Adapter For Use With Tracheal Tubes

Abstract

An adapter for use with trachael tubes, and embodying a connector for such tracheal tubes disposed in the central portion of an elongated portion of the adapter, with the connector extending a substantial distance into the central portion in a direction transverse to the length thereof and disposed in elevated position relative to the ends of the aforementioned elongated portion so as to protect against the accidental discharge of liquid into a tracheal tube connected to the adapter.

Description

BACKGROUND OF THE INVENTION

This invention relates to adapters, and, more particularly, to adapters of the type which are particularly well adapted for use with tracheal tubes, and the like.

It is a primary object of the present invention to provide a novel adapter for connection to tracheal tubes, and the like.

Tracheal tubes, as that term is used herein, may be of different types, such as, for example, orotracheal tubes, nasotracheal tubes and tracheostomy tubes.

As is well known in the art, tracheal tubes are commonly inserted into a person's trachea for various purposes, such as, for example, to enable the person to breathe, or to enable intermittent positive pressure ventilation of the respiratory tract to be carried out. In many instances, tracheal tubes which have been inserted into the tracheae of patients, are connected to suitable apparatus, such as a respirator, or the like, whereby suitable working fluid such as, for example, air, oxygen-enriched air, or a mixture of oxygen and other gases, such as helium, nitrogen or carbon dioxide, or the like, may be fed into the respiratory tract of the patient. In other instances, in what is commonly referred to as aerosol or mist therapy, and the like, tracheal tubes which have been inserted into the tracheae of patients, are connected to suitable apparatus, such as the nebulizer, for feeding into the respiratory tract of the patient a working fluid which consists of a suitable carrier, such as the aforementioned air, oxygen-enriched air or oxygen mixture, together with a suitable vapor or mist, such as, water, saline solution or amedicament in particulate form and intimately mixed with the carrier.

Heretofore, in the carrying out of aerosol or mist therapy, it has been common practice in the art to connect such a tracheal tube to the necessary apparatus, such as a nebulizer, by means of a T-shaped fitting or adapter, preferably made of a suitable, clear, transparent plastic material, such as the acrylic resin, known as Pelxiglas. In such instances, the tracheal tube commonly is connected to the lower leg of the adapter, with one crossarm of the adapter connected by a suitable conduit, such as a flexible, corrugated hose or tube made of a suitable material such as, for example, a suitable plastic material, such as polyvinyl chloride or polyethylene, and with the other crossarm of the adapter connected to a suitable exhaust conduit, such as, for example, a hose or tube made of suitable material such as, for example, the aforementioned polyvinyl chloride or polyethylene, with the latter tube being open to the atmosphere and of relatively short length, such as, for example, 6 to 8 inches long.

In the use of such arrangements, the working fluid normally is fed from the apparatus, through the aforementioned inlet tube, the first mentioned crossarm of the adapter, the lower leg of the adapter and the tracheal tube, into the respiratory tract of the patient during each inhalation of the latter, with the exhalations of the patient taking place through the tracheal tube, the lower leg of the adapter, said other crossarm of the adapter and the aformentioned exhaust tube to the atmosphere. With such an assembly, a certain amount of the residual gases in the exhaust tube will be sucked back into the patient's respiratory tract during each inhalation of the patient.

One of the major problems in aerosol therapy, and the like, commonly has been that the vapors or mist in the working fluid tend to condense to a liquid stage in the inlet tube. If this is permitted to occur for substantial periods of time, such liquid may accumulate in the inlet tube, particularly, in downwardly extending bends therein, and the like, to such an extent that it is effective to block the passage of working fluid from the source thereof to the patient, which may result in asphyxiation of the patient. As a result of this danger, it is common practice in the treatment of such patients to periodically check the condition of the inlet tube and to empty any accumulated liquid therein back into nebulizer, this checking and emptying of the inlet tube being performed at sufficiently short intervals of time so as to insure that a sufficient amount of liquid will not accumulate in the inlet tube to block the passage of working fluid therethrough.

However, one of the problems in connection with such emptying of the inlet tube back into the nebulizer is that this is commonly performed by raising the portion of the tube in which the liquid has accumulated to a sufficient height that the liquid will flow by gravity back into the nebulizer, and, unless such emptying is very carefully and properly performed, a part of the liquid in the tube may be discharged therefrom into the T-shaped fitting or adapter, and thus down through the tracheal tube directly into the trachea and lungs of the patient being treated. Any such occurrence, of course, is serious. Such a flow of liquid into the trachea and lungs of a patient may cause the patient to "drown" or, at least, particularly in the case of cardiac patients, and the like, to labor so hard for breath as to cause cardiac arrest. Also, it is not uncommon that secretions, including infectious mucus, accumulate in such tracheal tubes and the fittings connected thereto, so that, in the event of any such passage of liquid down through the tracheal tube, such secretions may be washed directly into the lungs of the patient and afford a definite occasion for infection.

It is an important object of the present invention to prevent such accidental discharge of liquid from aerosol therapy apparatus, and the like, into a tracheal tube inserted in the trachea of a patient.

Another object of the present invention is to afford a novel adapter for connecting a tracheal tube to a tube for feeding working fluid thereto, wherein the parts of the adapter are constituted and arranged in a novel and expeditious manner effective to protect against such accidental discharge of liquid into the tracheal tube.

Another object of the present invention is to afford a novel adapter of the aforementioned type which may be used for connecting a tracheal tube to suitable apparatus for carrying out the aforementioned aerosol therapy, and the like, and which also may be used for connecting a tracheal tube to a respirator, or the like, for positive pressure ventilation of the respiratory tract of a patient.

Yet another object of the present invention is to afford a novel adapter of the aforementioned type wherein the parts thereof are constituted and arranged in a novel and expeditious manner wherein the adapter may be effectively used on a patient disposed in any of the positions normally assumed by a patient during positive pressure ventilation or aerosol therapy treatment of the patient.

A further object of the present invention is to afford a novel adapter of the aforementioned type which may be constructed of suitable plastic material such as, for example, the aforementioned Plexiglas.

Another object of the present invention is to afford a novel adapter of the aforementioned type which is practical and efficient in operation, and which may be readily and economically produced commercially.

Other and further objects of the present invention will be apparent from the following description and claims and are illustrated in the accompanying drawings which, by way of illustration, show the preferred embodiment of the present invention and the principles thereof and what I now consider to be the best mode in which I have contemplated applying these principles. Other embodiments of the invention embodying the same or equivalent principles may be used and structural changes may be made as desired by those skilled in the art without departing from the present invention and the purview of the appended claims.

DESCRIPTION OF THE DRAWINGS

In the drawings:

FIG. 1 is a front elevational view of an adapter embodying the principles of the present invention, showing, somewhat diagrammatically, the adapter connected for use in the treatment of a patient;

FIG. 2 is a top plan view of the adapter shown in FIG. 1;

FIG. 3 is a bottom plan view of the adapter shown in FIG. 1;

FIG. 4 is a longitudinal sectional view taken substantially along the line 4--4 in FIG. 2;

FIG. 5 is an enlarged, fragmentary detail sectional view taken substantially along the line 5--5 in FIG. 1, and

FIG. 6 is a fragmentary elevational view of a portion of the adapter shown in FIG. 1, with one end of the adapter closed such as for use in positive pressure ventilation, and the like.

DESCRIPTION OF THE EMBODIMENT SHOWN HEREIN

An adapter 1 embodying the principles of the present invention is shown in the drawings to illustrate the presently preferred embodiment of the present invention.

The adapter 1 embodies two oppositely disposed, elongated tubular end portions 2 and 3 interconnected by an elongated tubular body portion 4, which extends therebetween, FIGS. 1-4. The body portion 4 includes a top wall portion 5 and a bottom wall portion 6, FIGS. 1, 4 and 5, and two lateral wall portions 7 and 8, FIGS. 2, 3 and 5, extending between the top wall portion 5 and the bottom wall portion 6.

Preferably, the body portion 4 is arcuate in shape, being convex upwardly, as shown in FIGS. 1 and 4, between its opposite ends for a purpose which will be discussed in greater detail presently. In addition, preferably the body portion 4 is laterally arcuate in shape, transversely to the upward convexity thereof, being convex toward the lateral wall portion 8, as shown in FIGS. 2 and 3, for a purpose which, also, will be discussed in greater detail presently.

The adapter 1 also includes a tubular connector 9, FIGS. 1 and 3-5, which extends through the bottom wall 6. The connector 9 preferably is disposed midway between the opposite ends of the body portion 4, and includes an inner nipple 10, which projects upwardly from the bottom wall 6 toward the top wall 5, and terminates in downwardly spaced relation to the latter. The connector 9 also includes an outer nipple 11 which projects downwardly from the bottom wall 6 and which preferably is disposed in axial alignment with the inner nipple 11, FIGS. 4 and 5.

In the adapter 1, the inner nipple 10 preferably extends upwardly from the bottom wall 6 more than 50 percent of the distance between the top wall 5 and the bottom wall 6, preferably so extending between 50 and 65 percent of the last mentioned distance. As may be seen in FIG. 5, the nipple 10 is spaced inwardly from the inner surfaces of the lateral wall portions 7 and 8 of the body member 4. Preferably, the end portions 2 and 3, the body portion 4 and the connector 9 are circular in transverse cross section, and the outside diameter of the nipple 10 is substantially less than the inside diameter of the body portion 4, the outside diameter of the nipple 10 preferably being between 1/2 and 2/3 of the inside diameter of that portion of the body portion 4 within which the nipple 10 is disposed.

The adapter 1 preferably is made as a single piece, and may be made of any suitable method, such as, for example, casting or injection molding. It may be made of any suitable material, but, preferably, is made of a suitable, clear, transparent plastic material, such as the aforementioned acrylic resin, known as Plexiglas.

In the preferred form of the adapter 1 shown in the drawings, an opening 12, having the same diameter as the inside diameter of the connector 9, is formed through the top wall portion 5 of the body portion 4 directly above and in axial alignment with the connector 9, to afford an access opening to the connector 9. A suitable closure member, such as a plug 13, made of any suitable material such as, for example, the aforementioned Plexiglas, is removably mounted in the opening 12 for closing the latter, preferably being disposed therein with a relatively snug force fit. Such access openings and closures therefore have been embodied in adapters heretofore known in the art, such as, for example, in certain of the aforementioned T-shaped fittings, and the like, the openings affording access to the interior of tracheal tubes connected to such fittings or adapters for the purpose of inserting suction tubes thereinto, and the like. As will be appreciated by those skilled in the art, such access openings may be of any suitable size and the opening 12 is shown as having the same diameter as the outside diameter of the connector 9 merely by way of illustration and not by way of limitation.

In the use of the adapter 1, the end portion 3 thereof may be connected by a suitable conduit 14 to a suitable apparatus 15, which may be in the form of a respirator or a nebulizer, or the like, as illustrated somewhat diagrammatically in FIG. 1, for the purpose of feeding working fluid of a selected one of the aforementioned types into the adapter 1, Preferably, the conduit 14 normally will be in the form of the aforementioned flexible, corrugated hose made of a suitable plastic material, such as polyvinyl chloride or polyethylene, and it normally will be of substantial length, such as, for example, 4 or 5 feet, or more.

Normally, the use to be made of the adapter 1 will determine what is connected to the other end portion 2 thereof. For example, if the adapter 1 is to be used in aerosol therapy, wherein the apparatus 15 comprises a nebulizer, or the like, an exhaust conduit in the form of the aforementioned relatively short length of hose or tubing 16 normally will be mounted thereon and connected thereto, as shown in FIGS. 1-4, the hose 16 being open to atmosphere. On the other hand, if the adapter 1 is to be used in an intermittent positive ventilation operation, wherein the apparatus 15 is a respirator, or the like, the end portion 2 of adapter 1 normally will be closed by a suitable closure member such as, for example, the closure cap 17 shown in FIG. 6.

In the use of the adapter 1, any suitable type of tracheal tube, such as, for example, the tracheal tube shown in Kamen and Wilkinson U.S. Pat. No. 3,640,280, issued Feb. 8, 1972, may be operatively connected to the connector 9 for receiving working fluid fed from the apparatus 15 through the conduit 14, the end portion 3 and the body portion 4 of the adapter 1, into the connector 9 and thus into the tracheal tube connected thereto, such as, for example, the tracheal tube 18 shown in FIGS. 1, 3 and 4. The tracheal tubes, such as the tracheal tube 18, may be connected to the connector 9 in any suitable manner, such as, for example, by a connector portion of the tracheal tube, such as the connector portion 19, FIGS. 1 and 4, which may be inserted into the connector 9 and removably held therein by suitable means such as, for example, a force fit connection therewith. As will be appreciated by those skilled in the art, if desired, the outer nipple 11 of the connector 9 may be eliminated and the tracheal tube may be connected to the adapter 1 by insertion of a connecting member, such as the member 19, directly into the inner nipple portion 10, without departing from the purview of the present invention. Also, as will be appreciated by those skilled in the art, tracheal tubes may be connected to the connector 9 of the adapter 1 in other suitable manners, not shown, such as, for example, by connecting the tracheal tube to the outer surface of the outer nipple 11, in the same manner as the conduits 16 and 14 are shown connected to the end portions 2 and 3, respectively, of the adapter 1, without departing from the purview of the present invention.

It will be remembered that in the use of tracheal tubes, such as the tracheal tube 18, in the pressure ventilation of the respiratory tract of patients, and in the aerosol therapy treatment of patients, condensate commonly collects in the passageway extending between the tracheal tube 18 and the apparatus 15, and, particularly, in the low portions of the hose or tube 14, and such condensate must be emptied, from time to time, from the aforementioned passageway. With such a tracheal tube connected to such apparatus by an adapter of the type embodying the principles of the present invention, effective protection is afforded by the adapter against the accidental discharge of such condensate or other liquid into the tracheal tube, such as the tracheal tube 18, and thus into the respiratory tract of the patient being treated. Thus, it will be remembered that the inner nipple 10 of the connector 9 extends a substantial distance above the inner surface of the bottom wall 16 of the body portion 4 of the adapter 1 and, likewise, is spaced a substantial distance inwardly from the inner surface of the lateral wall portions 7 and 8 of the body portion 4. Thus, even if liquid, in the form of condensate, or the like, is caused to flow into the adapter 1 from the hose 14 during use of the apparatus 15, it can pass through the body portion 4 of the adapter 1 around the inner nipple 10 of the connector 9 into the end portion 2 of the adapter 1, from which it can discharge outwardly through the exhaust conduit 16, when the adapter 1 is being used in aerosol therapy. On the other hand, even when the adapter 1 is being used in a pressure ventilation operation, so that the end portion 2 thereof is closed, such as by the cap 17, any such liquid which is caused to flow from the hose 14 into the body portion 4 may flow through the body portion 4, around the inner nipple 10 of the connector 9 and downwardly into the end portion 2 of the adapter 1, from which it may readily be emptied by removal of the closure member 17.

The convex-upwardly shape of the body portion 4 of the preferred form of the adapter 1 shown in the drawings serves several purposes. One of these purposes is that it tends to prevent any passage of liquid, in the form of condensate, and the like, into the central portion of the body portion 4, and thus tends to prevent such liquid from ever reaching the area adjacent to the connector 9. Another purpose is that it tends to insure that any such liquid that does pass through the body portion 4 will flow therethrough at a relatively low level above the bottom wall 9 at the raised portion of the body portion 4 immediately adjacent to the inner nipple 10, thus tending to insure that the liquid level will not be of sufficient height to permit liquid to flow over the top of the connector 9 into a tracheal tube connected thereto. A further purpose is that it affords protection against any such liquid accumulating in the portion of the adapter 1 immediately adjacent to the connector 9, any such liquid which may reach this central portion of the body portion 4 of the adapter 1 tending to flow immediately downwardly toward the end portion 2 or the end portion 3.

It will be remembered that the body portion 4 of the adapter 1 is also arcuate in a direction transverse to the convexity of the body portion 4 in an upward direction. This is for the purpose of enabling the adapter 1 to be conveniently located relative to a patient, such as, for example, beneath a patient's chin, when the tracheal tube 18 is in the form of a tracheostomy tube inserted into the throat of the patient, the lateral wall portion 7 normally being positioned in directly facing relation to the patient in the usual installation of the adapter 1. Another purpose of this latter convexity is that it affords another convexity for the body portion 4 so as to assist in insuring that the connector 9 will be disposed at an elevated position relative to the end portions 2 and 3 of the adapter 1 in any normal position assumed by a patient being treated with the apparatus 15, whether the latter be in the form of a respirator or a nebulizer, or the like. Thus, as will be understood by those skilled in the art, normally, a patient being so treated will be disposed in a substantially prone position on his or her back. However, in certain instances, the patient may be disposed with the upper portion of his or her body somewhat elevated, at least, such as, for example, when chest X-rays, or the like, are being takn in the patient's room. With the adapter 1 thus formed with what may be called a "double convexity," the body 4 thereof being both convex upwardly, as viewed in FIG. 1, and convex laterally, as viewed in FIG. 2, effective assurance is afforded that the connector 9 will be disposed in elevated position relative to the end portions 2 and 3 of the adapter 1 in any such normal position of such a patient.

From the foregoing it will be seen that the present invention affords a novel adapter for use with tracheal tubes, and the like, which affords effective protection against the accidental discharge of condensate, or the like, into a tracheal tube connected thereto and thus into the respirator tract of a patient being treated.

Also, it will be seen that the present invention affords a novel adapter for use with a tracheal tube, which is practical and efficient in operation and which may be readily and economically produced commercially.

Thus, while I have illustrated and described the perferred embodiment of my invention, it is to be understood that this is capable of variation and modification, and I therefore do not wish to be limited to the precise details set forth, but desire to avail myself of such changes and alterations as fall within the purview of the following claims.

Claims

I claim:

1. An adapter for connecting a tracheal tube to a source of working fluid comprising

a. two oppositely disposed tubular end portions,

b. an elongated tubular body portion

1. extending between and

2. interconnecting said end portions, and

c. one of said end portions being adapted to be connected to such a source of working fluid for feeding working fluid into said body portion,

d. a tubular connector opening into said body portion between said end portions transversely to the length of said body portion for connecting the interior of said body portion to a tracheal tube,

e. said connector projecting into said body portion transversely to the length of said body portion,

f. said body portion being

1. convex in a direction away from said connector, and

2. convex in a direction transverse to said first mentioned direction.

2. An adapter as defined in claim 1, and in which

a. said body portion is arcuate in shape throughout its length between said end portions, and

b. said connector is disposed

1. substantially midway between said ends, and

2. on the concave side of the arch of said body portion.

3. An adapter as defined in claim 2, and in which

a. said connector comprises

1. an inner nipple

(a) projecting into, and

(b) opening into said body portion, and

2. an outer nipple

(a) connected to said inner nipple, in communication therewith,

(b) projecting outwardly from said body portion in a direction opposite to the convexity of said arch, and

(c) opening outwardly from said body portion.

4. An adapter for use in feeding working fluid from a source thereof into a tracheal tube disposed in operative position in trachea of a patient, and comprising

a. a tubular end portion

1. open at its outer end, and

2. adapted to be connected to such a source of working fluid,

b. another tubular end portion open at its outer end,

c. an elongated tubular body portion

1. extending between and

2. operatively connected to said end portions for feeding such working fluid therebetween,

d. said body portion having

1. a top wall portion,

2. a bottom wall portion, and

3. two oppositely disposed lateral wall portions extending between said top and bottom wall portions, and

e. a tubular connector for operatively connecting such a tracheal tube to said body portion for receiving working fluid from such a source thereof connected to said first mentioned end portion,

f. said tubular connector

1. being mounted in said bottom wall portion,

2. projecting upwardly into said body portion toward said top wall portion, and

3. terminating at the top thereof in downwardly spaced relation to said top wall portion,

g. said body portion being convex upwardly between said end portions, said body portion also being convex laterally being said end portions in a direction transverse to said first mentioned convexity.

5. An adapter as defined in claim 4, and in which said connector is disposed in said bottom wall above said end portions.

6. An adapter as defined in claim 4, and in which

a. said connector is disposed

1. between said lateral wall portions, and

2. in inwardly spaced relation thereto.

7. An adapter as defined in claim 6, and in which

a. said end portions are disposed substantially in axial alignment to each other, and

b. said connector

1. extends through said bottom wall portion at said central portion, and

2. comprises

(a) an inner tubular nipple

1'. extending upwardly from said bottom wall portion the major portion of the distance toward said top wall portion, and

2'. having an open upper end terminating in downwardly spaced relation to said top wall portion, and

(b) an outer tubular nipple

1'. extending downwardly from said bottom wall portion for connection to such a tracheal tube, and

2'. operatively connected at its upper end to the lower end of said inner nipple for the passage of such working fluid from said body portion through said nipples into such a tracheal tube operatively connected to said outer nipple.

8. An adapter as defined in claim 7, and

a. in which said top wall has an opening disposed immediately above said connector for affording access to the interior of said connector, and

b. which includes a closure member removably mounted in said opening.

9. An adapter for use in feeding working fluid from a source thereof into a tracheal tube disposed in operative position in the trachea of a patient, and comprising

a. a tubular end portion

1. open at its outer end, and

2. adapted to be connected to such a source of workfluid,

b. another tubular end portion open at its outer end,

c. an elongated tubular body portion

1. extending between and

2. operatively connected to said end portions for feeding such working fluid therebetween,

d. said body portion having

1. a top wall portion,

2. a bottom wall portion, and

3. two oppositely disposed lateral wall portions extending between said top and bottom wall portions, and

e. a tubular connector for operatively connecting such a tracheal tube to said body portion for receiving working fluid from such a source thereof connected to said first mentioned end portion,

f. said tubular connector

1. being mounted in said bottom wall portion,

2. projecting upwardly into said body portion toward said top wall portion, and

3. terminating at the top thereof in downwardly spaced relation to said top wall portion,

g. said connector being disposed

1. between said lateral wall portions, and

2. in inwardly spaced relation thereto,

h. said end portions being disposed substantially in axial alignment to each other,

i. said body portions being convex upwardly from its ends to the longitudinally central portion thereof,

j. said connector

1. extending through said bottom wall portion at said central portion, and

2. comprising

(a) an inner tubular nipple

1'. extending upwardly from said bottom wall portion the major portion of the distance toward said top wall portion, and

2'. having an open upper end terminating in downwardly spaced relation to said top wall portion, and

(b) an outer tubular nipple

' . extending downwardly from said bottom wall portion for connection to such a tracheal tube, and

2'. operatively connected at its upper end to the lower end of said inner nipple for the passage of such working fluid from said body portion through said nipples into such a tracheal tube operatively connected to said outer nipple,

k. said body portion, from its ends to the longtiudinal central portion thereof, being convex transversely to said first mentioned convexity, and

l. said inner nipple

1. projecting from said bottom wall portion toward said top wall portion not substantially less than 50 percent and not substantially more than 65 percent of the distance between said bottom and top wall portions, and

2. having a width between said lateral wall portions of not substantially less than onehalf and not substantially more than twothirds of the maximum distance between the internal surfaces of said lateral wall portions.