U.S. patent number 3,754,554 [Application Number 05/227,734] was granted by the patent office on 1973-08-28 for endotracheal tube means.
Invention is credited to Hector Felbarg.
United States Patent |
3,754,554 |
Felbarg |
August 28, 1973 |
ENDOTRACHEAL TUBE MEANS
Abstract
An endotracheal tube having a protrusion with small orifice at
its forward end. An introducer or guide rod extends through the
orifice to guide the tube between the vocal cords. The rod has a
stop to limit its protrusion from the tube. A handle is provided on
the rod to operate it.
Inventors: |
Felbarg; Hector (Huntington,
NY) |
Family
ID: |
22854246 |
Appl.
No.: |
05/227,734 |
Filed: |
February 22, 1972 |
Current U.S.
Class: |
128/200.26;
128/207.14; 606/108 |
Current CPC
Class: |
A61M
16/0488 (20130101); A61M 25/09 (20130101) |
Current International
Class: |
A61M
16/04 (20060101); A61m 025/00 () |
Field of
Search: |
;128/10,11,341,343,348,349R,35R,351 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Truluck; Dalton L.
Claims
I claim:
1. A modified endotracheal tube having a tip; said tube having two
orifices in its tip, said tip having a large beveled orifice for
the gas passage during ventilation and a small orifice located next
to and forwardly of said large orifice at the tip of a cone-like
shaped protrusion, an introducer plastic rod removably received
within said tube bore so that said rod distal end may extend
several inches from the end of said endotracheal tube, said small
orifice being designed to thread and support said introducer
snuggly, said small orifice having such dimensions as to allow easy
threading yet support said introducer.
2. Apparatus as in claim 1 having a rubber sleeve mounted on the
plastic rod, said sleeve extending distally up to the cone like
shaped distal end of the endotracheal tube working as a stop to
limit the protrusion of the introducer beyond the endotracheal tube
and also causing the endotracheal tube to follow the introducer
when said introducer is pushed forward into the trachea beyond the
vocal cords, said sleeve extending proximally up to the end of the
plastic rod working as a handle, said handle being made with the
purpose of providing an easy grip for the removal of said
introducer.
Description
This invention relates to endotracheal tube means and more
particularly to a novel version for cases in which the regular
tubes are difficult to insert between the vocal cords.
Endotracheal tubes are generally introduced through the nose or
mouth beyond the vocal cords and into the larynx and trachea. For
this purpose a laryngoscope is used.
Quite often this is readily accomplished by using an ordinary
endotracheal tube. In some cases, because of the patient having a
small mouth, protrudent teeth, large tongue, etc., the operation
may not be so easy and become difficult or impossible.
One of the difficulties in inserting the tube is that the tube is
of such caliber that blocks up all the available visual field or
lumen of the laryngoscope instrument and the leading end of the
tube cannot be seen nor the opening between the vocal cords. The
operation ends up being a blind or almost blind intubation of the
trachea. Tubes that are transparent, made up of clear plastic, do
not solve the problem.
The present invention provides means to be able to see the narrow
opening between the vocal cords without interference from the
endotracheal tube, comprising a introducer made up of a teflon rod
or other suitable material. Teflon is desirable because it has
adequate stiffness and yet will bend easily should it encounter
resistance to advance, does not stick to rubber or plastic
requiring little lubrication for removal. It can also be bent to a
desirable curvature according to the needs of the particular
case.
The introducer is inserted inside the endotracheal tube and it is
adjusted to extend forwardly beyond the distal end of the
endotracheal tube several inches so that it can be seen easily in
the laryngoscope field.
Even if only part of the opening between the cords are seen it is
readily easier to insert the introducer rather than the much more
larger endotracheal tube.
The introducer serves as a guide and the endotracheal tube will
follow easily once the introducer is advanced between the vocal
cords.
Accordingly, a principal object of the invention is to provide new
and improved guide means for inserting an endotracheal tube.
Another object of the invention is to provide new and improved
guide means for inserting an endoctracheal tube having a teflon
introducer extending through the tube and protruding from the
distal portion of the tube.
Another object of the invention is to provide new and improved
guide means for use in an endotracheal tube comprising an
introducer, said introducer being adapted to be inserted through
said tube and protrude from the distal end of said tube to permit
visual guiding of said tube when said tube is inserted between the
vocal cords and advanced into the trachea.
These and other objects of the invention will be apparent from the
following specification and drawings of which:
FIG. 1 is a side view of an endotracheal tube.
FIG. 1A is an end view of FIG. 1.
FIG. 2 is a side view of the guide means.
FIG. 3 is a side view of the endotracheal tube with the guide means
inserted.
FIGS. 4 -- 7 are diagrams illustrating the operation of the
invention.
Referring to the figures, FIG. 1, there is shown an endotracheal
tube 1 which comprises a tubular member of rubber, plastic or latex
with a continuous spiral of nylon embedded in the wall.
Referring to the distal end of the tube 1, it has a large opening
1' obtusely cut in bevel which provides for the passage of gas
during breathing and a small orifice 3 located at the tip of a
small protrusion 2, through which the introducer is to be
threaded.
Referring to FIG. 2, the introducer comprises a length of teflon
rod 4, approximately 2/16 inch thick which could be blue colored
for easy detection in the laryngoscope field over the generally
pink background of the pharynx. The teflon rod 4 is mounted in a
rubber sleeve 5, which at the upper end the introducer is ended in
a handle 6.
The sleeve 5, on rod 4, increases the caliber of the teflon rod and
by bearing against the orifice 3 limits the amount of protrusion of
rod 4 beyond the tip of the endotracheal tube.
Handle 6, is at the end of the same rubber sleeve 5, for easy
gripping and quick removal of the introducer from inside the
endotracheal tube. This is illustrated in FIG. 3 which shows the
complete assembly.
The teflon rod 4, passes through the hole 3, in the protrusion 2
and the handle 6 is shown before the fitting 1a at the upper or
proximal end of the tube 1. The introducer goes through orifice 3
somewhat tightly and a small amount of a wetting agent such as
diluted zephiran chloride secures enough lubrication for
removal.
In practice, referring to FIG. 4, the assembly as shown in FIG. 3
is inserted through the laryngoscope 8. First the opening between
the vocal cords 10 is located, and due to its small size the end 4'
of the introducer can be seen in the same visual field. This
greatly facilitates the introduction of the assembly between the
cords under direct vision.
The operator, whose eye is 5 in the diagram, holds the laryngoscope
8 with his left hand. The tube 1 assembly can be seen just about to
enter between the vocal cords 10. As can be seen, the opening is
very small and the natural tendency for the tube if not visually
guided will be to fall into the esophogus 9 which is a larger
cavity where the larynx 7 is located. The rest of the drawing shows
the trachea 12 and the lungs 13, 13'. This invention is not
intended for blind intubation. If the vocal cords cannot be seen a
regular tube would be better for blind attempts.
As the tube 1 assembly is advanced, FIG. 5, into the trachea, the
introducer 4, works as a guide. Once the tube is properly located,
the introducer is withdrawn completely from the tube 1, as shown in
FIG. 6, and the supply tube 14 for the anesthetic may be connected
to the fitting 1a, FIG. 7.
If this introducer is used with any of the presently available
endotracheal tubes the vocal cords will prevent the advance of the
endotracheal tube 1 as none of them have a distal end adapted to
thread and hold an introducer through and beyond the distal
end.
It can be seen that tube 1 and introducer 4 form a unit and they
adapt to each other especially at the distal end.
Once the introducer is beyond the vocal cords, by advancing the
assembly, tube 1 will gain its way in by riding over the cords by
virtue of a very smooth transition of the two components. The
conelike shape of the distal end of the tube allows for continuity
of the two components.
* * * * *