U.S. patent number 3,774,616 [Application Number 05/222,546] was granted by the patent office on 1973-11-27 for endotracheal tube holder and airway.
This patent grant is currently assigned to Perry Plastics, Inc.. Invention is credited to Norman S. White, Alfred Zangrilli, deceased.
United States Patent |
3,774,616 |
White , et al. |
November 27, 1973 |
ENDOTRACHEAL TUBE HOLDER AND AIRWAY
Abstract
An airway and an endotracheal tube holder face plate are
detachably connected to constitute a unitary assembly for insertion
in the mouth of a patient. The inner face of the plate carries bite
block means in telescoping engagement with resilient biased detents
carried by the airway and engageable against the outer face of the
plate to prevent its separation from the airway until the detents
are released by manual pressure. Latching means on the outer face
of the face plate is operative to engage an intubated endotracheal
tube and hold it against axial movement in either direction. The
face plate is provided with apertures through which the detents
extend and through which suction catheters and other tubular
conduits may be passed for intubation. The body of the face plate
is provided with an upper edge opening recess for receiving an
intubated endotracheal tube to which the face plate is applied in
service.
Inventors: |
White; Norman S. (Pittsburgh,
PA), Zangrilli, deceased; Alfred (LATE OF Pittsburgh,
PA) |
Assignee: |
Perry Plastics, Inc. (Erie,
PA)
|
Family
ID: |
22832658 |
Appl.
No.: |
05/222,546 |
Filed: |
February 1, 1972 |
Current U.S.
Class: |
128/200.26;
128/DIG.26 |
Current CPC
Class: |
A61M
16/0497 (20130101); A61M 16/0488 (20130101); A61M
16/0495 (20140204); A61M 16/0493 (20140204); Y10S
128/26 (20130101) |
Current International
Class: |
A61M
16/04 (20060101); A61m 025/02 () |
Field of
Search: |
;128/133,205,208,351,DIG.26 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Pace; Channing L.
Claims
We claim:
1. An endotracheal intubation apparatus comprising, in combination,
an airway, a face plate engageable over the mouth of a patient and
having therein a central aperture for passage of an endotracheal
tube therethrough, the face plate having also therein at least one
auxiliary aperture at one side of the central aperture and adapted
for passage therethrough of at least one special purpose tube, said
airway having a curved body portion adapted to engage over a
patient's tongue, a pair of outer side walls and at least one inner
wall extending upwardly from said body portion to define an open
top central channel and at least one open top auxiliary side
channel, said central and side channel extending longitudinally of
said airway, said central channel communicating with said face
plate central aperture to receive the endotracheal tube and said
auxiliary side channel communicating with the auxiliary face plate
aperture to guidingly receive said selective purpose tube passing
through said auxiliary aperture, said means readily detachably
connected the airway and the face plate in service relation as a
unitary assembly.
2. In the apparatus of claim 1, means on the face plate operative
to engage an endotracheal tube disposed in the central aperture of
the face plate for holding the tube secured against axial movement
in either direction.
3. In the apparatus of claim 1, said detachable connecting means
including a resilient latch tongue carried by the airway at each
side thereof for projecting through said face plate auxiliary
apertures, the latch tongues being in parallel spaced relation such
that their passage through the face plate is blocked by the face
plate body at an edge of each auxiliary aperture, a detent on the
outer end of each tongue and engageable with the outer face of the
face plate in a manner preventing separation of the airway and the
face plate while the detent is in holding engagement with the
plate, said detents being constituted as cams slidably engageable
by an adjacent auxiliary aperture edge of the face plate body to
move the tongues laterally towards each other against their
resilience bias and thereby move the outer ends of the tongues into
registry with the auxiliary passages for free passage
therethrough.
4. In the apparatus of claim 3, said detents being operative
manually from the exterior of the face plate to release them from
holding engagement with the face plate and thereby permit removal
of the face plate from the airway without removal of the airway
from a position of service.
5. In the apparatus of claim 3, tubular bite block members carried
by the face plate and extending inwardly from its inner face, said
tubular bite block members being in axial registry with the
auxiliary apertures in the face plate, each member having a wall
longitudinally apertured to provide top and bottom track rails for
receiving said guiding therebetween the top and bottom edges of one
of the latch tongues when the face plate and the airway are moved
axially together in effecting their connection.
6. In the apparatus of claim 5, the latch tongues providing a
portion of the bite tube walls in which they are guided when the
airway and the face plate are being connected.
7. In the apparatus of claim 6, the body of the airway at its
forward end having therein at each side a longitudinal slot open at
its outer end to receive the bottom portion of the adjacent bite
tube in slidable relation.
8. In the apparatus of claim 7, the floor of the outer end portion
of the airway at the inner end of each slot having a section
extending at an angle between the front end of each side channel
and its adjacent latch tongue.
9. In the apparatus of claim 8, the floor of the airway between
said slots being flat and of a width to fill the space between the
inside walls of the bite tubes in sliding engagement therewith when
the airway and the face plate are connected.
10. In the apparatus of claim 9, said flat portion of the airway
floor lying in a plane common to the bottom edges of the latch
tongues and having at its outer end a depending portion for seating
over and in front of the lower teeth of a patient.
11. An endotracheal tube holder comprising a face plate having a
rear face and a front face with the rear face adapted to cover the
mouth of a patient, said face plate having formed substantially
centrally thereof a notch-like opening for receiving an
endotracheal tube and an auxiliary opening at each side of the
notch-like opening, a pair of bite block tubes projecting from the
rear face of the plate each in open communication with a respective
auxiliary opening of said face plate and each adapted to receive a
special purpose tube, said face plate notch-like opening extending
through one edge of the face plate at a point midway between the
bite block tubes, and being closed at the opposite edge at the
central portion of the face plate body to provide a seat for an
endotracheal tube when disposed in said opening, whereby the face
plate may be slid into supporting engagement with an endotracheal
tube inserted in the mouth of a patient without shifting the face
plate laterally in the direction of either bite block tube.
Description
BACKGROUND
1. Field of the Invention
The present invention relates to the art of endotracheal intubation
and extubation, and in particular to airways, face plates, and
means for holding intubated tubular conduits against axial movement
from a selected service position relative to an airway and face
plate with which they are associated.
2. Prior Art
Airways and their uses are well known in the field of surgical
appliances. Typical of these is the airway disclosed in U.S. Pat.
No. 3,306,298. Face plates equipped with bite blocks and tube
holder means are equally well known in the art of intubation and
extubation. Typical of these is the tube holder and bit block
disclosed in U.S. Pat. No. 2,908,269. Another example is the holder
disclosed in U.S. Pat. No. 2,820,457. However, so far as the
present inventors are aware, the prior art does not teach the
combination of an airway with a detachable face plate tube holder
and bite block assembly, either of which may be used separately or
connected in combination. Tube holder face plates with bite blocks,
and airways, have always been accepted in the prior art as separate
appliances having different uses, different advantages, and
different disadvantages. The prior art had no appreciation of the
fact, discovered by the present inventors, that the disadvantages
of each could be avoided by their synergetic combination as taught
by the present invention.
SUMMARY OF THE INVENTION
The present invention is an assembly comprising an airway in
detachable connection with an endotracheal intubation face plate
that has means for holding an endotracheal tube in a selected
position and which has also bite block means for preventing
constriction of closure of the tube by biting pressure exerted by a
patient. Connection is established automatically by moving the
airway and the face plate together in telescoping relation, and
disconnection is accomplished simply by manual depression of
resilient biased detents carried by the airway and projecting from
the front face of the face plate when the airway and the face plate
are connected in service relation. With reference to FIG. 5, and
assuming the assembly to be in service position in the patient's
mouth and trachea, the face plate may easily be disconnected and
removed by an anesthesist or surgeon simply by inserting the index
fingers behind the extremeties of the face plate wing panels 13 and
exerting an output pull causing the face plate to be slightly
distorted while simultaneously placing the thumbs on the detents 31
and moving them towards each other until they are free to pass
through the face plate openings 17. As soon as the detents 31 are
freed from engagement against the front face of the face plate, the
resilient bias of the face plate forces it to resume its initial,
undistorted shape, thereby automatically moving its outward a
distance sufficient to clear the detents and thus permit the face
plate and the airway to be separated simply by pulling them
apart.
DESCRIPTION OF THE DRAWINGS
FIG. 1 is an elevational view depicting the apparatus of the
present invention as applied in service position.
FIG. 2 is an exploded perspective of the airway and the face plate
of the present invention as positioned for connection.
FIG. 3 is an inner face elevation of the face plate.
FIG. 4 is a posterior elevation of the airway.
FIG. 5 is a top plan view of the airway and the face plate
connected in service position, with an endotracheal tube and a
suction catheter installed.
DESCRIPTION OF THE PREFERRED EMBODIMENT
The present invention is a combination of detachably connected
components comprising an airway 10 and a face plate 11 for use with
an endotracheal tube 12. The face plate is fashioned somewhat in
the patters of a butterfly, having a pair of wing panels 13
connected at their bottom portions by an integral bridge 14
recessed in its top edge to provide a semicircular passage 15 for
reception of the tube 12 when the face plate is applied
thereto.
As best shown in FIG. 3, the inner face of the face plate 11 is
formed with a shallow socket 16 extending between the bridge 14 and
the bottom edge of the passage 15. Passage 15 is open from its top
and is flanked on each side by an auxiliary aperture 17 through
which latch elements of the airway 10 are passed for detachable
connection between the airway and the face plate. The apertures 17
are preferably rectangular and are bordered by a pair of bite block
tubes that project inwardly from the face plate integral therewith
and in parallel spaced relation at opposite sides of the passage
15. Each tube comprises an inside wall 18, a top wall 19, and a
bottom wall 20. The outside ends of the top and bottom walls are
inturned to provide short flanges parallel to the side wall 18. The
front face of each wing panel 13 is formed with a projecting anchor
pin 21, one of which is shown in FIG. 1 for connection with the
ends of a strap 22 passed around the back of a patient's neck and
having a longitudinal series of holes 23 for selective engagement
with the anchor pin of the face plate to secure it in place. The
entire face plate is a one-piece integral structure of a suitable
thermoplastic having slight resilience. It may be sterilized for
reuse if desired or made as an expendable item. Preferably the face
plate and airway are injection molded from an olefinic material
such as polyethelene copolymer.
The airway 10 of the present invention is a one-piece body of
plastic material identical with or similar to the plastic material
of the face plate. The general configuration of the airway is
conventional in that it is shaped to engage over and hold a
patient's tongue against swallowing. Side walls 24 extend upwardly
from the side edges of the body, merging at their forward ends with
outwardly divergent portions 25. As best shown in FIG. 4, the top
edges of the side walls 24 arch slightly inwardly towards each
other to partially overhang the airway floor. A pair of inner walls
26 extend longitudinally of the airway between the side walls in
parallel spaced relation thereto and to each other. The forward
ends of these walls 26 merge with divergent portions 27 that
parallel the divergent side wall portions 25 of the side walls 24
and terminate in a plane normal to the longitudinal axis of the
airway body, which plane coincides with the inner ends of the bite
block tubes and provide abutments against which the inner ends of
the bite block tube walls 18 and the inturned flanges of the top
and bottom walls 19 and 20 engage in full face contact when the
airway and face plate are connected in service relation.
The height of the inner walls 26 - 27 is less than the height of
the outer side walls 24 - 25 with which they cooperate to define
open top channels 28 parallel to and at each outer side of a
central main channel 29, all of semicircular cross section. The
width of the main channel 29, which receives the endotracheal tube
12, is greater than the width of the auxiliary side channels
28.
A salient feature of the invention is the means by which the airway
and face plate are detachably connected in service relation. This
means includes a tongue 30 extended forwardly from the outer or
front end of each side wall portion 25 parallel to the side wall 18
of the adjacent bite block tube. The height of each extension 30 is
such that, when the airway and face plate are connected, it fills
completely the space between the opposed flanges of the tube top
and bottom walls 19 and 20. These flanges provide rails on which
the tongues 30 ride in registry therewith, thus forming together
with the flanges an outer side wall for each bite tube and parallel
to its inside wall 18. When the airway and the face plate are
connected in service relation the auxiliary passages 17 are
completely enclosed in their respective bite tubes and are in full
axial registry with the outer ends of the side channels 28.
Each tongue 30 is formed with a barb detent 31 on its outer end for
latching engagement with the face plate when the outer end of the
tongue is passed through its adjacent face plate opening 17. The
anterior face of the detent is serrated to facilitate thumb or
finger engagement, and it is constituted as a cam which engages the
body of the face plate to move the tongue ends towards each other
and permit the detents to pass freely through the face plate, after
which the inherent resilience of the tongues causes them to snap
back to their original positions with the detents engaged against
the face plate as shown in FIG. 5, thus providing a manually
releasable spring latch connection between the airway and the face
plate.
It is apparent in FIG. 2 that the bottoms of the side channels 28
in the airway merge with small triangular forward extensions 32
which, in turn, merge with the bottom edges of the latch tongues 30
forwardly from the abutments 33 constituted by the outer ends of
the airway channel walls 26. The bottom of the central channel 29
merges at its forward end with a flat floor plate 34 which lies in
a plane common to the floor sections 32. The width of the floor
plate 34 is the same as the width of the front end of the channel
29 with which it merges, thus leaving along each side of the floor
plate a slot for accommodation of the inside wall 18 of the
adjacent bite tube when the airway and the face plate are
connected. As its forward end the floor plate 34 carries a
depending apron 35 complemental to the shallow socket 16 in the
inner face of the face plate and adapted to seat therein when the
airway and the face plate are connected.
The front face of the face plate 11 has thereon a means for holding
the tube 12 in a position of adjustment fixed against axial
movement relative to the face plate. As here shown, this means
comprises an arrangement of a flexible plastic strap 36 anchored at
one end on the front face of one of the face plate wings 13 and
disposed so that it may be trained over and across the endotracheal
tube 12 when it is seated on the top edge of the bridge 14 at the
bottom of the central face plate passage 15. The face of strap 36
which engages tube 12 is serrated for engagement with a
complemental tooth on one of a pair of anchor blocks 37 formed
integral with and projecting forwardly of the front face of the
face plate arranged in slightly spaced apart relation just
sufficient to provide a passageway into which the securing strap 36
may be slid edgewise in the nature of a ratchet to interlock its
serrations with the tooth on one of the anchorblocks 37 in a
selected position of adjustment, whereby the tube 12 is gripped
between the top edge of the face plate bridge 14 and the overlying
securing strap 36, thus effectively preventing axial movement of
the tube relative to the face plate and the airway.
MODE OF OPERATION
When the above described apparatus is to be used in service, the
airway 10 and the face plate 11 are connected by inserting the
tongues 30 between the rails provided by the inturned flanges of
the bite tube top and bottom walls 19 and 20 and sliding the airway
and the face plate together along the longitudinal axis of the
airway until the detents 31 on the tongues pass through the face
plate apertures 17 and snap into latched engagement with the outer
face of the face plate. At this point, further telescoping movement
between the airway tongues 30 and the bite tubes of the face plate
is arrested by contact of the inner ends of the bite tubes against
the front end abutments 33 on the channel wall portions 27, as best
shown in FIGS. 2 and 5.
Because the primary function of the aforesaid unitary assembly is
to hold securely in place an already intubated endotracheal tube,
one that has been selective positioned with the aid of a
laryngoscope in a manner well known to those skilled in the art,
the assembly is not positioned in a patient's mouth until the tube
12 is fully intubated. After the tube is in place, the assembly is
inserted in the patient's mouth beneath the tube and with the
curved posterior portion of the airway engaged over and holding
down the patient's tongue in the conventional manner of airways.
During insertion of the airway the intubated tube 12 is
accommodated in the open top recess 15 of the face plate. This
recess permits the face plate to be shifted vertically into
engagement with the tube so that the tube is seated firmly on the
upper edge of the face plate bridge 14 at the bottom of the
recess.
The face plate seats against and covers the front of the patient's
mouth with the upper teeth seating on the top walls 19 of the bite
tubes and with the lower teeth bearing against the lower walls 20
just behind the apron 35, which apron seats on the upper edges of
the patient's lower jaw teeth and engages their fronts, thus
providing a means entirely on the body of the airway for holding it
secured against backward movement over the patient's tongue.
The height of each inside wall 18 of the face plate bite tubes is
greater than the outside diameter of the endotracheal tube 12. This
tube is made of plastic or rubber and is curved on an arc
subtending an angle of substantially ninety degrees. When the tube
is fully seated in the bottom of the face plate passage 15 it
cannot be constricted or closed by biting action of the patient's
teeth. In such action the patient's upper teeth will engage the
bite tube top walls 19 and the lower teeth will engage the bottom
walls 20, and will be held out of contact with the endotracheal
tube. In like manner, the height of each latch tongue 30 of the
airway body is slightly greater than the outside diameter of the
endotracheal tube 12, so that, when the face plate is disconnected
and removed without removal of the airway, the top edges of the
tongues 30 in cooperation with the under face of the airway floor
section 34 will constitute a bite block that will prevent contact
of the patient's teeth against the surface of the tube 12 or any
tube of lesser outside diameter. The upper teeth of the patient
will seat against the top edges of the tongues 30 and the lower
teeth will seat against the flat under face of the airway floor
section 34 just behind the apron 35. The symmetry of the face plate
wing panels 13 relative to the central passage 15 assures that the
body of the endotracheal tube 12 will seat in and on the central
airway channel 29 and be held centrally in the patient's
trachea.
After the airway and face plate are in position the securing strap
36 is manipulated to clamp the tube against the bottom of the
passage 15 and thus hold the tube firmly against axial movement
either outwardly or inwardly. The free outer end of the tube 12 is
then connected to a conduit 38 through which air and/or anesthetic
fluid are supplied to the patient's lungs from a pressurized
source, not shown. While the apparatus is in service, saliva and
phlegm collecting in the patient's trachea are removed through a
conventional suction catheter 39 intubated through one of the
auxiliary apertures 17 of the face plate and trained along its
associated side channel 28 of the airway. The other aperture 17 and
its associated airway side channel 28 may be used for intubation
and extubation of other instruments as desired.
Following initial clamping engagement of the securing strap 36 on
the tube 12, a tighter engagement may be effected simply by
pressing down upon the portion of the strap which overlies the
tube. The serrations on the strap are arranged as a ratchet rack
and the serrations on the guide blocks 37 serve as pawls. The strap
may be released simply by sliding it frontally from between the
blocks 37.
* * * * *