U.S. patent application number 12/473165 was filed with the patent office on 2010-03-11 for intubation device and method.
This patent application is currently assigned to Government of the United States as represented by the Secretary of the Army. Invention is credited to Sean O'Mara.
Application Number | 20100059048 12/473165 |
Document ID | / |
Family ID | 26775335 |
Filed Date | 2010-03-11 |
United States Patent
Application |
20100059048 |
Kind Code |
A1 |
O'Mara; Sean |
March 11, 2010 |
INTUBATION DEVICE AND METHOD
Abstract
In one embodiment, an apparatus is characterized by an
intubation-tube placement device; and an intubation tube secured to
the intubation-tube placement device. In another embodiment, an
apparatus is characterized by an intubation-tube placement device;
and an anti-perforation device coupled to the intubation-tube
placement device. In another embodiment, an apparatus is
characterized by an intubation-tube placement device; and at least
one tactile-accentuator flap coupled to the intubation-tube
placement device. In another embodiment, an apparatus is
characterized by an intubation-tube placement device; and a handle
affixed to the intubation-tube placement device. In another
embodiment, a method is characterized by inserting an
intubation-tube placement device, secured to an intubation tube,
into a patient's oral cavity; forcing the intubation-tube placement
device through the patient's vocal cords; and axially sliding the
intubation tube along the intubation-tube placement device such
that the intubation tube follows the intubation-tube placement
device through the patient's vocal cords.
Inventors: |
O'Mara; Sean; (Winchester,
VA) |
Correspondence
Address: |
SEED INTELLECTUAL PROPERTY LAW GROUP LLC
SUITE 5400, 701 FIFTH AVENUE
SEATTLE
WA
98104-7092
US
|
Assignee: |
Government of the United States as
represented by the Secretary of the Army
Fort Detrick
MD
|
Family ID: |
26775335 |
Appl. No.: |
12/473165 |
Filed: |
May 27, 2009 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10086940 |
Mar 1, 2002 |
7552729 |
|
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12473165 |
|
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|
|
60273795 |
Mar 5, 2001 |
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Current U.S.
Class: |
128/200.26 |
Current CPC
Class: |
A61M 16/0488
20130101 |
Class at
Publication: |
128/200.26 |
International
Class: |
A61M 16/04 20060101
A61M016/04 |
Goverment Interests
STATEMENT REGARDING GOVERNMENT INTEREST
[0002] The government has certain rights in this invention.
Claims
1.-72. (canceled)
73. An intubation device, comprising: an intubation tube; a
intubation placement device having a bendable first end configured
to be introduced through a set of vocal cords; and a retention
device configured to removably secure the intubation tube in
position on the intubation placement device, with the first end of
the intubation placement device extending out of the intubation
tube, and to be severed from the intubation tube.
74. The intubation device of claim 73 wherein the retention device
comprises a stopper integral with the intubation tube and having a
center hole configured to receive the intubation placement device
and a perforation configured to facilitate severing the stopper
from the intubation tube.
75. The intubation device of claim 74 wherein the stopper is a
rubber stopper.
76. The intubation device of claim 73 wherein the intubation
placement device comprises a hollow tube.
77. The intubation device of claim 73 wherein the intubation
placement device comprises a bendable rod.
78. A method of intubating a patient, comprising: securing an
intubation tube on a first portion of a endotracheal placement
device such that a bendable second portion of the endotracheal
placement device extends out through the intubation tube; guiding
the second portion of the endotracheal placement device through the
patient's vocal cords; severing the intubation tube from the
endotracheal placement device; guiding the intubation tube through
the patient's vocal cords such that a portion of the intubation
tube follows the second portion of the endotracheal placement
device through the patient's vocal cords; and removing the
endotracheal placement device from the intubation tube.
79. The method of claim 78 wherein the severing the intubation tube
from the endotracheal placement device comprises twisting the
endotracheal placement device and the endotracheal tube in opposite
directions to sever a retention device.
80. The method of claim 78 wherein the intubation tube comprises a
retention device configured to secure a tube of the intubation tube
on the endotracheal placement device and severing the intubation
tube from the endotracheal placement device comprises breaking a
perforation between the retention device and the tube of the
intubation tube.
81. An intubation device, comprising: a endotracheal placement
device having a semi-rigid first end configured to pass through
vocal cords and into a trachea; and an intubation tube having a
retention device configured to removably secure the intubation tube
on the endotracheal placement device with the first end of the
endotracheal placement device extending out of a first end of the
intubation tube, wherein the retention device is configured to be
severed from the intubation tube and the first end of the
intubation tube is configured to slide along the endotracheal
placement device through vocal cords after the retention device is
severed.
82. The intubation device of claim 81 wherein: the retention device
comprises a stopper having a hole; and the retention device is
configured to frictionally receive the endotracheal placement
device in the hole.
83. The intubation device of claim 81 wherein the retention device
comprises a detachable portion of a second end of the intubation
tube.
84. The intubation device of claim 81 wherein a second end of the
endotracheal placement device extends out of a second end of the
intubation tube.
85. The intubation device of claim 81 wherein the endotracheal
placement device comprises a semi-rigid rod.
86. The intubation device of claim 81 wherein a tip of the first
end of the intubation tube has a rounded shape.
87. The intubation device of claim 86 wherein the tip of the first
end of the intubation tube has an opening having a diameter
approximately equal to a diameter of the endotracheal placement
device.
88. The intubation device of claim 87 wherein a portion of a wall
of the intubation tube adjacent to the first end of the intubation
tube has a plurality of ventilation openings.
89. The intubation device of claim 81 wherein a tip of the first
end of the intubation tube is tapered.
90. The intubation device of claim 89 wherein the tip of the first
end of the intubation tube is configured to taper to approximately
a diameter of the endotracheal placement device.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This application claims the benefit under 35 U.S.C.
.sctn.119(e) of U.S. Provisional Patent Application No. 60/273,795
filed 5 Mar. 2001, said provisional patent application hereby
incorporated by reference, in its entirety, into the detailed
description portion of the present application. The
incorporated-by-reference provisional patent application has been
incorporated into the detailed description portion of the present
application because the incorporated-by-reference provisional
patent application described aspects of both the related art and
the present patent application under a "background information"
section; however, the description of aspects of the present patent
application under the "background information" section of the
provisional patent application is in no way an admission that such
related art or aspects of the present invention constituted "prior
art". In fact, several aspects of the present patent application
predate the related-art aspects described in the provisional patent
application. Accordingly, the foregoing statements constitute
public notice that the provisional patent application was intended
to contain no admissions related to prior art whatsoever.
BACKGROUND OF THE INVENTION
[0003] 1. Field of the Invention
[0004] The present invention relates, in general, to intubation
devices and methods.
[0005] 2. Description of the Related Art
[0006] Intubation is the operation of inserting a tube into an
animal's hollow organ or body passage to keep the organ or body
passage open. One common example of intubation is endotracheal
intubation, wherein a breathing tube is placed within the trachea
of an animal. While endotracheal intubation will be described
herein for sake of clarity, it is to be understood that the
teachings herein are not limited to endotracheal intubation, but
may instead be extended to other types of intubation.
[0007] The operation of endotracheal intubation may be described as
follows. First, a patient's head is positioned, and mouth is
opened, to allow a straight line of access from the mouth to the
vocal cords (e.g., by placing a pillow under the head and neck of
the patient). Second, the blade of a laryngoscope (a device which
typically consists of a blade, a light source, and a handle) is
introduced into the right-hand side of the patient's mouth, and the
blade is used to sweep the tongue to the left. Third, the blade is
advanced until the right tonsil is reached, at which point the
health care provider sweeps the blade toward the midline of the
patient's body--this brings the patient's epiglottis into view.
Fourth, the health care provider advances the laryngoscope blade
until it reaches the base of the epiglottis. Fifth, the health care
provider levers the laryngoscope such that the epiglottis is moved
toward the top of the patient's head such that the vocal cords of
the patient come into view. Sixth, the health care provider
advances the endotracheal tube through the vocal cords, until the
inflatable cuff of the endotracheal tube has traversed the
patient's vocal cords. Seventh, the health care provider inflates
the inflatable cuff of the endotracheal tube which holds the
endotracheal tube in the patient's trachea. Eighth, the health care
provider secures the endotracheal tube somewhere inside the
patient's mouth (typically, to the patient's upper jaw), and the
operation of endotracheal intubation is considered completed.
BRIEF SUMMARY OF THE INVENTION
[0008] The inventor named herein has devised intubation devices and
related methods.
[0009] In one embodiment, an apparatus is characterized by an
intubation-tube placement device; and an intubation tube secured to
the intubation-tube placement device.
[0010] In another embodiment, an apparatus is characterized by an
intubation-tube placement device; and an anti-perforation device
coupled to the intubation-tube placement device.
[0011] In another embodiment, an apparatus is characterized by an
intubation-tube placement device; and at least one
tactile-accentuator flap coupled to the intubation-tube placement
device.
[0012] In another embodiment, an apparatus is characterized by an
intubation-tube placement device; and a handle affixed to the
intubation-tube placement device.
[0013] In another embodiment, a method is characterized by
inserting an intubation-tube placement device, secured to an
intubation tube, into a patient's oral cavity; forcing the
intubation-tube placement device through the patient's vocal cords;
and axially sliding the intubation tube along the intubation-tube
placement device such that the intubation tube follows the
intubation-tube placement device through the patient's vocal
cords.
[0014] The foregoing is a summary and thus contains, by necessity,
simplifications, generalizations and omissions of detail;
consequently, those skilled in the art will appreciate that the
summary is illustrative only and is NOT intended to be in any way
limiting. Other aspects, inventive features, and advantages of the
devices and/or processes described herein, as defined solely by the
claims, will become apparent in the non-limiting detailed
description set forth herein.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S)
[0015] FIG. 1A, shows a side-plan view of an intubation-tube
placement device 100 secured to an intubation tube 116.
[0016] FIG. 1B shows that another implementation of an
intubation-tube placement device 100 secured to an intubation tube
116 is characterized by an intubation-placement-device guide 120
integral with the intubation tube 116, where the
intubation-placement-device guide 120 has a hole through which the
intubation-tube placement device 100 has been inserted.
[0017] FIG. 2 depicts a side-plan isolation view of an
anti-perforation device 102 coupled to an intubation-tube placement
device 100.
[0018] FIG. 3A shows a side-plan isolation view of an alternate
embodiment of an anti-perforation device 102 coupled to an
intubation-tube placement device 100.
[0019] FIG. 3B depicts a side-plan isolation view of an alternate
embodiment of an anti-perforation device 102 coupled to an
intubation-tube placement device 100.
[0020] FIG. 3C illustrates a side-plan isolation view of an
alternate embodiment of an anti-perforation device 102 coupled to
an intubation-tube placement device 100.
[0021] FIG. 4A shows a front-plan view of an anti-perforation
device 102 coupled to an intubation-tube placement device 100.
[0022] FIG. 4B depicts a front-plan view of an anti-perforation
device 102 coupled to an intubation-tube placement device 100.
[0023] FIG. 5 shows a side-plan view of tactile-accentuator flaps
114 coupled to an intubation-tube placement device 100.
[0024] FIG. 6A depicts a side-plan isolation view of an alternate
implementation of tactile-accentuator flaps 114 coupled to an
intubation-tube placement device 100.
[0025] FIG. 6B illustrates a side-plan isolation view of an
alternate implementation of tactile-accentuator flaps 114 coupled
to an intubation-tube placement device 100.
[0026] FIG. 6C shows a side-plan isolation view of an alternate
implementation of tactile-accentuator flaps 114 coupled to an
intubation-tube placement device 100.
[0027] FIGS. 7A and 7B show structures substantially analogous to
those depicted in FIGS. 4A and 4B, to which have been affixed
tactile-accentuator flaps 114.
[0028] FIG. 8 depicts an isolated perspective view of an
intubation-tube placement device 100 secured to an intubation tube
116.
[0029] FIG. 9 shows a perspective view of an intubation tube 116,
an intubation-tube placement device 100, and a rubber stopper 118
in disassembled form.
[0030] FIG. 10 depicts a top-plan view of three different-sized
implementations of a rubber stopper 118, and an intubation-tube
placement device 100.
[0031] FIG. 11 illustrates a side-plan view of an intubation-tube
placement device 100 internal to intubation tube 116.
[0032] FIG. 13 shows a perspective view of an intubation-tube
placement device 100 internal to a modified intubation tube
1300.
[0033] FIG. 14 depicts a perspective isolation view of the rounded
tip 1302 of the intubation tube 1300.
[0034] FIG. 15 illustrates a perspective view of an intubation-tube
placement device 100 internal to a modified intubation tube
1300.
[0035] FIG. 16 shows a perspective isolation view of an alternate
implementation of the modified intubation tube 1300.
[0036] FIG. 12 shows a high-level logic flowchart depicting a
process which illustrates how various of the foregoing-described
devices may be used.
[0037] The use of the same symbols in different drawings typically
indicates similar or identical items.
DETAILED DESCRIPTION OF THE INVENTION
[0038] With reference to the figures and with reference now to FIG.
1A, shown is a side-plan view of an intubation-tube placement
device 100 secured to an intubation tube 116. In one
implementation, the intubation-tube placement device 100 is secured
to the intubation tube 116 by a retaining device in contact with
the intubation tube 116. Illustrated is that, in one
implementation, the retaining device in contact with the intubation
tube 116 is characterized by a rubber stopper (or grommet) 118,
where the rubber stopper 118 has a hole through which the
intubation-tube placement device 100 has been inserted. Shown is
that, in one implementation, the rubber stopper 118 is affixed to
the intubation tube 116 via mechanical friction, which allows
rubber stopper 118 to be severed from the intubation tube 116 via
either a simple twisting or pulling motion. That is, in one
implementation, the health care provider grasps the intubation tube
116 with one hand, grasps the rubber stopper 118 and
intubation-tube placement device 100 with the other hand, and pulls
the intubation tube 116 and the rubber stopper 118 in opposite
directions such that the rubber stopper 118 breaks away from the
intubation tube 116 so that the rubber stopper 118 and the
intubation-tube placement device 100 may be removed from the
intubation tube 116.
[0039] Referring now to FIG. 1B, shown is that another
implementation of an intubation-tube placement device 100 secured
to an intubation tube 116 is characterized by an
intubation-placement-device guide 120 integral with the intubation
tube 116, where the intubation-placement-device guide 120 has a
hole through which the intubation-tube placement device 100 has
been inserted. Illustrated is that, in one implementation, the
intubation-placement-device guide 120 is affixed to the intubation
tube 116 via a breakaway perforated border 122, which allows the
intubation-placement-device guide 120 to be severed from the
intubation tube 116 via either a simple twisting or pulling motion.
That is, in one implementation, the health care provider grasps the
intubation tube 116 with one hand, grasps the
intubation-placement-device guide 120 and the intubation-tube
placement device 100 with the other hand, and twists the intubation
tube 116 and the intubation-placement-device guide 120 in opposite
directions such that the intubation-placement-device guide 120
breaks away from the intubation tube 116 so that the
intubation-placement-device guide 120 and the intubation-tube
placement device 100 may be removed from the intubation tube
116.
[0040] In various implementations, an intubation-tube placement
device (e.g., intubation-tube placement device 100) is a semi-rigid
structure constructed from a material having a relatively low
coefficient of friction, so that the intubation-tube placement
device 100 may be relatively easily slid back and forth through the
hole of a retaining device (e.g., rubber stopper 118 or
intubation-placement-device guide 120). In one implementation, this
is achieved by forming the intubation-tube placement device from a
medical-grade polymeric material, such as medical-grade polyvinyl
chloride (PVC) or medical-grade nylon.
[0041] In various implementations, an intubation-tube placement
device (e.g., intubation-tube placement device 100) is a semi-rigid
structure constructed from a material which is malleable and which
has a memory quality sufficient to permit a health care provider to
manipulate the intubation-tube placement device into a shape or
form according to the health care provider's preference. The
material is malleable enough to allow the health care provider to
relatively easily bend the intubation-tube placement device, and
the memory quality is such that, subsequent to the health care
provider's bending the intubation tube placement device into any
particular shape, the intubation-tube placement device will tend to
maintain both itself and an intubation tube (e.g., intubation tube
116), to which the intubation-tube placement device is secured,
during use of the intubation-tube-placement device secured to the
intubation tube. The inventor believes that health care providers
will find such construction particularly attractive in that such
health care providers can easily personalize the device to their
use preferences. In one implementation, this is achieved by forming
the intubation-tube placement device from a medical-grade,
reinforced, polymeric material, such as medical-grade reinforced
polyvinyl chloride (PVC) or medical-grade reinforced nylon.
However, those skilled in the art will appreciate that other
materials may be found suitable via a reasonable amount of
experimentation in light of the teachings herein.
[0042] In various implementations, an intubation-tube placement
device (e.g., intubation-tube placement device 100) is a semi-rigid
structure having either a cross section appropriate to an adult or
a cross section appropriate to a child. In one implementation, the
cross section appropriate to a neonatal premature infant is a cross
section whose widest point is no greater than 0.05 ("point zero
five") mm. In another implementation, the cross section appropriate
to a child is a cross section whose widest point is no greater than
0.5 ("point five") mm. In another implementation, the cross section
appropriate to an adult is a cross section whose widest point is no
greater than 6.0 ("six point zero") mm. In another implementation,
the intubation-tube placement device (e.g., intubation-tube
placement device 100) is a semi-rigid structure having a cross
section appropriate to a veterinary animal (e.g., a horse, a cow, a
monkey, a dog, a guinea pig, a mouse, a rat, etc.). In one
implementation, the cross section appropriate to a veterinary
animal is a cross section whose widest point is no greater than
10.0 ("ten point zero") mm. Those skilled in the art will recognize
that the cross sections listed herein are merely exemplary and that
many other cross sections can be used dependent upon the patient
undergoing intubation and health care provider preference.
[0043] As shown herein, the intubation-tube placement device is
depicted as a cylindrically-shaped rod. Those having ordinary skill
in the art will appreciate that the intubation tube placement
device can have many other shapes such as an octagonal shape, an
ellipsoid shape, or a square shape.
[0044] With reference now again to FIGS. 1A and 1B, illustrated is
that an anti-perforation device 102 is coupled to an
intubation-tube placement device 100. In one implementation, the
anti-perforation device 102 is characterized by an internal light
source, which aids the health care provider in placing the
intubation-tube placement device 100 (e.g., by illuminating the
vocal cords of a patient); in one implementation, the internal
light source contains its power source, while in another
implementation it is powered via an externalized battery pack via
wires (not shown) running through the length of the intubation-tube
placement device 100. In another implementation, the
anti-perforation device 102 is characterized by a channel which
articulates with a channel of the intubation-tube placement device
100 whereby suction can be applied via the anti-perforation device
102. For example, in one implementation, the anti-perforation
device 102 has a hole drilled all the way through it, and the
intubation-tube placement device 100 is a hollow tube; the
anti-perforation device 102 is affixed to the intubation-tube
placement device 100 such that the hole aligns with the hollow
tube, thereby forming one continuous channel which will support a
vacuum and thus allow the health care provider to apply suction
through the anti-perforation device 102. With respect to the aspect
of suctioning, in another implementation, the intubation-tube
placement device 100 forms a hollow tube, and there is no
anti-perforation device 102 is coupled to the intubation tube
placement device, in which case suction is directly applied via an
open end of the hollow tube formed by the intubation-tube placement
device 100.
[0045] Continuing to refer to FIGS. 1A and 1B, shown is that, in
one implementation, tactile-accentuator flaps 114 are coupled to
intubation-tube placement device 100. Illustrated is that, in one
implementation, each of the tactile-accentuator flaps 114 forms a
non-zero angle with an axis of the intubation-tube placement device
100 (e.g., a 90 degree angle such as is shown in FIGS. 1A and 1B).
In one embodiment, the tactile-accentuator flaps 114 are affixed to
a ring-like structure encompassing the intubation-tube placement
device 100. In another embodiment, the tactile-accentuator flaps
114 are directly affixed to the anti-perforation device 102. The
inventor points out that while tactile-accentuator flaps 114 are
illustrated herein as extending from the body of the
intubation-tube placement device 100 and beyond the outermost
portions of the anti-perforation device 102, in other contemplated
embodiments the tactile-accentuator flaps 114 extend no further
from the body of the intubation-tube placement device (100) than
the outermost portions of the anti-perforation device 100, thereby
allowing the health care provider a more clear line of sight to the
patient's vocal cords.
[0046] The inventor has found that the retaining device (e.g.
rubber stopper 118 or intubation-placement-device guide 120) serves
as a "handle" for the intubation-tube placement device 100. That
is, the inventor has found that the retaining device "amplifies"
the physical motion of the proximate end (e.g., the end to which
the anti-perforation device 102 is affixed) of the intubation-tube
placement device 100, making it easier to intubate a patient in the
absence of the handle. In addition, while the retaining device is
treated as the handle for the sake of illustration herein, in
another contemplated embodiment, a handle is actually affixed to
the intubation-tube placement device 100, while in another
contemplated embodiment the handle is actually affixed to the
intubation tube 116.
[0047] Referring now to FIG. 2, depicted is a side-plan isolation
view of an anti-perforation device 102 coupled to an
intubation-tube placement device 100. Illustrated is that, in one
implementation, the anti-perforation device 102 is characterized by
the light source internal to the anti-perforation device 102
(illustrated in FIG. 2 via light rays emanating from the
anti-perforation device 102). Shown is that the anti-perforation
device 102 has a trailing portion 104 and an exploratory portion
106. Depicted is that, in one implementation, the exploratory
portion 106 of the anti-perforation device 102 has a spheroid
shape, where lines drawn tangent to the spheroid shape would
typically form an oblique angle with the axis of the
intubation-tube placement device 100. Further depicted is that, in
one implementation, a portion of the spheroid shape extends beyond
the outer diameter of the intubation-tube placement device 100,
which the inventor has found particularly advantageous in
preventing perforation of internal body structures. In one
implementation, the spheroid shape proves particularly advantageous
in that it serves to protect the internal structures of a patient
undergoing intubation.
[0048] With reference now to FIG. 3A, shown is a side-plan
isolation view of an alternate embodiment of an anti-perforation
device 102 coupled to an intubation-tube placement device 100.
Depicted is an open channel 300 between the trailing portion 104
and the exploratory portion 106 of the anti-perforation device 102.
Illustrated is that, in one implementation, the intubation-tube
placement device 100 forms a hollow tube. Shown is that the
trailing portion 104 of the anti-perforation device 102 is coupled
to the intubation-tube placement device 100 such that the channel
300 of the anti-perforation device 102 substantially aligns with
the hollow tube formed by the intubation-tube placement device 100,
thereby forming a suctioning tube. Depicted is that, in one
implementation, the exploratory portion 106 of the anti-perforation
device 102 has a ellipsoid shape, where lines drawn tangent to the
ellipsoid shape would typically form an oblique angle with the axis
of the intubation-tube placement device 100. Further depicted is
that, in one implementation, a portion of the ellipsoid shape
extends beyond the outer diameter of the intubation-tube placement
device 100, which the inventor has found particularly advantageous
in preventing perforation of internal body structures.
[0049] Referring now to FIG. 3B, depicted is a side-plan isolation
view of an alternate embodiment of an anti-perforation device 102
coupled to an intubation-tube placement device 100. Illustrated is
an open channel 300 between the trailing portion 104 and the
exploratory portion 106 of the anti-perforation device 102. Shown
is that, in one implementation, the intubation-tube placement
device 100 forms a hollow tube. Depicted is that the trailing
portion 104 of the anti-perforation device 102 is coupled to the
intubation-tube placement device 100 such that the channel 300 of
the anti-perforation device 102 substantially aligns with the
hollow tube formed by the intubation-tube placement device 100,
thereby forming a suctioning tube. Depicted is that, in one
implementation, the exploratory portion 106 of the anti-perforation
device 102 has a spheroid shape, where lines drawn tangent to the
spheroid shape would typically form an oblique angle with the axis
of the intubation-tube placement device 100. Further depicted is
that, in one implementation, a portion of the spheroid shape
extends beyond the outer diameter of the intubation-tube placement
device 100, which the inventor has found particularly advantageous
in preventing perforation of internal body structures.
[0050] With reference now to FIG. 3C, illustrated is a side-plan
isolation view of an alternate embodiment of an anti-perforation
device 102 coupled to an intubation-tube placement device 100.
Shown is that, in one implementation, the anti-perforation device
102 has a spheroid shape formed from solid surfaces arranged in
various angles. Depicted is that, in one implementation, the
exploratory portion 106 of the anti-perforation device 102 has an
angled shape, where lines drawn tangent to the angled shape would
typically form an oblique angle with the axis of the
intubation-tube placement device 100. Further depicted is that, in
one implementation, a portion of the angled shape extends beyond
the outer diameter of the intubation-tube placement device 100,
which the inventor has found particularly advantageous in
preventing perforation of internal body structures.
[0051] While the exploratory portion 106 of the anti-perforation
device 102 has been shown in FIGS. 2-3C as having a fixed
structure, in one contemplated embodiment the exploratory portion
106 of the anti-perforation device 102 is formed from a
medical-grade room-temperature malleable material (e.g., a
medical-grade polymer or wax) which can be manipulated into a shape
chosen by the health care provider performing intubation. For
example, the anti-perforation device 102 could come prepackaged in
a spherical shape, which the health care provider could then
manipulate as he sees fit. In addition, in one contemplated
embodiment the anti-perforation device 102 comes prepackaged with a
lubricant coating the anti-perforation device 102.
[0052] Referring now to FIG. 4A, shown is a front-plan view of an
anti-perforation device 102 coupled to an intubation-tube placement
device 100. Depicted is that, in one implementation, the
intubation-tube placement device 100 has a cylindrical shape. In
one implementation, the intubation-tube placement device 100 forms
a hollow tube, while in another implementation, the intubation-tube
placement device 100 forms a solid rod.
[0053] With reference now to FIG. 4B, depicted is a front-plan view
of an anti-perforation device 102 coupled to an intubation-tube
placement device 100. Illustrated is that, in one implementation,
the intubation-tube placement device 100 has an octagonal shape. In
one implementation, the intubation-tube placement device 100 forms
a hollow tube, while in another implementation, the intubation-tube
placement device 100 forms a solid rod.
[0054] Referring now to FIG. 5, shown is a side-plan view of
tactile-accentuator flaps 114 coupled to an intubation-tube
placement device 100. Illustrated is that, in one implementation,
each of the tactile-accentuator flaps 114 forms a non-zero angle
with an axis of the intubation-tube placement device 100. Shown is
that, in one implementation, the tactile-accentuator flaps 114 are
affixed to a ring-like structure 116 encompassing the
intubation-tube placement device 100. Depicted is that, in one
implementation, the tactile-accentuator flaps 114 are proximate to
the anti-perforation device 102, which is itself coupled to the
intubation-tube placement device 100. In another implementation,
not shown, the tactile-accentuator flaps 114 are directly coupled
to the anti-perforation device 102.
[0055] With reference now to FIG. 6A, depicted is a side-plan
isolation view of an alternate implementation of
tactile-accentuator flaps 114 coupled to an intubation-tube
placement device 100. Illustrated is that, in one implementation,
each of the tactile-accentuator flaps 114 forms a non-zero angle
with an axis of the intubation-tube placement device 100. Shown is
that, in one implementation, the tactile-accentuator flaps 114 are
affixed to a ring-like structure 116 encompassing the
intubation-tube placement device 100. Depicted is that, in one
implementation, the tactile-accentuator flaps 114 are proximate to
the anti-perforation device 102 coupled to the intubation-tube
placement device 100. In another implementation, not shown, the
tactile-accentuator flaps 114 are directly coupled to the
anti-perforation device 102.
[0056] Referring now to FIG. 6B, illustrated is a side-plan
isolation view of an alternate implementation of
tactile-accentuator flaps 114 coupled to an intubation-tube
placement device 100. Shown is that, in one implementation, each of
the tactile-accentuator flaps 114 forms a non-zero angle with an
axis of the intubation-tube placement device 100. Depicted is that,
in one implementation, the tactile-accentuator flaps 114 are
directly affixed to the anti-perforation device 102. Illustrated is
that, in one implementation, the tactile-accentuator flaps 114 are
proximate to the anti-perforation device 102 coupled to the
intubation-tube placement device 100. In another implementation,
not shown, the tactile-accentuator flaps 114 are directly coupled
to the intubation-tube placement device 100.
[0057] With reference data FIG. 6C, shown is a side-plan isolation
view of an alternate implementation of tactile-accentuator flaps
114 coupled to an intubation-tube placement device 100. Shown is
that, in one implementation, each of the tactile-accentuator flaps
114 forms a non-zero angle with an axis of the intubation-tube
placement device 100. Depicted is that, in one implementation, the
tactile-accentuator flaps 114 are directly affixed to the
anti-perforation device 102. Illustrated is that, in one
implementation, the tactile-accentuator flaps 114 are proximate to
the anti-perforation device 102 coupled to the intubation-tube
placement device 100. In another implementation, not shown, the
tactile-accentuator flaps 114 are directly coupled to the
intubation-tube placement device 100.
[0058] In various implementations, a tactile-accentuator flap
(e.g., one of the tactile-accentuator flaps 114) is a semi-rigid
structure constructed from a material having a relatively low
coefficient of friction, so that the tactile-accentuator flaps may
be relatively easily slid back and forth across the internal
structures of the body (e.g., the cartilaginous rings lining the
trachea of an animal). In one implementation, this is achieved by
forming the tactile-accentuator flap from a medical-grade polymeric
material, such as medical-grade polyvinyl chloride (PVC) or
medical-grade nylon. The inventor has discovered that the tactile
accentuator flaps are particularly useful in performing intubations
in that the tactile accentuator flaps allow the intubating
health-care provider to detect the cartilaginous rings lining the
trachea, by amplifying the tactile impressions generated by such
cartilaginous rings. The inventor has discovered that such tactile
amplification increases the likelihood that an intubation tube will
be placed in the trachea of a patient rather than the esophagus of
the patient.
[0059] Referring now to FIGS. 7A and 7B, shown are structures
substantially analogous to those depicted in FIGS. 4A and 4B, to
which have been affixed tactile-accentuator flaps 114. Depicted is
that, in one implementation, each of the tactile-accentuator flaps
114 presents in front-plan view as having a 1 mm by 1 mm facial
profile. The inventor has found that it is advantageous that the
tactile-accentuator flaps 114 be thin enough to permit flexing and
bending in their profiles; exactly how thin the tactile-accentuator
flaps 114 will be will vary in application dependent upon the
materials used and can be determined empirically via a reasonable
amount of experimentation. However, while various sizes and shapes
of the tactile-accentuator flaps 114 have been illustrated and
described herein, those skilled in the art will appreciate that
other sizes and shapes of facial profiles can be utilized in light
of the teachings herein via a minimal amount of
experimentation.
[0060] Those skilled in the art will appreciate that while FIGS.
5-7B depict only two tactile-accentuator flaps 114, the teachings
herein are not limited to only two flaps and that other numbers of
tactile-accentuator flaps 114 are possible (e.g., one, three, four,
five, etc.).
[0061] With reference now to FIG. 8, depicted is an isolated
perspective view of an intubation-tube placement device 100 secured
to an intubation tube 116. Illustrated is the intubation-tube
placement device 100 held internal to the intubation tube 116 via a
retaining device in contact with the intubation tube 116. Shown is
that, in one implementation, the retaining device is a rubber
stopper 118 having a hole 140, which runs the length of the rubber
stopper 118, through which intubation-tube placement device 100 has
been inserted. Depicted is that, in one implementation, the rubber
stopper 118 holds the intubation-tube placement device 100 internal
to the intubation tube 116 via mechanical friction.
[0062] Referring now to FIG. 9, shown is a perspective view of an
intubation tube 116, an intubation-tube placement device 100, and a
rubber stopper 118 in disassembled form.
[0063] With reference now to FIG. 10, depicted is a top-plan view
of three different-sized implementations of a rubber stopper 118,
and an intubation-tube placement device 100. As has been described,
varying sizes of the intubation-tube placement device 100 can be
used depending upon the needs of the patient undergoing intubation
and/or preferences of the health-care provider performing
intubation.
[0064] Referring now to FIG. 11, illustrated is a side-plan view of
an intubation-tube placement device 100 internal to intubation tube
116. Shown is that the intubation-tube placement device 100 has
coupled to it an implementation of the anti-perforation device
120.
[0065] With reference now to FIG. 13, shown is a perspective view
of an intubation-tube placement device 100 internal to a modified
intubation tube 1300. Shown is the modified intubation tube 1300
has a rounded tip 1302, which is different from the beveled tip of
intubation tube 116. The inventor has empirically determined that
the rounded tip 1302 of the intubation tube 1300 is particularly
advantageous.
[0066] Referring now to FIG. 14, depicted is a perspective
isolation view of the rounded tip 1302 of the intubation tube
1300.
[0067] With reference now to FIG. 15, illustrated is a perspective
view of an intubation-tube placement device 100 internal to a
modified intubation tube 1300. Shown coupled to intubation-tube
placement device 100 is an implementation of an anti-perforation
device 102.
[0068] Referring now to FIG. 16, shown is a perspective isolation
view of an alternate implementation of the modified intubation tube
1300. Depicted is a rounded and tapered tip 1600 having open slots,
or ports, 1306 which allow for ventilation of an intubated
patient.
[0069] Although not explicitly shown, it is to be understood that
in most implementations the modified intubation tube 1300 will have
inflatable cuffs on them to allow proper oxygenation and
ventilation of intubated patients.
[0070] Those having ordinary skill in the art will recognize that
national hospital accreditation standards have recently prohibited
intubation (e.g., endotracheal) tubes from being opened before use.
The practical effect of such standards is that now that all health
care providers performing intubation must first open a
medical-grade sterile package, insert a metal stylet into the
endotracheal tube, and bend both to the desired shape before
intubating. Accordingly, in one implementation an intubation-tube
placement device 100 secured to an intubation tube 116 comes
pre-packaged, as a unit, in a medical-grade sterile package. This
is particularly attractive over the related art in that that when
the intubation-tube placement device 100 secured to an intubation
tube 116 is removed from its packaging it is substantially
immediately ready to be used. That is, the intubation-tube
placement device 100 secured to an intubation tube 116, prepackaged
as a unit in medical-grade sterile packaging, has the advantage of
saving time from having to load it.
[0071] The foregoing has described various devices. Following is a
description of one method implementation which illustrates how
several of the foregoing-described various devices may be used.
[0072] With reference now to FIG. 12, shown is a high-level logic
flowchart depicting a process which illustrates how various of the
foregoing-described devices may be used. Those skilled in the art
will recognize that the uses depicted and/or described are merely
illustrative, and are not exhaustive.
[0073] Referring now to FIG. 12 and FIG. 1A, method step 1200
depicts the start of the process. Method step 1202 illustrates
positioning a patient's head and opening the patient's mouth to
allow a straight line of access from the mouth to the vocal cords
as in the related art (typically with the aid of a lighted
laryngoscope). Method step 1204 shows the health-care provider
positioning the intubation-tube placement device 100, relative to
the intubation tube 116, in a location appropriate to the patient
undergoing intubation and/or in accordance with the health-care
provider's preference; in one implementation, this is achieved via
the health-care provider grasping the intubation tube 116 and/or
the rubber stopper 118 with one hand and manipulating the
intubation-tube placement device with the other hand until the
anti-perforation device 102 extends from the intubation tube 116 at
a distance which the health-care provider deems appropriate (e.g.,
extending 5 cm from the intubation tube for neonates or extending
20 cm from the intubation tube for average-sized adults).
[0074] Method step 1206 depicts the health-care provider grasping
the intubation tube 116 and/or the rubber stopper 118, and
thereafter inserting the intubation-tube placement device 100,
secured to the intubation tube 116, into the patient's oral cavity.
Method step 1208 illustrates the health-care provider manipulating
the intubation-tube placement device 100, secured to the intubation
tube 116, such that the anti-perforation device 102 may be used to
manipulate the epiglottis out of the line of sight so that the
patient's vocal cords may be visualized where standard laryngoscope
manipulation fails to reveal the cords. Additionally, when the
vocal cords are not otherwise able to be visualized through
laryngoscope or the device described herein's manipulation, the
exploratory portion of the device can be gently advanced as
anterior as possible to the posterior aspect of the visualized
epiglottis or where the health-care provider best believes the
epiglottis to be to facilitate insertion within the trachea. The
device's design allows for endotracheal placement interpretation by
allowing the health-care provider to appreciate either the
cartilaginous rings lining the trachea through tactile stimulus or
until hang-up of the device (usually at the bifurcation of the
trachea) is experienced strongly suggesting endotracheal
intubation; in one implementation, the light source internal to the
anti-perforation device 102 aids the health-care provider in this
process. One advantage to this one implementation of the light
source is the ability of the health-care provider to otherwise
dispense with the necessary reliance upon an expensive lighted
laryngoscope and the accompanying supportive costs to maintain
laryngoscopes (sterilization, changing light bulbs, incompatible
blades, bulbs, etc). This implementation allows for as many
intubations as there are devices for without reliance upon
sterilizing procedures or other costly supportive maintenance. In
addition to the foregoing, the inventor has found that one
particularly advantageous use of the structures described herein is
that the intubation-tube placement device 100 having
anti-perforation device 102 and/or tactile-accentuator rings 114
allows for blind placement without any light source. or use of even
a laryngoscope blade, by simply using the health-care provider's
fingers to first identify the position of the epiglottis and then
to slide the exploratory portion of the device as anterior as
possible again to the posterior aspect of the epiglottis to
facilitate endotracheal intubation until tactile confirmation
suggests endotracheal intubation. In one use, the endotracheal
intubation is confirmed through bagging and other standard
confirmatory techniques. The inventor points out that the
foregoing-described blind intubation may be very attractive where a
health-care provider may want to otherwise intubate a patient under
low lighting or unfavorable conditions such as out in the
pre-hospital setting or in a combat area.
[0075] Method step 1210 depicts the optional step of suctioning
materials from the vicinity of the patient's vocal cords; in one
implementation, the foregoing is achieved via the trailing portion
104 of the anti-perforation device 102 coupled to the
intubation-tube placement device 100 such that the channel 300 of
the anti-perforation device 102 substantially aligns with the
hollow tube formed by the intubation-tube placement device 100,
thereby forming a suctioning tube (e.g., see FIGS. 3A and 3B).
[0076] Method step 1212 shows the step of the health-care provider
positioning the exploratory portion 106 of the anti-perforation
device 102 in a position such that the anti-perforation device 102
can traverse the patient's vocal cords; in one implementation, the
health-care provider is aided in this task of positioning in that
the intubation-tube placement device 100 secured to the intubation
tube 116 serves as a "handle" for the intubation-tube placement
device 100, where the "handle" tends to "amplify" the movements of
the health-care provider's fingers to allow for very accurate
positioning of the intubation-tube placement device 100 (and hence
the anti-perforation device 102) within the patient's oral
cavity.
[0077] Method step 1214 depicts the step of the health-care
provider forcing the intubation-tube placement device 100 (and
hence the anti-perforation device 102) through the patient's vocal
cords; in one implementation, the foregoing is achieved via the
health-care provider grasping the intubation-tube placement device
100 near the rubber stopper 118, and applying pressure along the
axis of the intubation-tube placement device 100 such that the
intubation-tube placement device 100 slides axially within the hole
of the rubber stopper 118 such that the exploratory surface 106 of
the anti-perforation device 102 pushes aside the patient's vocal
cords.
[0078] Method step 1216 illustrates the step of the health-care
provider continuing to apply axial pressure along the
intubation-tube placement device 100 such that the intubation-tube
placement device 100 (and hence the anti-perforation device 102)
moves further into the confines of the patient's body, making sure
that the intubation-tube placement device 100 enters the patient's
trachea rather than the patient's esophagus; in one implementation,
the health-care provider is aided in the foregoing-described
endeavor by the tactile-accentuator flaps 114, in that various of
the tactile-accentuator flaps 114 impact upon the cartilaginous
rings lining the trachea, and mechanically transmit such impact,
back through the intubation-tube placement device 100, such that
the health-care provider performing the intubation can be
substantially assured that he has placed the intubation-tube
placement device 100 in the trachea rather than in the
esophagus.
[0079] Method step 1218 shows the step of the health-care provider
axially sliding the intubation tube 116 along the intubation-tube
placement device 100 such that the intubation tube 116 follows the
intubation-tube placement device 100 through the patient's vocal
cords; in one implementation, this is achieved via the health-care
provider grasping the intubation-tube placement device 100 and
sliding the rubber stopper 118 axially along the intubation-tube
placement device 100 such that the intubation tube 116 clears the
patient's vocal cords.
[0080] Method step 1220 depicts the step of the health-care
provider inflating an inflatable cuff of the intubation tube 116,
as in the related art.
[0081] Thereafter, method step 1222 illustrates the step of the
health-care provider removing the intubation-tube placement device
100 and the rubber stopper 118 from the intubation tube 116; in one
implementation, this is achieved via the health-care provider
simultaneously grasping the intubation-tube placement device 100
and the rubber stopper 118, and pulling the intubation-tube
placement device 100 and the rubber stopper 118 from the intubation
tube 116. Method step 1224 shows the end of the process.
[0082] As noted in the provisional patent application, filed 5 Mar.
2001, and hereby incorporated by reference, in its entirety, in the
present detailed description, the methods and devices described
herein differ from the related-art use of the Eschmann stylet in
several ways. For example, the related-art Eschmann stylet does not
have an anti-perforation device, such as has been described herein,
and, in fact, the present inventor has observed the Eschmann stylet
perforating body tissues (e.g., a tumor) during use. The
anti-perforation device described herein decreases the likelihood
that such perforation will occur and hence provides an advantage
over the related-art Eschmann stylet. In addition, in use, a
health-care provider first passes the related-art Eschmann stylet
through a patient's vocal cords, and thereafter the health-care
provider introduces the endotracheal tube over the Eschmann stylet,
in through the patient's vocal cords into the patient's trachea.
The inventor points out that, according to the Eschmann stylet's
manufacturer's recommendation it is intended as a rescue device and
only for use only after failed conventional laryngoscopy, whereas
the herein described one unit assembly design (i.e., the
intubation-tube placement device 100 secured to the intubation tube
116) permits attempted intubation during all scenarios--a
characteristic feature not known to any other device. In contrast,
the intubation-tube placement device secured to an intubation tube,
such as has been described herein, is used differently in that it
allows the intubation-tube placement device secured to the
intubation tube to be placed as a unit, thereby increasing the
speed and ease of intubation over the related-art use of the
Eschmann stylet. The inventor has found empirically that the one
unit assembly character of the intubation-tube placement device 100
secured to the intubation tube 116, described herein, provides a
much larger surface area to be held by the health-care provider
thereby greatly improving their ability to control the device and
improve the success rate of intubations. The inventor has found
empirically that the Eschmann stylet's surface area held by the
health-care provider is considerably smaller and therefore more
difficult to grasp and more importantly control with control being
a critical feature during any attempted life saving procedure.
Additionally, the inventor has found empirically that the Eschmann
stylet's resin-coated exterior is very susceptible to cracking and
flaking which can lead to foreign objects being aspirated into the
bronchial airway system and to be a site for foreign debris to be
retained. The inventor also points out that the Eschmann stylet is
not intended to be a disposable item (as are most implementations
described herein), and that the Eschmann stylet is costly to
produce whereas the devices described herein is, in most
implementations, entirely disposable and therefore not reliant upon
a sterilizing process before use.
[0083] In addition, the methods and devices described herein differ
from the related-art lighted wand technique in several ways. For
example, the related-art lighted wand technique uses an intense
light to trans-illuminate a patient's laryngeal structures
internally which can be seen from the exterior of a patient's body
to place an endotracheal tube. In contrast, the methods and devices
described herein allow for placement of the endotracheal tube
either blindly or by direct visual inspection of the interior of
the patient's mouth and vocal cords, and light source described
herein facilitates such placement by direct visual inspection.
[0084] In addition, the methods and devices described herein differ
from the related-art devices and techniques in that none of the
related-art devices and techniques used tactile-accentuator flaps
to detect the cartilaginous rings of the patient's trachea, nor do
the related-art devices and techniques provide for suction via the
use of an intubation-tube placement device such as has been
described herein.
[0085] From the foregoing it will be appreciated that, although
specific embodiments of the invention have been described herein
for purposes of illustration, various modifications may be made
without deviating from the spirit and scope of the invention.
Accordingly, the invention is not limited except as by the appended
claims.
[0086] The foregoing described embodiments depict different
components contained within, or connected with, different other
components. It is to be understood that such depicted architectures
are merely exemplary, and that in fact many other architectures can
be implemented which achieve the same functionality. In a
conceptual sense, any arrangement of components to achieve the same
functionality is effectively "associated" such that the desired
functionality is achieved. Hence, any two components herein
combined to achieve a particular functionality can be seen as
"associated with" each other such that the desired functionality is
achieved, irrespective of architectures or intermedial components.
Likewise, any two components so associated can also be viewed as
being "operably connected", or "operably coupled", to each other to
achieve the desired functionality.
[0087] While particular embodiments of the present invention have
been shown and described, it will be obvious to those skilled in
the art that, based upon the teachings herein, changes and
modifications may be made without departing from this invention and
its broader aspects and, therefore, the appended claims are to
encompass within their scope all such changes and modifications as
are within the true spirit and scope of this invention.
[0088] For example, although the tactile-accentuator flaps have
been described herein in the context of a specifically-crafted
intubation-tube placement device, it is to be understood that such
tactile-accentuator flaps would also have utility when used with
other devices utilized to place intubation tubes (e.g., the
Eschmann stylet, fiber optic scopes, bronchoscopes, etc.). As
another example, although the specifically-crafted intubation-tube
placement device secured to an intubation tube has been described
herein, it is to be understood that the foregoing-described
structure would also have utility when used with other devices
utilized to place intubation tubes (e.g. the Eschmann stylet, the
lightwand, fiber optic intubating scopes, etc.).
[0089] Furthermore, it is to be understood that the invention is
solely defined by the appended claims. It will be understood by
those within the art that, in general, terms used herein, and
especially in the appended claims (e.g., bodies of the appended
claims) are generally intended as "open" terms (e.g., the term
"including" should be interpreted as "including but not limited
to," the term "having" should be interpreted as "having at least,"
the term "includes" should be interpreted as "includes but is not
limited to," etc.). It will be further understood by those within
the art that if a specific number of an introduced claim recitation
is intended, such an intent will be explicitly recited in the
claim, and in the absence of such recitation no such intent is
present. For example, as an aid to understanding, the following
appended claims may contain usage of the introductory phrases "at
least one" and "one or more" to introduce claim recitations.
However, the use of such phrases should not be construed to imply
that the introduction of a claim recitation by the indefinite
articles "a" or "an" limits any particular claim containing such
introduced claim recitation to inventions containing only one such
recitation, even when the same claim includes the introductory
phrases "one or more" or "at least one" and indefinite articles
such as "a" or "an" (e.g., "a" and/or "an" should typically be
interpreted to mean "at least one" or "one or more"); the same
holds true for the use of definite articles used to introduce claim
recitations. In addition, even if a specific number of an
introduced claim recitation is explicitly recited, those skilled in
the art will recognize that such recitation should typically be
interpreted to mean at least the recited number (e.g., the bare
recitation of "two recitations," without other modifiers, typically
means at least two recitations, or two or more recitations).
* * * * *