump, housing and methods for medical purposes
Remote controllable medical pumping apparatus
This application is a continuation of Ser. No. 08/241,075 filed May 9, 1994 now U.S. Pat. No. 5,611,096.
The present invention relates to methods and apparatus for monitoring and/or controlling therapeutic beds and mattress systems and the patients supported thereon. More particularly, the invention relates to monitoring angular deviations of the mattress surface and patient from the flat, horizontal position and for controlling the system in response.
2. Description of Background Art
Therapeutic supports for bedridden patients have been well known for many years. Well known therapeutic supports include (without limitation) low air loss beds, lateral rotation beds and fluidized bead beds. Commercial examples are the "KinAir", "RotoRest" and "FluidAir" beds, all of which are products manufactured and commercialized by Kinetic Concepts, Inc. of San Antonio, Tex. Similar beds are described in U.S. Pat. Nos. 4,763,463, 4,175,550 and 4,635,564, respectively.
Other examples of well-known therapeutic supports for bedridden patients are the inflatable mattresses, mattress overlays or mattress replacements that are commercialized independent of a rigid frame. Because of the simpler construction of these products separate from a costly rigid frame, they tend to be more versatile and economical, thereby increasing options for customers and allowing them to control costs. A specific example of one such mattress is the "TheraKair" mattress, described in U.S. Pat. No. 5,267,364, dated Dec. 7, 1993, also manufactured and commercialized by Kinetic Concepts, Inc. The TheraKair mattress is a composite mattress including a plurality of transversely-oriented inflatable support cushions that are controlled to pulsate and to be selectively adjustable in groups.
Most therapeutic mattresses are designed to reduce "interface pressures", which are the pressures encountered between the mattress and the skin of a patient lying on the mattress. It is well known that interface pressures can significantly affect the well-being of immobile patients in that higher interface pressures can reduce local blood circulation, tending to cause bed sores and other complications. With inflatable mattresses, such interface pressures depend (in part) on the air pressure within the inflatable support cushions. Although a number of factors are at play, as the cushion's air pressure decreases, the patient interface pressure also tends to decrease, thereby reducing the likelihood that the patient will develop bedsores and other related complications. Hence the long-felt need to have an inflatable mattress which optimally minimizes the air pressure in the inflated cushions.
The desired air pressure within a given cushion or group of cushions may also depend on inclination of the patient support, or portions thereof. For instance, it is known that when the head end of a bed is raised, a greater proportion of the patient's weight tends to be concentrated on the buttocks section of the mattress. Hence, it has long been known to divide inflatable therapeutic mattresses into groups of transversely-oriented inflatable cushions corresponding to different regions of patient's body, with the pressure in each group being separately controlled. Then, when a patient or attendant controls the bed to elevate the patient's head, pressure in the buttocks cushions is automatically increased to compensate for the greater weight concentration and to prevent bottoming of the patient. ("Bottoming" refers to any state where the upper surface of any given cushion is depressed to a point that it contacts the lower surface, thereby markedly increasing the interface pressure where the two surfaces contact each other.)
It is also well known in the field of treating and preventing bedsores, that therapeutic benefits may be obtained by raising and lowering (or "pulsating") the air within various support cushions. The effectiveness of this therapy may be reduced or negated if the surface inclination of a region (i.e., angle of the region relative to a horizontal plane) changes, or if the pressure in the appropriate support cushions is not properly adjusted. As with bottoming, such a condition may occur when the head of the patient is raised to facilitate, for example, feeding of the patient. As the angle of the head end of the support mattress (and thus the angle of patient's head) becomes greater, the patient's weight redistributes. Consequently, a greater proportion of the patient's weight is concentrated on the patient's buttocks region, while less weight is concentrated on the head and back region.
It is also known to subject patients to gentle side-to-side rotation for the treatment and prevention of pulmonary problems. It is known to achieve such rotation therapy by alternating pressure in two inflatable bladders which are disposed longitudinally under the support mattress along the length of the left and right sides of the patient. Consequently, as one of the inflatable bladders inflates, the patient rotates by an angle up to approximately 45 degrees. Although references such as RWM's U.S. Pat. No. 4,769,584 have long taught the importance of sensing the actual angle of rotation, the actual rotation angle in inflatable supports was typically controlled by the amount of pressure applied to the pivot bladder without measuring the actual angle of rotation attained. Unfortunately, during this treatment, if too great of a rotation angle is achieved, then the patient tends to roll to the edge of the support mattress as one of the inflatable bladders inflates. Therefore, if an apparatus could be designed which would measure and control rotation angles of the therapeutic bed surface this would prevent attaining excess angles resulting in the patient rolling to the edge of the support mattress during side-to-side alteration, and possibly falling off the support mattress. Also, if a minimum rotation angle of about twenty five degrees is not attained, then minimal or no therapeutic value is received by the patient.
It has also long been known in the art to control other aspects of the patient surface in response to inclination of specific portions of the patient. For instance, the Eggerton "Tilt and Turn" bed popular in the 1980's was adapted to raise a restraining portion of the patient surface during lateral turning, in order to help prevent the patient from rolling off the bed. Another example is the automatic knee gatch feature popularized in Hill-Rom frames, particularly such as described in U.S. Pat. No. 3,237,212. Such knee gatch feature was adapted to automatically raise the knee section of the patient support whenever the patient or caregiver desired to raise the head section, hence compensating to prevent a patient from sliding toward the foot end of the bed when the head section was raised.
The concept of controlling air pressure inflatable support cushions in response to changes in the patient surface is at least plausible in bed systems which utilize a rigid frame structure beneath the patient. The frame structure provides an attractive location for mounting the transducers required for such control. With flexible mattresses, to position any foreign devices in closer proximity to a patient, because a patient might be injured by contact with the device would be steadfastly avoided, mounting a sensor to a rigid base board helps shield a patient from contact with the sensor. The result, though, is that a health care facility is inclined to acquire the entire bed system in order to gain the benefits of such technology—an acquisition which may not be readily affordable. Such acquisitions also limit the health care facility to using specific mattresses with specific frames, rather than separately selecting and interchanging the preferred mattresses and bed frames. Interchangeability, on the other hand, would tend to maximize the facilities cost containment and efficiency.
Unfortunately, conventional support mattresses fail to properly adjust the pressure within the support cushions as the surface angles of the support mattress vary. Therefore, if an apparatus could be implemented which would adjust the pressure within the support cushions as the mattresses surface angles change, the pressure points on the patient would be significantly reduced, thereby preventing or significantly reducing the number of bedsores.
Others have taught that the desired air pressure within the air cushions may depend in part on the angle to which the patient is desired to be rotated. For instance, U.S. Pat. No. 5,003,654 dated Apr. 2, 1991 described an oscillating low air loss bed which laterally rotates a patient to varying degrees depending in part on the pressure within the cushions which achieve the turn.
The present invention comprises a new and improved apparatus for measuring the angular positions of a therapeutic mattress surface and adjusting the pressures within the mattress in accordance with the angular position, and providing feedback to control rotation angles attained by the therapeutic mattress. The apparatus is particularly suited for use with a therapeutic mattress which comprises a plurality of inflatable support cushions positioned latitudinally under the patient's body. Typically, such a mattress is divided into four regions: The head region, the back region, the buttock region, and the legs/feet region. Furthermore, the mattress comprises two inflatable guard rails, each positioned on either side of the patient on the mattress surface.
The apparatus comprises an angular position sensor and a rotation sensor which are housed together in an enclosure having a top surface in the form of a circular plate. The circular plate mounts either on the surface of the mattress between two cushions or on the bottom of a bed frame supporting the mattress. The angular position and rotation sensors measure the angular position of the mattress's surface in relation to the horizontal and vertical planes, respectively.
The apparatus further comprises a controller which typically mounts on the bed frame. The controller processes the data received from the angular position and rotation sensors to maintain, increase, or decrease, when necessary, the pressure within the appropriate cushions of the mattress, the pivot bladders, or the inflatable guard rails.
It is, therefore, an object of the present invention to provide a feedback signal to a controller of a therapeutic mattress surface, on which a patient is receiving therapy, to cause compensations in the support surface pressures corresponding to changes in mattress surface angles.
Another object of the present invention is to provide an apparatus which measures and adjusts the pressure within the support cushions of the therapeutic mattress in relation to the changes in the mattresses surface angles. Such an apparatus may significantly reduce the prevalence number of bedsores. Another object is to provide an apparatus that measures and displays the rotation angle of a therapeutic bed surface to help prevent the patient from rolling to the edge of the support mattress during side-to-side alteration. Still another object is to control such rotation in response to current measurement, for various purposes. Such a system may help preclude the patient from falling off the support mattress, while ensuring that adequate rotation angles were achieved to provide the patient proper therapy.
It is still another object of the present invention to provide a feedback signal to the controller corresponding to changes in the rotation angle of the mattress surface to facilitate pressure compensations in the inflatable guard rails and to control the amount of rotation angle achieved by causing adjustments of pressures in the pivot bladders.
Another object of the present invention is to provide controlling feedback to the mechanism which adjust pressures in inflatable bladders located such as to cause side to side rotation of the therapeutic bed surface.
These and other objects, features, and advantages of the present invention will become evident to those skilled in the art in light of the following brief description of the drawings and detailed description.
FIG. 1 is a perspective view depicting a therapeutic bed 10 having a preferred embodiment of the present invention mounted thereon.
FIG. 2 is a perspective view off the therapeutic bed 10 of FIG., with its head section in an elevated position.
FIG. 3 is a diagram depicting the control system 38 of the preferred embodiment.
FIG. 4 is a front elevation view depicting the operator input and display of the preferred embodiment of the present invention.
FIG. 5 is a diagram depicting the mounting of the angular position and rotation sensors of the preferred embodiment on a circuit board.
FIG. 6 is a schematic diagram depicting the wiring of the angular position and rotation sensors of the preferred embodiment.
FIG. 7A is a top view depicting the mounting of the angular position and rotation sensors of the preferred embodiment onto the mattress 13.
FIG. 7B is a side elevation view depicting the mounting of the angular position and rotation sensors of the preferred embodiment onto the therapeutic mattress 13.
FIG. 7C shows a detailed portion of the illustration in FIG. 7B.
FIG. 7D shows a detailed portion of the illustration in FIG. 7A.
FIG. 8 is an end-on schematic elevation view, taken in cross-section, depicting the rotation bladders 90, 91 and guard bladders 92, 93 of the preferred embodiment.
FIG. 9 shows a perspective view of the embodiment of FIG. 8 in use for supporting and turning patient 200.
FIG. 10 shows a perspective view of an alternative embodiment, and
FIGS. 11 and 12 show schematic diagrams of the FIG. 9 and FIG. 10 embodiments, respectively.
Therapeutic bed 10, as described herein, is an example of a presently preferred embodiment of the present invention. As illustrated generally in FIGS. 1 and 2, therapeutic bed 10 comprises mattress 13, control unit 38, and frame 11.
Frame 11 in the illustrated embodiment is a conventional hospital bed frame. More particularly, frame 11 is commercially available through Amedco Health Care, Inc., of Wright City, Mo. under the designation "Futura Series Bed," Model No. 2110. Such frames are equipped with conventional raise-and-lower mechanisms and sit-up mechanisms for adjusting the position of the patient surface.
Frame 11 includes sub-frame 12, which is the portion of frame 11 that directly supports mattress 13. As will be evident from viewing the frame itself, sub-frame 12 is subdivided into four sections 12a-12d. More particularly, section 12a is the head section of sub-frame 12, section 12b is the buttock section of sub-frame 12, section 12c is the thigh section of sub-frame 12, and section 12d is the foot section of sub-frame 12. Sections 12a-12d are pivotally linked (or "hinged") to one another at pivot joints 14a-14c to form an articulatable mattress support system, which supports mattress 13. Subframe 12b is actually fixed relative to the remainder of frame 11, whereas sections 12a and 12c are pivotable relative to section 12b, with section 12a pivoting about pivot joint 14a, and section 12c pivoting about joint 14b relative to section 12b. Section 12d, in turn, pivots relative to section 12c about pivot joint 14c. Pivot joints 14a-c, together with opposite pivot joints (not shown) which correspond to pivot joints 14a-14c along the opposite side of subframe 12, provide three, mutually-parallel pivot axes about which sections 12a, c and d pivot. Each of said sections 12a-12d in the preferred embodiment are conventionally adapted with sheet metal (or "pan") surfaces spanning across the width of subframe 12. The pan surface of each of sections 12a-12d may be referred to as the "baseboard" of the respective section.
Frame 11 is equipped with a conventional drive device (not shown), such as a combination of electric motors together with mechanical linkage, for enabling elevation and articulation (i.e. angular movement) of sub-frame 12 relative to the horizontal. Conventional controls for such lifting device allow a user of bed 10 to raise and lower the entire sub-frame 12 and/or to articulate the mattress supporting surface of sub-frame 12. "Articulation" of sub-frame 12 includes raising or lowering head section 12a relative to buttock section 12b and/or raising or lowering of thigh and foot sections 12c and 12d relative to buttock section 12b. All such features of frame 11 are standard features with conventional hospital bed frames.
Other commercially available hospital bed frames may also be employed. For instance, in another embodiment of the present invention, the frame utilized is one manufactured by Stryker Medical of Kalamazoo, Mich. under the designation "Renaissance Series, Dual Control Critical Care Bed".
Referring again to the embodiment shown in FIG. 1, mattress 13 comprises a foam submattress (or "pad") 13a, a plurality and inflatable tubular elements (or "cushions" or "air bags") enclosed by cover 37. Although certain details of the construction of mattress 13 are described here in detail, it will be evident that many details are not critical to the present invention. Various alternative constructions will be evident from the description of U.S. Pat. No. 5,168,589, entitled "Pressure Reduction Air Mattress and Overlay", dated Dec. 8, 1992, as well as from a viewing or incorporation of various products commercialized by Kinetic Concepts, Inc. of San Antonio, Tex., including those marketed under the designations "DynaPulse", "TheraKair", "FirstStep", and "Homekair DMS". All in a construction generally like U.S. Pat. No. 5,267,364, entitled "Therapeutic Wave Mattress", dated Dec. 7, 1993.
In the presently preferred embodiment of mattress 13, cover 37 contains inflatable support cushions 15-36. Although not pictured in FIG. 1, cover 37 may be accompanied by opposite retaining sleeves 37a, 37b (FIGS. 7A & 7B) for positioning cushions 15-36. Each sleeve 37a, 37b includes twenty-one vertical baffles that divide cover 37 into twenty-two individual pockets 37d which each receive an end of one of cushions 15-36 to form mattress 13. Each of such baffles 37c are formed integrally with the respective sleeve 37a, 37b by means of sewing the baffles 37c in the desired orientation. Such a construction is like that used in the commercially available "DynaPulse" product marketed by Kinetic Concepts, Inc. of San Antonio, Tex. Such a construction has the benefit of leaving the central region of mattress 13, where sensor enclosure 86 is located, free of baffles so that sensor enclosure 86 can be mounted directly to the air cushions 33 and 34. Various alternative constructions for sleeve 37a and 37b will be evident to those of ordinary skill in the art. For instance, a sleeve may be centrally oriented in mattress 13, with each of the opposite ends of cushions 15-36 extending beyond the lateral limits of such a sleeve. Cover 37 may also include zippers and/or a releasable Velcro-like flap to help seal cushions 15-36 within their respective pockets. Such a flap may seal to the body of cover 37 using any suitable means.
Cushions 15-36 are arranged into four body support regions: the head region, the back region, the buttock region, and the leg/foot region. Illustratively, cushions 33-36 form the head region, cushions 29-32 form the back region, cushions 23-28 form the buttock region, and cushions 15-22 form the leg/foot region.
Control unit (or "controller") 38 includes the components for inflating and controlling mattress 13, and for interfacing with patient caregiver. As will be evident to those of ordinary skill in the art, such components (not shown) include a blower, a microprocessor or the equivalent, a heater, various valves and an equal number of pressure sensors, manifolds, connections, and insulation in such manner as may be desired. Controller 38 has a housing adapted with adjustable hooks for mounting on the footboard or siderail of frame 11. Control unit 38 connects to each one of cushions 15-36 via a plurality of fluid lines (not shown) contained within trunk line 39 to supply cushions 15-36 with air as an inflating medium. Other inflating medium such as water will be evident to those of ordinary skill in the art. The fluid lines connect to their respective cushions using any suitable means such as a quick connect valve that includes a male member having a flange and a female member having a cavity about its inner surface for receiving the flange. Trunk line 39 enters cover 37 through an opening (not shown) to allow each individual fluid line to communicate the inflating medium to the cushions. Cushions 15-36 each include a cut-out portion (not shown) at their lower end on one side of mattress 13 to provide space for trunk line 39 to run through cover 37. Although those of ordinary skill in the art will understand conventional means of connecting fluid lines to cushions 15-36 in the preferred embodiment, description of the fluid connections pictured in FIG. 11 may be of further assistance in such understanding.
Referring to FIG. 3, controller 38 comprises operator input and display 41, processor unit 42, power supply 43, angular position sensor 44, rotation sensor 45, temperature sensor 46, blower 47, blower relay 48, heater 49, heater relay 50, analog to digital (A/D) converter 51, and air controller valve bank 65. Controller 38 connects to any suitable power source such as a 120 VAC public power line, preferably via a "hospital grade" outlet. Power supply 43 receives the 120VAC input and converts it into a standard 5 VDC suitable for use by both processor 42 and operator input and display 41. Power supply 43 also furnishes power to angular position sensor 44, rotation sensor 45, and temperature sensor 46. Processor unit 42 comprises a microprocessor having associated RAM and ROM.
As illustrated in FIGS. 3 and 4, operator input and display 41 includes ON/OFF button 52 which allows a user to control power delivery to controller 38. Upon the initial application of power, display 64 indicates that air is switched off. When the on/off button 52 is depressed, processor unit 42 generates a control signal that activates blower relay 48, resulting in blower relay 48 delivering the 120 VAC input signal to blower 47. Processor unit 42 also generates control signals that energize each air control valve in air control valve bank 65 to allow blower 47 to inflate each of cushions 15-36. Air control valve bank 65 comprises 8 air control valves corresponding at least in part to the segregation of sections of cushions forming mattress 13.
CPR button 58 provides the user with the option of automatically and completely deflating each of cushions 15-36. If the user presses CPR button 58, processor unit 42 deactivates blower relay 48 and generates control signals that energize each air control valve in air control valve bank 65 such that the individual air control valves open the fluid lines to the atmosphere. Consequently, the inflating medium in each of cushions 15-36 escapes to the atmosphere. Once cushions 15-36 vent their inflating medium to the atmosphere, processor unit 42 restores the valves in air control valve bank 65 to their previous settings.
Buttons 55, 56, 57, 58, 66 and 87 are soft keys whose functions are defined by text on the display to their left. Immediately following power up and depression of on/off button 52, the label HT/WT appears next to button 57.
Height/weight (HT/WT) button 57 permits the user to enter the height and weight of the patient 200 using therapeutic bed 10. After the user presses HT/WT button 57, the display shows test as follows: WT INCREASE next to button 55, WT DECREASE next to button 56, HT INCREASE next to button 57, HT DECREASE next to 66, and ENTER next to 87. The user enters. the height of patient 200 by pressing adjust buttons 55 and 56 until LCD 64 displays the correct height. The user enters the weight of patient 200 by pressing adjust buttons 57 and 66 until LCD 64 displays the correct weight. When LCD 64 displays the correct height and weight, the user presses save button 87 to store the patient's weight in processor unit 42. Processor unit 42 utilizes the patient's height and weight to properly regulate the pressure of the inflating medium within cushions 15-36. Illustratively, persons having smaller statures require lower pressures of the inflating medium within cushions 15-36, while patient's having larger statures require greater pressures.
Pressure adjust buttons 59-62 provide the user with control over the pressure of inflating medium within the head region, the back region, the buttock region, and the leg/foot region of mattress 13. During sustained operation, processor unit 42 displays bar graphs 67-70 on LCD 64 to provide the user with a visual indication of the inflating medium pressure in each region. Bar graphs 67-70 allow the user to quickly and easily determine which of the regions must be adjusted. Illustratively, to increase the inflating medium pressure within the head region, the user presses the plus side of pressure adjust button 59. That pushing of pressure adjust button 59 furnishes processor unit 42 with a signal to indicate that pressure should be increased in the head section cushions. In response, processor unit 42 generates a control signal that increases the opening of valves corresponding to the head section in air control valve bank 65.
Alternatively, to decrease the inflating medium pressure within the head region, the user presses the minus side of pressure adjust bottom 59. That pushing of pressure adjust button 59 furnishes processor unit 42 with a signal to indicate that a portion of the inflating medium within the head region should be vented to the atmosphere. Consequently, processor unit 42 generates control signals that energize only the air control valves in air control valve bank 65 which are connected to the fluid lines communicating with cushions 33-36. Those air control valves open the fluid lines so that the inflating medium in the head section cushions 22-26 escapes to the atmosphere. Once cushions 33-36 vent their inflating medium to the user selected pressure, processor unit 42 deactivates the activated air control valves. Pressure adjust buttons 60-62 operate identically to pressure adjust button 59 to either increase or decrease the pressure of the inflating medium within their respective body regions.
Notwithstanding that manual control of the inflating medium pressure within the body regions defined by cushions 15-36 provides the user with significant flexibility, processor unit 42 is adapted to perform the more important task of automatically adjusting such pressure. Particularly, the inflating pressure within the body regions is adjusted to compensate for weight shifts due to a changed body orientation commensurate with angular adjustment of the position of mattress 13. For instance, as mattress 13 pivots from the position shown in FIG. 1 to the position shown in FIG. 2, a patient 200 on therapeutic bed 10 will shift such that a larger portion of his body weight resides over the buttock region. To counter that shift, the pressure of the inflating medium within the buttock region (i.e., cushions 22-28) is increased while the pressure within the back regions (i.e., cushions 29-32) is decreased. The above is reversed if mattress 13 pivots from the position shown in FIG. 2 to the position shown in FIG. 1.
As shown in FIG. 3, controller 38 includes angular position sensor 44 to furnish processor unit 42 with a signal representing the incline of mattress 13 so that processor unit 42 may automatically adjust the inflating medium pressure within each body region. Controller 38 further includes rotation sensor 45 which supplies processor unit 42 with a signal representing the rotation of mattress 13. With such signal, controller 38 can determine the current angle of lateral rotation of mattress 13 and, hence, a patient 200 lying thereon. Once determined, such angle can be output by controller 38 via an appropriately-adapted display 64, such as a digital or graphical representation thereon. Other uses of such output may also be employed, including feedback control of blower unit 38 and/or bed frame 11. More particularly, processor unit 42 may automatically adjust the inflation medium pressures within guard rails 92-93 positioned longitudinally at each side of mattress 13 and pivot bladders 90-91 positioned longitudinally underneath mattress 13 along each side as shown in FIG. 8.
Referring to FIG. 6, angular position sensor 44 comprises inclinometer 77, voltage regulator 71, variable resistor 72, resistor 73, capacitor 74, and diode 75. Inclinometer 77 comprises a resistive element that changes value as inclinometer 77 rotates from a horizontal to an angular position. Voltage regulator 71 is configured as a current source to supply the current to inclinometer 77 which ultimately becomes the output signal from angular position sensor 44. Variable resistor 72 establishes the output current from voltage regulator 71 and, further, provides a calibration adjustment for position sensor 44 that allows a user to normalize the relationship between the current produced from voltage regulator 71 relative to the ratio of change in resistance verses change in angular position of inclinometer 77. Resistor 73 and capacitor 74 form a dampening filter to remove spurious transient outputs from inclinometer 77, while diode 75 limits the output voltage of inclinometer 77 to the bias voltage received from power supply 43. Header 76, having pins 1 shorted to 2 and 3 shorted to 4 in normal operation, allows the disconnection of inclinometer 77 during the calibration of angular position sensor 44. Connector 77 provides the electrical connection of angular position sensor to controller 38.
Rotation sensor 45 comprises inclinometer 78, voltage regulator 79, variable resistor 80, resistor 81, capacitor 82, and diode 83. Inclinometer 78 comprises a resistive element that changes value as inclinometer 78 rotates about a central horizontal axis. Voltage regulator 79 is configured as a current source to supply the current to inclinometer 78 which ultimately becomes the output signal from rotation sensor 45. Variable resistor 80 establishes the output current from voltage regulator 79 and, further, provides a calibration adjustment for rotation sensor 45 adjustment that allows a user to normalize the relationship between the current produced from voltage regulator 79 relative to the ratio of change in resistance verses change in angular position of inclinometer 78. Resistor 81 and capacitor 83 form a dampening filter to remove spurious transient outputs from inclinometer 78, while diode 83 limits the output voltage of inclinometer 78 to the bias voltage received from power supply 43. Header 76, having pins 1 shorted to 2 and 3 shorted to 4 in normal operation, allows the disconnection of inclinometer 78 during the calibration of rotation sensor 45, while connector 77 provides the electrical connection 45 of rotation sensor 45 to controller 38.
It has also been found that the tilt angle sensed by sensor 45 and the sit-up angle sensed by sensor 44 provide angular measurements relative to an imaginary vertical plane oriented along the longitudinal axis of bed 10. The therapeutic objective, rather than determine the degree of rotation relative to such axis, is to determine the degree of rotation relative to the base board supporting the head section of mattress 13. To achieve this objective, the sit-up angle is utilized in an algorithm to translate the angle measured by the tilt sensor from the universal coordinates of the earth to the coordinates of the base board of head section 12a. The details of such algorithm will be evident to those of ordinary skill in the art.
As illustrated in FIG. 5, angular position sensor 44 and rotation sensor 45 each mount to circuit board 84. Circuit board 84 includes electrical paths that interconnect the components of angular position sensor 44 and rotation sensor 45. Additionally, circuit board 84 comprises a malleable material so that inclinometer 78 may be positioned at an angle of approximately 90 degrees relative to inclinometer 77 using bend zone 85. That angular difference between inclinometers 77 and 78 permits inclinometer 77 to measure the movement of mattress 13 from a horizontal to an angular position and inclinometer 78 to measure the rotational movement of mattress 13 about a central horizontal axis.
Referring to FIGS. 1, 2, and 7, circuit board 84 mounts into enclosure 86 using any suitable means, such as an adhesive to protect circuit board 84 and the components of angular position sensor 44 and rotation sensor 45. Enclosure 86 mounts on mattress 13 between, for example, cushions 33 and 34 using any suitable means, such as snaps 88 and 89 or velcro fasteners (see FIG. 7). Alternatively, enclosure 86 could mount underneath frame 11 near the head region of mattress 13 using any suitable means such as screws or nuts and bolts. With angular position sensor 44 and rotation sensor 45 positioned at the head region of mattress 13, any elevation or lowering of mattress 13 or rotation of mattress 13 about its central horizontal axis will be registered. Alternately, enclosure 86 could be mounted under sub-frame 12.
After the initial inflation of cushions 15-36, controller 38 maintains their inflation at the user selected values. However, if a person in therapeutic bed 10 desires to elevate mattress 13 from a horizontal position to an angled position, controller 38 alters the inflation levels of certain cushions to compensate for the change in the weight distribution of the patient's body. Illustratively, as mattress 13 travels to the angled position depicted in FIG. 2, the resistance value of inclinometer 77 changes, resulting in a change in the current level of the signal delivered from angular position sensor 44 to processing unit 42. However, A/D converter 51 first receives that signal and digitizes it into a signal readable by processor unit 42.
Processor unit 42 receives and processes the signal from angular position sensor 44 to determine the necessary control required to supply cushions 15-36 with adequate inflating medium pressure to ensure proper support of the therapeutic bed user. In response to the above signal, processor unit 42 generates a control signal to activate air control valves in air control valve bank 65. Because the buttock region requires inflation during the elevation of mattress 13, processor unit 42 activates the air control valves in air control valve bank 65 which control inflating medium flow to cushions 23-38 (i.e., the buttock region). Consequently, blower 47 increases the inflation within cushions 23-28, but not cushions 15-22 and 28-36. Additionally, because the back region requires deflation during the elevation of mattress 13, processor unit 42 generates control signals to activate the air control valves in air control valve bank 65 which control cushions 29-32. Those air control valves open the fluid lines so that the inflating medium within cushions 29-32 escapes to the atmosphere.
Processor unit 42 maintains the activation of the valves controlling cushions 23-32 as long as it receives a changing signal from angular position sensor 44. Once mattress 13 ceases to elevate, the output signal from angular position sensor 44 returns to a constant value. In response to the constant signal, processor unit 42 adjusts air control valves as necessary to maintain the steady state pressures.
Alternatively, if mattress 13 lowers, the resistance value of inclinometer 77 again changes, resulting in a change in the current level of the signal delivered from angular position sensor 44 to processing unit 42. In response to the above signal, processor unit 42 generates a control signal to activate air control valves in air control valve bank 65. Because only the back region requires inflation during the lowering of mattress 13, processor unit 42 activates the air control valves in air control valve bank 65 which control inflating medium flow to cushions 29-32 (i.e., the back region). Consequently, blower 47 increases the inflation within cushions 29-32, but not cushions 15-28 and 33-36. Because the buttock region requires deflation during the lowering of mattress 13, processor unit 42 generates control signals to activate the air control valves in air control valve bank 65 which control cushions 23-28. Those air control valves open the fluid lines so that the inflating medium within cushions 23-28 escapes to the atmosphere.
Processor unit 42 adjusts air control valves controlling cushions 23-32 as long as it receives a changing signal from angular position sensor 44. Once mattress 13 ceases to elevate, the output signal from angular position sensor 44 returns to a constant value. In response to the constant signal, processor unit 42 adjusts air control valves as necessary to maintain the steady state pressures.
Referring to FIGS. 8 and 9, an alternative feature of therapeutic bed 10 includes rotation bladders 90 and 91 and guard bladders 92 and 93 (not shown in FIG. 9). Bladders 90 and 91 reside on frame 95 and are positioned underneath the sides of mattress 94 along its entire length. Mattress 94 comprises a similar mattress to mattress 13 except that its cover includes guard bladders 92 and 93 which extend along the entire length of mattress 94.
Referring to FIG. 11, controller 38 connects to bladders 90 and 91 and guard bladders 92 and 93 via fluid lines 150-156 contained within trunk line 39 to provide an inflating medium to bladders 90 and 91 and guard bladders 92 and 93. The fluid line of bladder 91 is connected to guard rail 92 and the fluid line of bladder 90 is connected to guard rail 93. Processor unit 42 controls the inflation and deflation of bladders 90 and 91 concurrently with guard bladders 93 and 92 to rotate mattress 94 about its central horizontal axis, thereby imparting rotational motion and providing a restraining barrier to the therapeutic bed user. To select mattress rotation, a user pushes rotate button 100 to furnish processor unit 42 with a signal indicating that air control valves in air control valve bank 65 should supply bladders 90 or 91 with the inflating medium.
In response, processor unit 42 generates a control signal that activates air control valves in air control valve bank 65 associated with bladders 90 and 91. However, to produce the rocking motion of mattress 94, processor unit 42 must alternately inflate and deflate bladders 90 and 91. Illustratively, to commence rotation beginning to the left, processor unit 42 generates a control signal to energize the air control valve controlling inflating medium flow to and from bladder 90. As a result, blower 47 delivers the inflating medium to bladder 90, thereby inflating it. Additionally, processor unit 42 generates a control signal to energize the air control valve controlling inflating medium flow to and from bladder 91. However, the actuated air control valve opens the fluid line to bladder 91 to vent any inflating medium in bladder 91 to the atmosphere. With bladder 90 inflated and bladder 91 deflated, mattress 94 rotates to the left. Processor unit 42 generates the air control valve control signals until a predetermined angle is attained, as selected, to ensure the inducement of adequate therapy to the therapeutic bed user. At the attainment of the predetermined angle, after a preset time period, processor unit 42 reverses the energizations of the air control valves to inflate bladder 91 and deflate bladder 90. Thus, processor unit alternately inflates and deflates bladders 90 and 91 to rotate mattress 94 about its central horizontal axis.
One issue to be addressed with rotation of a mattress 94 about its central horizontal axis consists of insuring sufficient inflation of bladders 90 and 91 to provide adequate therapy while also ensuring that patient 200 does not roll off mattress 94. Therapeutic bed 10 includes guard bladders 92 and 93 to restrain the patient and prevent him from falling from mattress 94. Guard bladders 92 and 93 comprise elongated pillows filled with an inflating medium which provide a barrier at the sides of mattress 94 to prevent a bed user from falling from mattress 94 during its rotation.
After commencement of mattress rotation, processor unit 42 must alternately inflate and deflate guard bladders 92 and 93, concurrent with bladders 91 and 90, to restrain the bed user within mattress 94. To properly control the inflation and deflation of bladders 91 and 90 with guard bladders 92 and 93, processing unit 42 must receive signals indicating the rotational position of mattress 94. Thus, controller 38 includes rotation sensor 45 to provide a signal to processor unit 42 which indicates the rotational position of mattress 94. Illustratively, as mattress 94 rotates to the position depicted in FIG. 8, the resistance value of inclinometer 77 changes, resulting in a change in the current level of the signal delivered from rotation sensor 45 to processing unit 42. However, A/D converter 51 first receives that signal and digitizes it into a signal readable by processor unit 42.
Processor unit 42 receives and processes the signal from rotation sensor 45 to determine the necessary control required to inflate and/or deflate the bladder 91/guard rail 92 and bladder 90/guard rail 93 pairs. In this instance, processor unit 42 generates a control signal to activate air control valves in air control valve bank 65 to energize and open the air control valve controlling inflating medium flow to and from bladder 90 with guard bladder 93. Consequently, blower 47 delivers the inflating medium to bladder 90 and guard rail 93, thereby inflating them. Additionally, processor unit 42 generates a control signal to energize the air control valve controlling inflating medium flow to and from bladder 91 with guard rail 92. However, the actuated air control valve opens the fluid line to bladder 91 with guard bladder 92 to vent any inflating medium in bladder 91 and guard bladder 92 to the atmosphere. With bladder 90 and guard bladder 93 inflated and bladder 91 with guard bladder 92 deflated, a barrier on the left side of mattress 94 is formed to prevent a bed user from falling from mattress 94 as the bed surface is rotated to the left.
Processor unit 42 maintains the inflation of bladder 90 with guard bladder 93 and deflation of bladder 19 with guard bladder 92 until it receives a signal from rotation sensor 45 which indicates that the predetermined angle of rotation has been attained. In response to attaining the predetermined angle, after a preset time period, processor unit 42 generates a control signal to energize the air control valve controlling inflating medium flow to and from bladder 91 with guard bladder 92. Consequently, blower 37 delivers the inflating medium to bladder 91 guard bladder 92, thereby inflating them. Additionally, processor unit 42 generates a control signal to energize the air control valve controlling inflating medium flow to and from bladder 90 with guard bladder 93. The actuated air control valve opens the fluid line to bladder 90 and guard bladder 93 to vent the inflating medium within bladder 90 and guard bladder 93 to the atmosphere. With bladder 91 with guard bladder 92 inflated and bladder 90 with guard bladder 93 deflated, a barrier on the right side of mattress 94 is formed to prevent a bed user from falling from mattress 94 as the bed surface is rotated to the right. Thus, processor unit 42 alternately inflates and deflates guard bladders 92 and 93 concurrently with bladders 91 and 90 to form a barrier which prevents a bed user from falling from mattress 94 as the bed surface is rotated to the left and right.
The foregoing description of a primary embodiment provides a detail example of the present invention. Many other embodiments, however, will be evident to those of ordinary skill in the art from the foregoing description, particularly when considered in view of the appended claims and accompanying drawings.
As an example of the alternatives, in one alternative embodiment, the sensors are moved from the central location (of FIG. 1) to the very end of the head section of the mattress. This relocation not only aids in accessing the sensor but also ensures that the sensors do not interfere with the radio-luminescence of the chest section of the mattress. To aid in such relocation, the sensor circuit board 84 is rotated ninety degrees within enclosure 86, and the extending flange 86a of enclosure 86 is oriented vertically at the head end of the bed mattress 13. The flange 86a can also be extended in length to extend across most of the width of the head end of the bed. In such orientation, the flange 86a is removably inserted within an elongate pocket along the perimeter of the head end of the bed. The flange 86a then helps provide rigidity to the fabric border surrounding the mattress. The pocket itself is sleeve-like with velcro-like closures at one longitudinal end thereof. Hence, the sensor housing with extended flange is selectively removable from said sleeve-like pouch for servicing the same and for laundering the remainder of the mattress 13. A possible downside of such alternative embodiment relative to the first embodiment is that the sensors are less proximal to the chest of the patient and may not as accurately reflect the angle of rotation of the patient's chest. It is noted that the rotation of the chest is of particular interest because an important benefit of laterally rotating a patient is the prevention and therapy of nosocomial pneumonia, which obviously occurs primarily in the chest region.
Alternative configurations of guard bladders 92 and 93 in such alternative embodiment utilize a semi-rigid support integrated in the outer edge thereof. Such semi-rigid support comprises a section of relatively stiff plastic sheet within an adjacent foam pad adhered thereto. The pad itself is also inserted within rectangular velcro pocket which is formed integral with the flexible perimeter surrounding the mattress. Such perimeter is simply a relatively stiff, upstanding border (or "wall") formed of fabric, much like wall 7a described in U.S. Pat. No. 5,267,364.
In addition, the guard bladders 92 and 93 may be relatively short in length as compared to the length of the mattress as a whole. Other restraints and/or support bladders may also be utilized in various portions of the upper surface of the mattress, such as the flexible thoracic packs 37a-37b shown in FIG. 10. Such packs and other exemplary restraints are described in co-pending application Ser. No. 07/823,281, entitled "Patient Positioners For Use On Oscillating Air Support Surfaces", filed Jan. 21, 1992, now U.S. Pat. No. 5,357,641. For instance, the packs may be secured to a cover sheet that is then secured over inflatable bolsters, and the patient lies directly on such cover sheet. Such cover sheet is fitted with excess material forming pockets for receiving and fitting directly on the inflatable bolsters. Such cover sheet is also provided with flexible thoracic packs having removable velcro straps much as described in said co-pending application.
Although not shown in FIG. 10, releasable clips adjoining opposing straps, much like those described in U.S. Pat. No. 5,267,364, are also utilized in alternative embodiments such as that shown in FIG. 10. In such embodiment, various straps can also be utilized to ensure proper alignment in relationship between turning bladders 90 and 91. Moreover, a side panel 90 may be secured at its lowermost portion by means of a zipper connection with another fabric layer 90b that is firmly connected to a base board of frame 11. Screws are utilized in the preferred mode of such embodiment.
In addition, various safety features may also be incorporated into such embodiments. Amongst such safety features are the disabling of the rotation mode in various circumstances, including the lowering of a side rail or the raising of head section 12a of frame 11 beyond a comfort zone. Such comfort zone may be up to approximately 60°, or such other level as may be deemed safe while turning a patient from side-to-side to the degree selected.
The independent blower control unit 38 in the first embodiment is eliminated in various alternative embodiments, with its components being integrated into the frame in such alternative embodiments. The blower components and related hardware with connecting pneumatic hoses and the like, are mounted beneath the base boards of the bed in a suitable manner, and the display panel together with its control processor are integrated into the foot board of such alternative frame. Naturally, suitable electrical connections are also made.
Various other features may be added as desired in such alternative embodiments, including scales built in to the frame of such alternative embodiment, percussion controls for selectively controlling the transversely oriented air sacs to percuss the chest region of a patient during rotating modes, and various CPR features for deflating and leveling the patient surface for enabling CPR procedures.
With reference to FIGS. 10 and 12, other aspects of one such alternative embodiment include plumbing which enables counter rotation of the foot section of mattress 94′ relative to the head section of mattress 94′. More particularly, rather than a single left rotation bladder and a single right rotation bladder extending the full length of the bed (as shown in FIGS. 9 and 11), two left rotation cells 90 prime and 191 for the head section and leg section of patient 200, respectively, are utilized. Likewise two left pillows and/or retainers 92 prime and 193 are used in combination with two right pillows and/or retainers 192 prime and 93 prime. The plumbing for such alternative embodiment will be evident those of ordinary skill of the art from the schematic diagram shown in FIG. 12. A switch valve 199 is provided to allow selective switching of the configuration shown in FIG. 12 to one more in line with that shown in FIG. 11. Appropriate modification of various retainers, cells and bladders will be evident to those of ordinary skill in the art. Such counter rotation may not only help retain patient 200 on the upper surface of mattress 13′, but is believed to also stimulate the lymphatic system of patient 200. Such lymphatic stimulation, or twisting of patient 200 is believed to promote circulation of lymph throughout the lymphatic system of patient 200 by creating pressure differentials on such lymphatic system. Such lymphatic stimulation may be achieved, in part, by turning the head portion of patient 200 to a greater extent that the foot section of patient 200, although greater lymphatic stimulation is thought to result from counter rotation of the foot section relative to the head section of the patient. It addition, the patient may be retained to a greater degree on the top surface of mattress 13′ by rotating only the head section thereof and leaving the foot section level, rather than rotating both the head and foot sections in the same direction.
Various prior U.S. Patents and applications have been referenced in certain portions of this disclosure to possibly increase the reader's understanding of the invention and embodiments described and claimed herein. Each of such patents and applications is incorporated herein by this reference as though set forth in their entirety, particularly including (without limitation) U.S. Pat. Nos. 5,267,364, 5,168,589, and application Ser. No. 07/823,281. Further details of such patents have been referenced elsewhere herein.
Although the present invention has been described in terms of the foregoing embodiment, such description has been for exemplary purposes only and, there will be apparent to those of ordinary skill in the art, many alternatives, equivalents, and variations of varying degrees that will fall within the scope of the present invention. That scope, accordingly, is not to be limited in any respect by the foregoing description, rather, it is defined only by the claims which follow.
1. An apparatus for measuring the angular position of a patient support surface relative to gravity force, comprising:
a patient support;
an angle sensor mounted to said patient support and having an output responsive to changes in said angle sensor's position relative to gravity force; and
said angle sensor comprising circuitry for relating the output therefrom to the change in angular position of said patient support from horizontal to provide a measurement of the angular position of said patient support.
2. The apparatus according to claim 1, said angle sensor comprising;
an enclosure to house said angle sensor;
an inclinometer having output which changes responsively to said inclinometer's positional changes relative to gravitational forces acting thereupon.
3. The apparatus according to claim 1, comprising:
multiple angle sensors having outputs which change responsively to said angle sensor's positional changes relative to gravitational forces acting thereupon; and
one or multiple enclosures to house said angle sensors.
4. The apparatus according to claim 3 wherein said angle sensors comprise inclinometers having resistive outputs responsive to positional changes.
5. The apparatus according to claim 4 further comprising:
electrical current sources connected to said inclinometers to convert said inclinometers' outputs to voltages.
a second angle sensor mounted to said patient support and having an output responsive to changes in said angle sensor's position relative to gravity force; and
circuitry for relating the output therefrom to the change in the angular position of said patient support from horizontal to provide a measurement of the tilt angle of said patient support.
7. The apparatus according to claim 6 wherein said second angle sensor is mounted to said patient support at an angle of approximately 90° relative to said first angle sensor.
8. The apparatus according to claim 7 wherein said patient support surface comprises an inflatable patient support and circuitry responsive to the measurements of angular position and tilt angle for changing the pressure in said inflatable patient support.
9. The apparatus of claim 8 wherein said patient support surface comprises an inflatable patient support surface comprised of multiple sections for supporting respective portions of the body of a patient and circuitry for changing the pressure in each of said sections in response to the measurements of angular position and tilt angle.
10. Apparatus for supporting a patient comprising:
an inflatable patient support comprised of a plurality of separately inflated sections for supporting respective sections of the body of a patient at a desired pressure;
a source for inflating each of the sections of said inflatable patient support to the desired pressure;
an angle sensor mounted to said inflatable patient support and having an output responsive to changes in the position of said inflatable patient support relative to gravity force; and
circuitry for changing the pressure in each of the sections of said inflatable patient support in response to the output of said angle sensor as said inflatable patient support rotates from a horizontal to an angular position relative to horizontal.
11. The apparatus for supporting a patient according to claim 10 wherein said angle sensor comprises an inclinometer having a resistive output responsive to positional changes.
12. The apparatus for supporting a patient according to claim 10 wherein said angle sensor is mounted to a planar flange, the planar flange being oriented in a plane which is substantially parallel to the plane on which the patient is supported by said inflatable patient support.
13. The apparatus for supporting a patient according to claim 12 further comprising:
a second angle sensor mounted to said inflatable patient support and having an output responsive to changes in said angle sensor's position relative to gravity force; and
circuitry for relating the output therefrom to the change in the angular position of said patient support from horizontal to provide a measurement of the tilt angle of said inflatable patient support along the longitudinal axis of said inflatable patient support.
14. The apparatus for supporting a patient according to claim 13 wherein said second angle sensor is mounted to said inflatable patient support surface at an angle of approximately 90° to said planar flange.
15. The apparatus for supporting a patient according to claim 13 wherein said first and second angle sensors are mounted to a circuit board which is mounted to said planar flange, said circuit board having a bend therein at a point between said first and second angle sensors.
16. The apparatus for supporting a patient according to claim 13 additionally comprising first and second inflatable bladders positioned under said inflatable patient support surface and along the entire length thereof and inflated by said source to desired pressures in response to the output of said circuitry comprising said second angle sensor.
17. A patient support system comprising:
a patient support comprised of multiple sections, each section being adapted for supporting a respective section of the body of a patient;
a first angle sensor mounted to said patient support and having an output responsive to changes in the position of said first angle sensor relative to gravity force;
a second angle sensor mounted to said patient support an angle of approximately 90° relative to said first angle sensor and having an output responsive to changes in the position of said second angle sensor relative to gravity force; and
circuitry for relating the outputs of said first and second angle sensors to the change in the position of the patient support surface relative to horizontal and providing outputs measuring any such changes.
18. The apparatus according to claim 17 wherein said first and second angle sensors are mounted to a circuit board having the bend of approximately 90° therein at a point between said first and second angle sensors.
19. The apparatus according to claim 17 wherein said first and second angle sensors comprise inclinometers having resistive outputs responsive to positional changes.
20. The apparatus according to claim 17 further comprising:
a display responsive to said circuitry for providing outputs measuring the changes in the position of the patient support surface relative to horizontal.
4628556 December 16, 1986 Blackman
4761000 August 2, 1988 Fisher et al.
4769584 September 6, 1988 Irigoyen et al.
4949413 August 21, 1990 Goodwin
5044029 September 3, 1991 Vrzalik
5181288 January 26, 1993 Heaton et al.
5611096 March 18, 1997 Bartlett et al.
Assignee: Kinetic Concepts, Inc. (San Antonio, TX)
Inventors: Alan L. Bartlett (New Braunfels, TX), Randall Ohman (San Antonio, TX)
Primary Examiner: Michael F. Trettel
Attorney, Agent or Law Firm: Wayne J. Colton, Inc.
Current U.S. Class: Upper Body Portions Of User Supported By Adjustable Section (5/617); Fluid Inflatable Bag Adjusts Position Of Support Section (5/615); With Cyclical Back And Forth Turning (5/609); Variably Pressurizable Chambers (e.g., With Pump) (5/713)
International Classification: A61G/700;


text:
Category: Savanna Illinois
Election Results Surprise Some in Carroll County
Posted by Sarah Hanviriyapunt | Nov 7, 2018 | Carroll County News, Chadwick Illinois, Forreston News, Freeport News, Government, Illinois Government, Lanark Illinois, Local Government, Milledgeville Illinois, Morrison Illinois, Mount Carroll Illinois, Ogle County News, Pearl City Illinois, Polo Illinois, Rock Falls News, Savanna Illinois, Shannon Illinois, Thomson Illinois, Thomson, Illinois
Carroll County Votes Republican 60% of the Time Every single state office that was up for election went to Republicans, in Carroll County. The state as a whole did not go Republican. In fact, every single state office is now held by Democrats, including JB Pritzer, multi-billionaire from Chicago and Kwame Raoul. Raoul was previously appointed to fill the Illinois Senate seat vacated by Barack Obama in the 13th District, upon Obama's election to the U.S. Senate. Both politicians sailed to easy wins. In the districts affecting Carroll County, Republicans won with mostly large margins, in all except the heavily...
Savanna Stop Light Malfunctions, Creates Frustration
Posted by Sarah Hanviriyapunt | Oct 30, 2018 | Carroll County News, Savanna Illinois
The stop light in Savanna has been causing headaches and frustration for many who live in or travel through Savanna. A sensor at the light has been malfunctioning, so IDOT put it on a timer. This causes very long wait times for the left-turn lane, in particular, and many in Savanna are complaining to Savanna Mayor Chris Lain about it. On Tuesday afternoon, October 30, 2018, Mayor Lain reached out to Savanna residents, via Facebook, to address the issues they are coming to him about, and to give them an update on what is being done. "I spoke with...
Savanna City Council Hires New Officer, Manny's Asks for Help Receiving TIF Funds
BY MICHAEL MILLER SAVANNA POLICE DEPARTMENT HIRES NEW OFFICER, CODY TAPLIN SAVANNA, IL — The City of Savanna's police department will have a full squad, with the addition of a new officer approved at the council's October 23rd meeting at city hall. Savanna Police Chief Kevin Dimmick announced that after a testing and interview process, the department nominated Cody Taplin for the city's open full-time position on the squad. Taplin is a 21-year-old native of Savanna who has worked in the railroad industry but has chosen law enforcement as his field of interest, Dimmick said. Lain said that after going through a training program with the force, Taplin will attend policy academy in February of 2019. Dimmick said that officers who go through this process have their training paid for and in return are obligated to stay with the force for at least two years. "I'm a fan of the fact that he'll be here for a little while working in the department before we make this other huge investment, if it's something that's not suited, which I think it will be," Lain said. "Until he goes to the academy, he can't be by himself," Dimmick explaining the training that Taplin will receive and his role for now. He will familiarize himself with the daily operations of the force during ride time with the other officers. The full council approved...
Canadian Pacific Holiday Train to Visit Savanna
The Canadian Pacific Holiday Train will be making a stop in Carroll County in 2018! The Canadian Pacific Holiday Train is a train decked out with 14 cars lit up like a Christmas Tree. If you have never experienced this fun event, according to the Canadian Pacific Holiday Train website, this is a bit what it's like: "A typical Holiday Train event goes something like this: the train arrives and pulls to a safe stop in front of the crowd. The stage door lowers and the band opens with its first song. After that, a brief presentation takes place...
Savanna Police Asks for Witnesses to Come Forward
Posted by Sarah Hanviriyapunt | Oct 23, 2018 | Carroll County News, Police, Savanna Illinois
The Savanna Police Department would like to talk with anyone who has not already spoken to the department concerning the incident that occurred outside of Manny's on the night of September 13, 2018. If you were a witness to this incident please contact the Savanna Police Department at 815-273-2246. Thank you. See related articles at the below links: UPDATE: Woman Killed in Savanna Identified as Judy Kness of Chadwick Status Hearing Held for Darrel J....
Merger and acquisition services

redpajama_set_name: RedPajamaCommonCrawl


text:
Home > California > San Diego County
Top Coronado Public Schools
(3)View Private Schools
(3) Private
For the 2021 school year, there are 5 public schools in Coronado, CA, serving 2,937 students. Coronado has one of the highest concentrations of top ranked public schools in California.
Coronado, CA public schools have an average math proficiency score of 67% (versus the California public school average of 38%), and reading proficiency score of 76% (versus the 50% statewide average). Schools in Coronado have an average ranking of 10/10, which is in the top 10% of California public schools.
The top ranked public schools in Coronado, CA are Coronado Middle School, Silver Strand Elementary School and Coronado Village Elementary School. Overall testing rank is based on a school's combined math and reading proficiency test score ranking.
Minority enrollment is 36% of the student body (majority Hispanic), which is less than the California public school average of 77% (majority Hispanic).
The student:teacher ratio of 23:1 is equal to the California public school average of 23:1.
Top Coronado, CA Public Schools (2021)
Coronado Middle School Math: 70% | Reading: 84%
550 F Ave.
Coronado, CA 92118
Silver Strand Elementary School Math: 65-69% | Reading: 70-74%
1350 Leyte Rd.
Coronado Village Elementary School Math: 70% | Reading: 70%
600 Sixth St.
Coronado High School Math: 55% | Reading: 66%
650 D Ave.
Grades: 9-12 | 1,160 student
Coronado Unified Special Education Pre-k
Grades: n/a | n/a student
[+] Show Closed Public Schools in Coronado, California
(2) All Schools
(2) High Schools
(2) Middle Schools
Coronado, California Public Schools (Closed)
School Location Grades Students
Coronado Pathways Charter (Closed 2017) Charter School 555 D Ave.
(619) 437-7256Grades: K-12 | n/a student
Palm Academy For Learning (Closed 2018) Alternative School 650 D Ave.
(619) 437-7256Grades: 9-12 | 18 students
Homework-Free Weekends: The Ongoing Debate over How Much Homework is Too Much
A number of school districts either have or are considering homework-free weekend policies, but the idea is not without its share of controversy. We'll take a look at both sides of the issue.
Private schools in San Diego, CA Boarding schools in California
10 Major Challenges Facing Public Schools
California Top Ranked Public Schools
10 Advantages to Public Education


The Maricopa County Department of Planning and Development is responsible for regulating development activity and land use within the unincorporated areas of Maricopa County. Obtaining the necessary permits is the first step in ensuring your development activity is successful.
With an increase of volume and in an effort to provide the most timely turnaround times, we are now requiring all plan sets to be folded prior to acceptance at the Intake Counter.
All plan sets of 30 pages or less must be folded to not exceed approximately 9" x 12" in size. The title block or the bottom right portion, needs to face up.
Plan sets of over 30 pages may be rolled.
Plans folded incorrectly will not be accepted.
Commercial construction can be defined as any structure intended to house commercial activity or those structures which are located on property with either commercial or industrial zoning. There are two broad categories of commercial development: new and tenant improvements. Please refer to the Commercial Construction page for more details.
Your commercial project may need to consider land conditions affecting the drainage systems and patterns of the area in which you wish to build. For information about drainage regulations and requirements, please refer to the Drainage Review page.
To immediately view submittal requirements for all permit types, open the Submittal Matrix (PDF). Refer to specific application packets for more in depth information.
Residential Construction is defined as any construction that is not considered commercial in nature. The value, safety, and code compliance of your structure is heavily dependent on obtaining a building permit prior to construction. There are many types of residential projects, so please refer to the Residential Construction page to determine what type of permit you will need for your project.
Your residential project may need to consider land conditions affecting the drainage systems and patterns of the area in which you wish to build. For information about drainage regulations and requirements, please refer to the Drainage Review page.


text:
CDC awards $2.4 million to 5 large U.S. cities to fight Zika
Posted by Physicians Weekly | Sep 13, 2016
The Centers for Disease Control and Prevention (CDC) has awarded $2.4 million to respond to Zika, quickly identify cases of adverse birth outcomes linked to Zika, coordinate with state efforts, and refer affected infants and families to services.
The CDC has awarded $2.4 million to Chicago, Houston, New York City, Philadelphia, and Los Angeles County to establish, enhance, and maintain information-gathering systems to rapidly detect microcephaly–a serious birth defect of the brain–and other adverse outcomes linked to Zika virus infection.
This funding is in addition to the $16.4 million recently awarded to states and territories for surveillance of microcephaly and other adverse outcomes and will enable these local areas to participate in these important activities in coordination with state efforts. The funds will allow these local areas to:
Enhance information-gathering to carry out strategies for real-time, population-based monitoring for microcephaly and other birth defects caused by Zika virus
Enhance capacity development through partner collaboration and infrastructure improvements
Provide referral of infants and families to health and social resources
Participate in CDC data reporting
Expand access to examination of health and monitoring of developmental outcomes of children born to women with positive or inconclusive Zika virus test results
As of August 26, CDC had obligated more than $193 million of the repurposed funds available for Zika preparedness, including over $110 million to support state, territorial, and local jurisdictions fight Zika. As of August 26, HHS has obligated $264 million of the $374 million redirected for the domestic Zika response.
Surveillance and referral to services for infants with microcephaly or other adverse outcomes linked with the Zika virus in local areas will be supported through three complementary approaches:
The $16.4 million award in early August to states and territories for the surveillance of microcephaly and other adverse outcomes
The $2.4 million award announced today, which will enable highly populated jurisdictions to participate in surveillance of microcephaly and other adverse outcomes in coordination with state efforts
CDC also recently awarded $5.5 million to support the expansion of the public health emergency response capacity at the local level to report on Zika-exposed pregnant women, their developing fetuses, pregnancy outcomes and live-born infants. Information on how to apply for support will be made available to local health departments.
Zika virus spreads to people primarily through the bite of an infected Aedes species mosquito (specifically, Aedes aegypti and Aedes albopictus). Zika infection can also be spread by infected men and women to their sex partners. There is no vaccine or treatment for Zika and many people infected with Zika have no symptoms. Of those who do have symptoms, the most common are fever, rash, joint pain, and conjunctivitis (red eyes). Zika infection during pregnancy can cause microcephaly and other severe brain abnormalities in the developing fetus.
CDC encourages everyone, especially pregnant women and women planning to become pregnant, to protect themselves from mosquito bites to avoid possible Zika virus infection.
For more information about Zika: https://www.cdc.gov/zika/
PreviousTSRI scientists discover antibodies that target holes in HIV's defenses
NextUpdate: Current Number of Pregnant Women in the U.S. with Zika
Yale Team discovers how Zika virus causes fetal brain damage
New Rules for Paying MDs Proposed in NY
US reviews plan to infect mosquitoes with bacteria to stop disease
Ancient Remedy Becomes Novel Approach to Treating Clostridium Difficile Infection September 23, 2016
Assessing Injection Drug Use-Related Infective Endocarditis March 31, 2017
CME/CE – MACRA: 5 Tips to Protect Your Practice's Reputation October 3, 2017


text:
Once upon a time, the economic update was presented to Parliament - Macleans.ca
Once upon a time, the economic update was presented to Parliament
A short history of the fall update
On Tuesday of next week, Finance Minister Jim Flaherty will present the fall economic and fiscal update. To a luncheon crowd at the Edmonton Chamber of Commerce. This will be the fifth consecutive year Mr. Flaherty has delivered the economic update to an audience other than Parliament.
Paul Martin created the economic and fiscal update in 1994, when he appeared before the finance committee. After he was done with his presentation, he would take questions from the committee—see, for instance, his appearances in 1995, 1996 and 1998.
In 1997 and 1999, the update was presented outside of Ottawa, but both times at meetings of the finance committee.
In 2000, Mr. Martin presented something of a mini-budget to the House a few days before an election call. He then appeared before the finance committee with an update in May 2001.
In 2002, John Manley presented the update at a meeting of the finance committee in Halifax. In 2003, Mr. Manley appeared before the committee in Ottawa. In 2004 and 2005, Ralph Goodale presented the update to the finance committee.
In 2006, Jim Flaherty picked up the tradition and appeared before the finance committee. In 2007, he apparently intended to deliver the update to the House, but did not announce his intention to do so until the day before and then failed to get the opposition's approval to proceed. Mr. Flaherty was thus apparently compelled to deliver his speech to a news conference at the National Press Theatre (the speech is archived with the references to "Mr. Speaker" still included).
In 2008, he successfully delivered the update to the House (only the government was then nearly defeated and replaced by a coalition as a result of what he had to say).
Since then, Mr. Flaherty has felt no need to appear before MPs. In 2009, he presented it the Thursday before the House of Commons was due to return for the fall. And in each of the last four years he's picked weeks when the House was on break to deliver the update. Mr. Flaherty appeared before the finance committee in the fall of 2009, 2010, 2011 and 2012 to discuss each year's second budget implementation bill—the Harper government starting, in 2006, to move two budget bills each year. In 2006, he managed to do both: appearing before the finance committee to both discuss a budget bill and, later, provide an economic update.
In Britain, the autumn statement is presented to the House of Commons.
Jim Flaherty
John Manley
Ralph Goodale
The eternal, futile quest for perfect democracy
Stephen Harper: 'No'
Prostitution laws: Over to you, Parliament
The Reform Act and how to fix Parliament


Comprehensive list of Lawton, Oklahoma based furniture shops, companies and manufacturers offering home and office furniture for sale.
Mckay's Interior Design Center has been servicing the Lawton and surrounding community since 1980. We specialize in custom draperies, upholstering, quality consignment furniture and accent pieces. We offer decorating services from experienced and trained decorators. Our professional and friendly team is here to answer any questions you may have about our firm or our services.
Y oast Furniture 1st opened their doors in 1963. Starting off as a very tiny used furniture and appliance business we continued growing and eventually dropped all appliances and chose to sell only home furnishings. The furniture business has been a wonderful business for the Yoast family and if we had it to do all over again we would do just the same.
Are you furnishing or redecorating your office or home? H & H Furniture Sales has a wonderful range of new furniture that is ideal for both huge and tiny spaces. Whether it's new seating for the executive staff, a simple computer workstation for your home, or a luxurious new living room that you are creating, we currently have what you're searching for!
Darbys' Big Furniture, with locations in Duke and Lawton, Oklahoma, has long been the choice of discerning individuals who desire quality furnishings, reasonable prices and exceptional service. Family-owned & operated since 1907, Darbys' is unmatched in delivering superior furniture and accessories from dozens of name-brand manufacturers.
Welcome to the palace of furniture, the new world of furniture shopping experience. At Alcazar Furniture Store you'll find great selections of best quality home furnishings at very low prices. Our main mission is to become your number one choice for all of your home furniture shopping requirements, by providing best quality furniture at low prices. We provide fast and free nationwide delivery.
Time to transform the porch into your new outdoor living room! Statuary World has the biggest range of outdoor furniture in Oklahoma with over twelve major brands in stock and 45 styles to select. Since 1974 Statuary World has brought Oklahomans the highest value and quality with the top name brands in the casual furniture industry. We have just the price selection to suit your budget.


text:
Vanessa Bryant "Devastated" by Reports of Deputies Sharing Crash Photos
Neena Pesqueda
LA County sheriff's deputies allegedly shared graphic photos of the helicopter crash site where Kobe Bryant, his 13-year old daughter, and seven others died, according to an LA Times report.
Some of the photos reportedly include the victims' remains and after seeing a deputy show off the images in a bar, one citizen filed a complaint.
But rather than launch a formal inquiry, sources say the department quietly ordered deputies to delete any photos they had.
After the news broke, the department said it was investigating and Vanessa Bryant's legal team called for those responsible to face discipline.
Deputies Allegedly Share Gruesome Photos
Vanessa Bryant's lawyer said she is "absolutely devastated" by allegations that Los Angeles County sheriff's deputies shared photos from the helicopter crash site where her husband, Kobe, their 13-year-old daughter, Gianna, and seven others died.
The Los Angeles Times first reported on the allegations last week after speaking with two public safety sources. One source said first responders were talking about the crash scene photos, some of which included the victims' remains, two days after the tragic January 26 incident.
The source said he saw one photo on the phone of another official in a setting that "had nothing to do with the investigation of the crash." The sources also told the paper that the Sherrif's Department quietly ordered deputies to delete any photos of the crash after a citizen complained that a deputy was showing the gruesome images at a bar in Norwalk.
TMZ reported Friday that the deputy, who they said was a trainee, allegedly showed the photos to a woman in the bar to try and impress her. A bartender reportedly overheard and filed the complaint with the Sheriff's Department.
The LA Times' sources said a complaint of this nature would have normally triggered a formal inquiry and possible internal affairs investigation. However, in this case, they said deputies were instead ordered to report to the sheriff's Lost Hills station and were told that if they came clean and deleted the photos, they would not face discipline.
The sources said they were concerned that the order to delete the photos could amount to the destruction of evidence.
Department Responds with Investigation
The citizen's complaint was reportedly sent to the sheriff's information bureau. When the Times asked about the allegations on Wednesday, the head of the sheriff's information bureau Capt. Jorge Valdez said he was "unaware of any complaint" and said "there was no order given to delete any photographs." But on Friday the LA Times' sources said Valdez was among those who handled the complaint.
That same Friday, the Sheriff's Department also said it had launched an investigation. In a Facebook post, the department said, "The facts surrounding these allegations are currently under investigation, as are the effectiveness of existing policies and procedures."
LA Sheriff's Facebook Page
The statement added that Sheriff Alex Villanueva was "deeply disturbed at the thought deputies could allegedly engage in such an insensitive act."
Brian Williams, executive director of the Civilian Oversight Commission, also told reporters that his office planned to question officials during a meeting next week that had already been scheduled with the Sheriff's Department
For now, it's unclear how widely the photos might have been shared and who exactly was involved. It's also unclear whether the deputies had actually taken the photos at the scene or if they received them from someone else. CBS LA reported that the LA County Fire Department is investigating whether or not its firefighters were also passing around the images.
Vanessa Bryant's Lawyer Responds
Vanessa Bryant's legal team issued a statement about the news on Sunday that was shared on her Instagram page. In it, Attorney Gary C. Robb said Bryant personally visited the Sheriff's office the day of the crash to request that the area be designated as a "no-fly zone" and guarded from photographers.
"At that time, Sheriff Alex Villanueva assured us all measures would be put in place to protect the families' privacy, and it is our understanding that he has worked hard to honor those requests," Robb said.
After learning of the allegations, Robb expressed disappointment and frustration with the department. "First responders should be trustworthy," Robb said before calling the breach of duty "inexcusable and deplorable."
"This is an unspeakable violation of human decency, respect, and of the privacy rights of the victims and their families. We are demanding that those responsible for these alleged actions face the harshest possible discipline, and that their identities be brought to light, to ensure that the photos are not further disseminated. We are requesting an Internal Affairs investigation of these alleged incidents."
He closed by saying Bryant was grateful to the person who filed the complaint and asked that anyone with information about the allegations contact his office.
CORRECTED: The department at issue is the Los Angeles County Fire Dept (LACoFD) NOT the LAFD KANSAS CITY, Mo.–(repost: BUSINESS WIRE)–Statement From Gary C. Robb, Legal Counsel on Behalf of His Client, Vanessa Bryant: Our client, Vanessa Bryant, is absolutely devastated by allegations that deputies from the Lost Hills Los Angeles County Sheriff's Department and Los Angeles County Fire Department publicly disseminated photos from the helicopter crash site. Mrs. Bryant personally went to the Sheriff's office on January 26th and requested that the area be designated a no-fly zone and protected from photographers. This was of critical importance to her as she desired to protect the dignity of all the victims, and their families. At that time, Sheriff Alex Villanueva assured us all measures would be put in place to protect the families' privacy, and it is our understanding that he has worked hard to honor those requests. First responders should be trustworthy. It is inexcusable and deplorable that some deputies from the Lost Hills Sheriff's substation, other surrounding substations and LACOFD would allegedly breach their duty. This is an unspeakable violation of human decency, respect, and of the privacy rights of the victims and their families. We are demanding that those responsible for these alleged actions face the harshest possible discipline, and that their identities be brought to light, to ensure that the photos are not further disseminated. We are requesting an Internal Affairs investigation of these alleged incidents. Mrs. Bryant is grateful to the individual who filed an online complaint exposing these acts of injustice, and for the choice to protect human dignity. We ask that anyone else who has information as to the facts underlying these alleged grievous and shameful incidents contact our office at 816–474-8080 or email via www.robbrobb.com
A post shared by Vanessa Bryant 🦋 (@vanessabryant) on Mar 1, 2020 at 8:22am PST
See what others are saying: (The Los Angeles Times) (TMZ) (CBS)
Related Topics:deputiesDeputyFeaturedGiannagianna bryantGigi BryantHelicopterHelicopter CrashKObeKobe BryantLA CountyLos AngelesLos Angeles County SheriffsPhotossharesheriffsspreadvanessa bryant
Miss Staten Island Banned From St. Patrick's Day Parade After Coming Out As Bisexual
Ex-Baltimore Mayor Catherine Pugh Sentenced to 3 Years in Prison for Children's Book Scam


This power lift recliner chair is an excellent choice for people with limited mobility, helping them rise to a standing position effortlessly.
It doesn't lock into a particular position giving you the range to stop the recliner where it is comfortable for you.
This solid power recliner features a 2 button remote controller for easy operation and side pockets for handy storage. One is for the lift and the other is for reclining.
The cushion is filled with high density foam and polyester fiber, which greatly improves its comfort. So it is also perfect for leisure time.
Notice: If you have any concerns regarding to your health, consult your doctor before using this product. Individuals with pacemakers should not use this product. If you have pain in a muscle or joint after using for a prolonged period of time, discontinue using and consult your doctor. Persistent pain could be symptom of a more serious condition.


text:
Musical Pitch Perception May Have Long Evolutionary History
By Christine Herman on January 27, 2016
Credit: COMSTOCK IMAGES (MARS)
A tiny primate, the marmoset, appears to process pitch perception the same way we do, implying that the ability evolved in a common ancestor at least 40 million years ago.
The ability to distinguish between sounds of varying pitch makes people capable of producing and understanding speech and music. And the way we are able to process pitch has been thought to be unique to our big-brained species.
But now, there's evidence that a tiny monkey—the common marmoset from Brazil—can distinguish pitch the same way we do. That's according to a study in the Proceedings of the National Academy of Sciences. [Xindong Song et al, Complex pitch perception mechanisms are shared by humans and a New World monkey]
Ten years ago, researchers identified a region of the marmoset brain that appeared to process pitch. But they needed to confirm that the animals did indeed notice changes in pitch—which presented a challenge: they had to find a way to get the animal to indicate that it had heard something. So they trained the marmosets to respond to a change in pitch with a behavior—specifically, they would lick a waterspout.
The researchers then had the animals listen to a series of notes with the same pitch. And, at random, they'd change it up. "Just like, for example, when I say, 'ma ma ma MA.' Right, at some point I make the pitch a little higher." Johns Hopkins neuroscientist Xiaoqin Wang, lead researcher of the study. The actual difference in pitch, he says, was much smaller than that. But you get the idea. "And, when the animal hears that change, it will lick the waterspout to indicate they hear the difference." Which the miniscule monkeys indeed did.
Because both we and marmosets have this talent, the ability likely evolved in a common ancestor long-ago—this type of pitch perception may thus go back more than 40 million years ago, much earlier than previously thought. And the understanding of how the brain processes pitch may eventually explain why some people have perfect pitch, while others are tone deaf.
—Christine Herman
From Side Effects Public Media
Recent Articles by Christine Herman
College Coronavirus Testing Plans Are All Over the Map
Chemical Tweak Recycles Polyurethane into Glue
Including Indigenous Voices in Genomics
Discover new insights into neuroscience, human behavior and mental health with Scientific American Mind.


This page was printed on Apr 22, 2019. For the current version, visit https://help.shopify.com/en/api/reference/orders/draftorder.
Create new orders for sales made by phone, in person, via chat, or by other means. Credit card payments for these orders can subsequently be entered in the Shopify admin.
Send invoices to customers to pay with a secure checkout link.
Use custom items to represent additional costs or products that aren't displayed in a shop's inventory.
Sell products at discount or wholesale rates.
The ID of the draft order.
The ID of the order that 's created and associated with the draft order after the draft order is completed.
Name of the draft order.
Information about the customer. To load a customer, provide the ID as part of the draft order object in the Create POST request. To remove a customer, set the customer property to null as part of the Create POST request. For more information, see Loading and removing customers. For more information about the customer object, see the Customer resource.
city: The city of the shipping address.
country_code: The two-letter code for the country of the shipping address.
province: The name of the state or province of the shipping address.
province_code: The two-letter abbreviation of the state or province of the shipping address.
zip: The zip or postal code of the shipping address.
city: The city of the billing address.
country_code: The two-letter code (ISO 3166-1 alpha-2 two-letter country code) for the country of the billing address.
province: The name of the billing address region, such as province, state, or prefecture.
province_code: The two-letter abbreviation of the region for the billing address.
zip: The postal code of the billing address, such as zip, postcode, or Eircode.
The text of an optional note that a shop owner can attach to the draft order.
The three letter code (ISO 4217 format) for the currency used for the payment.
The date and time (ISO 8601 format) when the invoice was emailed to the customer.
The URL for the invoice.
custom: Read only field Whether this is a custom line item or a product variant line item. If set to true indicates a custom line item. If set to false indicates a product variant line item.
variant_id: The ID of the product variant ID corresponding to the line item. Required for a product variant line item. Set to null for a custom line item.
product_id: The ID of the product corresponding to the line item's product variant.
variant_title: The title of the product variant. Defaults to Custom for custom line items created via the API.
gift_card: Indicates if the product is a gift card. Valid values are true or false.
fulfillment_service: Service provider responsible for fulfillment. Valid values are either manual or the name of the provider. eg amazon, shipwire, etc. Defaults to manual for custom line items.
properties: An array of custom information for an item that has been added to the draft order, often used to provide product customization options. Copied to created order when draft order is completed.
applied_discount: The discount applied to the line item. For more information, see applied_discount.
tax_line: The calculated rate and amount of taxes. For more information, see tax_lines.
title: The title of the product or variant. Only applicable to custom line items. Required field.
price: The price of the item before discounts have been applied. Only applicable to custom line items. Required field.
grams: Weight in grams. Only applicable to custom line items. If not specified, defaults to 0.
requires_shipping: Whether the fulfillment requires shipping. Applicable only to custom line items. Valid values are true or false.
sku: A unique identifier of the item in the fulfillment. Applicable only to custom line items.
taxable: Whether the product is taxable. Only applicable to custom line items.
custom: Whether this is a regular shipping line or custom shipping line.
handle: The handle of the shipping rate which was selected and applied. Required for regular shipping lines.
price: The price of the shipping method. Required for custom shipping lines.
A comma-seperated list of additional short descriptors, commonly used for filtering and searching. Each individual tag is limited to 40 characters in length. For example, tags: "tag1","tag2","tag3".
Whether taxes are exempt for the draft order. If set to false, then Shopify refers to the taxable field for each line_item. If a customer is applied to the draft order, then Shopify uses the customer's tax_exempt field instead.
price: The amount of tax to be charged.
title: Title of the discount.
description: Reason for the discount.
value: The value of the discount. If the type of discount is fixed_amount, then it corresponds to a fixed dollar amount. If the type is percentage, then it corresponds to percentage.
value_type: The type of discount. Valid values: percentage, fixed_amount.
amount: The applied amount of the discount, based on the setting of value_type. For more information, see Applying discounts.
Whether taxes are included in the order subtotal. Valid values are true or false.
The sum of all the taxes applied to the order.
the price of the order before shipping and taxes.
The sum of all the prices of all the items in the order, taxes and discounts included.
The date and time (ISO 8601 format) when the order is created and the draft order is completed.
The date and time (ISO 8601 format) when the order was created in Shopify.
The status of a draft order as it transitions into an order. When a draft order is created it is set to open status. The invoice can then be sent to the customer, and status changes to invoice_sent. The draft order can then be paid, set to pending, or paid by credit card. In each case, the draft order is set to completed and an order is created.
After a draft order is set to completed the only further modifications that can be made are adding tags or metafields.
open: Draft order is open.
invoice_sent: Invoice has been sent for the draft order.
completed: Draft order has been completed and turned into an order.
Using the DraftOrder resource you can create orders in draft state using product variant line items, or custom line items. To create a product variant draft order, provide the variant_id, quantity and discount properties. To create a custom line item, provide the title, price, taxable, and quantity properties.
If you are using this endpoint with a Partner development store or a trial store, then you can only create five draft orders per minute.
You can use the DraftOrder resource to send orders with custom shipping lines. A custom shipping line includes a title and price with handle set to Nil. A shipping line with a carrier provided shipping rate (currently set via the Shopify admin) includes the shipping rate handle.
A draft order and its line items can have one discount each. Calculations for discounts are based on the setting of the value_type property, which can be set to either fixed_amount or percentage. For example, you can apply a fixed amount discount to a draft order to reduce the price by the specified value property. When you use a percentage discount, the discount amount property is the price multiplied by the value property. For line item discounts, the value property is applied per individual unit of the item, based on the line item's quantity.
amount = floor(price * quantity * value) / 100, where floor() is the usual round down function.
For non-fractional currencies, this formula needs to use round() instead of floor(), and the division by 100 takes place inside the rounding, resulting in a non-fractional value. Otherwise, an error is returned.
For a fixed amount example, see Create a draft order with a discount.
For a percentage example, see Set a percent discount on a line item.
You can load a customer to a draft order by sending the customer_id as part of the draft order object. The recommended way to remove a customer from a draft order is to make a POST request with the Customer object set to null, without specifying an email, shipping address, or billing address. A customer may also be removed by setting customer, email, shipping_address, and billing_address to null.
An optional boolean that you can send as part of a draft order object to load customer shipping information. Valid values: true or false.
Used to load the customer. When a customer is loaded, the customer's email address is also associated.
Create a simple draft order with only a product variant ID.
"note": "Customer contacted us about a custom engraving on this iPod"
"custom_message": "Thank you for ordering!"
Using the DraftOrder resource, you can create a draft order and transition it to an order.
Create a draft order that calculates taxes and totals but accept payment from the customer outside of Shopify.
Create a draft order and send an invoice to the customer.
Use the DraftOrder and Checkout resources to create a checkout from a draft order (sales channel apps only).
true: Sets payment pending to true.
false: Sets payment pending to false. default value.


Simon Grayson looks set to land the vacant manager's job at Huddersfield Town.
Huddersfield have been searching for a new manager since the sacking of Lee Clark last week and it appears they have plumped for Grayson.
Talks are believed to have been held between Grayson and Huddersfield over the weekend and the 42-year-old has agreed to take up the role at the Galpharm Stadium.
Terriers chairman Dean Hoyle revealed last week he was due to return from a holiday this week to appoint a new manager and it appears he is set to rubberstamp the move for Grayson with further talks planned for Monday.
It will mean a speedy return to management for Grayson following his sacking by Leeds at the start of February.