U.S. patent number 3,853,130 [Application Number 05/421,726] was granted by the patent office on 1974-12-10 for sterile handling catheter assemblies.
Invention is credited to David S. Sheridan.
United States Patent |
3,853,130 |
Sheridan |
December 10, 1974 |
**Please see images for:
( Certificate of Correction ) ** |
STERILE HANDLING CATHETER ASSEMBLIES
Abstract
A sterile handling catheter assembly comprises a catheter
enveloped by a protective sheath which has a longitudinal slit
extending the entire length thereof and a pair of ribs extending
radially from the sheath which run the full length of the sheath
adjacent and parallel to the slit creating a barrier which
preserves sterility of the edges of the slit during manipulation of
the assembly for installation of the catheter in a patient.
Inventors: |
Sheridan; David S. (Argyle,
NY) |
Family
ID: |
23671788 |
Appl.
No.: |
05/421,726 |
Filed: |
December 4, 1973 |
Current U.S.
Class: |
604/171;
128/DIG.26 |
Current CPC
Class: |
A61M
25/013 (20130101); A61M 25/0111 (20130101); A61M
2025/09116 (20130101); Y10S 128/26 (20130101) |
Current International
Class: |
A61M
25/01 (20060101); A61m 025/00 () |
Field of
Search: |
;128/348,349R,35R,351,1R,33R,DIG.26 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Truluck; Dalton L.
Attorney, Agent or Firm: Kemon, Palmer & Estabrook
Claims
The embodiments of the invention in which an exclusive property or
right is claimed or defined in the accompanying claims:
1. A sterile handling catheter assembly comprising:
a catheter having a distal end portion, a proximal end portion and
a central body portion integrally connecting the distal end portion
to the proximal end portion,
a protective sheath formed of flexible plastic material that,
throughout the length thereof, substantially completely and closely
encircles said catheter, the length of said sheath being sufficient
that at least the proximal end and central body portions of said
catheter are so encircled,
said sheath having a longitudinal slit extending substantially the
length thereof,
a first rib running substantially the length of said sheath
adjacent one side of said slit extending radially outwardly from
said sheath,
a second rib running substantially the length of said sheath
adjacent the other side of said slit extending radially outwardly
from said sheath substantially the same distance as said first
rib,
said ribs creating a pair of parallel barrier members above said
slit to preserve the sterility of the edges of the slit during
manipulation of said assembly in the installation of said catheter
in a patient.
2. The catheter assembly of claim 1 wherein said catheter is a
suction catheter.
3. The catheter assembly of claim 1 wherein moveable slide means
encircles a portion of the proximal end of said protective
sheath.
4. The catheter assembly of claim 1 wherein said catheter is
extruded of flexible water-proof nonfibrous thermoplastic
material.
5. The catheter assembly of claim 4 wherein said protective sheath
is extruded of flexible water-proof non-fibrous thermoplastic
material with said ribs integral with the remainder of the
sheath.
6. The catheter assembly of claim 1 wherein said catheter is a
suction catheter having vacuum control means fixed to the proximal
end thereof.
7. The catheter assembly of claim 6 wherein said sheath is retained
against movement longitudinally relative to said catheter by
frictional engagement between the inner surface of the proximal end
of the sheath and a tubular member connecting the catheter to said
vacuum control means.
8. The catheter assembly of claim 1 wherein the edges of said slit
in said sheath abut one another.
9. The catheter assembly of claim 1 wherein one of the edges of
said slit in said sheath overlaps the other edge of said slit.
10. The catheter assembly of claim 1 wherein the height of said
ribs above the outside wall of the catheter is between about 1 to 3
mm. and the distance between the central axes of the ribs is
between about 3 to 5 mm.
11. The catheter assembly of claim 1 wherein said catheter has a
frosted outer surface.
12. The catheter assembly of claim 1 wherein said catheter and said
sheath are both extruded plasticized polyvinyl chloride material.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
The invention pertains to catheter assemblies designed for sterile
handling without requiring use of sterile surgical gloves to
preserve sterility of the catheter upon its installation in a
patient. More particularly, it concerns sterile handling catheter
assemblies in which the catheter is enveloped by a protective
sheath of unique construction which permits the assembly to be
manipulated for installation of the catheter in a patient by
contact only with the protective sheath so that sterility of the
catheter is completely preserved during the installation procedure.
Catheter assemblies of the invention are especially useful for
sterile handling of suction catheters but the new assemblies may be
utilized with urethral catheters, Foley catheters or any other form
of tubes or catheters known to the surgical and medical arts which
require sterile handling for installation in a patient.
2. Description of the Prior Art
In the use of suction catheters, urethral catheters and similar
medico-surgical tubes, it is necessary to preserve the sterility of
that portion of the catheter which enters the body of a patient in
order to prevent the patient from becoming infected by the
insertion of the catheter. This presents difficulties to the
surgeon or other person performing the catheter installation. For
example, if it is necessary to catheterize a patient during a
surgical operation, the surgeon's hands or gloves will normally be
soiled by blood or other materials which would come in contact with
the walls of the catheter and be carried into the patient's body if
the surgeon were to directly contact the catheter during the
installation with such soiled gloves. As a result, catheter
installation under such circumstances is frequently performed by
another person wearing a sterile pair of surgical gloves. As a
matter of fact, this occurs so frequently that manufacturers of
catheters make and sell so-called "tray" packages which enclose in
sterile condition a catheter along with a pair of surgical gloves
to be used in performing the installation of the catheter. Of
course, not only does this add to the cost of catheterization of a
patient, but the procedure consumes more time than is desirable.
The magnitude of the problem can be understood if one realizes that
a post-operative patient may need to be suctioned every 15 minutes
and at progressively longer intervals as his condition improves.
Couple this with the fact that it is the current trend for
hospitals to use suction catheters for a single use only and that
as many as 400 suction catheters could be used on one patient
within a 2-week period and it becomes apparent great saving in time
can be made by eliminating the need for sterile gloves when suction
catheters are installed.
It has been proposed to enclose catheters in protective sheaths
which are slit longitudinally so that the catheter can be
manipulated into the body of a patient while its sterility is
protected by the sheath. Catheter assemblies of this type are
disclosed, for example, in U.S. Pat. Nos. 3,262,448 and 3,559,643.
However, the concept of use of a protective sheath in the handling
of catheters as employed in the prior art has been of relatively
limited scope. Thus, in order to use the prior known catheter
assemblies involving the protective sheath, the devices have
required means other than the sheath itself to push the catheter
for installation in the patient while preserving its sterility.
Furthermore, use of the prior known catheter assemblies have
essentially been limited to a two-hand type of operation.
OBJECTS
A principal object of this invention is the provision of new forms
of sterile handling catheter assemblies. Further objects include
the provision of:
1. Sterile handling catheter assemblies in which the catheter is
carried in a protective sheath of unique construction which permits
the sheath to be used as a means by which the catheter is advanced
for installation in a patient.
2. Improved sterile handling catheter assemblies which are capable
of being installed in a patient with a one-hand technique.
Other objects and further scope of applicability of the present
invention will become apparent from the detailed description given
hereinafter; it should be understood, however, that the detailed
description, while indicating preferred embodiments of the
invention, is given by way of illustration only, since various
changes and modifications within the spirit and scope of the
invention will become apparent to those skilled in the art from
this detailed description.
SUMMARY OF THE INVENTION
The stated objects are accomplished according to the present
invention by provision of sterile handling catheter assemblies
which comprise a catheter, and a protective sheath formed of
flexible plastic material enveloping at least the proximal end and
central body portions of the catheter. The protective sheath has a
longitudinal slit extending the entire length thereof, a pair of
ribs extend radially from the sheath and run the full length
thereof adjacent and parallel to the slit. These ribs serve as
barrier members above the slit to preserve the sterility of the
edges of the slit while the protective sheath is manipulated by a
surgeon or other person and used as the means to advance the
catheter for its installation in a patient. In one embodiment of
the new catheter assemblies, the sheath is shorter in length than
the catheter so that the distal end portion of the catheter remains
uncovered by the sheath. In another embodiment, the sheath is
longer than the catheter so that even the distal end portion is
covered and the sheath extends beyond the distal end, e.g., about
1-3 cm.
Advantageously, both the catheter and the protective sheath are
formed by extrusion from flexible waterproof non-fibrous
thermoplastic material. In such an extrusion, the ribs which
constitute the barrier members for the slit are formed integrally
with the remainder of the protective sheath. Although the
longitudinal slit in the sheath can be formed by cutting, it is
advantageously formed in the sheath during the extrusion operation.
The extrusion die may be structured to form a sheath in which the
edges of the slit abut one another or, alternatively, so that one
edge of the slit overlaps the other edge.
BRIEF DESCRIPTION OF THE DRAWINGS
A more complete understanding of the new catheter assemblies of the
invention and their methods of use may be had by reference to the
accompanying drawings in which:
FIG. 1 is a fragmented perspective view of a catheter assembly of
the invention in the hand of a surgeon ready for insertion into a
patient.
FIG. 2 is a diagrammatic fragmented side view partially in section
of the catheter of FIG. 1 being inserted into a patient through a
tracheostomy tube.
FIG. 3 is an enlarged fragmentary side view of the distal end
section of a catheter assembly of the invention.
FIG. 4 is an enlarged fragmentary side view of the proximal end
section of a catheter assembly of the invention.
FIG. 5 is an enlarged sectional end view of a catheter assembly of
the invention.
FIG. 6 is an enlarged sectional end view of the catheter assembly
of FIG. 5 showing the protective sheath being strippped from the
catheter as the catheter is inserted into a patient.
FIG. 7 is an enlarged sectional end view of another form of
catheter assembly of the invention.
FIG. 8 is an enlarged fragmentary plan view of a catheter assembly
of the invention. FIG. 9 is a fragmented perspective view of
another form of suction catheter assembly of the invention.
FIG. 10 is a fragmented perspective view of the catheter assembly
of FIG. 9 at the beginning of the manipulation to install the
catheter in a patient.
FIG. 11 is a fragmented perspective view of the catheter assembly
of FIG. 9 in a further stage of manipulation prior to
installation.
DESCRIPTION OF PREFERRED EMBODIMENTS
Referring in detail to the drawings, a catheter assembly of the
invention 2 comprises a catheter 4 and a protective sheath 6. The
catheter has a distal end portion 8, a proximal end portion 10 and
a central body portion 12 which connects the distal end portion 8
to the proximal end portion 10. The protective sheath 6 formed of
flexible plastic material is shorter in length than the catheter 4
so that the distal end 14 of the sheath terminates proximally of
the tip 16 of the catheter leaving the distal end portion 8 of the
catheter uncovered. The remainder of the catheter comprising the
central body and proximal end portions is enveloped by the
protective sheath.
The sheath 6 has a longitudinal slit 18 which extends the entire
length of the sheath. A first rib 20 runs the full length of the
sheath adjacent one side of the slit and, as can be seen in detail
in FIG. 5, the rib 20 extends radially outwardly from the sheath 6.
A second rib 22 which also runs the full length of the sheath
adjacent the other side of the slit 18 extends radially outwardly
from the sheath 6 substantially the same distance as the first rib
20.
With reference to FIG. 5, it can be seen that the ribs 20 and 22
create a pair of parallel barrier members above the slit 18
preventing objects, such as the finger 24 of a surgeon, from
contacting the edges of the slit during manipulation of the
catheter assembly in installation of the catheter in a patient.
Hence, the pair of ribs 20 and 22 preserve the sterility of the
slit edges 26 and 28 and thereby insure the sterility of the
catheter when these edges contact the catheter as the protective
sheath 6 is stripped from the catheter 4 during insertion of the
catheter in a patient (see FIGS. 2 and 6).
The catheter assemblies of the invention require only one-hand
manipulation to accomplish sterile installation of the catheter
into a patient. The method of use of the new catheter assemblies
can be understood by reference to FIGS. 1 and 2 which illustrate
the installation of a suction catheter into a patient by way of a
tracheostomy tube 30. With reference to FIG. 1, the protective
sheath 6 of the suction catheter assembly 2 is grasped between the
thumb 36 and index finger 38 of the hand 34 of the surgeon or other
person installing the catheter 4 in the patient slightly proximal
of the distal end 14 of the protective sheath. The exposed distal
end portion 8 of the catheter 4 is then inserted into the inlet
opening 32 of the tracheostomy tube 30. The surgeon by pulling
lightly on the protective sheath 6 can then cause the sheath to
part (see FIG. 6) at the slit 18 and slide past the catheter 4. The
surgeon then moves a short distance further along the protective
sheath away from the junction between the catheter 4 and the
parting in the sheath 6 and gently pushes the catheter assembly
toward the patient so that a further section of the catheter enters
the tracheostomy tube 30. As the catheter enters the tube, a
further section of the sheath will part along the slit 18 and the
portion of the sheath 6 which separates from the catheter 4 will
slide down the outside and away from the catheter as illustrated in
FIG. 2. This procedure is repeated a sufficient number of times so
that the catheter advances into the patient to the distance
required for the particular procedure being performed. The suction
catheter having been joined by way of the vacuum controller 40 to a
suction source, the suction catheter can be operated by
manipulation of the vacuum controller 40 in the customary manner.
It will be understood from this description of use and by reference
to the accompanying FIGS. 1 and 2 that during the manipulation of
the catheter assembly for installation of the catheter in the
patient, the catheter never comes in contact with any part of the
hand 34 of the surgeon. Furthermore, no part of the protective
sheath which comes in contact with the fingers or other portion of
the surgeon's hand will make contact with the catheter. The lumen
of the protective sheath 6 is sterile and remains so throughout
manipulation of the catheter assembly. The same is true of the
edges 26 and 28 of the slit 18 because, as can be seen by reference
to FIG. 5, the ribs 20 and 22 prevent any contact by the fingers or
other portions of the surgeon's hand so that sterility of the slit
edges is maintained. This in turn preserves the sterility of the
catheter 4.
Details of construction of the proximal end portion of the catheter
assembly illustrated at FIG. 1 are shown in FIG. 4. The vacuum
controller 40, which may be of the form shown and described in U.S.
Pat. No. 3,610,242 or of any other suitable structure, is joined to
the proximal end 10 of the catheter by a short section of tubing 42
which is cemented at one end to the inlet port 44 of the vacuum
controller 40. The tube section 42 has an inside diameter
approximately the same size as the outside diameter of the catheter
and the proximal end of the catheter is inserted in the tube
section 42 and cemented therein.
In the embodiment of the new catheter assemblies shown in FIG. 9,
the assembly 60 comprises a catheter 62, a protective sheath 64 and
the vacuum controller 66. The sheath 64 is longer than the catheter
62 so that the free end 68 of the sheath extends about 1 to 3 cm.
beyond the distal end 70 of the catheter. The sheath 64 has a
longitudinal slit 72 extending the full length thereof and adjacent
ribs 74 and 76 as in the case of the embodiments described in
connection with FIGS. 1-8.
The use of a catheter assembly as shown in FIG. 9 begins as a
two-hand operation. As seen in FIG. 10, the free-end 68 of the
sheath 64 with the slit 72 on top is grasped by the surgeon or
other operator between thumb 78 and finger 80. Simultaneously, the
sheath 64 is grasped near the catheter tip 70 in the other hand
between thumb 82 and finger 84. With the finger 86 acting as a
support below the catheter tip 70, the sheath end 68 is moved
downward by thumb 78 and finger 80. This motion will bend the
sheath over the tip 70 of the catheter and the slit 72 will open
leaving the catheter tip 70 exposed as shown in FIG. 11. From then
on, the installation of the catheter 62 into the patient will be
essentially a one-hand procedure as described previously in
connection with the embodiment of FIGS. 1-8.
Different sizes of catheters are required for a variety of reasons,
e.g., different sizes of patients, different medical or surgical
procedures or the like. In the preferred embodiments of catheter
assemblies of the invention, each size of catheter will have a
protective sheath of the most advantageous size for the particular
size catheter with which it will be assembled. Preferably, the
catheter sheath will be just slightly larger in inside diameter
than the outside diameter of the catheter, e.g., the ID of the
protective sheath 6 will be about 0.1 to 1 mm. larger than the O.D.
of the catheter 4. The wall thickness of the plastic sheath will
depend, in part, upon the nature and type of material of which the
plastic sheath is formed. Thus, with more rigid material, a thinner
wall thickness for the sheath 6 is preferred. The sheath can be
formed of any suitable flexible material including polyolefins,
e.g., polyethylene or polypropylene; nylon; acrylic resins; etc.,
although polyvinyl chloride is preferred because this class
material offers a wide range of selection and control in
flexibility and strength properties making it possible to construct
catheter assemblies of a wide range of sizes and shapes from a
single type of material. The wall thickness of the plastic sheath
advantageously will be between about 0.2 to 1 mm.
The ribs 20 and 22 which extend radially from the tubular
cross-section of the plastic sheath may be varied in configuration.
A preferred shape is triangular with the base formed integral with
the shape per se and a rounded apex. Other shapes, however, are
possible including semi-circular, rectangular, square
cross-sections or the like. Advantageously, the ribs will protrude
between about 0.5 and 5 mm. and particularly 1 to 3 mm. above the
outer surface of the protective sheath and the distance between the
central axes of the ribs will be between about 2 to 10 mm. and
particularly 3 to 5 mm.
When plastic sheaths for the catheter assemblies of the invention
are constructed and sized as described above, they will be
relatively free to slide longitudinally along the catheters which
are enclosed within the sheath. It is preferable, therefore, to
arrange some means at the proximal end of the sheath to restrain
the sheath from sliding along the catheter. This can be done in a
variety of ways. For example, the sheath may be cemented or clamped
at its proximal end about the encircled catheter. However, the
surgeon or other user of the device may wish to completely separate
the sheath from the catheter upon completion of the insertion
procedure. Accordingly, a sheath restraining arrangement which does
not permanently connect the sheath to the catheter is advantageous.
An arrangement of this type is illustrated in FIG. 4. The section
of connector tubing 42 is of slightly larger outside diameter than
the inside diameter of the sheath 6. Accordingly, when the proximal
end 46 of the sheath surrounds the connector tube section 42 there
will be sufficient frictional engagement between these two parts 42
and 46 to restrain movement of the sheath 6 along the catheter
4.
In certain types of operations and for other considerations, it may
be desirable not to remove the protective sheath from the catheter
upon completion of the insertion procedure, but allow it to remain
in a draped condition as shown in FIG. 2 until the catheter is
removed from the patient. Further, when the catheter is removed, it
may also be desirable to return the catheter back into the sheath,
e.g., to provide a means for sanitary handling of the catheter by
preventing the soiled outer surface of the catheter to come into
contact with objects which might be contaminated by the mucus or
other soiling material upon the catheter. For this purpose, the
catheter assemblies of the invention may be provided with a movable
slide 48 which can be used for encasing the used catheter within
the protective sheath as it is withdrawn. In such a situation, the
catheter and sheath will be separated from each other back as far
as the catheter had been inserted into the patient. The slide
member 48 would be moved distally on the sheath to this point. By
holding the slide 48 in one hand and grasping the assembly in the
other hand at some more proximal position, e.g., by the attached
vacuum controller 40, the slide 48 may be moved towards the distal
end of the assembly using a back and forth twisting motion. This
forces the catheter back within the sheath as the catheter is
simultaneously extracted from the patient. The slide member 48 is a
short section of tubing, e.g., extruded plastic tubing, having an
I.D. just slightly larger than the O.D. of the sheath 6.
In the embodiment of the catheter assembly shown in FIG. 5, the two
edges 26 and 28 of the slit 18 abut one another. An alternative
arrangement is shown in FIG. 7. Here, one edge 50 of the slit
overlaps the other edge 52. A construction of this type for the
sheath 6a can easily be obtained in forming the protective sheath
by plastic extrusion by shaping the extrusion die to create a thin
lip or ledge on the edge 52 which will underlay the opposing edge
50 of the slit 18a.
DISCUSSION OF DETAILS
The catheter which comprises the assemblies of the invention may be
manufactured to professional specifications and may be produced in
varying degrees of flexibility or rigidity by varying the
formulation of the plastic material from which the tubes are
extruded. They should be water-proof, flexible over a relatively
wide range of temperatures, resistant to attack by body fluids,
capable of being sterilized, such as exposure to ethylene oxide or
gamma radiation, and preferably produced by extrusion at high speed
in order to be relatively low in cost. There are a variety of
plastic materials capable of providing these requirements for the
production of catheter assemblies of the invention. Advantageously,
both the catheters and the protective sheaths will be formed of
non-fibrous plastic material and plasticized polyvinyl chloride is
preferred. A particular useful material of this type can be
formulated to have an extrusion temperature of about
325.degree.-375.degree.F. However, the invention is contemplated
for use in connection with any plastic or elastomeric material
known or found to be useful in the formation of disposable
catheters, e.g., polyethylene, polypropylene, natural rubber,
synthetic rubber, etc.
The catheters of the new assemblies may be constructed with any
special features which are known to be useful with medico-surgical
tubes or which may be required for particular procedures in which
the catheters are to be employed. These may include a non-sparking
feature (see U.S. Pat. No. 3,007,132), x-ray markings (see U.S.
Pat. No. 3,605,750) or a frosted surface to reduce friction in
contact with other plastic items (see U.S. Pat. No. 3,508,554). Any
of the known forms of tips and side openings may be incorporated in
the catheters. Moreover, the unique protective sheath assemblies of
the invention may be employed with other medico-surgical tubes such
as post-surgical drainage tubes including those with a capped
proximal end (see U.S. Pat. No. 3,589,368).
Since the new catheters are designated particularly for disposable,
single use purpose, they will be advantageously packaged as single
units each in its own individual peel-back package. A variety of
film or other packaging material is available for such purposes in
which the new catheter assemblies may be contained for extended
periods of time in sterile condition immediately available to the
surgeon or other user at the location where the catheter is to be
used with a patient. Once enclosed in such package, the catheter
assembly may be rendered sterile by the use of known sterilization
methods, e.g., exposure to ethylene oxide or gamma radiation.
CONCLUSION
The invention as described herein provides a means for removing a
catheter from a sterile peel-back package and preserving the
sterility of the catheter while it is being inserted into a
patient, such as through the nose, mouth, urethra, an endotracheal
tube, a tracheostomy tube, a body incision or the like. This is
accomplished without the person making the catheter installation
needing to wear sterile gloves. When the catheter is introduced
into a patient, the distal portion of the catheter, which extends
out of the unique protective sheath, is entered into the orifice
through which the catheter is to pass. With only one hand, the
surgeon or the protective sheath to advance the catheter into
required position in the patient. The protective sheath being of
such construction that complete sterility of the catheter is
maintained during such manipulation, moves out of the way as the
catheter is advanced and creates no discomfort or trauma to the
patient. Hence, the invention provides new sterile handling
catheter assemblies of a single-use, disposable type which can be
utilized with maximum efficiency in any required surgical or other
medical procedure.
* * * * *