U.S. patent application number 13/958056 was filed with the patent office on 2013-11-28 for simultaneous display video laryngoscope and video stylet.
The applicant listed for this patent is James P. Barry, George Berci, John J. Elliott, JR.. Invention is credited to James P. Barry, George Berci, John J. Elliott, JR..
Application Number | 20130317300 13/958056 |
Document ID | / |
Family ID | 44983434 |
Filed Date | 2013-11-28 |
United States Patent
Application |
20130317300 |
Kind Code |
A1 |
Berci; George ; et
al. |
November 28, 2013 |
Simultaneous Display Video Laryngoscope And Video Stylet
Abstract
A video intubation system that provides for multiple image
streams to be simultaneously presented to a user on a touch screen
display, the first image stream generated by a video laryngoscope
and the second image stream generated by a video stylet. The video
stylet is provided with a deflection section for ease of
introducing an ETT into the trachea of a patient, the video stylet
having a pistol-type grip and a control interface in the form of a
trigger-type lever to facilitate comfortable griping and
manipulation by the user. The first and second image streams may be
saved and annotated by a user as desired.
Inventors: |
Berci; George; (Los Angeles,
CA) ; Barry; James P.; (Charlton, MA) ;
Elliott, JR.; John J.; (Ashburnham, MA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Berci; George
Barry; James P.
Elliott, JR.; John J. |
Los Angeles
Charlton
Ashburnham |
CA
MA
MA |
US
US
US |
|
|
Family ID: |
44983434 |
Appl. No.: |
13/958056 |
Filed: |
August 2, 2013 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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12889095 |
Sep 23, 2010 |
|
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13958056 |
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Current U.S.
Class: |
600/188 |
Current CPC
Class: |
A61B 1/2676 20130101;
A61B 1/06 20130101; A61B 1/267 20130101; A61B 1/0005 20130101; A61B
1/00082 20130101; A61B 1/04 20130101; A61B 1/042 20130101; A61B
1/0051 20130101; A61B 1/00052 20130101 |
Class at
Publication: |
600/188 |
International
Class: |
A61B 1/267 20060101
A61B001/267; A61B 1/04 20060101 A61B001/04; A61B 1/06 20060101
A61B001/06 |
Claims
1. A video intubation system comprising: a video laryngoscope
having a video laryngoscope imager generating laryngoscope image
data; a video stylet having: a housing having a distal and a
proximal end, said housing comprising a control interface; a shaft
including a distal and a proximal end, the proximal end of the
shaft coupled to the distal end of said housing and the distal end
of said shaft comprising a deflectable section; wherein deflection
of the deflectable section is controlled by the control interface;
an illumination source generating illuminating light for
illuminating an area ahead of the distal end said shaft; a video
stylet imager generating video stylet image data of an area ahead
of the distal end of said shaft; a video stylet storage having use
or maintenance data saved thereon; a control unit detachably
coupled to said video laryngoscope and said video stylet, said
control unit receiving the laryngoscope image data and the video
stylet image data; an image storage accessible by said control unit
where both the laryngoscope image data and the video stylet image
data are stored on said image storage; and a touch screen display
detachably coupled to said control unit and receiving the video
stylet image data and the laryngoscope image data; wherein both the
video stylet image data and the laryngoscope image data are
simultaneously displayed on said touch screen display.
2. The video intubation system according to claim 1 wherein the
image data generated by said video stylet imager is wirelessly
transmitted to said control unit.
3. The video intubation system according to claim 2 wherein said
illumination source is positioned in said housing.
4. The video intubation system according to claim 3 further
comprising a battery providing electrical power to said video
stylet imager and to said illumination source.
5. The video intubation system according to claim 2 wherein when
said video stylet is brought within a predefined radius of said
control unit, said video stylet automatically wirelessly connects
with said control unit.
6. The video intubation system according to claim 1 wherein said
video stylet storage includes video stylet information such that
when said video stylet is coupled to said control unit, said
control unit automatically identifies the video stylet and adjusts
operational settings to function with the identified video
stylet.
7. The video intubation system according to claim 6 wherein said
control unit sends updated use and/or maintenance data to said
video stylet, which is stored on said video stylet storage.
8. The video intubation system according to claim 1 further
comprising an interface on said touch screen display, wherein at
least one of the laryngoscope data or the video stylet data is
annotated.
9. The video intubation system according to claim 8 wherein the
annotation is selected from the group consisting of: text, audio,
symbols, marking, highlighting, tagging and/or combinations
thereof.
10. The video intubation system according to claim 1 wherein said
control unit is coupled to a network and said video intubation
system further comprises a remote storage, wherein the video
laryngoscope data and/or the video stylet image data is transmitted
via said network and saved on said remote storage.
11. The video intubation system according to claim 1 wherein said
control interface comprises a trigger hand grip comprising a closed
loop.
12. The video intubation system according to claim 1 wherein said
touch screen display presents the video stylet image data in a
first frame and the laryngoscope image data in a second frame, and
the size of each frame is adjustable.
13. The video intubation system according to claim 12 wherein the
first frame and the second frame are repositionable on the touch
screen display such that either frame may be positioned in a manner
to overlap the other.
14. The video intubation system according to claim 13 wherein said
frames are adjustable by touching the frames on the touch screen
display and dragging the frames to a desired location.
15. The video intubation system according to claim 1 wherein
control commands for controlling said video stylet are entered by
activating said touch screen display.
16. The video intubation system according to claim 15 wherein
control commands for controlling said video laryngoscope are
entered by activating said touch screen display.
17. The video intubation system according to claim 1 wherein the
laryngoscope image data and the video stylet image data are stored
on said image storage as combined image data.
18. The video intubation system according to claim 17 further
comprising an interface on said touch screen display, wherein the
combined image data is annotated.
19. The video intubation system according to claim 18 wherein the
annotation is selected from the group consisting of: text, audio,
symbols, marking, highlighting, tagging and/or combinations
thereof.
20. The video intubation system according to claim 1 wherein said
shaft is apportioned into a first section located at the proximal
end of said shaft, the first section comprising a rigid material, a
second section comprising a semi-rigid material, and a third
section located at the distal end of said shaft, the third section
comprising a deflectable section, where the second section is
positioned between the first and the third sections.
21. The video intubation system according to claim 20 wherein when
the semi-rigid material is bent into a particular shape, the
semi-rigid material will maintain the particular shape when
inserted into an Endotracheal Tube (ETT).
22. A video intubation system comprising: a video laryngoscope
having a video laryngoscope imager generating laryngoscope image
data; a video stylet having: a housing having a distal and a
proximal end, said housing comprising a control interface; a shaft
including a distal and a proximal end, the proximal end of the
shaft coupled to the distal end of said housing, said shaft
apportioned into a first section located at the proximal end of
said shaft, the first section comprising a rigid material, a second
section comprising a semi-rigid material, and a third section
located at the distal end of said shaft, the third section
comprising a deflectable section, where the second section is
positioned between the first and the third sections; wherein
deflection of the deflectable section is controlled by the control
interface; an illumination source generating illuminating light for
illuminating an area ahead of the distal end said shaft; a video
stylet imager generating video stylet image data of an area ahead
of the distal end of said shaft; a control unit detachably coupled
to said video laryngoscope and said video stylet, said control unit
receiving the laryngoscope image data and the video stylet image
data; an image storage accessible by said control unit where both
the laryngoscope image data and the video stylet image data are
stored on said image storage; and a touch screen display detachably
coupled to said control unit and receiving the video stylet image
data and the laryngoscope image data.
23. The video intubation system according to claim 22 wherein both
the video stylet image data and the laryngoscope image data are
simultaneously displayed on said touch screen display.
24. The video intubation system according to claim 22 further
comprising a video stylet storage having use or maintenance data
saved thereon.
25. The video intubation system according to claim 24 wherein said
video stylet storage includes video stylet information such that
when said video stylet is coupled to said control unit, said
control unit automatically identifies the video stylet and adjusts
operational settings to function with the identified video
stylet.
26. The video intubation system according to claim 25 wherein said
control unit sends updated use and/or maintenance data to said
video stylet, which is stored on said video stylet storage.
27. The video intubation system according to claim 22 further
comprising an interface on said touch screen display, wherein at
least one of the laryngoscope data or the video stylet data is
annotated.
28. The video intubation system according to claim 22 wherein said
control interface comprises a trigger hand grip comprising a closed
loop.
29. The video intubation system according to claim 22 wherein said
touch screen display presents the video stylet image data in a
first frame and the laryngoscope image data in a second frame, and
the size of each frame is adjustable.
30. The video intubation system according to claim 22 wherein
control commands for controlling said video stylet are entered by
activating said touch screen display.
31. The video intubation system according to claim 22 wherein the
laryngoscope image data and the video stylet image data are stored
on said image storage as combined image data.
32. The video intubation system according to claim 31 further
comprising an interface on said touch screen display, wherein the
combined image data is annotated.
33. The video intubation system according to claim 22 wherein when
the semi-rigid material is bent into a particular shape, the
semi-rigid material will maintain the particular shape when
inserted into an Endotracheal Tube (ETT).
Description
FIELD OF THE INVENTION
[0001] The invention relates to a video laryngoscope and video
stylet that may be directed by a user, and more specifically, to a
combination video laryngoscope and video stylet where the video
laryngoscope and video stylet each generate a video image stream,
which is displayed on a touch screen display.
BACKGROUND OF THE INVENTION
[0002] During a medical procedure that requires the patient to be
anesthetized, the patient's breathing functions are temporarily
disabled. Ventilation is supplied to the patient through an
endotracheal tube. This tube is inserted into the trachea, and is
typically closed against the wall of the trachea by an inflatable
cuff. However, the insertion of the tube involves risks, such as,
damage to the vocal cords and a prolonged intubation procedure in
which the patients breathing is stopped but oxygen is not yet
delivered to the patient as the tube has not yet been inserted. It
is estimated that about one third of deaths occurring during a
surgical procedure while under anesthesia for morbidly obese
patients are associated with the intubation process.
[0003] Some of the difficulties the user encounters include: the
restriction of view as the tube is inserted, variations in the
anatomy of the patients, an uncomfortable and unnatural position
for the anesthesiologist while holding the instrument and the
necessity for rapid intubation.
[0004] With the advent of video laryngoscopes and cameras,
instrumentation has been improved to the extent that it can enable
viewing of the cords and larynx on a video screen thereby
facilitating the intubation of the patient in a relatively quick
and safe manner. For example, U.S. Pat. Nos. 6,890,298, 6,875,169
and 7,044,909 are variously directed toward video imaging systems.
However, typically the view provided by the equipment has been
limited requiring more time for the user to intubate the
patient.
[0005] For example, video laryngoscopes have been used to help
facilitate the intubation of a patient. Video laryngoscopes
typically contain a light guiding system, usually in the form of
fiber optic cables, in order to bring light to the surgical area.
Video laryngoscopes also typically contain an image guiding system,
for example in the form of a rigid rod lens system, arranged in the
blade of the laryngoscope, or in the form of an ordered, flexible
fiber optic bundle. In these configurations, the image guiding
system is utilized to transmit reflected light from the area ahead
of the blade to a camera, which may be attached to the
laryngoscope. Alternatively, it is known to affix an imager, which
may comprise, for example, a Charge Couple Device (CCD), or
Complementary Metal Oxide Semiconductor (CMOS) to the distal end of
the laryngoscope blade. In this case, the image data may be
transmitted to the camera affixed to the laryngoscope via
electrical wires (or wirelessly) as digital image data.
[0006] While this configuration for a video laryngoscope does
provide a user very useful information in the form of image data, a
major problem with current systems is the limited field of view.
For example, when the user is intubating the patient, the imaging
device, typically positioned on the underside and distal end of the
laryngoscope blade, only provides a view of the, roughly,
two-thirds of the configuration of the anatomy (depending on the
patient it could be more or less) with the lower one-third not
visible to the user. This is because the laryngoscope is only
advanced into the throat of the patient far enough to lift the
tongue (the upper anatomy part of the epiglottis and the vocal
cords) and facilitate the introduction of the Endotracheal Tube
("ETT", and which typically comprises a flexible plastic) into the
trachea.
[0007] A malleable aluminum stylet is an accessory used with the
ETT (typically inserted into the tube) to provide the tube with
additional rigidity for the intubation process. The anatomy of
patients often requires that the tip of the ETT to have a sharper
bend and be partially more rigid so as to introduce it through the
vocal cords, which are located toward an anterior (at the 12
o'clock) position. The stylet, which may comprise a malleable
aluminum rod covered with a plastic material (disposable) is slid
inside the ETT and is used to increase the bend of the tip of the
ETT and form the proper angulation for the particular patient.
After intubation, the stylet is removed and the ETT remains in
place.
[0008] So, a major problem with current systems is two-fold, 1) if
the stylet is not provided with the proper angulation or bend
radius prior to insertion of the ETT, the user must remove the ETT
and bend the stylet to match the patient's particular anatomy
(which takes additional time and is highly undesirable); and 2) as
the ETT (and stylet) is advanced through the vocal cords, the view
in front of the ETT blocked by the stylet and ETT.
[0009] While current systems do provide a view from the bottom of
the laryngoscope blade, this view is limited to the upper portion
of the patient's anatomy.
[0010] Still another problem with current systems is that there is
no provision for allowing a physician to save the video data or to
provide any type of annotation to the video data.
SUMMARY OF THE INVENTION
[0011] It is therefore desired to provide an improved video
laryngoscope system that provides the user with a greater field of
view.
[0012] It is also desired to provide an improved video laryngoscope
system that allows the user to see virtually all of the larynx and
the trachea as the ETT is advanced.
[0013] It is further desired to provide an improved video
laryngoscope system that facilitates a quicker intubation and
reduces the probably of injuring the patient.
[0014] It is still further desired to provide an improved video
laryngoscope system that is relatively comfortable for the user to
grip.
[0015] It is also desired to provide an improved video laryngoscope
system that provides enhanced control to the user for the
intubation process.
[0016] It is yet further desired to provide an improved video
laryngoscope system that allows for video data to be saved, and to
allow a user to annotate the video data.
[0017] These and other objectives are achieved by the provision of
a video laryngoscope system that provides a split image
simultaneously to a user, such that, the user is provided with a
greater field of view.
[0018] The video laryngoscope system may include a video
laryngoscope having an imaging device positioned at a distal end of
the blade and a flexible stylet having an imaging device positioned
at a distal end of the stylet. The two imaging devices provide two
different views of the patient's anatomy during the intubation
process. These two image streams may then be presented to the user
on a touch screen display. This provides the advantage that the
user is presented with a view of the upper portion of the patient's
anatomy via the laryngoscope as well as being presented with a view
in front of the video stylet as the stylet is advanced through the
trachea.
[0019] It is contemplated that the video stylet may be provided as
a flexible member that allows the user to actuate the tip allowing
the tip to deflect to the proper angulation or bend radius for the
patient's particular anatomy. This provides the further benefit
that the video stylet does not need to be removed from the trachea
in order for the user to alter the angulation of the tip, thereby
reducing the time needed to complete the intubation process. As one
example, the tip is deflectable by mechanical actuation where the
user need only pull a lever of the grip handle to deflect the tip.
As another example, the video stylet is provided having a
pistol-type grip with a trigger-type lever having a loop that a
user may insert a finger into, thereby facilitating easy gripping
and manipulation by the user in the event the user needs to rotate
the device during intubation. Still further, the shaft of the video
stylet may be apportioned into three different sections, the first
section comprising a substantially rigid material that maintains a
pre-formed shape; the second section comprising a semi-rigid or
deformable material that allows a user to bend the shape of this
portion of the shaft as desired, however, this section of the shaft
is rigid enough to maintain the shape once bent; and the third
section comprises the deflectable section as described above.
[0020] The video stylet may also be provided with a camera that is
detachably connected to a proximal end of the video stylet. The
camera may be provided with image processing circuitry and may
receive image data from the imaging device on the distal end of the
video stylet. As an alternative example, the video stylet is
provided with fiber optical cables running along a longitudinal
length of the video stylet such that light from the area ahead of
the distal end of the video stylet is picked up and transmitted to
the camera, which in turn, processed the received light into image
data. As yet another example, a light source, for example, an Light
Emitting Diode (LED) is positioned at the distal end of the video
stylet (either in the detachable camera or in the video stylet
itself), for generating illuminating light. The illuminating light
is transmitted through the video stylet via illumination cable
(fiber optic cables) to an area ahead of the distal end of the
video stylet.
[0021] The video stylet may further be provided as either a wired
or wireless device. For example, the device may include a power
cable for providing electrical power to the electronics and
illuminating device, or electrical power may be provided via
battery power (such as a rechargeable battery). Still further, it
is contemplated that the video stylet may be wirelessly powered via
resonant coupling as disclosed in previous U.S. Patent Application
Publication No. 2010/0179384 A1. Likewise, the image data generated
by the imaging device may be coupled to a control unit or a
directly to a display via a cable (e.g., a digital cable
connection) or may be wirelessly transmitted to the control unit or
directly to the display. It is also contemplated that the control
unit may comprise a configurable control unit, such that, upon
connection of the video stylet with the control unit, the control
unit automatically identifies the particular video stylet and/or
associated camera and configures itself to properly function with
the video stylet to, for example, process image data from, and
receive/send control and/or command signals with the particular
video stylet. In this particular example, the video stylet and/or
the detachable camera may comprise storage having video stylet
and/or camera information identifying the type of video stylet
and/or camera. Still further, the storage may comprise video stylet
and/or camera use and maintenance data, which may be updated as the
video stylet and/or camera are used. Additionally, all of the image
data, control/command, maintenance and/or use data may be
transmitted and stored over a network connection.
[0022] It is contemplated that the video laryngoscope may be
provided with similar functionality as discussed in connection with
the video stylet except that the laryngoscope imaging device is
positioned typically at a distal end of the blade coupled to the
laryngoscope handle. The laryngoscope may further be provided with,
for example, a Macintosh-type of blade, which may detachably
connected with the handle of the laryngoscope. The handle of the
laryngoscope may also be provided with a piston-type grip
facilitating ease of gripping for the user.
[0023] By the provision of both the video laryngoscope and video
stylet working on conjunction with each other, the user is able to
obtain a full view of both the upper and lower portions (shown
simultaneously on a display(s)) of the patient's anatomy during the
intubation process, which provides for a safer and quicker
intubation process.
[0024] For this application the following terms and definitions
shall apply:
[0025] The term "data" as used herein means any indicia, signals,
marks, symbols, domains, symbol sets, representations, and any
other physical form or forms representing information, whether
permanent or temporary, whether visible, audible, acoustic,
electric, magnetic, electromagnetic or otherwise manifested. The
term "data" as used to represent predetermined information in one
physical form shall be deemed to encompass any and all
representations of the same predetermined information in a
different physical form or forms.
[0026] The term "network" as used herein includes both networks and
internetworks of all kinds, including the Internet, and is not
limited to any particular network or inter-network.
[0027] The terms "first", "second" and "third", etc. are used to
distinguish one section, element, set, data, object or thing from
another, and are not necessarily provided to limit relative
position or arrangement in time.
[0028] The terms "coupled", "coupled to", "coupled with",
"connected", "connected to", and "connected with" as used herein
each mean a relationship between or among two or more devices,
apparatus, files, programs, media, components, networks, systems,
subsystems, and/or means, constituting any one or more of (a) a
connection, whether direct or through one or more other devices,
apparatus, files, programs, media, components, networks, systems,
subsystems, or means, (b) a communications relationship, whether
direct or through one or more other devices, apparatus, files,
programs, media, components, networks, systems, subsystems, or
means, and/or (c) a functional relationship in which the operation
of any one or more devices, apparatus, files, programs, media,
components, networks, systems, subsystems, or means depends, in
whole or in part, on the operation of any one or more others
thereof.
[0029] The terms "process" and "processing" as used herein each
mean an action or a series of actions including, for example, but
not limited to: the continuous or non-continuous, synchronous or
asynchronous; direction of data; modification of data; formatting
and/or conversion of data; tagging or annotation of data;
measurement, comparison and/or review of data; and may or may not
comprise a program.
[0030] As one example, a video intubation system includes a video
stylet for inserting into an ETT and a video laryngoscope having a
laryngoscope imager generating image data is provided, where the
video stylet comprises a housing having a distal and a proximal
end, the housing comprising a pistol-type grip and a control
interface. The video stylet also includes a shaft including a
distal and a proximal end, the proximal end of the shaft coupled to
the distal end of the housing and the distal end of the shaft
comprising a deflectable section, where deflection of the
deflectable section is controlled by the control interface. The
video stylet further includes an illumination source generating
illuminating light for illuminating an area ahead of the distal end
the shaft and a video stylet imager positioned in the deflectable
section of the shaft, the video stylet imager generating image data
of an area ahead of the distal end the shaft. The video stylet
still further includes a video stylet camera coupled to the
housing, the video stylet camera receiving the image data, and a
display coupled to the camera and to the laryngoscope imager, the
display receiving both the image data from the video stylet imager
and the laryngoscope imager. The video intubation system is
provided such that both the image data generated by said video
stylet imager and the image data generated by the laryngoscope
imager are simultaneously displayed.
[0031] As another example, a video intubation system is provided
comprising a video laryngoscope having a video laryngoscope imager
generating laryngoscope image data and a video stylet. The video
stylet is provided having a housing having a distal and a proximal
end, the housing comprising a control interface, and a shaft
including a distal and a proximal end, the proximal end of the
shaft coupled to the distal end of the housing and the distal end
of the shaft comprising a deflectable section where deflection of
the deflectable section is controlled by the control interface. The
video stylet further includes an illumination source generating
illuminating light for illuminating an area ahead of the distal end
the shaft, a video stylet imager generating video stylet image data
of an area ahead of the distal end the shaft, and a video stylet
storage having use or maintenance data saved thereon. The video
intubation system further comprises a control unit detachably
coupled to the video laryngoscope and the video stylet, the control
unit receiving the laryngoscope image data and the video stylet
image data, an image storage accessible by the control unit where
both the laryngoscope image data and the video stylet image data
are stored on the image storage, and a touch screen display
detachably coupled to the control unit and receiving the video
stylet image data and the laryngoscope image data. The video
intubation system is provided such that both the video stylet image
data and the laryngoscope image data are simultaneously displayed
on the touch screen display.
[0032] As still another example, a video intubation system is
provided comprising a video laryngoscope having a video
laryngoscope imager generating laryngoscope image data and a video
stylet. The video stylet is provided with a housing having a distal
and a proximal end, the housing comprising a control interface, and
a shaft including a distal and a proximal end, the proximal end of
the shaft coupled to the distal end of the housing, the shaft
apportioned into a first section located at the proximal end of the
shaft, the first section comprising a rigid material, a second
section comprising a semi-rigid material, and a third section
located at the distal end of the shaft, the third section
comprising a deflectable section, where the second section is
positioned between the first and the third sections. The video
stylet is provided such that deflection of the deflectable section
is controlled by the control interface. The video stylet is also
provided with an illumination source generating illuminating light
for illuminating an area ahead of the distal end the shaft and a
video stylet imager generating video stylet image data of an area
ahead of the distal end of the shaft. The video intubation system
further comprises a control unit detachably coupled to the video
laryngoscope and the video stylet, the control unit receiving the
laryngoscope image data and the video stylet image data. The video
intubation system still further comprises an image storage
accessible by the control unit where both the laryngoscope image
data and the video stylet image data are stored on the image
storage and a touch screen display detachably coupled to the
control unit and receiving the video stylet image data and the
laryngoscope image data.
[0033] Other objects of the invention and its particular features
and advantages will become more apparent from consideration of the
following drawings and accompanying detailed description.
BRIEF DESCRIPTION OF THE DRAWINGS
[0034] FIG. 1 is an illustration of a stylet and ETT as is known in
the prior art.
[0035] FIG. 2 is an illustration of the stylet inserted into the
ETT according to FIG. 1.
[0036] FIG. 3 is an illustration of the video stylet according to
one advantageous embodiment of the present invention.
[0037] FIG. 3A is an illustration of the video style according to
FIG. 3.
[0038] FIG. 4 is an illustration of the video stylet with the
camera detached from the video stylet.
[0039] FIG. 5 is an illustration of the video stylet inserted into
an ETT according to FIG. 3.
[0040] FIG. 6 is a block diagram of the video stylet according to
FIG. 3.
[0041] FIG. 7 is an illustration of the video stylet according to
FIG. 3.
[0042] FIG. 8 is an illustration of a video intubation system
including the video stylet according to FIG. 3 and a video
laryngoscope providing simultaneous images on a display(s).
[0043] FIG. 9 is an illustration of the video intubation system
according to FIG. 6.
DETAILED DESCRIPTION OF THE INVENTION
[0044] Referring now to the drawings, wherein like reference
numerals designate corresponding structure throughout the
views.
[0045] FIGS. 1 and 2 illustrate a stylet 10 and ETT 100, as is
known in the prior art. As previously discussed, to intubate a
patient, it is known to use a stylet 10, which is typically
inserted into the ETT 100 as illustrated in FIG. 2, for
introduction into the trachea. Stylet 10 typically comprises a
malleable aluminum rod with a plastic cover.
[0046] The ETT typically comprises a plastic material with a distal
end 102 with an inflatable cuff 104 positioned near distal end 102.
Once the ETT has been inserted into the patient's trachea, the
inflatable cuff 104 can be expanded to form a seal around the ETT
and the inner surface of the treacha. The stylet 10 may be
withdrawn and the ETT connected to a machine to facilitate
breathing for the patient.
[0047] FIG. 3 is an illustration of one advantageous embodiment of
the video stylet 200. The video stylet 200 includes a housing 202
having a handle 204, which in this illustration, is provided in the
form of a pistol-type grip with a control interface 206. In this
particular embodiment, the control interface 206 is provided in the
form of a trigger-type lever having a closed loop 208 into which a
user may insert a finger.
[0048] The video stylet 200 also includes a shaft 210 coupled at
one end to the housing 202. Shaft 210 further includes a
deflectable section 212 located at a distal end 214 of shaft 210.
Actuation of control interface 206 allows a user to actuate
deflectable section 212 as indicated by the arrows in FIG. 3.
[0049] The shaft 210 comprises a proximal end connected to housing
202. As illustrated in FIG. 3A, the shaft 210 may be partitioned
into three sections, a first section extending from the proximal
end (connected to housing 202) to an intermediate point along the
shaft length (e.g., to the point where the shaft enters the ETT
100). The first section of shaft 210 can be provided as a rigid
portion that is substantially inflexible.
[0050] The shaft 210 may further comprise a second section
extending from the termination point of the first section to the
beginning of the deflectable section 212. This second section of
shaft 210 may be provided as semi-rigid comprising a deformable
material, meaning that the shaft may be bent and will maintain the
shape such that when inserted into the ETT 100 the ETT 100 will
conform to the shape of the deformed shaft 210 for intubation
purposes. In this manner, the shaft 210 can be shaped as desired to
accommodate the anatomy of the particular patient.
[0051] The shaft 210 also includes a third section, which comprises
deflectable section 212. Deflectable section 212 is controlled via
control interface 206 such that the tip of deflectable section 212
may be deflected in at least one plane proportional to the
actuation of the trigger 208.
[0052] While the three sections (first--rigid; second--semi-rigid;
and third--deflectable) have been described in connection with
FIGS. 3-5, which illustrate estimated proportions, it should be
understood that virtually any proportions could be used. For
example, the shaft could essentially be apportioned 50/50 between
rigid and semi-rigid sections with the small deflectable section
provided at the end of the semi-rigid section. Alternatively, the
first and section sections could be apportioned as 30/70 or 40/60,
etc. The apportioning of the first and second sections can take
virtually any proportion. Likewise, while the deflectable section
212 is illustrated as comprising a relatively small apportionment
of the overall shaft 210 length, it is understood that the
deflectable section 212 could be provided as a longer section
(relative to the entire shaft length) or a shorter section. The
various proportions of the three sections will typically be
adjusted depending upon the application for the video stylet (e.g.,
larger stylet for use in intubating adult patients as opposed to a
small stylet for use in intubating children, and a very small
stylet for use in intubating infants).
[0053] Camera 218 may be provided detachably coupled (FIG. 4) to
housing 202 such that different cameras (218, 218' . . . 218.sup.n)
may be attached to housing 202. In the advantageous embodiment
illustrated in FIG. 3, camera 218 is provided with multiple
channels for transmitting power and information. For example, it is
contemplated that illuminating light may be provided via an optical
channel 222 (which may comprise fiber optic cables), while image
data may be transmitted from camera 218 via data channel 220 (which
may comprise two or more copper wires). While optical channel 222
and data channel 220 are illustrated as comprising two different
cables, it is understood that both may be consolidated as a single
cable surrounded by a protective jacketing (not shown).
Illuminating light will then be transmitted from camera 218 through
housing 202 and shaft 210 out the distal end 214 to illuminate the
area ahead of the shaft. Reflected light is then picked-up and
transmitted back to camera 218, which converts the received light
to image data. It is contemplated that the transmitted and received
light may be transmitted via coherent optical fibers.
[0054] In an alternative example, a video stylet imager 216 may be
located at the distal end 214 (see FIG. 7). Video stylet imager 216
is provided to convert received light into digital image data,
which in turn, is transmitted to housing 202 on onward to a display
(FIGS. 6 & 8). It is contemplated that video stylet imager 216
may comprise virtually any type of digital imaging device,
including, but not limited to, a CMOS device or a CCD.
[0055] As illustrated in FIG. 5, the video stylet 200 may be used
in conjunction with ETT 100. For example, shaft 210 may be inserted
into a proximal end 106 of ETT 100. The distal end 102 of ETT 100
may then be guided by a user controlling the movement of
deflectable section 212. This provides a distinct advantage over
the prior art stylet 10. For example, when a user intubates a
patient with stylet 10, the user must pre-bend the stylet 10
(typically made of a malleable alloy) to provide a particular bend
radius to distal end 102. However, because of various anatomical
anomalies and variations from patient to patient, if the bend
radius is not correct to guide the ETT/stylet through the patient's
anatomy (e.g., through the vocal cords and into the trachea so that
the cuff can then be inflated), the user will be required to remove
the ETT/stylet (100,10), adjust the bend of the distal end 12 of
stylet 10, and try to intubate the patient a second time. However,
with the video stylet 200, the user need only view the image data
being transmitted by the video stylet imager 216 and actuate the
control interface 206 to adjust the bend radius of distal end 102
to the desired angle for the particular patient without the need to
remove ETT 100. This results in a faster intubation with a lower
chance of causing injury to the patient during the intubation
process.
[0056] Referring now to FIGS. 6-9, FIG. 6 is a block diagram of a
video intubation system, and FIGS. 7-9 are illustrations of various
embodiments of the video stylet 200 used in conjunction with a
video laryngoscope 300. The video intubation system is illustrated
in these embodiments comprising the video stylet 200 with (or
without) detachable camera 218 coupled to housing 202. The camera
218 is shown (FIGS. 8 & 9) coupled to a control unit 226 via a
cable 224 (which may comprise, for example, optical channel 222 and
data channel 220; cable 224' for video laryngoscope 300).
Alternatively, it is understood that camera 218 may be wirelessly
coupled to control unit 226. Still further, the camera 218 may be
replaced by use of a video stylet imager 216, which may be
positioned at the distal end 214 of the shaft 210. In this
embodiment, image data is generated by the video stylet imager 216
and transmitted to the display.
[0057] Inside housing 202 video stylet electronics 228 is
illustrated. Video stylet electronics 228 is shown coupled to video
stylet imager 216 via an image data channel 230. An arrow is
provided to indicate that image data generated by video stylet
imager 216, may in this embodiment, be transmitted to video stylet
electronics 228. Video stylet electronics 228 may or may not be
utilized, and when utilized may comprise, but is not limited to,
processing circuitry, amplification circuitry, memory (e.g., cache
memory), etc. Also illustrated in housing 202 is storage 232, which
is provided as a memory to storage video stylet information,
including but not limited to, identification data, configuration
data, use data and maintenance data. Storage 232 may further be
provided to store image data as needed.
[0058] The image data may, in certain embodiments, be transmitted
from video stylet electronics 228 to camera electronics 234 (when
used), which may be provided to generate image data from the
received reflected light. Alternatively, the image data may be
generated by the video stylet imager 216 and received by video
stylet electronics 228 for transmission to the display. In various
advantageous embodiments, the generated/processed image data may be
transmitted to control unit 226 via cable 224 (or wirelessly). The
control unit may be used to further process the information (by
means of control unit electronics 236) and/or transmit the image
data to display 238 via connection 240. It should be noted that
cable 224 coupling camera 218 to control unit 226 is illustrated
with a two-way arrow, which is provided to indicate two-way
communication. For example, the video stylet 200 transmits video
stylet information, such as, for example,
identification/use/maintenance data to control unit 226. Control
unit 226 may then use this information to automatically configure
to function properly with video stylet 200. Additionally, command
and control data may be transmitted to video stylet 200 from
control unit 226, and image data is also transmitted from video
stylet 200 to control unit 226. It is contemplated that in one
example, an input device 242 (keyboard, mouse, track pad,
microphone, etc.) may be used by a user to provide input commands
for the system. It is further contemplated that rather than having
a separate input device 242 (optional), that display 238 may be
provided as a touch screen control device, which may be used to
display both image data and provide for control/command inputs. As
a touch screen display 238, both the video laryngoscope data and
the video stylet data may be simultaneously displayed on the touch
screen. It is understood that the user can provide control of both
the video laryngoscope 300 and the video stylet 200 by means of the
touch screen display 238. For example, the user could control the
brightness/color/pulsing/etc. of the illuminating light generated
by illumination sources; and/or the
saving/recording/routing/annotation/etc. of video data. It is
contemplated that the touch screen display 238 can provide the user
with complete control of the video instruments.
[0059] Also shown coupled to control unit 226 is a storage device
244, which is provided to store, for example, the received image
data. Storage device 244 may comprise virtually any type of digital
storage device and may be internal or external to control unit 226,
including a magnetic, high density hard drive, a writable medium
including a CD/DVD, or card inserted into the screen casing
including, for example, a removable drive, such as a thumb drive,
volatile or non-volatile memory, etc. It is further contemplated
that storage 244 may have saved thereon, configuration data for
configuration of control unit 226 so that control unit 226 may
properly process the received image data and control video stylet
200.
[0060] Control unit 226 is further shown coupled to computer 246
via a network connection 248. It is contemplated that network
connection 248 may comprise, for example, an Internet connection.
Computer 246 is further coupled to a remote storage 248, which may
comprise virtually any type of memory device as is described in
connection with storage 244. Additionally, virtually any type of
digital data may be saved on remote storage 248, such as, but not
limited to, configuration data, update information, image data,
etc.
[0061] An illumination source 250 is also shown in camera 218. It
should be noted that illumination source 250 may be positioned in
camera 218 (as illustrated), or in housing 202 or be positioned in
control unit 226 (indicated as illumination source 250'). In the
case where illumination source 250 is positioned in either camera
218 or housing 202, cable 224 would then only comprise a digital
transmission cable for transmitting image data, control/command
data, update, use, maintenance data, etc. However, in the
embodiment where the illumination source 250' is positioned in
control unit 226, cable 224 would then be provided with a fiber
optic channel for transmission of illuminating light from
illumination source 250' to video stylet 200. In either case,
illuminating light is transmitted via illuminating light channel
252.
[0062] Also illustrated in FIGS. 6, 8 and 9 is video laryngoscope
300, which is provided with a housing 302, a blade 304 coupled to
housing 302 and a camera 306 (if necessary) coupled to housing 302.
The blade 304 may be provided with a laryngoscope imager 308, which
may comprise, for example, a CCD and/or CMOS device. Laryngoscope
imager 308 may, in one advantageous embodiment, be positioned on an
underside of blade 304 and generates image data, which is
transmitted to camera 306. Alternatively, a camera 306 may be used
to generate the image data. If camera 306 is used, it may then be
coupled to control unit 226, otherwise, the image data generated by
the laryngoscope imager 308 may be transmitted to control unit 226.
It is contemplated that control unit 226 may identify laryngoscope
300 upon connection and automatically configure itself based on the
identification. Once configured, control unit is able to properly
process the received image data from laryngoscope 300. It should be
noted that, like video stylet 200, the connection between video
laryngoscope 300 and control unit 226 may be either wired or
wireless. Additionally, it is understood that control unit 226 need
not be used, rather, the image data may be transmitted directly to
the display.
[0063] The video laryngoscope 300 has similar functionality as
video stylet 200, and therefore the various functions and features
of video laryngoscope 300 will not be reiterated.
[0064] Display 238 is illustrated comprising a display having a
split frame (Frame 1 and Frame 2; FIGS. 6 and 8). It should be
understood that control unit receives first image data from video
stylet 200 and second image data from video laryngoscope 300. These
two video streams may be combined into one digital video stream
(e.g., may be multiplexed) that is transmitted to display 238 and
presented as a split-screen display (e.g., simultaneous
presentation of video stylet image data stream in Frame 1 and video
laryngoscope image data stream in Frame 2). As a touch screen
display, display 238 further allows the user to configure the
Frames in virtually any manner desired. For example, the relative
sizes of the Frames can be controlled by the user manually dragging
on the corner of one of the Frames to increase/decrease the size of
the Frame. Likewise, the various positioning of the Frames is
controllable, where the user need only drag the Frame to a location
on the touch screen as desired. As an example, the Frames could be
positioned side-by-side, or one Frame could overlap the other Frame
with the user being able to select which Frame will be pulled
forward or sent backward relative to the other Frame. It could be
the user desires to size and position the Frames in a manner that
will not over lay particular touch screen control interface icons,
or event to send the Frames into the background relative to
selected icons such that activation of selected icons in the
foreground will not impact the video streams displayed in the
background. The idea is to provide maximum flexibility to the user
to configure the touch screen display as desired.
[0065] FIG. 9 is an illustration of both video stylet 200 and video
laryngoscope 200 each generating and transmitting image data. It
should be understood that the video intubating laryngoscope is used
to elevate the tongue and displays the majority of the view of the
epiglottis and upper part of the vocal cords. The video stylet,
which is introduced below the tongue and the tip directed from the
pistol grip simultaneously with the video laryngoscope, displays
the lower part of the larynx and clearly shows the introduction
into the trachea and displays the proper position of the ETT in
relation to the bifurcation (not seen by the blind introduction of
the ETT with a standard stylet). Both images can be simultaneously
observed, for example, on the split screen.
[0066] Although the invention has been described with reference to
a particular arrangement of parts, features and the like, these are
not intended to exhaust all possible arrangements or features, and
indeed many other modifications and variations will be
ascertainable to those of skill in the art.
* * * * *