U.S. patent number 3,818,907 [Application Number 05/353,219] was granted by the patent office on 1974-06-25 for double cylinder lavage syringe.
Invention is credited to Mark W. Walton.
United States Patent |
3,818,907 |
Walton |
June 25, 1974 |
DOUBLE CYLINDER LAVAGE SYRINGE
Abstract
A syringe for stomach lavage is described having dual cylinders
and pistons with a common handle for operating the pistons. A check
valve system causes discharge from one cylinder for injection
purposes and from the other cylinder for discharge purposes when
the pistons are moved simultaneously inward, and allows filling of
the one cylinder for injection purposes and filling of the other
cylinder for discharge purposes when the pistons are simultaneously
withdrawn.
Inventors: |
Walton; Mark W. (Park Forest,
IL) |
Family
ID: |
23388221 |
Appl.
No.: |
05/353,219 |
Filed: |
April 23, 1973 |
Current U.S.
Class: |
604/38;
607/105 |
Current CPC
Class: |
A61F
7/12 (20130101); A61M 1/0062 (20130101) |
Current International
Class: |
A61F
7/12 (20060101); A61M 1/00 (20060101); A61m
031/00 () |
Field of
Search: |
;128/234,218G,255,218P,400,172.2 ;222/386 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Trapp; Lawrence W.
Attorney, Agent or Firm: Fitch, Even, Tabin &
Luedeka
Claims
What is claimed is:
1. A syringe for internal lavage, comprising, an injection cylinder
and discharge cylinder, each cylinder having an inlet and an
outlet, means for connecting a tube to be inserted into a patient
to said outlet of said injection cylinder and to said inlet of said
discharge cylinder to allow flow to and from the patient, each of
said inlets and outlets having a check valve therein, an injection
piston in said injection cylinder and a discharge piston in said
discharge cylinder, said pistons each having an inward stroke
wherein said check valves in said inlets of said cylinders are
closed and said check valves in said outlets of said cylinders are
open, said pistons each having an outward stroke wherein said check
valves in said inlets of said cylinders are open and said check
valves in said outlets of said cylinders are closed, and means for
manually operating said pistons simultaneously.
2. A syringe according to claim 1 wherein said inlet in said
injection cylinder is adapted for connection to a source of
injection fluid, wherein said outlet of said injection cylinder is
adapted for connection to a tube, wherein said inlet of said
discharge cylinder is adapted for connection to a tube, and wherein
said outlet of said discharge cylinder is adapted for connection to
a discharge reservoir.
3. A syringe according to claim 1 wherein said cylinders are
parallel with each other, a flexible tube is connected to said
connecting means for insertion into a patient's stomach, and
another tube is connected to said inlet of said injection cylinder
to allow cold liquid to flow directly from a reservoir therefor
into said injection cylinder.
4. A syringe according to claim 3 wherein said outlet of said
injection cylinder and said inlet of said discharge cylinder are
adjacent each other at the ends of said cylinders opposite said
manual operating means.
5. A syringe according to claim 1 wherein said manual operating
means comprise a handle.
6. A syringe for internal lavage of a patient's stomach with ice
water, comprising, an injection cylinder and a discharge cylinder
disposed adjacent each other and parallel with each other, said
injection cylinder having a first orifice at one end thereof, said
discharge cylinder having a second orifice at one end thereof
adjacent said first orifice, a check valve in said first orifice
arranged to allow ice water flow from said injection cylinder, a
check valve in said second orifice arranged to allow stomach fluid
flow into said discharge cylinder, a hollow flexible tube means
adapted to be swallowed by the patient connected to said first and
second orifices to allow fluid into and from the stomach, a third
orifice adjacent the end of said injection cylinder having said
first orifice, and a fourth orifice in said discharge cylinder
adjacent the end thereof having said second orifice, a check valve
in said third orifice arranged to allow ice water flow into said
injection cylinder, passageway means connected to said third
orifice and extending to a reservoir of ice water for conveying ice
water directly to said injection cylinder for injection into the
stomach, and a check valve in said fourth orifice arranged to allow
stomach fluid flow out of said discharge cylinder, a pair of
pistons, each in a respective one of said cylinders disposed
parallel with each other, and a handle connected to said pistons
for manually moving same axially and simultaneously in said
cylinders.
Description
This invention relates generally to syringes and, more
particularly, to an improved syringe suitable for internal lavage
such as in performing fluid lavage of the stomach.
Certain medical conditions are treated by lavage of an internal
member such as the stomach by the use of fluids. For example, in
the treatment of upper gastrointestinal bleeding, ice water lavage
is typically used.
In the treatment of upper gastrointestinal bleeding by ice water
lavage, prior art techniques have involved the insertion of a
nasogastric tube into the stomach. A standard 50cc syringe or 100cc
bulb syringe containing the ice water is adapted to the nasogastric
tube and the water is introduced. This, of course, necessitates the
constant attaching and detaching of several syringes to and from
the tube or the constant filling and emptying of the bulb syringe.
Often, this means that the pumping action and therefore the flow of
fluids into and out of the stomach must be interrupted. Moreover,
in the time that it takes to rotate or refill a syringe, the normal
homeostatic mechanisms of the body may partially warm the water
previously introduced into the stomach. All of these factors may
contribute to a lengthening of the time in which it takes to
control the hemorrhage.
In addition, the person performing the lavage over an extended
period of time, e.g. several hours, is discomforted by constantly
inserting his hands into the ice water during filling of the bulb
syringe and by the repetitive squeezing operations to fill and to
discharge the ice water. Although there have been mechanical
devices proposed in prior art patents for lavage, these devices for
one reason or another have not been adopted on any widescale
commercial basis. Thus, a more efficient stomach lavage syringe to
eliminate the discomforture of the physician is still needed.
Other applications of internal lavage may include the treatment of
accidental or intended overdose of potentially lethal medications,
particularly in the case of patients in a semicomatose or fully
comatose state. Also, where intentionally induced vomiting is
contraindicated, internal lavage may be preferable.
It is an object of the present invention to provide an improved
syringe for internal lavage.
Another object of the invention is to provide a syringe for
internal lavage which may be operated to both introduce and
withdraw fluid without the necessity of detaching the syringe from
an inserted tube.
It is another object of the invention to provide a syringe for
internal lavage which provides operation superior to prior art
devices.
Other objects of the invention will become apparent to those
skilled in the art from the following description, taken in
connection with the accompanying drawings wherein:
FIG. 1 is a full section view of a syringe constructed in
accordance with the invention; and
FIG. 2 is a full section view of the syringe of FIG. 1, with part
broken away, in a different operating condition.
Very generally, the syringe of the invention comprises an injection
cylinder 11 and a discharge cylinder 12. Each cylinder has an inlet
13 and 14, respectively, and each cylinder has an outlet 15 and 16,
respectively. Each of the inlets and outlets has a check valve 17,
18, 19 and 21 therein. These check valves may be ball valves as
illustrated somewhat diagrammatically. An injection piston 22 is
provided in the injection cylinder 11, and a discharge piston 23 is
provided in the discharge cylinder 12. The pistons each have an
inward stroke wherein the respective check valves 17 and 19 are
closed and the respective check valves 18 and 21 are open, and each
piston has an outward stroke wherein the respective check valves 18
and 21 are closed and the respective check valves 17 and 19 are
open. Handle means 24 are provided for manually operating the
pistons simultaneously.
Referring now more particularly to the drawings, the syringe of the
invention is shown used in connection with a nasogastric tube 26
inserted into the stomach of a patient for the purpose of treating
upper gastrointestinal bleeding by ice water lavage. The tube 26
has a forked end 28, from each branch of which projects a
respective reduced diameter connector portions 31, 33. As will be
explained, ice water is injected through the connector portion 31
and through the tube 26 into the stomach of the patient. On the
alternate stroke of the syringe, explained below, ice water, blood
and other discharge products pass up the tube 26 from the stomach
and through the connector portion 33. The respective injection and
discharge flows are indicated by the arrows in FIGS. 1 and 2,
respectively. The injection and discharge flows occur automatically
without the necessity for the physician to continually insert his
hands into the cold ice water as with prior art syringes and
without the accompanying hand fatigue caused by the repetitive
squeezing operations, i.e., first squeezing for filling the tube
with ice water, secondly squeezing the tube to discharge the ice
water into the stomach, thirdly squeezing the bulb to discharge the
stomach discharge liquid. The illustrated tube 26 has but a single
passageway but it may be provided with two separate discrete
passageways with one connected to the cylinder 11 and the other
connected to the cylinder 12. The tube 26 is soft, flexible and is
adapted to be swallowed or otherwise inserted through the throat
into the stomach. Rather than the tube forked section 28 and
connectors 31 and 33, suitable passages could be provided
internally of the syringe itself so that only a single tube
connector need be utilized.
The syringe itself comprises two tubular cylinders 11 and 12 which
are secured in parallel relationship with each other in any
suitable fashion. A flange 35 is provided at one end of the tube,
and at the other end the tubes terminate in a housing 37. The
housing, with the walls of the tubes 11 and 12, defines openings 39
and 41 at the end of the housing towards the tube 26, and also
defines openings 43 and 45 which are aligned with each other on
opposite sides of the housing on an axis which extends transversely
to the axes of the tubular cylinders 11 and 12. An orifice fitting
47 is provided in the opening 43 to define the inlet 13. An orifice
fitting 49 is provided in the opening 39 defining the outlet 15. An
orifice fitting 51 is provided in the opening 41 defining the inlet
14, and an orifice fitting 53 is provided in the opening 45
defining the outlet 16. The cylinder 11 defines the injection
cylinder with the inlet 13 and the outlet 15 communicating
therewith. Similarly, the cylinder 12 defines the discharge
cylinder with the inlet 14 and the outlet 16 communicating
therewith.
In order that the inlet 13 can operate only as an inlet, the check
valve 17 is mounted therein in such a manner that fluid flow can
take place only into the cylinder 11 through the inlet 13. The
outlet 15 contains the check valve 18 oriented such that only fluid
flow can take place through the outlet 15 out of the cylinder 11.
The check valve 19 is placed in the inlet 14 and oriented such that
fluid flow can take place only through the inlet 14 into the
cylinder 12. The check valve 21 is placed in the outlet 16 such
that fluid flow can take place from the cylinder 12 only out
through the outlet 16. The check valves are operated by pressure
such that when the pressure on the downstream side of the check
valve exceeds the pressure on the upstream side, the valve will
close and prohibit flow therethrough.
The piston 22 is provided in the cylinder 11 and is shown as a
rod-like structure having an annular seal 55 at one end such that
movement of the piston axially in the cylinder 11 either enlarges
or diminishes the internal volume of the cylinder. Similarly, the
piston 23 is a rod-like structure contained within the cylinder 12
and provided with an annular seal 57 at one end. Axial movement of
the piston 23 within the cylinder 12 serves to either enlarge or
decrease the internal volume of the cylinder 12. Both the piston 22
and the piston 23 are arranged parallel with each other within the
respective cylinders 11 and 12 and are operable simultaneously by a
handle 24 which is connected to the ends of the pistons at the ends
thereof opposite the annular seals 55 and 57.
In operating the syringe of the invention, the inlet 13 is
connected through a suitable tube 59 to a source of ice water, not
shown. The outlet 15 is connected to the connector portion 31 of
the tube 26, and the inlet 14 is connected to the connector portion
33 of the tube 26. The outlet 16 is connected through a suitable
tube 61 to a discharge reservoir, not shown. The tube 26 may be a
portion of the lavage syringe apparatus or it may be a separate
tube adapted to be connected to lavage syringe apparatus at the
time of insertion through the throat into the stomach.
In beginning operation, the handle 24 is operated to withdraw both
of the pistons 22 and 23 to the position shown in FIG. 2. This
serves to fill the interior of the cylinder 11 with ice water
flowing through the inlet 13 as indicated by the arrows 63. The
handle is then moved to force the pistons 22 and 23 inwardly,
causing the valve 17 to close and the valve 18 to open. This forces
the ice water from the cylinder 11 through the outlet 15 and into
the tube 26 as shown by the arrows 65 in FIG. 1.
Once the handle is pushed to the full inward position shown in FIG.
1, the handle may then be withdrawn to simultaneously refill the
cylinder 11 with ice water through the inlet 13 (the valve 18
closing) and fill the cylinder 12 with discharge fluids from the
stomach through the inlet 14 (the valve 21 closing). The flow of
ice water into the cylinder 11 is the same as previously described
and is shown in FIG. 2 by the arrows 63. The flow of discharge
fluids into the cylinder 12 is shown by the arrows 67 in FIG.
2.
Once the pistons 22 and 23 have been withdrawn to the position
shown in FIG. 2, the handle 24 is once again operated to return the
pistons to the position shown in FIG. 1. This stroke both empties
the cylinder 11 through the outlet 15 (the check valve 17 closing)
and empties the cylinder 12 through the outlet 16 (the check valve
19 closing). Thus, by reciprocating the handle 24 and thus the
pistons 22 and 23, alternate injection and discharge from the
stomach may be accomplished without the necessity of changing
connections to the tube 26. Moreover, the action of the double
cylinder syringe provides that substantial injection and discharge
occur positively on both strokes, for a strong and sure pumping
action, as in contrast, for example, with squeeze syringes where
injection is limited by the size and strength of the operator's
handgrip and discharge is limited by the recovery of the squeeze
mechanism without the aid of the operator. The operator need never
stop the pumping action and interrupt flow and, as a result, more
rapid control of hemorrhage is made possible. The operator also
need not continually have his hands exposed to the cold of the ice
water or experience the hand fatigue resulting from the multiple
squeezing operations.
Although the invention has been described in connection with ice
water lavage to control upper gastro-intestinal bleeding, the
syringe of the invention is applicable for other purposes. The
lavage of the stomach for intended or accidental overdose of
potentially lethal medications is possible by use of the syringe of
the invention. Rapid removal of particulate matter with the
invention is also feasible.
It may therefore be seen that the invention provides an improved
syringe for internal lavage. The syringe of the invention provides
positive injection and discharge action without the necessity of
changing connection between strokes. This minimizes the delay in
the treatment of many conditions, including the internal lavage of
the stomach, maximizing the effects of the treatment.
Various modifications of the invention in addition to those shown
and described herein will become apparent to those skilled in the
art from the foregoing description and accompanying drawings. Such
modifications are intended to fall within the scope of the appended
claims.
* * * * *