U.S. patent number 3,777,757 [Application Number 05/104,960] was granted by the patent office on 1973-12-11 for sucking wound plug and chest aspirator.
Invention is credited to John Caswell, R. Flanagan Gray, William G. Muller.
United States Patent |
3,777,757 |
Gray , et al. |
December 11, 1973 |
SUCKING WOUND PLUG AND CHEST ASPIRATOR
Abstract
A unique inflatable bag catheter is provided having a pliable
elongated bag disposed generally at the distal end thereof. A
cylindrical end portion of the distal end may be formed with a
plurality of apertures for the passage of fluids into the catheter
from a space immediately adjacent the distal end. A terminal-most
portion of the distal end of the catheter may be formed with a
cushioning device to prevent damage to delicate internal portions
of the body such as the lungs. A hand pump portion of the catheter
may be threadedly and removably engaged with an inflatable balloon
portion of the catheter. One-way valves may be provided in both the
inflatable balloon portion of the catheter and the hand pump
portion of the catheter to insure that fluids sucked in from the
distal end of the catheter will travel only away from the distal
end toward the proximal end of the catheter. One one-way valve may
be disposed on either side of the hand pump which may comprise an
elastomeric bulb. A conduit may be connected with the inflatable
balloon for directing inflating fluids thereto. The free terminal
end of the conduit may be fitted with threading corresponding with
threading on the inflatable balloon portion of the catheter.
Because of this arrangement, the hand pump may be attached
initially to the conduit for inflating the balloon and then may be
removed to be reconnected with the inflatable balloon portion of
the catheter for evacuating fluids from within a body cavity. When
the hand pump is threadedly engaged with the conduit for inflating
the balloon, another one-way valve may be threadedly engaged within
a free end portion of the elastomeric bulb portion of the catheter
to convert the pump from a suction device to one for pressurizing
of the inflatable balloon. In one alternative embodiment, a valved
face mask may be provided to require a user to forceably exhale so
as to increase the compression force on internal drainage fluids
which force, in turn, permits the expulsion of undesirable internal
fluids through the catheter by the pumping action of the chest
wall. BACKGROUND OF THE INVENTION The invention relates to means
for simultaneously sealing off atmospheric leaks into the chest and
blood escaping from chest, sucking wounds of various irregular
shapes, and for draining off fluids leaking into the intrathoracic
spaces defined by the lungs and chest wall. More particularly, the
invention relates to an inflatable bag catheter which may be
installed within a body perforation by one unskilled in medical
practices, and which then may be manually or automatically operated
without fear of overpressurizing the internal spaces adjacent the
sucking wound. In view of the high casualty rate of severly wounded
men in Indo-China, and in view of the possibility of future
conflicts among nations which may result in vast numbers of wounded
men who might be saved if immediately and properly treated, it is
imperative that continuing efforts be made to improve the medical
tools available for preserving the lives of such victims. In war
and at accident scenes, the medical expertise necessary to treat a
large sucking wound is, too often, not available. Such wounds, as a
large irregular perforation of the chest wall, can mean death to
the victim if not sealed and drained within a very short period of
time. If the wound is not sealed, the victim may, of course, die
due to a loss of blood. If the natural vacuum of the intrathoracic
space, surrounding the lungs, is not promptly restroed, the
victim's breathing may be severely curtailed. Threfore, surgical
apparatus must be advanced for providing a simple and inexpensive
means for smultaneously sealing and draining such a wound as a
perforation of the chest wall. Such apparatus must be operable by
one having no medical training and must, itself, not present any
hazards to the life of the victim. The cannula has been previously
known in the surgical arts, and has been utilized for withdrawing
fluids from internal body spaces. For example, the catheter has
long been used for draining fluids contained within internal
organs. More specifically, inflatable bag catheters have been used
commonly by physicians for many years to drain the internal organs
of patients. Such catheters are comprised of thin walled, flexible,
hollow drainage tubes provided with one or more lateral openings in
the distal end thereof to permit the passage of fluid contained
within an internal organ, into which the catheter has been
inserted, to be drawn into the hollow tube and expelled at the
proximal end of the tube. The catheter is provided, adjacent the
distal end thereof, with a bulbous shape which may be inflated to
retain a catheter in operational position once the catheter has
been inserted into the internal organ to be drained. The inflatable
bag is inflated through an inflation tube which connects with the
inflatable bag and may extend to the proximal end of the catheter.
In using such an inflatable bag catheter, the distal end of the
catheter first is inserted into the organ to be drained. Then, the
inflatable retention bag is inflated by introducing a required
amount of inflating fluid, such as air or water. The inflating
fluid is usually introduced through the use of a hypodermic syringe
inserted through a plug in the inflation arm when a plug is used
therein. When a valve is employed in the inflation tube, the bag
may be inflated by means of a syringe provided with a tip capable
of opening the valve. In view of the rather delicate operation
involved, heretofore such an operation had to be performed by those
skilled in the surgical arts. Also, when such devices were applied
to perforated flesh wounds as opposed to natural cavities of the
body, additional problems were encountered. One attempt at
providing an effective means for sealing a wound comprising a flesh
perforation is evidenced by U. S. Pat. No. 3,253,594, issued to
Matthews, et al, in 1966. Matthews, et al, disclose a cannula or
catheter having an inflatable bag disposed at a distal end thereof.
Although the Matthews, et al, patent shows that a catheter with an
inflatable bag attached thereto may be used to seal a perforation
in body flesh, the apparatus is rather crude and requires the use
of washers and nuts for the installation thereof which may require
or cause an enlargement of the wound opening. Also, if the
perforation were in the chest cavity area, the Matthews, et al,
apparatus makes no provision for removing gas and liquids draining
into the intrathoracic space which maintains the vacuum which
normally surrounds the lungs. This normal vacuum is of critical
importance in that it permits natural unforced inhalation upon
chest expansion. It would, therefore, be advantageous if a combined
apparatus were provided which performed the dual functions of
effectively sealing a wound comprising a flesh perforation adjacent
the chest cavity and which automatically withdrew fluids draining
into the intrathoracic space in response to the natural movement of
the chest during respiration. OBJECTS AND SUMMARY OF THE INVENTION
It is therefore an object of the present invention to provide a
combined sucking wound plug and chest aspirator which solves many
of the problems confronting the medical profession today. It is
another object of the present invention to provide a sucking wound
plug and chest aspirator which may be installed by one who is not
skilled in the surgical arts. It is still another object of the
present invention to provide a chest aspirator which may operate
automatically in response to normal chest movement during
respiration. It is yet another object of the present invention to
provide a sucking wound plug and chest aspirator which includes a
hand pump which is simple, inexpensive, and may be automatically
bypassed if the pumping action provided thereby is inadequate. It
is a further object of the present invention to provide a sucking
wound plug and chest aspirator having a hand pump which may be used
to both inflate an inflatable bag portion of the catheter and to
withdraw fluids draining into an internal space adjacent a
perforated flesh wound. It is still another object of the present
invention to provide a simple means for sealing flesh perforations
despite the permutations of irregular shapes and sizes of such
perforations. It is yet another object of the present invention to
provide a sucking wound plug and chest aspirator which may be
inserted through a flesh perforation of a human body without fear
of damaging the internal organs thereof. It is still yet another
object of the present invention to provide a sucking wound plug and
a chest aspirator having a hand pump which cannot be operated in a
manner that will place a damaging suction on an internal space
adjacent a perforated wound. It is still yet a further object of
the present invention to provide a sucking wound plug and chest
aspirator which is more effective, inexpensive, and versatile than
the plugs or aspirators heretofore known. It is another object of
the present invention to provide a valved face mask means which
cooperates with the aspirator to cause fluids to be expelled from
the intrathoracic space with relatively high force. At least some
of the above listed objects are carried out by the provision of a
unique catheter having an inflatable bag at a distal end thereof
and a hand pump disposed adjacent a proximal end thereof. One way
valve means is provided for directing fluid passage only from the
distal to proximal ends of the catheter. The catheter may comprise
two portions. The first portion of the catheter includes the
proximal end and the hand pump means which may be operatively
engaged with the second portion including the distal end of the
catheter for draining internal fluids, or with an inflation tube
for inflating the inflatable bag. In one independent feature of the
invention, cushion means is provided at the terminal-most portion
of the distal end of the catheter to prevent damage to internal
organs and additional one-way valve means is provided for use with
the hand pump means to convert the pump from a suction to a
pressurizing apparatus. In another independent feature of the
invention, a face mask provides a resistance to exhalation which
assistance, in turn, increases the force with which internal fluids
are expelled.
Inventors: |
Gray; R. Flanagan (Washington
Crossing, PA), Caswell; John (Newtown, PA), Muller;
William G. (Yardley, PA) |
Family
ID: |
22303364 |
Appl.
No.: |
05/104,960 |
Filed: |
January 8, 1971 |
Current U.S.
Class: |
604/99.04;
604/247; 604/99.03; 604/919; 604/212; 604/540 |
Current CPC
Class: |
A61M
25/1011 (20130101); A61M 39/0247 (20130101); A61M
25/02 (20130101); A61M 16/06 (20130101); A61M
2210/101 (20130101); A61M 2205/0216 (20130101); A61M
2039/0273 (20130101); A61M 2210/10 (20130101); A61M
2039/0297 (20130101); A61M 2025/0233 (20130101); A61M
2039/0276 (20130101); A61M 2039/027 (20130101); A61M
2025/028 (20130101); A61M 16/0683 (20130101); A61M
2230/005 (20130101); A61M 2210/10 (20130101) |
Current International
Class: |
A61M
25/02 (20060101); A61M 16/06 (20060101); A61M
25/10 (20060101); A61M 1/00 (20060101); A61m
001/00 () |
Field of
Search: |
;128/349B,349BV,350,344,1,246,276-278 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Rosenbaum; Charles F.
Claims
What I claim is:
1. Apparatus comprising:
catheter means having a distal end and a proximal end; inflatable
bag means disposed at said distal end of said catheter means;
inflating tube means for directing inflating fluid to said
inflatable bag means;
cushioning means presented on a terminal-most portion of said
distal end of said catheter means;
suction forming means for drawing fluid in through said distal end
of said catheter means; and
first one-way valve means disposed in said catheter means and
operable to pass fluid from said distal end of said catheter toward
said proximal end of said catheter in response to overpressure
being transmitted thereagainst by fluid disposed within and
adjacent said distal end.
2. An apparatus according to claim 1, wherein said inflatable bag
means has end walls having areas generally larger than the
cross-sectional areas of a chest wall perforation to be sealed and
said inflatable bag means has a generally cylindrical portion
extending between said end walls so that said generally cylindrical
portion engages snugly within various irregular surfaces of said
chest wall perforation.
3. An apparatus according to claim 1, wherein said suction forming
means comprises hand pump means; and
said hand pump means forms a portion of a continuous closed fluid
passageway extending from said distal end to said proximal end of
said catheter means.
4. An apparatus according to claim 3, wherein said hand pump means
comprises an elastomeric bulb formed as a part of said catheter and
disposed intermediate the terminal ends thereof.
5. An apparatus according to claim 4, wherein said first one-way
valve means comprises one valve disposed on each side of said
elastomeric bulb.
6. An apparatus according to claim 5, wherein a first portion of
said catheter including said proximal end presents said elastomeric
bulb and is detachably connected with a remaining second portion of
said catheter which second portion includes said distal end.
7. An apparatus according to claim 6, wherein a first end of said
first portion of said catheter is formed with a first female
threading and a first end of said second catheter portion is formed
with a first male threading corresponding with said first female
threading;
a second end of said first portion of said catheter being formed
with second female threading;
a first end of said inflating tube means being formed with male
threading corresponding with said second female threading of said
second portion of said catheter;
a second one-way valve means being removably engageable within said
first female threading of said first portion of said catheter;
and
whereby said first portion of said catheter may be initially
threadedly engaged with said inflating tube means for directing
fluid to said inflatable bag means with said second one-way valve
means being engaged within said first female threading of said
first portion of said catheter and may then be removed from said
inflating tube means and threadedly engaged within said second
portion of said catheter for sucking fluids in through said distal
end of said catheter and expelling said fluids through said
proximal end after said second one-way valve has been removed.
8. A combined plug and chest aspirator for sealing wounds
penetrating the chest wall cavity, comprising:
an inflatable bag catheter;
tube means for conducting fluid to said inflatable bag;
cushion means disposed at the terminal-most portion of a distal end
of said catheter;
hand pump means provided on said catheter;
a first one-way valve disposed in said catheter between said hand
pump means and a proximal end of said catheter;
a second one-way valve disposed in said catheter between said hand
pump means and said distal end of said catheter; and
said first and said second valves operable to pass fluid from said
distal end of said catheter toward said proximal end thereof.
9. A combined plug and chest aspirator according to claim 8,
wherein said catheter comprises a first portion and a second
portion;
said first portion having said hand pump and said first one-way
valve;
said second portion having said inflatable bag and said second
one-way valve;
a first end of said first portion being provided with female
threading;
a first end of said second portion being formed with male threading
corresponding with said last mentioned female threading;
a free end of said tube means for conducting fluid to said
inflatable bag having male threading; and
said first portion of said catheter being formed with female
threading at a second end thereof corresponding with said male
threading formed on said tube means for conducting fluid to said
inflatable bag.
10. An apparatus according to claim 8, wherein said inflatable bag
comprises two generally radially extending end walls and a
generally cylindrical surface extending therebetween; and whereby
the outer periphery of said end walls extend beyond the peripheral
extent of a body perforation and said cylindrical surface is
operable to engage flush against an irregular surface of the
marginal edges defining the perforation in response to the
inflation of said inflatable bag.
11. An apparatus according to claim 9, wherein said hand pump means
comprises an elastomeric bulb.
12. An apparatus according to claim 11, wherein each said one-way
valve comprises two radially extending end walls having axially
aligned apertures; and
a valve disc is spring biased against one of said apertures.
13. An apparatus according to claim 11, wherein a second one-way
valve means is releasably engaged within said first portion of said
catheter; and
whereby said elastomeric bulb may be converted from a suction
forming to a pressure forming means.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
While the invention is particularly pointed out and distinctly
claimed in the concluding portion of the specification, a preferred
embodiment is disclosed in the following detailed description,
which may be best understood when read in connection with the
accompanying drawings in which:
FIG. 1 is a partial axial sectional view of a distal end portion of
an apparatus according to the present invention, properly installed
within a chest wall perforation;
FIG. 2 is an axial sectional view of a first portion of the
catheter, which may be connected with either a body fluid draining
tube or an inflation tube of the second portion of the
catheter;
FIG. 3 is an axial sectional view of a one-way valve which may be
used in combination with the first portion shown in FIG. 2 to
convert a pump of the first portion from a suction apparatus to a
pressurizing apparatus; and
FIG. 4 is a sectional view of a valved face mask which may be used
in combination with the apparatus of FIG. 1.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring now to the drawings, FIGS. 1 and 2 show an inflatable
balloon catheter assembly according to the present invention. The
assembly includes a first portion 16 and a second portion 10 which
is installed within a perforation 12 defined within a patient's
chest wall 14. The portion 10 of the overall catheter will be
referred to herein as the distal end portion of the catheter.
FIG. 2 shows the first portion 16 of the inflatable balloon
catheter, which portion shall be referred to herein as the proximal
portion. It can readily be seen, that the proximal portion 16 may
be threadedly engaged with the distal portion 10 to form an
operable apparatus by the engagement of the male threads 18 of
portion 10 within the female threads 20 of the portion 16.
It will be noted that the distal portion 10 of the overall
apparatus is provided with an inflatable bag 22, which may be of a
very pliable elastomeric substance. The bag 22 may be formed with
end walls 24 and 26, having areas which may be expected to be
generally larger than the cross-sectional areas of a chest wall
perforation to be sealed. In this manner, the generally cylindrical
portion of the balloon 28 extending between the end walls 24 and 26
may fit snugly within the various irregular surfaces, e.g. surface
30, of the marginal edges of the chest wall 14, defining the
perforation 12.
The terminal distal end of the catheter may be of a generally
cylindrical configuration, having apertures 32 formed therein for
the passage of body fluids from an intrathoracic space 34
surrounding the distal end into the internal passageway 36 of the
overall catheter assembly. A very soft cushioning means 38 may be
presented on the terminal-most edge of the distal end of the
catheter to prevent damage to any delicate internal organs such as
the lung 40.
An inflating tube 42 may be connected with the inflatable bag 22
for directing inflating fluid thereto. The tube 42 may be provided
with a valve 44 and a threaded fitting 46 at a terminal free end
thereof.
The second portion 16 of the catheter assembly may be formed with
internal female threading 48 which corresponds with the male
threading of the fitting 46 of the inflation tube 42. Through this
correspondence of the various male and female threadings of the
various members of the overall assembly, the hand pump, which, in
the preferred embodiment, comprises an elastomeric bulb 49, may be
operatively attached to the drainage tube portion of the catheter
10 by engaging threads 18 within threads 20 or may be attached to
the bag inflating tube 42 by the engagement of female threads 48 of
the catheter portion 16 with the male threading 46 of the inflating
tube 42.
A unique arrangement of one-way valves is provided throughout the
overall assembly. A one-way valve 50 is provided in the portion 16
of the catheter intermediate the terminal ends thereof. The valve
50 comprises two end plates 52 and 54, having axially aligned
apertures 56 and 58, respectively, formed therein. A valve disc 60
is urged against the end plate 56 to seal the aperture formed
thereby by means of a helical spring 62 which urges at its opposite
end against the second end plate 54.
In operation, after the portion 10 of the overall catheter has been
properly inserted within a flesh perforation 12 and after the
inflatable bag 22 has been inflated by directing pressurized fluid
through the tube 42, so that the inflatable bag tightly seals and
adheres within all the various jagged portions 30 of the
perforation 12, the normal action of the lung 40 in combination
with the compression forces of the chest wall during exhalation
will assert pressure against any fluids within the intrathoracic
space 34. The overpressure applied to the fluids within the space
34 will then force the fluid in through the apertures 32 to the
passageway 36 of the catheter and will simultanously force the
valve disc 60 to lift off the seat formed by the valve end plate
52. When the chest wall is restored to an expanded position, there
is no longer an overpressure with respect to the spring 62 of the
one-way valve, so that the valve disc 60 is urged against its seat
52 formed by end plate 56 and fluid cannot return through the
catheter into the space 34 through the apertures 32. It can be see
that, through this operation, the normal breathing of a patient
will cause the systematic and cyclic pumping of any fluid which has
seeped into the intrathoracic space.
If the normal breathing action of the patient should be
insufficient to operate the one-way valve 50, the portion 16 of the
assembly may be connected to provide proper suction for draining
fluids from the intrathoracic space. The installation of the
portion 16 will not interfere with normal automatic chest
aspiration due to respiration and, therefore, a single operator may
take rest periods between periods of manual pumping.
The portion 16 of the overall apparatus may comprise a relatively
rigid tube 64, having the elastomeric bulb 49 formed integrally
therewith. A second one-way valve 66 may be provided within the
tube 64 and may be of the same configuration and structure as the
last described one-way valve 50. The one-way valves 50 and 64 must
be operable to pass fluid in the same direction when the female and
male threadings 20 and 18 respectively, of the first portion and
the second portion of the apparatus are connected.
When the portion 16 is connected with the inflating tube 42 by
means of female threads 48 engaging on the male threads 46 of the
tube 42, a third one-way valve 68 may be installed within the
portion 16 to convert the pump to a pressurizing device. FIG. 3
shows a tubular housing for the one-way valve 68, which housing is
provided with male threading 70 at one end thereof for engagement
within female threading 20 of the portion 16 of the overall
assembly. The one-way valve 68 may be identical in configuration
with the two other valves 50 and 64.
When it is desired to inflate the bag 22 by means of the
elastomeric bulb 49, the female threads 48 are engaged within the
male threads 46 to connect the hand pump with the tube 42 and the
one-way valve 68 is attached to the other end of the portion 16, by
engaging the male threads 70 within the female threads 20. With the
hand pump attached in this manner, squeezing the hand pump
aspirates air through the one-way valve 68 and forces air through
the one-way valve 66 into the inflatable bag 22. When the bag is
properly inflated, the valve 44 on the conduit 42 is closed to trap
the pressurized fluid in the bag 22. Any suitable fluid may be used
in inflating the bag 22.
FIG. 4 shows a face mask 100, which may be used in combination with
the catheter portion of the present invention. The mask 100 may
comprise an elastomeric substance such as natural rubber and may be
held in an operational posture by conventional head straps 102
which may be connected with a portion of the mask by hooks 104 or
the like. Valve 44 may offer pressure relief.
The mask 100 may be provided with a sealing ring 106 disposed about
the marginal edge thereof. A flapper valve 108 and a spring loaded
valve 110 may be mounted generally centrally of the mask 100. The
flapper valve 108 comprises a cylindrical body 112 and a hinged
valve member 114, which swings freely inwardly to permit ease of
inhalaton but closes when moved outwardly to prevent exhalation
therethrough. The valve 110 is arranged to prevent inhalation
therethrough and to permit only forced exhalation against the bias
of the spring 116.
The overall effect of the valves 108 and 110 is to cause the user
of the mask 100 to inhale freely but to exhale forcibly. The forced
exhalation is operable to increase the chest wall pressures on
fluids in the intrathoracic space to increase the force with which
they are expelled through the catheter apparatus. Thus, it can be
seen that the face mask 100 cooperates with the catheter apparatus
in a synergistic manner to produce the new and improved functional
result of expelling undesirable internal fluids utilizing the
action of a patient's respiratory movement more efficiently than
heretofore possible.
SOME ADVANTAGES OF THE PRESENT INVENTION
It can thus be seen that a combined sucking wound plug and chest
aspirator has been herein provided which may be installed by one
not skilled in the surgical arts. The configuration of the
inflatable bag 22 of the catheter apparatus is such as to provide a
tight seal with the jagged marginal edges of a chest wall
perforation. The distal end cushion 38 insures that the overall
catheter may be inserted within a perforation without damaging
internal organs such as the lung 40. Th first portion 10 of the
overall assembly may function without any additional auxiliary
equipment as an automatic pump whereby overpressure caused by the
expansion of the lung on fluids within the intrathoracic space 34,
force the cyclic opening and closing of the one-way valve 50 so as
to expel fluids draining into the space 34. The face mask may be
utilized to increase the resistance to exhalation which, in turn,
increases the pressures in the intrathoracic spaces to aid the
natural forces of respiration in the expulsion of fluids. If the
natural respiratory action of the lung is insufficient to properly
expel the unwanted fluids, the hand pump 49 may be attached by the
threaded engagement of the male threads 18 within the female
threads 20. Since the pumping action of the hand pump 49 is
effected only when the elastomeric bulb is released to move from a
contracted to an expanded condition due to the natural resiliency
of the elastomeric material comprising the bulb, it is impossible
for an excited or overzealous operator to exert too much pumping
force on the internal space 34 of the patient.
Since the hand pump 49 may be utilized to either drain fluids from
the intrathoracic space 34 or to pressurize the inflatable balloon
22, the overall apparatus is provided with more versatility than
heretofore known. The interaction of the various parts of the
overall assembly operate in a synergistic manner to simultaneously
provide the dual functions of sealing perforated body wall and of
draining harmful fluids developing within the intrathoracic space
so as to restore proper breathing.
SCOPE OF THE INVENTION
While what has been shown herein is the preferred embodiment of the
present invention, it is, of course, understood that various
modifications and changes may be made therein without departing
from the invention. It is, therefore, intended to cover in the
following claims all such modifications and changes as may fall
within the true spirit and scope of the present invention.
* * * * *