U.S. patent number 3,756,233 [Application Number 05/129,857] was granted by the patent office on 1973-09-04 for liquid administration apparatus.
Invention is credited to Michael Goldowsky.
United States Patent |
3,756,233 |
Goldowsky |
September 4, 1973 |
LIQUID ADMINISTRATION APPARATUS
Abstract
An administration set includes a narrow bore valveless metering
tube which leads from a liquid container to a vented drip chamber.
From the drip chamber, the liquid discharges through one end of an
infusion tube, the opposite end of which is adapted to infuse the
reservoir liquid into an independent liquid system, e.g. the
circulatory system of a patient. A container access cap having a
tubular spout through which the container liquid flows and a vented
sump into which the spout leads, maintains the effective elevation
of the liquid drawn from the bottle at a substantially constant
value. The drip chamber is mounted on a channel for vertical
movement with respect to the access cap. One end of the metering
tube drains the sump and the other forms the inner wall of a double
walled nozzle in the drip chamber. A float is provided as a flow
regulator in the chamber to automatically vary a constriction to
the liquid access to the infusion tube in response to variations in
system back pressure.
Inventors: |
Goldowsky; Michael
(Westchester, NY) |
Family
ID: |
22441939 |
Appl.
No.: |
05/129,857 |
Filed: |
March 31, 1971 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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85474 |
Oct 30, 1970 |
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Current U.S.
Class: |
604/254 |
Current CPC
Class: |
A61M
5/1411 (20130101) |
Current International
Class: |
A61M
5/14 (20060101); A61m 005/16 () |
Field of
Search: |
;128/213,214R,214C,214F,214.2,275,276 ;137/390,399 ;206/1A |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Other References
Lancet, Apr. 6, 1963, pp. 754-755..
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Primary Examiner: Truluck; Dalton L.
Parent Case Text
RELATED APPLICATION
This application is a continuation-in-part of my previous
application Ser. No. 85,474 filed Oct. 30, 1970.
Claims
Having thus described the invention, there is claimed as new and
desired to be secured by Letters Patent:
1. A calibrated administration set for the variable control of the
infusion flow of a liquid carried in a container over a range of
flow rates, including particularly low flow rates, into a separate
liquid system having a variable liquid back pressure, the
administration set comprising means adapted to form an access for
liquid flow from the container, the access means including means
maintaining a substantially constant effective elevational level of
container supply liquid at atmospheric pressure while liquid is
flowing from the container and actual liquid level in the container
decreases, flexible flow metering conduit means for transmitting
the liquid from the access means, one end of the flow metering
conduit means being in liquid communication with the access means,
means providing a discharge nozzle at the other end of the flow
metering conduit means, means atmospherically venting the nozzle,
the flow metering conduit means, the access means and the nozzle
forming an unconstricted valveless passageway for gravity liquid
flow from the substantially constant level of supply liquid located
in the access means, the primary factor of flow resistance in the
valveless passageway being provided solely by the flow metering
conduit means, flow regulating means for adjustably controlling the
rate of flow of liquid through the valveless passageway and
maintaining such flow at a predetermined valve without sub-stantial
fluctuations, the flow regulating means consisting of means
adjustably fixing the nozzle end of the flow metering conduit means
at a specific elevation with respect to the elevational level of
supply liquid at atmospheric pressure to thereby maintain the
effective head of liquid at the nozzle at a fixed desired value,
the means adjustably fixing the nozzle end including means
receiving the nozzle end of the flow metering conduit means,
support means, means maintaining the support means fixed with
respect to the elevational level of supply liquid at atmospheric
pressure and means selectively permitting and preventing relative
movement between the support means and the receiving means, the
liquid flowing through the conduit means at a rate adjustably
controlled solely by the effective head of liquid at the nozzle,
and infusion means for infusing the liquid discharged from the
nozzle into the system at the same flow rate as the liquid is
flowing through the conduit means regardless of changes in system
back pressure whereby the desired liquid flow rate may be
adjustably set and accurately maintained over extended time
durations.
2. An administration set constructed in accordance with claim 1
wherein the means selectively permitting and preventing relative
movement between the support means and the receiving means includes
means slidably interconnecting the receiving means and the support
means.
3. An administration set constructed in accordance with claim 2
wherein the support means includes a slotted channel extending
downwardly from the access means, the receiving means being movable
along a fixed path registered with the slot.
4. An administration set constructed in accordance with claim 1
wherein the unconstricted valveless passageway includes a flow path
of transverse cross sectional area at least as great as the
transverse cross sectional area of the flow metering conduit
means.
5. An administration set constructed in accordance with claim 1
wherein the means maintaining the effective level of liquid
includes means forming a liquid spout for liquid communication with
the liquid in the container, means forming a sump beneath the
spout, the spout extending into the sump, means atmospherically
venting the sump, the flow metering conduit means being in liquid
communication with the sump for drawing from the liquid collected
in the sump, the spout having a discharge opening positioned within
the sump, at least a portion of said discharge opening extending in
a plane angularly oriented with respect to the plane of the liquid
level within the sump, the liquid meniscus easily breaking at the
highest elevation of the spout opening to permit the entrance of
air into the container and the discharge of additional liquid
through the spout to replenish the sump, whereby the effective
atmospheric level of liquid drawn from the container is
substantially maintained at the highest elevation of the spout
discharge opening.
6. An administration set constructed in accordance with claim 1
wherein the infusion means includes a cylindrical drip chamber, the
means atmospherically venting the nozzle including means venting
the chamber, means forming an outlet orifice in the chamber, said
outlet orifice being positioned at the bottom of the chamber, a
flow regulating valve positioned within the chamber, the valve
including a cylindrical body of smaller diameter than the chamber
and a dependent valve stem, the valve having a specific gravity
such that it is buoyant in the supply liquid, the valve stem being
generally aligned with the outlet orifice, and a quantity of supply
liquid collecting in the chamber and lifting the valve body to
permit liquid flow through the outlet orifice and into the separate
liquid system, the valve body lowering to constrict the outlet
orifice upon a decrease in the back pressure of the separate liquid
system and rising from the outlet orifice upon an increase in said
system back pressure to thereby maintain a constant infusion of
flow.
7. An administration set constructed in accordance with claim 1
wherein the nozzle includes a downwardly extending hollow
protuberance having an open bottom, a substantially cylindrical
shell positioned about the protuberance, the shell having inner
dimensions larger than the outer dimensions of the protuberance and
thereby providing a span between the shell and the protuberance,
the shell extending downwrdly to an open bottom, the shell open
bottom being at an elevation lower than the bottom of the
protuberance, the means venting the nozzle including means forming
a vent passage through the shell, the span carrying a column of
liquid having a meniscus at the bottom of the shell, the surface
tension of the meniscus supporting and maintaining the column, the
flow of liquid through the conduit means causing the column to
enlarge and causing a drop to form and be released, the infusion
means including a drip chamber means in the chamber for collecting
drops issuing from the nozzle, the collecting means being spaced
from the shell bottom a distance sufficient to permit successive
drops to freely fall, and means providing an atmospherically vented
free fall space between the shell bottom and the collecting
means.
8. A drip chamber for use with a physiological liquid
administration set, the chamber comprising a nozzle having a
downwardly extending hollow probuberance, the protuberance having
an open bottom, and a substantially cylindrical shell positioned
about the protuberance, the shell having inner dimensions larger
than the outer dimensions of the protuberance and thereby providing
a span between the shell and the protuberance, the shell extending
downwardly to an open bottom lower than that of the protuberance,
means forming a vent passage through the shell, the span carrying a
column of liquid having its meniscus at the bottom of the shell,
the surface tension of the meniscus supporting and maintaining the
column, the flow of liquid through the protuberance causing the
column to rise and a drop to form and be released, the chamber
further including means for collecting drops issuing from the
nozzle, the collecting means being spaced from the shell bottom a
distance sufficient to permit successive drops to freely fall, and
means providing an atmospherically vented free fall space between
the shell bottom and the collecting means.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
Administration sets with hydrostatic head variation means for flow
rate regulation.
2. Brief Description of the Prior Art
Physiological fluids are normally infused into a patient with a
parenteral administration set. The administration set is utilized
to provide a fluid passage between a physiological fluid, e.g. a
parenteral solution of sterile water or a saline or glucose water
solution, etc., carried in a glass bottle for intravenous or
arterial administration. Infusion of the parenteral solution has
been achieved by suspending an inverted bottle above the patient
and interconnecting a length of tubing forming part of the
administration set to the bottle with a threaded bottle access cap
or, if the bottle is stoppered, by piercing a membrane stopper at
the mouth of the bottle with a vented penetrant. The tubing
included a drip chamber connected in series therewith and through
which the rate of solution flow could be observed. A constriction
pinch valve was provided to restrict the fluid flow through the
tubing to levels meeting the prescribed requirements of the
patient. The free end of the tubing was connected to a hollow bore
needle which was usually inserted into a blood vessel, e.g. a vein,
of the patient.
A major disadvantage encountered with the presently used
administration sets was the fact that the rate of solution flow has
been known to vary. The rate of flow was observed through a drip
chamber which included a nozzle constructed so that drops formed
were of a predetermined size. The nurse or technician thereby
determined the fluid flow rate in standard liquid measure and in
accordance with the doctor's specifications by counting the number
of drops during a given period of time. The flow rate was adjusted
by constricting the tubing with various valve clamps.
Factors contributing to flow rate changes in actual hospital usage
included the following: changes in the elevation of the infusion
arm; changes in patient blood pressure; partial clotting at the
infusion needle; a change in orientation of the infusion needle
within the blood vessel; patient constriction of the infusion
tubing, e.g. from lying on the tubing, and in some instances,
actual tampering with the pinch valves by the patients.
Unfortunately, even under precisely controlled laboratory test
conditions, with a constant restriction at the needle end of the
tubing (the effect of which is a steady patient blood pressure and
no change in the elevation level of the needle) the flow rate has
been known to vary considerably over extended periods of time. In
one such test, a flow rate had varied to the extent that after 14
hours the flow rate had decreased to one quarter of the original
flow rate. In another test, the flow rate after 22 hours had
decreased to one-seventh the original flow rate.
The gradual change in flow rate necessitated the constant checking
and adjustment of intravenous feeding administration equipment
during the administration. Thus, nurses usually were required to
check the flow rate of all intravenous equipment as they made their
usual rounds. Unfortunately, intravenous equipment has been known
to remain unchecked for a considerable period of time, which often
resulted in complications detrimental to the patient's health and
recovery rate.
In addition to the previously mentioned factors contributing to
flow rate changes under hosiptal conditions, there are the causes
attributable to flow rate changes under laboratory conditions.
Among the later causes are small variations in infusion liquid
hydrostatic head at the needle and slight changes or "creeping" of
the valves restricting the free fluid flow through the tubing (see
U.S. Pat. No. 3,099,429). Dimensional changes in the tube itself
may also be a factor.
It is believd that the purity of the physiological solutions
contributes to flow rate changes and is such that the tubing will
readily clog at the valve constrictions. This is because although
the solutions are sterile, they still may have minute particles
which will be deposited at the constriction in the tubing.
It is also believed that the variation in hydrostatic head, to
which flow rate changes have been attributed was partially due to
the inefficiency of the previous venting mechanisms utilized in the
bottle access caps or stopper penetrants of previous administration
sets. Previously, a relatively large vent opening e.g. 1/16th inch
diameter was utilized. Unfortunately, the volumetric capacitance of
the vents was such that they did not vent reliably and several
bubbles at a time could be released. Furthermore, these bubbles
would only be released when a fairly large partial vacuum was
obtained above the vent level in the bottle. Thus, erratic venting
was common and resulted in a pulsating flow rate. Because the vents
did not reliably maintain an effective atmospheric pressure level
at the outlet orifice, it was extremely difficult to achieve
adequate flow control at slow flow rates, although the degrading
effects were predominantly caused by the valving. Some bottle vents
included a snorkel tube which led upward into the bottle to a level
above the solution. This eliminated vent bubbles through the
solution and kept atmospheric pressure above the solution. The
drawback was that while solution was drawn from the bottle, the
hydrostatic head forcing the solution into the patient continually
decreased.
SUMMARY OF THE INVENTION
It is an object of the invention to provide a liquid administration
apparatus of the general character described which is so
constructed that it is not subject to any of the foregoing
disadvantages.
More specifically, it is an object of the present invention to
provide a liquid administration apparatus of the general character
described which includes a flow rate regulation system whereby
changes in flow rate over periods of time are effectively
eliminated.
A further object of the present invention is to provide a liquid
administration apparatus of the general character described which
includes a drain tube drawing liquid from a liquid container to an
outlet substantially at atmospheric pressure and wherein the
effective elevation of the outlet with respect to the effective
elevation of the liquid drained from the container may be
adjustably varied and maintained in any one of a number of
positions to thereby adjust and maintain a steady flow rate of
liquid from the container.
Another object of the present invention is to provide a liquid
administration apparatus of the general character described which
includes an improved liquid container venting system having a sump
at atmospheric pressure and a tubular discharge spout leading from
the container to the sump with the sump liquid permitting air to
enter the container through the spout upon exposure of the spout
opening by a slight lowering of the sump liquid level.
A further object of the present invention is to provide a self
adjusting gravity flow liquid infusion device of the general
character described which includes a hollow chamber into which a
liquid is fed at a constant rate and a discharge tube leading from
the chamber to an independent liquid system having a variable
liquid back pressure and with the chamber including a float
selectively restricting liquid communication between the chamber
and the tube to equate the flow rate into the chamber with the flow
rate out of the chamber.
A still further object of the present invention is to provide a
liquid infusion device of the general character described which
prevents the introduction of air into an infusion tube.
Further objects of the invention in part will be obvious and in
part will be pointed out hereinafter.
The invention accordingly consists in the features of construction,
combinations of elements and arrangements of parts which will be
exemplified in the liquid administration apparatus hereinafter
described and of which the scope of application will be indicated
in the appended claims.
BRIEF DESCRIPTION OF THE DRAWINGS
In the accompanying drawings in which is shown one of the various
possible embodiments of the invention,
FIG. 1 is an elevational view of a parenteral liquid administration
set constructed in accordance with and embodying the invention, and
showing the administration set positioned for use in feeding a
physiological liquid;
FIG. 2 is an enlarged fragmentary elevational sectional view
through a vented bottle access cap through which liquid is drawn
from a reservoir bottle and from which portions of the
administration apparatus are suspended ;
FIG. 2a is a sectional view taken substantially along the line
2a--2a of FIG. 2 and showing a restricting gasket which
peripherally seals the mouth of the reservoir bottle;
FIG. 2b is a fragmentary elevational sectional view through a
bottle having a stoppered opening and showing an adapter which is
suitable for securing the vented access cap to the bottle;
FIG. 3 is an enlarged fragmentary perspective view of a drip
chamber into which liquid flows from the sump through a metering
tube, which chamber is slidably secured to a slotted channel
depending from the access cap;
FIG. 4 is an enlarged sectional view taken substantially along the
plane 4--4 of FIG. 3 and through the drip chamber and channel;
FIG. 5 is an enlarged longitudinal sectional view through the drip
chamber and showing a float nested in the interior of the chamber
with the float downwardly biased by a spring and with the chamber
including an upper cover having a double walled drip nozzle;
FIG. 6 is a sectional view through the drip chamber, the same being
taken substantially along the line 6--6 of FIG. 5 and showing the
nozzle with both walls, and a vent through the cover;
FIG. 7 is a fragmentary sectional view taken sub-stantially along
the line 7--7 of FIG. 6 and illustrating a nozzle vent hole between
the nozzle and the chamber.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring now in detail to the drawings, the reference numeral 10
denotes an administration apparatus constructed in accordance with
and embodying the invention. The liquid administration apparatus 10
includes a physiological liquid administration bottle 12
conventionally constructed of glass and carrying a typical
physiological fluid, e.g. a parenteral solution 14 of sterile water
with or without medicinal solutes. The bottle 12 is adapted to be
supported at an elevation above the patient, and for this purpose,
a bail 16 is usually provided. It will be noted that bail 16 is
pivotally connected to the bottle adjacent the bottom thereof and
when suspended from a support 18, the bottle will lie in inverted
position with its mouth downwardly directed.
In accordance with the invention, an administration set 20 is
provided which permits constant and accurate metered control of the
flow of liquid solution from the bottle into a separate independent
liquid system. The administration set 20 includes a narrow bore,
e.g. 0.04 inch diameter, flexible metering tube 22, the effective
elevation of the discharge end of which may be varied with respect
to the effective level of liquid drawn from the bottle 12 to
thereby vary the hydrostatic head of liquid at the discharge end,
thus the flow rate through the tube 22. The metering tube 22
discharges the parenteral solution 14 at a controlled flow rate
determined solely by the hydrostatic head and the solution is
subsequently infused into the patient through a conventional bore,
e.g. 0.10 inch diam., infusion tube 24. If the administration set
is utilized for inducing liquid into a patient's circulatory system
through a blood vessel, a hollow bored needle 25 is positioned at
the free end of the infusion tube.
In order to interconnect the metering tube 22 and parenteral
solution 14 stored in the bottle 12, a vented access cap 26 is
provided. The cap 26 is generally cylindrical and includes a
threaded bore at the upper end which mates with the male threaded
neck of the bottle 12. A tubular spout 30 extends downwardly from
an annular shoulder stop 28 at the base of the threaded bore. The
solution 14 flows through the spout 30 into an interior sump 29 of
the access cap 26. The solution 14 is drawn from the sump 29
through the metering tube 22, one end of which is seated in a
hollow drain socket extending from the base of the cap.
To provide an air vent for the bottle 14, a tapered Luer passageway
32 extends downwardly from the top of the cap adjacent the bore
toward the sump 29. A suitable filtering material 34, e.g.
synthetic sponge, etc. preferably having negligible resistance to
air flow and hence a minimal air pressure drop, is seated in the
passageway to remove airborne contaminants.
It will be appreciated that under normal operating conditions, a
quantity of solution 14 will be collected in the sump 29 at the
level L.sub.1 (see FIG. 2) and, as solution drains from the sump
through the metering tube 22, the level of solution in the sump
decreases to expose part of the open bottom of the spout 30. Upon
exposure of the spout bottom, air enters the bottle through the
spout and thus additional liquid is permitted to flow down the
spout 30 bringing the liquid level L.sub.1 back to its normal
position.
The cylindrical wall of the spout 30 is cut along an inclined plane
to form the open bottom so that only a portion of the total
cross-sectional area of the spout interior is exposed to
atmospheric pressure. It has been found that if the spout opening
were along a horizontal plane parallel to the liquid line at the
level L.sub.1, the meniscus of the solution would prevent air from
entering the spout until the level L.sub.1 was considerably below
the open spout bottom. Such lowering of the liquid level L.sub.1
within the sump 29 (which level controls the effective head of
water at the inlet end of the metering tube 22) would permit
undesirable variation in metering tube flow rate. Cutting the
cylindrical spout wall along an incline allows the meniscus to
break easily such that minimal level change occurs in the sump
between bubbles. Under actual operating conditions, the liquid
level L.sub.1 oscillates about the highest elevation of the spout
bottom a total distance of approximately 1/16th inch and the flow
rate changes for such variation are inconsequential to the
operation of the administration set even at very slow flow rates
through the metering tube 22.
A membrane gasket 36 (see FIG. 2a) rests on the shoulder 28 and
effects a water and air tight seal between the bottle 12 and the
cap 26. Constrictions to free liquid flow from the bottle are
provided by the gasket 36 which may include two openings. A minimal
restriction to liquid flow from the bottle such as that presented
by the membrane gasket is desirable to prevent flooding of the sump
with a wetting of the filter 34 upon inversion of the bottle during
initial set up.
It has been found that if a membrane gasket with two openings is
utilized, upon bottle inversion, the solution usually flows slowly
through one of the openings while air bubbles rise upwardly into
the bottle through the other opening. Such controlled flow permits
the level L.sub.1 to rise slowly and stop substantially at the
highest elevation of the spout bottom. Satisfactory results have
also been obtained using a single opening through the gasket.
The effective head of water drawn through the metering tube 22 from
the sump is governed by the elevational distance between the sump
level L.sub.1 (which remains substantially constant at the highest
elevation of the spout opening) and the vented discharge of the
metering tube 22.
Bottle venting through the cap 26 is highly reliable even at
extremely slow flow rates through the metering tube 22 and since
the spout opening (hence the normal level L.sub.1) is a substantial
distance from the air filter 34, the filter 34 is seldom wetted.
Even if the filter 34 becomes wet, e.g. upon drastic shaking of the
bottle, accidental bottle inversion, mishandling, etc., normal
venting resumes automatically as liquid is drawn from the sump 29.
This is because a sufficient vacuum will form above the level
L.sub.1 to remove any water blocking the filter 34. If the bottle
is shaken or jolted, tending to force more liquid into the sump,
the liquid level L.sub.1 in the sump will rise slightly resulting
in a momentary increase in flow through the infusion tube until the
level L.sub.1 reaches the highest elevation of the spout opening.
The level L.sub.1 thus maintains its substantially constant value
with only slight oscillations about the highest elevation of the
spout opening.
Although the access cap 26 has been described for use in
conjunction with a bottle 12 having a male threaded neck, it is
also suitable for use with a stoppered bottle 112 (see FIG. 2b).
For this purpose, an adapter having a hollow stopper penetrant tube
35 leading from the bottle to a hollow male threaded nipple 37 may
be utilized. It will be appreciated that the inner upper wall of
the nipple is downwardly outwardly flared from the tube 35 to
prevent the entrapment of air bubbles. Optionally, a unitarily
formed stopper penetrant and cap can be constructed with the
stopper penetrant tube forming the sump spout at its lower end. In
such instance, a flow constricting gasket need not be utilized
since the penetrant tube will be of a diameter sufficient to
constrict flow.
Valveless flow rate regulation of parenteral solution discharge
from the sump 29 through the metering tube 22 is principled upon
liquid flow in a gravity flow system which may be regulated by
changing the head or elevation between the atmospheric pressure
level at the fluid reservoir and the discharge port of a siphon
tube. For viscous flow in a small bored tube (not considering
kinetic energy of the fluid) it has been found that the flow rate
in a siphon system is proportional to the effective head height,
i.e. the head between the atmospheric level in the reservoir and
the atmospherically vented discharge end of the siphon tube. It
should be noted that the effective atmospheric level in the bottle
reservoir, i.e. the liquid level L.sub.1 in the sump of the present
system, remains substantially constant near the opening of the
spout.
In order to maintain and adjustably vary the effective elevation of
the discharge end of the metering tube 22 with respect to the sump
liquid level L.sub.1, a movable drip chamber 38 is provided. The
drip chamber 38 includes a metering tube receiving nozzle cover 40
which engages a hollow body formed of a transparent cylindrical
viewing segment 42. The cover 40 includes a cylindrical side wall
at the lower end of which an annular groove is formed and within
which the upper end of the segment 42 is seated.
A passage fixture 44 which receives and guides the metering tube 22
is formed in the cover 40. The fixture 44 includes a passageway
which accommodates the metering tube 22 without constricting its
bore (to eliminate calibration problems). A portion of the metering
tube 22 adjacent the free end extends vertically downward from the
cover 40 as a hollow protuberance into a downwardly projecting
hollow cylindrical shell 46 having a downwardly outwardly flared
discharge opening 47 at the bottom, thereby forming a double walled
discharge nozzle 48. The inner wall of the nozzle 48 is, in
actuality, one wall of the metering hollow protuberance, i.e. the
tube 22, while the shell 46 forms the outer wall.
The purpose and function of the double walled nozzle 48 is to
reduce the hydrostatic head variation normally encountered in
forming a drop of solution 14. If a single walled nozzle is used,
which is, in effect, the discharge end of the metering tube 22, the
radius of the meniscus at the open end of the bore will be
initially quite small. This is because the tube bore is of a
relatively small diameter. Since surface tension fluid pressure
formed by the meniscus is inversely proportional to the radius, a
relatively high hydrostatic head is required to break through the
meniscus and allow a drop to be formed.
Presently used drip chamber nozzles would be disadvantageous in
particular applications of the flow control system of this
invention because the system would not operate with maximum
reliability at extremely slow flow rates where minimal hydrostatic
head at the nozzle is utilized. If the administration set is not
for use at extremely low infusion flow rates, a conventional nozzle
will suffice.
The double walled nozzle 48 is ideal for producing a stabilized
system wherein very little drop formation pressure variation is
required at the metering tube. This is because a column of solution
14 will collect within the shell 46 which acts as a pressure bias.
It should be noted that the shell 46 includes a vent passage 54
(see FIGS. 5 and 7) above the collected liquid and communicating
with the interior of the drip chamber (which is at atmospheric
pressure). The passage 54 is at an elevation well above the
discharge end of the metering tube 22. It will now be seen that the
upper level L.sub.2 of the column of liquid collected in the shell
46 is at atmospheric pressure because the vent passage 54 is above
the column. Thus, the surface tension of the meniscus formed at the
discharge opening 47 of the shell 46 is just sufficient to keep the
collected column of solution within the shell 46.
The slightest addition of liquid to the column within the shell 46
will increase the elevation of the solution level L.sub.2 and hence
the head of pressure at the shell discharge opening. As soon as the
head of liquid collected within the drop is sufficient to expand
the meniscus, the drop will grow. Thus, only a minimal head
increase of solution at the nozzle is necessary to cause a drop to
fall.
The internal diameter of the shell 46 can be optimized to minimize
fluctuations of the level L.sub.2, hence head fluctuations in the
nozzle column for a given drop size. For drops having a volume of
about 1/15th cc., an internal shell diameter of about 1/4 inch has
been found satisfactory. For drops of a smaller size, a reduced
diameter may be used. Good results with only small fluctuations of
the level L.sub.2 have been obtained with a liquid meniscus having
a volume approximately 1/3 the drop size suspended below the nozzle
discharge opening at the commencement of each drop formation
cycle.
It was previously mentioned that the drip chamber 38 is at
atmospheric pressure. This is accomplished by a passage 56 through
the cover 40. A suitable filter 58 of construction similar to the
filter 34 is seated and recessed in the passage 56 to prevent the
entrance of airborne contaminants.
A further disadvantage of conventional nozzles is the fact that the
drop formation pressure was not consistent. It is believed that
various naturally occurring vibration frequencies enable a meniscus
to vibrate and the meniscus ruptures easier at the natural
frequencies with the released drop starting successive oscillation
cycles. If the frequency of drop formation matches one of these
natural frequencies, the flow rate no longer remains a linear
function of head height. In order to retard such oscillations in
the column of solution within the shell, the metering tube 22
extends to an elevation only slightly above the discharge end of
the shell and thus provides a friction drag to dampen the
oscillations. Alternatively, baffles (not shown) may be positioned
between the metering tube and the shell.
As has been previously mentioned, flow rate through the metering
tube 22 is regulated by varying the liquid level L.sub.2 at the
effective discharge end of the metering tube 22. Since there are no
valve constrictions in the metering tube 22, the flow will remain
constant for any set elevation of the drip chamber 38. A slotted
support channel 60 extends vertically downwardly from the access
cap 26, and may be unitarily molded therewith. The channel 60
provides a support for the drip chamber 38 and permits the
adjustment of the elevation of the drip chamber with respect to the
level L.sub.1.
In order to adjustably mount the drip chamber 38 to the channel 60,
a threaded shank 62 (see FIG. 5) extends radially outwardly from
the wall of the cylindrical segment 42 into a longitudinal slot 64
formed in the channel 60. It should be noted that the slot is
closed ended at its top and bottom to provide sufficient strength
for the channel and to prevent the drip chamber from inadvertent
disengagement from the channel. A hand tightened thumb screw or nut
66 engages the threaded shank 62 and it utilized to tighten the
drip chamber against the channel once a desired flow rate has been
set. It will be appreciated that when the nut 66 is loosened, the
drip chamber 38 may slide with respect to the channel with the
shank riding in the slot 64.
Although the particular configuration of the channel 60 is not of
major consequence, it has been found that a channel having a
cylindrical inner wall of concave transverse cross section
conforming to that of the drip chamber has been quite suitable
because it guides the drip chamber for up and down movement yet
permits the drip chamber to be locked at a selected elevation by
the nut 66.
The channel 60 includes numerical indicia vertically positioned
along a generally planar vertical face 68 which is readily viewable
by an operator adjusting or setting the flow rate of the
administration set. The indicia are consecutively numbered and
uniformly spaced and are provided in convenient readily used flow
measuring terms, e.g. cc/hour. An indicator reference such as an
arrow 70 is positioned on the drip chamber 38. More than one scale
of indicia may be provided for calibration of liquids of widely
differing viscosities.
On a production basis, the scale indicia positions are chosen, and
by coordinating the diameter and length of the metering tube 22,
accurate calibration is achieved. Each unit is subsequently
calibrated by using the proper length of tubing 22, once the bore
diameter is fixed. This calibration method utilizes the phenomenon
that flow rate is directly proportional to the fourth power of the
bore diameter and inversely proportional to the tube length.
It will be appreciated that if the nut 66 is loosened and the drip
chamber 28 slid upwardly along the channel so that a lower number
appears at the arrow 70, the effective head between the liquid
level L.sub.1 of the sump and the liquid level L.sub.2 of the
nozzle 48 will be reduced, resulting in a reduction in flow rate.
Additionally, the channel zero indicium is coordinated so that when
the arrow 70 is in alignment therewith, the sump liquid level
L.sub.1 and the nozzle column liquid level L.sub.2 are at
substantially the same elevation effecting a null head at the
discharge end of the metering tube thereby stopping flow. Flow is
also reliably stopped if the level L.sub.2 is above L.sub.1. Since
the sole flow rate control of this administration set is by moving
the drip chamber in the channel, (which is positioned remotely from
the patient) the opportunity for a patient to change the flow rate
by tampering is greatly reduced.
In order to regulate flow through the infusion tube such that the
flow rate into the patient is the same as the flow rate into the
drip chamber through the metering tube, a generally cylindrical
float 72 is provided within the cylindrical segment 42 of the drip
chamber. The float 72 is preferably hollow and constructed of
plastic or may be formed of a buoyant material, e.g. closed celled
synthetic foam. The float 72 includes a valve stem 74 extending
downwardly along the longitudinal axis of the float and terminating
at a pointed tip. The stem 74 extends into a hollow tail 75 of the
funnel shaped bottom of the cylindrical segment 42 with a conical
pointed tip of the valve stem 74 engaging an annular valve seat 76.
The seat 76 is constructed of a relatively soft material, e.g.
silicone rubber, and is nested within the tail 75. The base of the
seat 76 abuts an annular inwardly extending flange stop 78 while
the wall of the seat 76 is upwardly inwardly tapering at its top.
The tapered upper wall facilitates flexing of the seat 76 to
accommodate and effectively seal against the conical tip of the
valve stem 74. It provides an extremely reliable seal even if
foreign particles are present in the solution 14. Furthermore, the
seal is reliable in the presence of slight molding defects in the
valve stem or seat 76. The tail 75 provides a guide for the valve
stem 74 because the clearance between the valve stem 74 and the
tail 75 is less than the inner radius of the valve seat. Thus, the
tip of the valve stem will always be aligned with the valve seat
bore.
The apex angle of the conically pointed tip of the valve stem is
selected so that cooperation between the valve stem 74 and the seat
76 results in a fast response. Furthermore, angle selection will
prevent the valve stem 74 from sticking in the valve seat 76. To
prevent the valve stem 74 from pushing into the seat 76 to the
extent that the seat would receive a set degrading deformation, a
stem penetration limit stop is provided. The limit stop is effected
by dimensioning the drip chamber and float such that the float
bottoms at the base of the cylindrical segment 42 only after a
predetermined penetration of the valve stem 74 into the seat 76.
The limit stop thus assures an indefinite shelf life for the
administration set.
The float 72 is generally positioned so that its longitudinal axis
and the longitudinal axis of the drip chamber 38 are coincident. At
the upper end of the float, an annular horizontal shoulder 80 is
provided. Projecting upwardly from the area circumscribed by the
shoulder is a domed head 82. It will be noted that the head 82 is
positioned beneath the nozzle 48 so that drops of solution 14
discharged from the nozzle will impinge upon the head 82 then flow
down the sides of the float 72 as a curtain to be collected between
the side walls of the float 72 and the inner wall of the
cylindrical segment 42. It has been previously mentioned that the
wall of the cylindrical segment 42 is transparent. This is to
facilitate viewing the drops of solution 14 as they fall.
The nozzle 48 may be offset slightly from the center of the dome 82
so that the liquid tends to flow down one side of the float and air
may raise up the opposite side. Furthermore, longitudinal grooves
may be provided along the wall of the float or the inner wall of
the drip chamber to act as flow channels for the liquid to thus
insure rapid filling of the drip chamber to operative levels.
If the clearance between the float and the segment 42 is too small,
viscous drag on the float results while too large a clearance is
not advantageous since it retards alignment of the float in the
drip chamber.
It will be appreciated that slight clearance is provided between
the walls of the float and the walls of the cylindrical segment 42
so that a minimal amount of dead volume is present and very few
drops are required to bring a collected solution level within the
drip chamber to a sufficient height to raise the float 72 and hence
the valve stem 74 thereby permitting the flow of liquid through the
infusion tube.
Once the infusion tube is filled with liquid and with the needle 25
end of the infusion tube positioned for infusion into the patient's
circulatory system, the float provides a variable pressure flow
regulator which maintains the flow rate through the infusion tube
coincident with the flow rate into the drip chamber. Hence, the
actual infusion rate into the independent liquid system will be
solely dependent upon the head height between the levels L.sub.1
and L.sub.2. If the patient's blood pressure increases, the flow
rate through the infusion tube 24 momentarily decreases due to the
increased back pressure. Since the flow into the drip chamber
remains constant, the drip chamber liquid level i.e. the liquid
collected in the clearance between the float 72 and the walls of
the cylindrical segment 42 rises, thereby lifting the float
upwardly.
When the float lifts, the valve stem rises and increases the
dimensions of the access passageway through the valve seat 76. Flow
through the infusion tube remains constant since the infusion
pressure at the needle has increased primarily due to the enlarged
access passageway. Thus, the effective pressure of solution
entering the patient increases automatically. Similarly, the
increase in circulatory system back pressure due to other
variables, e.g. the patient raising the elevation of an infusion
arm, partial needle clotting, etc. will be automatically
compensated in response to increased back pressure.
If the circulatory system back pressure decreases due to a lowering
of the patient's blood pressure or the lowering of an infusion arm,
an initial momentary increase in draw or flow through the infusion
tube will cause the collected level within the drip chamber to
decrease (since the in flow through the nozzle into the drip
chamber remains constant while the draw through the infusion tube
momentarily increases) thereby causing the float to lower and the
valve stem 74 to constrict the access passageway through the seat.
The head of liquid pressure at the infusion needle will now
decrease primarily because the valve seat is constricted. Thus, the
float valve equates the flow rate through the infusion tube with
the flow rate into the drip chamber by automatically compensating
for external factors which might affect flow.
Should a nurse or attendant decide to completely stop flow for a
short period of time, she need merely adjust the elevation of the
drip chamber so that the levels L.sub.1 and L.sub.2 are
coincident,thus terminating flow through the nozzle 48. As soon as
flow through the nozzle 48 is terminated, the liquid level within
the drip chamber decreases (since the liquid is still being
infused) until such point as the float lowers to completely seal
against the valve seat 76 so that air will not enter and a column
of trapped liquid is effectively sealed within the infusion tube.
Upon resumption of flow through the metering tube, the float rises
to resume infusion.
From an observation of FIG. 5 it will be seen that a spring 84 is
employed between the chamber 40 and the float 72 to downwardly bias
the float. One end of the spring 84 is seated against the shoulder
80 of the float while the other end of the spring abuts an annular
flange 86 which extends inwardly from the side wall of the cover 40
adjacent the grooved shoulder interlock between the cover 40 and
the cylindrical segment 42. As shown in FIG. 5, the spring employed
is a helical coil spring, but it has been found that any
conventional spring, e.g.a leaf spring, might optionally be
employed. The spring is utilized to provide a force to positively
seat the valve stem 74 in the seat 76. Furthermore, the spring
keeps the float valve closed under severe shock loads, and will
provide an additional margin of safety precluding the entrance of
air into the infusion tube should the drip chamber be inverted
during infusion because it exerts a seating force on the float
greater than the float weight.
This particular drip chamber permits the use of the same
administration set with successive solution bottles. When a bottle
is emptied, the liquid level in the drip chamber lowers to the
point wherein the valve stem seats, the nurse may then unscrew the
bottom from the cap 26, turn the administration set upside down and
secure the cap to a new bottle. Then the bottle and administration
set are inverted to resume infusion at the previously determined
rate. During this entire reloading procedure, the spring 84 has
positively sealed the infusion tube against the entrance of air.
The response time of flow regulating systems embodying this
invention has been approximately one second. The response time is a
function of float diameter, float clearance, float specific
gravity, seat bore diameter and the spring constant.
Quite successful operation has been found utilizing a drip chamber
wherein the float weight was approximately 3 grams and with the
spring force on the order of three to five times the float weight
with a spring constant of about 1/4 lb./inch. Additionally, it has
been found that utilizing a float of approximately one inch
diameter and 1.5 inches in length, a float clearance, i.e. distance
between the float and the inner wall of the cylindrical segment 42
of about 0.01 inches has been found quite satisfactory in
minimizing dead volume and assuring rapid filling of the drip
chamber and fast response to fluid system back pressure
changes.
The float volume is preferably large so that the float specific
gravity provides a buoyant force sufficient to overcome the suction
force of the liquid draining through the valve seat. A relatively
small valve seat bore diameter (approximately 0.04 inches) helps to
minimize the suction force without sacrificing system response
time. It has been found that most of the float buoyant force is
used to overcome the spring force. Because the actual float
movement is extremely small, the spring force exerted on the float
is practically constant, enabling near optimum operation at all
rates of flow and back pressure combinations.
Float vibration problems are effectively eliminated if the float
mass is kept relatively small. This is because the resonant
frequency of the system would be high (about 100 cycles/sec.).
In actual operation, the administration set 20 is set up under a
procedure substantially as follows: the cap 26 is secured to the
neck of the bottle 12 and the bottle is inverted. The drip chamber
is lowered along the channel 60 and solution 14 rapidly flows
through the metering tube, discharging through the nozzle 48 and
filling the space between the float and the cylindrical segment 42.
The float rises a total travel of about 1/64 inch and allows the
solution to fill the infusion tube 24, purging the air contained
therein. Once the infusion tube is completely filled with liquid,
the drip chamber is moved along the channel 60 to the position
indicating zero flow, at which point flow through the metering tube
terminates. The float 72 then seals the valve seat 76 preventing
the entrance of air and further preventing the discharge of liquid
through the needle. The needle may now be inserted into the proper
blood vessel of the patient after which the desired flow rate may
be set by moving the drip chamber downwardly along the channel 60
and the nut 66 is thereafter tightened to lock the precalibrated
flow rate.
Although the administration apparatus embodying the present
invention has been described in an exemplary fashion as a device
for the metered infusion of liquid into the circulatory system of a
patient, it will be appreciated that this invention may be equally
utilized for controlled infusion of any liquid into a suitable
liquid system thereby replacing costly liquid chemical feeders.
Thus, it will be seen that there is provided an administration
apparatus which achieves the various objects of the invention and
which is well adapted to meet the conditions of practical use.
As various possible embodiments might be made of the present
invention and as various changes might be made in the embodiment
above set forth, it is to be understood that all matter herein
described or shown in the accompanying drawings is to be
interpreted as illustrative and not in a limiting sense.
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