U.S. patent number RE48,598 [Application Number 15/474,974] was granted by the patent office on 2021-06-22 for laryngoscope and method of use.
This patent grant is currently assigned to Salter Labs. The grantee listed for this patent is Salter Labs. Invention is credited to John R. Hicks, James P. Tenger, Leslie A. Tenger.
United States Patent |
RE48,598 |
Tenger , et al. |
June 22, 2021 |
Laryngoscope and method of use
Abstract
A laryngoscope device for use in the performance of direct
laryngoscopy, the device including a laryngoscope blade portion
connectable to a laryngoscope handle through a connector, the
laryngoscope blade comprising an ultraviolet light, a white light
and an imaging or viewing device at the same distance relative to
the distal end of the laryngoscope blade.
Inventors: |
Tenger; James P. (Carlsbad,
CA), Tenger; Leslie A. (Carlsbad, CA), Hicks; John R.
(Carlsbad, CA) |
Applicant: |
Name |
City |
State |
Country |
Type |
Salter Labs |
Lake Forest |
IL |
US |
|
|
Assignee: |
Salter Labs (Lake Forest,
IL)
|
Family
ID: |
1000003636538 |
Appl.
No.: |
15/474,974 |
Filed: |
March 30, 2017 |
Related U.S. Patent Documents
|
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
Issue Date |
|
|
13290792 |
Nov 7, 2011 |
|
|
|
|
12698467 |
Apr 10, 2012 |
8152719 |
|
|
|
29346594 |
Feb 15, 2011 |
D632787 |
|
|
|
12368952 |
Feb 10, 2009 |
|
|
|
|
12173961 |
Sep 6, 2011 |
8012087 |
|
|
|
12144147 |
Sep 4, 2012 |
8257250 |
|
|
|
61288779 |
Dec 21, 2009 |
|
|
|
Reissue of: |
13328499 |
Dec 16, 2011 |
9072446 |
Jul 7, 2015 |
|
|
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B
1/043 (20130101); A61B 1/0638 (20130101); A61B
1/0676 (20130101); A61M 16/04 (20130101); A61B
1/2673 (20130101); A61B 1/0684 (20130101) |
Current International
Class: |
A61B
1/04 (20060101); A61B 1/06 (20060101); A61B
1/267 (20060101); A61M 16/04 (20060101) |
Field of
Search: |
;600/184-249
;385/115-117 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
|
|
|
|
|
|
|
1020070044379 |
|
Apr 2007 |
|
KR |
|
WO93/01170 |
|
Jun 1993 |
|
WO |
|
2007/147211 |
|
Dec 2007 |
|
WO |
|
Other References
Rydell et al., "Fluorescence investigations to classify malignant
laryngeal lesion in vivo", Head Neck (2008) 30 (4):419-426,
XP002715156. cited by applicant .
International Search Report and Written Opinion for PCT/US08/074878
dated Mar. 19, 2009, 10 pages. cited by applicant .
International Search Report and Written Opinion for
PCT/US2010/023194 dated Oct. 5, 2010, 8 pages. cited by applicant
.
ISO 21348, Space Environment (natural and artificial)--Process for
determining solar irradiances, 2007, ISO 21348:2007(E). cited by
applicant .
Walsh, Laurence J. and Shakibaie, Fardad, Ultraviolet-induced
fluorescence: shedding new light on dental biofilms and dental
carries, Nov./Dec. 2007, Australasian Dental Practice, pp. 56-58.
cited by applicant .
Notification, International Search Report and Written Opinion dated
Feb. 8, 2013 from PCT/US2012/63972. cited by applicant .
Extended European Search Report for related European Patent
Application No. 08799005.7, dated Nov. 4, 2013 in 7 pages. cited by
applicant.
|
Primary Examiner: Flanagan; Beverly M.
Attorney, Agent or Firm: Procopio Cory Hargreaves and
Savitch LLP
Parent Case Text
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a continuation-in-part of U.S. patent
application Ser. No. 13/290,792, filed on Nov. 7, 2011, which is a
continuation of U.S. patent application Ser. No. 12/698,467, filed
Feb. 2, 2010, which is a continuation-in-part of U.S. patent
application Ser. No. 29/346,594, filed Nov. 3, 2009, now U.S. Des.
Pat. No. D632,787, and is a continuation-in-part of U.S. patent
application Ser. No. 12/368,952, filed Feb. 10, 2009, now
abandoned, which is a continuation-in-part of U.S. patent
application Ser. No. 12/173,961, filed on Jul. 16, 2008, now U.S.
Pat. No. 8,012,087, which is a continuation-in-part of U.S. patent
application Ser. No. 12/144,147, filed Jun. 23, 2008. This
application also claims priority under 35 U.S.C. 119(e) to U.S.
Provisional Patent Application No. 61/288,779, filed Dec. 21, 2009.
The contents of each and all of the above patent applications are
incorporated herein by reference in their entirety.
Claims
We claim:
1. A device for use in the performance of an endotracheal
intubation, comprising: a laryngoscope blade having a proximate
portion and a distal portion with a distal end, the laryngoscope
blade connectable to a laryngoscope handle through a connection
section; at least two different light sources carried by the
laryngoscope blade and in equal distance from the distal end of the
laryngoscope blade, the two light sources comprising an ultraviolet
light source and a white light source that, in combination, allows
for the illumination of ultraviolet light being absorbed and self
promotes back light from phosphorous reactions; and an imaging
device carried by the laryngoscope blade a distance from the distal
end that is substantially equal to the distance between the distal
end and the ultraviolet light source and the white light source,
wherein the ultraviolet light source and the white light source
include ends that light is emitted from, and the light sources are
.Iadd.stacked white light and ultraviolet light LEDs
.Iaddend.combined into a single integrated unit including epoxy
holding compartments that contain the white light source and the
ultraviolet light source, the epoxy holding compartments integrated
together into a single unit and including epoxy extending beyond
the ends of the ultraviolet light source and the white light source
.Iadd.so that the epoxy holding compartments form an external
dual-domed configuration.Iaddend..
2. The device of claim 1, further comprising an electrical circuit
including a 3.6-4.5 volt lithium battery power source in the
laryngoscope handle.
3. The device of claim 1, wherein the connection section is
configured to cause the light sources to be automatically activated
when the laryngoscope blade is connected to the laryngoscope
handle.
4. The device of claim 3, wherein the connection section is
configured to cause the imaging device to be automatically
activated when the laryngoscope blade is connected to the
laryngoscope handle.
5. The device of claim 1, wherein the imaging device is a camera
head.
6. The device of claim 1, wherein the ultraviolet light source
emits electromagnetic radiation having a wavelength in the range of
300 to 450 nm.
7. The device of claim 1, wherein the white light is a 2-8 mm LED
diode.
8. The device of claim 1, wherein the white light is a cool white
LED with a rating of 100-10,000 millicandela (mcd).
9. The device of claim 1, wherein the ultraviolet light is an
ultraviolet diode.
10. A method of performing direct laryngoscopy, comprising:
connecting the laryngoscope blade of claim 1 and a laryngoscope
handle to create a laryngoscope; using the laryngoscope to lift a
patient's tongue and mandible for locating and/or viewing a foreign
object in the patient; providing the two light sources to: prompt a
visible illumination effect in the patient's epiglottis and vocal
cords resulting from: the absorption of some or all of the
ultraviolet light by tissues in the patient; and a self-providing
back light from phosphorus reactions; and allow a reaction with a
foreign body in the patient; and locating the foreign object in the
patient.
11. A laryngoscope for use in viewing the vocal chords and trachea
of a patient while performing endotracheal intubation or attempting
to remove a foreign body obstructing the trachea, comprising: a
laryngoscope handle adapted for gripping by a user; a laryngoscope
blade having a proximal portion configured for connection to the
laryngoscope handle and a distal portion configured for insertion
into a patient's mouth into an operative position, the distal
portion having a distal end facing an opening of the trachea in the
operative position; at least two different light sources carried by
the laryngoscope blade and both located at a first distance from
the distal end of the laryngoscope blade, the at least two light
sources comprising an ultraviolet (UV) light source and a white
light source, the light sources .Iadd.being stacked white light and
ultraviolet light LEDs and .Iaddend.together configured to provide
illumination in a portion of the trachea extending from the trachea
opening, and the UV light source configured to prompt the visible
effects of fluorescence and phosphoresence in illuminated tissues
in the trachea and to produce phosphorescence from absorption of UV
light in a foreign body having a phosphor content located in the
illuminated portion of the trachea; and an imaging device carried
by the laryngoscope blade and configured to produce an image of the
illuminated portion of the trachea and any foreign object
obstructing the illuminated portion, wherein the light sources are
combined into a single integrated unit including epoxy holding
compartments that contain the white light source and the
ultraviolet light source, the epoxy holding compartments integrated
together into a single unit .[.and each epoxy holding compartment
including a domed configuration.]. .Iadd.so that the epoxy holding
compartments form an external dual-domed
configuration.Iaddend..
12. The device of claim 11, wherein the imaging device is at
substantially the same distance from distal end as the light
sources.
13. The device of claim 12, wherein the light sources and imaging
device are in a single unit mounted in the distal portion of the
blade.
14. A method of retrieving a foreign object from a patient's
trachea, comprising: illuminating both of the light sources of the
laryngoscope of claim 11; inserting the distal portion of the
laryngoscope into a patient's mouth over a patient's tongue and
mandible and into the throat area to an operative position in which
a portion of the trachea extending from the vocal cords is
illuminated by the light sources and the UV light source prompts
the visible effects of fluorescence and phosphoresence in the
tissue of the illuminated portion of the trachea and UV light is
absorbed by any phosphor content in a foreign object trapped in the
illuminated portion of trachea to produce phosphoresence to further
illuminate the object; inserting ends of forceps into the trachea
and advancing the ends of the forceps towards the illuminated
object while viewing the illuminated object to aid in locating the
object with the forceps; and retrieving the object from the trachea
using the forceps.
15. The method of claim 14, wherein the imaging device is a camera
head, and the method further comprises viewing the object with the
camera head.
16. The method of claim 14, wherein the method further comprises
viewing the object as deep as one circoid ring into the
trachea.
17. The method of claim 14, wherein the method further comprises
viewing the object as deep as two circoid rings into the
trachea.
18. The method of claim 14, wherein the method further comprises
viewing the object as deep as three circoid rings into the
trachea.
19. The method of claim 14, wherein the method further comprises
viewing the object as deep as four circoid rings into the
trachea.
.Iadd.20. A device for use in the performance of an endotracheal
intubation, comprising: a laryngoscope blade having a proximate
portion and a distal portion with a distal end, the laryngoscope
blade connectable to a laryngoscope handle through a connection
section; at least two different light sources carried by the
laryngoscope blade, the two light sources comprising an ultraviolet
light source and a white light source that, in combination, allows
for the illumination of ultraviolet light being absorbed and self
promotes back light from phosphorous reactions, wherein the
ultraviolet light source and the white light source are stacked
white light and ultraviolet light LEDs and include ends that light
is emitted from and are combined into a single integrated unit
including epoxy holding compartments that contain the white light
source and the ultraviolet light source, the epoxy holding
compartments integrated together into a single unit and including
epoxy extending beyond the ends of the ultraviolet light source and
the white light source so that the epoxy holding compartments form
an external dual-domed configuration. .Iaddend.
.Iadd.21. The device of claim 20, wherein the ultraviolet light
source and the white light source are in equal distance from the
distal end of the laryngoscope blade. .Iaddend.
.Iadd.22. The device of claim 20, wherein each epoxy holding
compartment includes a domed configuration. .Iaddend.
.Iadd.23. A laryngoscope for use in viewing the vocal chords and
trachea of a patient while performing endotracheal intubation or
attempting to remove a foreign body obstructing the trachea,
comprising: a laryngoscope handle adapted for gripping by a user; a
laryngoscope blade having a proximal portion configured for
connection to the laryngoscope handle and a distal portion
configured for insertion into a patient's mouth into an operative
position, the distal portion having a distal end facing an opening
of the trachea in the operative position; at least two different
light sources carried by the laryngoscope blade and both located at
a distance from the distal end of the laryngoscope blade, the at
least two light sources comprising an ultraviolet (UV) light source
and a white light source, the light sources being stacked white
light and ultraviolet light LEDs and together configured to provide
illumination in a portion of the trachea extending from the trachea
opening, and the UV light source configured to prompt the visible
effects of fluorescence and phosphoresence in illuminated tissues
in the trachea and to produce phosphorescence from absorption of UV
light in a foreign body having a phosphor content located in the
illuminated portion of the trachea, wherein the light sources are
combined into a single integrated unit including epoxy holding
compartments that contain the white light source and the
ultraviolet light source, the epoxy holding compartments integrated
together into a single unit so that the epoxy holding compartments
form an external dual-domed configuration. .Iaddend.
.Iadd.24. The device of claim 23, wherein the epoxy holding
compartments include epoxy extending beyond the ends of the
ultraviolet light source and the white light source. .Iaddend.
.Iadd.25. The device of claim 23, wherein the ultraviolet light
source and the white light source are spaced an equal distance from
the distal end of the laryngoscope blade. .Iaddend.
Description
FIELD OF THE INVENTION
The field of this invention relates to laryngoscopes and the
laryngoscopy procedure.
BACKGROUND OF THE INVENTION
Health care providers perform direct laryngoscopy to either clear a
patient's airway of debris, or place an endotracheal tube into a
patient's trachea to assist or replace a patient's ability to
oxygenate his/her system. The laryngoscope utilizes either a
lighted straight or curved blade that allows visualization of the
vocal cords, indicating the opening of the trachea. This lighted
blade is used to keep the tongue from obstructing the medical
provider's view of the vocal cords. The tip of the blade lifts the
epiglottis, thereby providing a direct view into the patient's
trachea, and reducing the risk of intubating the esophagus instead.
Laryngoscopes in the past have used halogen or LED bulbs to provide
a white light source on the laryngoscope blade to illuminate the
vocal cords during laryngoscopy. Even with a light source on the
laryngoscope blade, viewing of the vocal cords has still proven
difficult during laryngoscopy. Accordingly, without the ability to
view the vocal cords, many possible laryngoscopy procedures are not
performed successfully, resulting in additional harm or death for
the patient.
SUMMARY OF THE INVENTION
To solve these problems and others, an aspect of present invention
involves a laryngoscope including an improved light source. The
laryngoscope blade carries a black light source that emits a black
light during laryngoscopy. The black light enhances visualization
of the vocal cords so that visualization of the endotracheal tube
passing through the vocal cords is enhanced. The black light
emitted from the laryngoscope enhances colors that are white and/or
contain phosphors in the region of the vocal cords, enhancing
visualization of the target vocal cords. In another implementation
of the laryngoscope, the laryngoscope blade carries a black light
source and a white light source. A switch on the laryngoscope
enables the health care provider to actuate the black light source,
the white light source, or to activate both light sources.
An additional aspect of the invention involves a laryngoscope for
use in viewing the vocal cords of a patient in performance of an
endotracheal intubation. The laryngoscope includes a handle to be
gripped by a medical professional in performing the endotracheal
intubation; a blade portion extending from the handle to lift the
patient's tongue and mandible for viewing the vocal cords and aid
in the insertion of an endotracheal tube; a power source; and a
black light source powered by the power source and carried by the
blade portion to prompt the visible effects of fluorescence and
phosphorescence with respect to the patient's vocal cords for
viewing the vocal cords and passing of the endotracheal tube there
between during endotracheal intubation. Another aspect of the
invention involves an endotracheal intubation system for performing
an endotracheal intubation including the laryngoscope described
immediately above; and an endotracheal tube insertable into the
patient's mouth, between the patient's vocal cords into the
patient's larynx, and into the patient's trachea for opening the
patient's airway.
A further aspect of the invention involves a method of performing
an endotracheal intubation including using the laryngoscope
described immediately above to lift the patient's tongue and
mandible for viewing the vocal cords and aid in the insertion of an
endotracheal tube; illuminating the patient's vocal cords with the
black light source to prompt the visible effects of fluorescence
and phosphorescence with respect to the patient's vocal cords for
viewing the vocal cords; and simultaneously visualizing the
patient's vocal cords with the black light source and sliding the
endotracheal tube between the patient's vocal cords and into the
patient's larynx and trachea.
A still further aspect of the invention involves a laryngoscope
blade for use in viewing the vocal cords of a patient in
performance of an endotracheal intubation. The laryngoscope blade
includes a laryngoscope blade portion connectable to a laryngoscope
handle to lift the patient's tongue and mandible for viewing the
vocal cords and aid in the insertion of an endotracheal tube; and a
black light source carried by the blade portion to prompt the
visible effects of fluorescence and phosphorescence with respect to
the patient's vocal cords for viewing the vocal cords and passing
of the endotracheal tube there between during endotracheal
intubation.
According to another embodiment, a laryngoscope for use in viewing
the vocal cords of a patient in performance of an endotracheal
intubation includes a handle to be gripped by a medical
professional in performing the endotracheal intubation, and a blade
portion pivotally connected to a first/upper end of the handle and
extending from the handle to lift the patient's tongue and mandible
for viewing the vocal cords and for aiding in the insertion of an
endotracheal tube. The handle is of an ergonomically curved or
angled overall shape, and has an inner surface with a series of
arcuate finger grip indents. In one embodiment, an outwardly
projecting blade stop is formed integrally on the inner surface of
the handle adjacent the upper end, and prevents the blade from
touching the handle. The handle may be curved continuously along
all or most of its length in an ergonomic shape for comfortable
gripping by the user. Alternatively, the handle may have a first
end portion extending from one end up to an angled bend, and a
second end portion extending from the bend at an angle to the first
portion.
Another aspect of the invention involves a laryngoscope handle of a
laryngoscope for use in viewing the vocal cords of a patient in
performance of an endotracheal intubation, the laryngoscope
including a laryngoscope blade connectable to the handle to lift
the patient's tongue and mandible for viewing the vocal cords and
aid in the insertion of an endotracheal tube. The laryngoscope
handle includes a first end; a second end; an inner surface which
faces towards a patient during use; and an outer surface, wherein
the inner surface of the handle having a plurality of spaced finger
grip indents along at least part of the length of the handle
between the first and second ends.
One or more implementations of the aspect of the invention
described immediately above includes one or more of the following:
the handle is at least one of angled and curved to direct the
second end towards the blade, when the blade is connected to the
handle; the outer surface of the handle includes a convex surface
with a radius of curvature in the range of 3 to 5 inches; the outer
surface of the handle includes a thumb engaging section with a
thumb location for engaging the laryngoscope handle with one's
thumb; the thumb engaging section includes an elongated recessed
section; the thumb engaging section includes an indicia to indicate
proper orientation of the laryngoscope handle; the thumb location
is located near the second end of the laryngoscope handle, and
further including a second thumb location near the first end of the
laryngoscope handle; the plurality of spaced finger grip indents
include four spaced finger grip indents; the four spaced finger
grip indents include a first finger grip indent that receives an
index finger, a second finger grip indent that receives a middle
finger, a third finger grip indent that receives a third finger,
and a fourth finger grip indent that receives a little finger; the
plurality of spaced finger grip indents include three spaced finger
grip indents; the three spaced finger grip indents include a first
finger grip indent that receives a middle finger, a second finger
grip indent that receives a third finger, and a third finger grip
indent that receives a little finger; the laryngoscope blade is
connected to the second end of the laryngoscope handle, the
laryngoscope blade carrying a black light source to prompt the
visible effects of fluorescence and phosphorescence with respect to
the patient's vocal cords for viewing the vocal cords, providing
visible definition of the other structures, and passing of the
endotracheal tube there between during endotracheal intubation, the
black light source emitting electromagnetic radiation having a
wavelength in the range of 300 to 450 nm; the laryngoscope blade
includes a proximal portion, a distal portion, and a white light
source, and the black light source is located closer to the distal
portion and the white light is located closer to the proximal
portion; the handle has a bend which separates the handle into a
first end portion and a second end portion which is bent at an
angle in the range from 40 to 60 degrees relative to the first end
portion; and/or the blade is pivotally connectable to the handle
and the inner surface of the handle has a blade stop projection
extending towards the blade, when the blade is pivotally connected
to the handle, which restricts contact between the handle and
blade, when the blade is pivoted towards the handle.
A further aspect of the invention involves a laryngoscope handle of
a laryngoscope for use in viewing the vocal cords of a patient in
performance of an endotracheal intubation, the laryngoscope
including a laryngoscope blade connectable to the handle to lift
the patient's tongue and mandible for viewing the vocal cords and
aid in the insertion of an endotracheal tube. The laryngoscope
handle includes a first end; a second end; an inner surface which
faces towards a patient during use; and an outer surface, wherein
the handle is at least one of angled and curved to direct the
second end towards the blade, when the blade is connected to the
handle.
One or more implementations of the aspect of the invention
described immediately above includes one or more of the following:
the inner surface of the handle having a plurality of spaced finger
grip indents along at least part of the length of the handle
between the first and second ends; the outer surface of the handle
includes a convex surface with a radius of curvature in the range
of 3 to 5 inches; the outer surface of the handle includes a thumb
engaging section with a thumb location for engaging the
laryngoscope handle with one's thumb; the thumb engaging section
includes an elongated recessed section; the thumb engaging section
includes an indicia to indicate proper orientation of the
laryngoscope handle; the thumb location is located near the second
end of the laryngoscope handle, and further including a second
thumb location near the first end of the laryngoscope handle; the
plurality of spaced finger grip indents include four spaced finger
grip indents; the four spaced finger grip indents include a first
finger grip indent that receives an index finger, a second finger
grip indent that receives a middle finger, a third finger grip
indent that receives a third finger, and a fourth finger grip
indent that receives a little finger; the plurality of spaced
finger grip indents include three spaced finger grip indents; the
three spaced finger grip indents include a first finger grip indent
that receives a middle finger, a second finger grip indent that
receives a third finger, and a third finger grip indent that
receives a little finger; the laryngoscope blade is connected to
the second end of the laryngoscope handle, the laryngoscope blade
carrying a black light source to prompt the visible effects of
fluorescence and phosphorescence with respect to the patient's
vocal cords for viewing the vocal cords, providing visible
definition of the other structures, and passing of the endotracheal
tube there between during endotracheal intubation, the black light
source emitting electromagnetic radiation having a wavelength in
the range of 300 to 450 nm; the laryngoscope blade includes a
proximal portion, a distal portion, and a white light source, and
the black light source is located closer to the distal portion and
the white light is located closer to the proximal portion; the
handle has a bend which separates the handle into a first end
portion and a second end portion which is bent at an angle in the
range from 40 to 60 degrees relative to the first end portion;
and/or the blade is pivotally connectable to the handle and the
inner surface of the handle has a blade stop projection extending
towards the blade, when the blade is pivotally connected to the
handle, which restricts contact between the handle and blade, when
the blade is pivoted towards the handle.
An additional aspect of the invention involves a laryngoscope blade
for use in viewing the vocal cords of a patient in performance of
an endotracheal intubation. The laryngoscope blade includes a
laryngoscope blade portion connectable to a laryngoscope handle to
lift the patient's tongue and mandible for viewing the vocal cords
and aid in the insertion of an endotracheal tube, the laryngoscope
blade portion includes a proximal portion and a distal portion; a
white light source carried by the laryngoscope blade portion; a
black light source carried by the blade portion to prompt the
visible effects of fluorescence and phosphorescence with respect to
the patient's vocal cords for viewing the vocal cords, providing
visible definition of the other structures, and passing of the
endotracheal tube there between during endotracheal intubation, the
black light source located closer to the distal portion and the
white light located to the proximal portion, and the black light
source emitting electromagnetic radiation having a wavelength in
the range of 300 to 450 nm.
One or more implementations of the aspect of the invention
described immediately above includes one or more of the following:
the black light source emits electromagnetic radiation having a
wavelength in the range of 385 to 395 nm; the white light source is
a cool white LED with a mcd rating of 100-10,000 millicandela
(mcd); an electrical circuit including the white light source and a
150 ohm resistor associated with the white light source to provide
5 ma at 2.9 volts; an electrical circuit including the black light
source and a 13 ohm resistor so that the distal black light source
is at 49-50 ma at 3.6 volts; an electrical circuit including a 3.6
volt lithium battery power source; an endotracheal intubation
system for performing an endotracheal intubation, including a
laryngoscope including the laryngoscope blade described in the
aspect of the invention described immediately above; and an
endotracheal tube insertable into the patient's mouth, between the
patient's vocal cords into the patient's larynx, and into the
patient's trachea for opening the patient's airway, the
endotracheal tube includes a distal portion and an expandable body
near the distal portion, the distal portion includes a dimension,
and the expandable body includes a dimension less than the
dimension of the distal portion of the expandable body during
intubation and a dimension greater than the dimension of the distal
portion of the expandable body to secure the endotracheal tube in
place in the trachea; the distal portion includes a recessed
section that carries the expandable body, and the expandable body
is recessed in the recessed section so that the expandable body
includes a dimension less than the dimension of the distal portion
of the expandable body during intubation and so that the expandable
body expands to a dimension outside of the recessed section,
greater than the dimension of the distal portion, to secure the
endotracheal tube in place in the trachea; the distal portion
includes a movable sheath that covers the expandable body during
intubation and is movable to uncover the expandable body so that
the expandable body is expandable to a dimension greater than the
dimension of the distal portion, to secure the endotracheal tube in
place in the trachea; the distal portion includes at least one of a
fluorescent and phosphorescent material that is at least one of
enhanced by and reacts to the black light source to aid in
visibility and positioning of the endotracheal during intubation;
an endotracheal intubation system for performing an endotracheal
intubation, including a laryngoscope including the laryngoscope
blade of the aspect of the invention described immediately above;
an endotracheal tube insertable into the patient's mouth, between
the patient's vocal cords into the patient's larynx, and into the
patient's trachea for opening the patient's airway; and a stylet
for the endotracheal tube, the stylet including at least one of a
fluorescent and phosphorescent material that is at least one of
enhanced by and reacts to the black light source to aid in
visibility and positioning of at least one of the stylet and the
endotracheal tube; and/or an endotracheal intubation system for
performing an endotracheal intubation, including a laryngoscope
including the laryngoscope blade of the aspect of the invention
described immediately above; an endotracheal tube insertable into
the patient's mouth, between the patient's vocal cords into the
patient's larynx, and into the patient's trachea for opening the
patient's airway; an endotracheal tube introducer including at
least one of a fluorescent and phosphorescent material that is at
least one of enhanced by and reacts to the black light source to
aid in visibility and positioning of at least one of the
endotracheal tube introducer and the endotracheal tube.
A further aspect of the invention involves an introducer including
a distal portion, an intermediate portion, and a proximal portion,
wherein one or more of the distal portion, the intermediate
portion, and the proximal portion including at least one of a
fluorescent and phosphorescent material that is at least one of
enhanced by and reacts to the black light source to aid in
visibility and positioning of the introducer.
One or more implementations of the aspect of the invention
described immediately above include one or more of the following:
the introducer includes a polyethylene body; the introducer is at
least one of an endotracheal tube introducer and an orotracheal
intubation introducer; the introducer includes smooth outer ends;
and/or the introducer includes a length of 50-70 cm.
A still further aspect of the invention involves an endotracheal
intubation tube for performing an endotracheal intubation, the
endotracheal intubation tube insertable into the patient's mouth,
between the patient's vocal cords into the patient's larynx, and
into the patient's trachea for opening the patient's airway. The
endotracheal intubation tube includes an endotracheal tube body; a
distal portion; and an expandable body near the distal portion,
wherein the distal portion includes a dimension, and the expandable
body includes a dimension less than the dimension of the distal
portion of the expandable body during intubation and a dimension
greater than the dimension of the distal portion of the expandable
body to secure the endotracheal tube in place in the trachea.
One or more implementations of the aspect of the invention
described immediately above includes one or more of the following:
the distal portion includes a recessed section that carries the
expandable body, and the expandable body is recessed in the
recessed section so that the expandable body includes a dimension
less than the dimension of the distal portion of the expandable
body during intubation and so that the expandable body expands to a
dimension outside of the recessed section, greater than the
dimension of the distal portion, to secure the endotracheal tube in
place in the trachea; the distal portion includes a movable sheath
that covers the expandable body during intubation and is movable to
uncover the expandable body so that the expandable body is
expandable to a dimension greater than the dimension of the distal
portion, to secure the endotracheal tube in place in the trachea;
and/or a stylet for the endotracheal tube, the stylet including at
least one of a fluorescent and phosphorescent material that is at
least one of enhanced by and reacts to the black light source to
aid in visibility and positioning of at least one of the stylet and
the endotracheal tube.
Another aspect of the invention involves an endotracheal tube
stylet which comprises an elongate, malleable member and an
illuminating material comprising at least one of a fluorescent and
phosphorescent material extending along at least part of the
malleable member to aid in visibility and positioning of an
endotracheal tube.
One or more implementations of the aspect of the invention
described immediately above includes one or more of the following:
the removable sheath includes a substantially tubular portion that
covers the distal portion of the endotracheal tube and protect the
expandable body; the removable sheath includes a finger portion
engageable by a user's finger to facilitate removal of the
removable sheath from the distal portion of the endotracheal tube;
the finger portion includes a finger hole engageable by a user's
finger to facilitate removal of the removable sheath from the
distal portion of the endotracheal tube; and/or the removable
sheath carries a lubricant for lubricating the distal portion and
the expandable body of the endotracheal tube.
Another aspect of the invention involves a device for use in the
performance of an endotracheal intubation. The device includes a
proximate portion of a laryngoscope blade, a distal portion of a
laryngoscope blade and a connection section allowing the
laryngoscope blade to connect and disconnect from the laryngoscope
handle. The laryngoscope blade carries an imaging or viewing device
and two different light sources all in equal distance from the
distal end of the laryngoscope blade. The two light sources include
an ultraviolet light source and a white light source. In this
aspect of the invention, the light sources allow for the
illumination of ultraviolet light being absorbed and self promotes
back light from phosphorous reactions.
Yet another aspect of the invention involves a method of performing
direct laryngoscopy. In this method, a laryngoscope blade carrying
an imaging or viewing device and two different light sources all in
equal distance from the distal end of the laryngoscope blade is
connected to a laryngoscope handle forming a laryngoscope. The
laryngoscope is then used to lift a patient's tongue and mandible
for locating and viewing a foreign object in the patient. In this
embodiment, the two light sources used in the laryngoscope prompt a
visible illumination effect in the patient's epiglottis and vocal
cords, and allow for the detection of the foreign object in the
patient. The illumination in this embodiment is a result of the
absorption of some or all of the ultraviolet light by tissues in
the patient and a self-providing back light from phosphorus
reactions. The detection of the foreign object then allows for the
prompt removal.
Another aspect of the invention involves the use of a single
compartment (e.g. epoxy holding) that contains a white light source
and a black/ultraviolet light source in the laryngoscope blade.
An additional aspect of the invention involves a device for use in
the performance of an endotracheal intubation. The device includes
a laryngoscope blade having a proximate portion and a distal
portion with a distal end, the laryngoscope blade connectable to a
laryngoscope handle through a connection section; at least two
different light sources carried by the laryngoscope blade and in
equal distance from the distal end of the laryngoscope blade, the
two light sources comprising an ultraviolet light source and a
white light source that, in combination, allows for the
illumination of ultraviolet light being absorbed and self promotes
back light from phosphorous reactions; and an imaging device
carried by the laryngoscope blade a distance from the distal end
that is substantially equal to the distance between the distal end
and the ultraviolet light source and the white light source.
One or more implementations of the aspect of the invention
described immediately above includes one or more of the following:
further comprising an electrical circuit including a 3.6 volt
lithium battery power source in the laryngoscope handle; the
connection section is configured to cause the light sources to be
automatically activated when the laryngoscope blade is connected to
the laryngoscope handle; the connection section is configured to
cause the imaging device to be automatically activated when the
laryngoscope blade is connected to the laryngoscope handle; the
imaging device is a camera head; the ultraviolet light source emits
electromagnetic radiation having a wavelength in the range of 300
to 450 nm; the white light is a 2-8 mm LED diode; the white light
is a cool white LED with a rating of 100-10,000 millicandela (mcd);
the ultraviolet light is an ultraviolet diode; the light sources
are in a single epoxy holding; and/or the device is used in a
method of performing direct laryngoscopy including connecting the
laryngoscope blade and the laryngoscope handle to create a
laryngoscope; using the laryngoscope to lift a patient's tongue and
mandible for locating and/or viewing a foreign object in the
patient; providing the two light sources to: prompt a visible
illumination effect in the patient's epiglottis and vocal cords
resulting from: the absorption of some or all of the ultraviolet
light by tissues in the patient; and a self-providing back light
from phosphorus reactions; and allow a reaction with a foreign body
in the patient; and locating the foreign object in the patient.
A further aspect of the invention involves a laryngoscope for use
in viewing the vocal chords and trachea of a patient while
performing endotracheal intubation or attempting to remove a
foreign body obstructing the trachea. The laryngoscope includes a
laryngoscope handle adapted for gripping by a user; a laryngoscope
blade having a proximal portion configured for connection to the
laryngoscope handle and a distal portion configured for insertion
into a patient's mouth into an operative position, the distal
portion having a distal end facing the opening of the trachea in
the operative position; at least two different light sources
carried by the laryngoscope blade and both located at a first
distance from the distal end of the laryngoscope blade, the at
least two light sources comprising an ultraviolet (UV) light source
and a white light source, the light sources together configured to
provide illumination in a portion of the trachea extending from the
trachea opening, and the UV light source configured to prompt the
visible effects of fluorescence and phosphoresence in illuminated
tissues in the trachea and to produce phosphorescence from
absorption of UV light in a foreign body having a phosphor content
located in the illuminated portion of the trachea; and an imaging
device carried by the laryngoscope blade and configured to produce
an image of the illuminated portion of the trachea and any foreign
object obstructing the illuminated portion.
One or more implementations of the aspect of the invention
described immediately above includes one or more of the following:
the imaging device is at substantially the same distance from
distal end as the light sources; the light sources and imaging
device are in a single unit mounted in distal portion of the blade;
the device is used in a method of retrieving a foreign object from
a patient's trachea including illuminating both of the light
sources of the laryngoscope; inserting the distal portion of the
laryngoscope into a patient's mouth over a patient's tongue and
mandible and into the throat area to an operative position in which
a portion of the trachea extending from the vocal cords is
illuminated by the light sources and the UV light source prompts
the visible effects of fluorescence and phosphoresence in the
tissue of the illuminated portion of the trachea and UV light is
absorbed by any phosphor content in a foreign object trapped in the
illuminated portion of trachea to produce phosphoresence to further
illuminate the object; inserting the ends of forceps into the
trachea and advancing the ends of the forceps towards the
illuminated object while viewing the illuminated object to aid in
locating the object with the forceps; and retrieving the object
from the trachea using the forceps; the method further comprises
viewing the object on an imaging device connected to the camera;
the method further comprises viewing the object as deep as one
circoid ring into the trachea; the method further comprises viewing
the object as deep as two circoid rings into the trachea; the
method further comprises viewing the object as deep as three
circoid rings into the trachea; and/or the method further comprises
viewing the object as deep as four circoid rings into the
trachea.
Further objects and advantages will be apparent to those skilled in
the art after a review of the drawings and the detailed description
of the preferred embodiments set forth below.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a schematic depiction of a laryngoscope being used to
view a patient's larynx;
FIG. 2 is a perspective view of a laryngoscope in accordance with
an embodiment of the present invention;
FIG. 3A is a bottom plan view of the laryngoscope of FIG. 2, and
illustrates an embodiment of a switch that may be used with the of
the laryngoscope of FIG. 2;
FIG. 3B is a bottom plan view of an alternative embodiment of a
laryngoscope, and illustrates an embodiment of a black light source
on the bottom of the laryngoscope;
FIG. 4 is an embodiment of an endotracheal tube that may be used
with the laryngoscope of FIGS. 1-3.
FIG. 5 is an embodiment of a kit of endotracheal tubes that may be
used with the laryngoscope of FIGS. 1-3.
FIG. 6 is an alternative embodiment of an endotracheal tube that
may be used with the laryngoscope of FIGS. 1-3 or a standard
laryngoscope.
FIG. 7 is an embodiment of a pair of protection intubation glasses
that may be used with the laryngoscope of FIGS. 1-3 and/or the
endotracheal tube(s) of FIGS. 4-6.
FIG. 8 is a side-elevational view of a separate laryngoscope blade
in accordance with an embodiment of the present invention;
FIG. 9 is a side-elevational view of a separate laryngoscope blade
in accordance with another embodiment of the present invention;
FIG. 10 is a side-elevational view of an embodiment of a pair of
forceps;
FIG. 11 is a rear perspective view of an alternative embodiment of
a laryngoscope with an ergonomically shaped handle;
FIG. 12 is a side elevation view of the laryngoscope of FIG.
11;
FIG. 13 is a front perspective view of the laryngoscope of FIGS. 11
and 12;
FIG. 14 is a cross-sectional view of the laryngoscope on the lines
14-14 of FIG. 11;
FIG. 15 is a rear perspective view of another embodiment of a
laryngoscope with a shaped handle; and
FIG. 16 is a side elevation view of the laryngoscope of FIG.
15.
FIG. 17 is a perspective view of another embodiment of a
laryngoscope.
FIG. 18 is a bottom plan view of the laryngoscope illustrated in
FIG. 17.
FIG. 19 is a front elevational view of the laryngoscope illustrated
in FIG. 17.
FIG. 20 is a right side elevational view of the laryngoscope
illustrated in FIG. 17.
FIG. 21 is a left elevational view of the laryngoscope illustrated
in FIG. 17.
FIG. 22 is a rear elevational view of the laryngoscope illustrated
in FIG. 17.
FIG. 23 is a top plan view of the laryngoscope illustrated in FIG.
17.
FIG. 24 is a front elevational view of another embodiment of a
laryngoscope.
FIG. 25 is a cross-sectional view of the handle of the laryngoscope
illustrated in FIG. 24.
FIG. 26 is an exemplary graph of Radiant Power versus Forward
Current for the black light source of the laryngoscope shown in
FIG. 24.
FIG. 27 is an exemplary graph of Radiant Power versus Wave Length
for the black light source of the laryngoscope shown in FIG.
24.
FIG. 28 is an exemplary graph of Peak Wave Length versus Forward
Current for the black light source of the laryngoscope shown in
FIG. 24.
FIG. 29 is an exemplary graph of Radiant Power versus Time for the
black light source of the laryngoscope shown in FIG. 24.
FIG. 30 is an embodiment of an introducer (e.g., endotracheal tube
introducer) that may be used with a black light source such as the
black light source of the laryngoscopes described and shown
herein.
FIG. 31 is an embodiment of a stylet (e.g., endotracheal tube
stylet) that may be used with a black light source such as the
black light source of the laryngoscopes described and shown
herein.
FIGS. 32A and 32B are side elevational/end views of a stylet body
of the stylet shown in FIG. 31.
FIGS. 33A, 33B, 33C are top perspective, bottom perspective, and
cross-sectional views of the plug connector of the stylet shown in
FIG. 31.
FIG. 34 is a further embodiment of a stylet (e.g., endotracheal
tube stylet) that may be used with a black light source such as the
black light source of the laryngoscopes described and shown
herein.
FIGS. 35A and 35B are side elevational/end views of a stylet body
of the stylet shown in FIG. 34.
FIGS. 36A, 36B, 36C are top perspective, bottom perspective, and
cross-sectional views of the plug connector of the stylet shown in
FIG. 31.
FIG. 37A is a partial perspective view of another embodiment of an
endotracheal tube with a balloon and movable cuff sheath and shows
the distal portion of the endotracheal tube with the movable cuff
sheath in an extended position where it covers the balloon.
FIG. 37B is a partial perspective view of the endotracheal tube of
FIG. 37A and shows the distal portion of the endotracheal tube with
the movable cuff sheath in a retracted position where the balloon
is not covered and is in an expanded configuration.
FIG. 38A is a partial front elevational view of a further
embodiment of an endotracheal tube with a balloon shown in a
collapsed, low-profile position.
FIG. 38B is a partial front elevational view of the endotracheal
tube of FIG. 38A and shows the balloon in an expanded
configuration.
FIGS. 39A, 39B, 39C, 39D, 39E, 39F, 39G are perspective, left side
elevational, right side elevational, rear elevational, front
elevational, top plan, and bottom plan views of another embodiment
of a laryngoscope handle.
FIGS. 40A, 40B, 40C, 40D, 40E, and 40F are front elevational, top
plan, rear elevational, bottom plan, right side elevational, and
left side elevational views of another embodiment of a laryngoscope
blade.
FIGS. 41A, 41B, 41C, 41D, 41E, and 41F are right side elevational,
rear elevational, left side elevational, front elevational, bottom
plan, and top plan views of an additional embodiment of a
laryngoscope blade.
FIGS. 42A, 42B, 42C, 42D, 42E, 42F, and 42G are right side
elevational, rear elevational, left side elevational, front
elevational, bottom plan, perspective, and top plan views of a
further embodiment of a laryngoscope blade.
FIGS. 43A, 43B, 43C, 43D, 43E, and 43F are right side elevational,
rear elevational, left side elevational, front elevational, bottom
plan, and top plan views of a still further embodiment of a
laryngoscope blade.
FIGS. 44A, 44B, 44C, 44D, 44E, 44F, and 44G are right side
elevational, rear elevational, left side elevational, perspective,
front elevational, bottom plan, and top plan views of an additional
embodiment of a laryngoscope blade.
FIGS. 45A, 45B, 45C, 45D, 45E, 45F, and 45G are right side
elevational, rear elevational, left side elevational, perspective,
front elevational, bottom plan, and top plan views of another
embodiment of a laryngoscope blade.
FIGS. 46A, 46B, 46C, 46D, 46E, and 46F are right side elevational,
rear elevational, left side elevational, front elevational, bottom
plan, and top plan views of a further embodiment of a laryngoscope
blade.
FIGS. 47A, 47B, 47C, 47D, 47E, and 47F are right side elevational,
rear elevational, left side elevational, front elevational, bottom
plan, and top plan views of a further embodiment of a laryngoscope
blade.
FIGS. 48A, 48B, 48C, 48D, 48E, and 48F are right side elevational,
rear elevational, left side elevational, front elevational, bottom
plan, and top plan views of a still further embodiment of a
laryngoscope blade.
FIGS. 49A, 48B, 49C, 49D, 49E, 49F, and 49G are right side
elevational, rear elevational, left side elevational, perspective,
front elevational, bottom plan, and top plan views of a yet further
embodiment of a laryngoscope blade.
FIGS. 50A, 50B, and 50C are side-elevational views of an embodiment
of a removable sheath for a cuff of an endotracheal tube.
FIGS. 51 and 52 are an exploded perspective view and a perspective
view of another embodiment of a laryngoscope blade that includes a
video camera next to an ultraviolet light and a white light.
FIG. 53 is a schematic depiction of the laryngoscope in FIGS. 51
and 52 being used to remove an obstruction from a patient.
FIG. 54 illustrates an embodiment of a combination
ultraviolet/black light source and white light source.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
With reference to FIGS. 1 and 2, a laryngoscope 100 constructed in
accordance with an embodiment of the invention will be described.
In FIG. 1, the laryngoscope 100 is shown placed in the mouth of a
patient 112 for viewing the vocal cords adjacent the larynx and to
aid in the insertion of an endotracheal tube 200 (FIG. 4) past the
vocal cords. The laryngoscope 100 includes a handle or handgrip 114
and a blade portion 116, the latter being used to lift the tongue
and mandible 118 out of the way for viewing the vocal cords.
As shown in FIG. 2, the blade portion 116 is pivotally connected to
a handle cap 120. The blade portion 116, the handle cap 120, and
the handle 114 can be readily assembled together for use. In the
embodiment shown, when assembled, a white light source 150 and a
black light source 160 are automatically actuated. In an
alternative embodiment, the blade portion 116 is directly connected
to a top of the handle 114 (i.e., there is no handle cap). The
handle 114 is essentially a hollow tube having a closed lower or
outer end 122 (FIG. 3) and an open upper end. The handle cap 120 is
removably secured to an open upper end of the handle 114. A power
source 123 (e.g., one or more dry cell batteries) is located within
the handle cavity to provide power for light source(s) to be
described.
A side of the handle 114 includes a switch 128 in the form of two
pressure/push buttons 129, 130 interconnected with the power source
123, the white light source 150, and the black light source 160
that, when pressed (e.g., by a user's thumb), deactivate the
respective light sources 150, 160. When the laryngoscope 100 is
clicked together/assembled, both light sources 150, 160 are placed
in electrical communication with the power source 123 and are
automatically turned on. In the embodiment shown, push button
("white light button") 129 controls the white light source 150 so
that pushing on the white light button 129 turns off the white
light source 150 and push button ("black light button") 130
controls the black light source 160 so that pushing on the black
light button 130 turns off the black light source 160. Thus, by
applying pressure to the push buttons 129, 130, the respective
light sources 150, 160 are turned off. Removing the pressure to the
push buttons 129, 130 causes the respective light sources 150, 160
to be turned back on. Accordingly, the switch 128 enables the
laryngoscope 100 to be switched between at least a "both on"
condition where both black light is emitted from the black light
source 160 and white light is emitted from the white light source
150, a black light condition where black light is emitted from the
black light source 160 and the white light source 150 is off, and a
white light condition where white light is emitted from the white
light source 150 and the black light source 160 is off.
With reference to FIG. 3, an alternative embodiment of a switch 131
located on a bottom 124 of the handle 114 is shown. The switch 131
cooperates with electronics in the laryngoscope 100 for switching
between an "off" condition, a black light condition, a white light
condition, and a "both on" condition. In the embodiment shown, the
switch 131 is a rotating switch with a rotating knob 132 that
rotates between different positions to actuate the above
conditions.
In alternative embodiments, other types of switches may be used
(e.g., push-button switch, a toggle switch) on the bottom 124 of
the handle 114 (or at other locations on the laryngoscope 100) to
switch between an "off" condition and one or more of a black light
condition, a white light condition, and a "both on" condition. In
alternative embodiments, the switch 128, 131 may switch between
conditions in addition to or other than an "off" condition, a black
light condition, a white light condition, and a "both on"
condition. For example, in an alternative embodiment, where the
laryngoscope 100 includes only a black light source 160, the switch
128, 131 may switch the laryngoscope 100 between an "off" condition
and a black light condition.
One or more light sources 140 are interconnected with the power
source 123 in the handle 114. In the embodiment shown, as discussed
above, the one or more light sources 140 include two light sources:
1) a white light source 150, and 2) a black light source 160.
Example white light sources 150 include, but not by way of
limitation, a white halogen light, a white incandescent light, and
a white LED. The black light source 160 emits long wave UVA
radiation and very little visible light. The black light source is
a lamp emitting electromagnetic radiation that is almost
exclusively in the soft near ultraviolet range. The black light
source 160 prompts the visible effects of fluorescence and
phosphorescence with respect to the patient's vocal cords and the
glottis, which is the space between the vocal cords, during
laryngoscopy. The black light source 160 may be a Wood's light made
using Wood's glass, which is a nickel-oxide-doped glass, which
blocks substantially all visible light above 400 nanometers. In
alternative embodiments, other black light sources 160 (e.g.,
LED(s)) may be used. In one embodiment, the black light source 160
emits electromagnetic radiation including a wavelength in the range
of 315 to 400 nm, with out emitting substantial electromagnetic
radiation including a wavelength outside of the range of 315 to 400
nm. In another embodiment, the black light source 160 includes a
wavelength of 385-395 nm.
In the embodiment shown, the blade portion 116 is a curved
Macintosh blade; however, in alternative embodiments, other types
of blades (e.g., straight Miller/Robertshaw blade) may be used. The
blade portion 116 carries the one or more light sources 140.
Although the one or more light sources 140 are shown on a top of
the blade portion 116, in alternative embodiments, the one or more
light sources 140 are disposed at one or more of the following
locations: a side of the blade portion 116, a bottom of the blade
portion 116, a top of the blade portion 116, a distal tip of the
blade portion 116, and other locations on or relative to the blade
portion 116.
With reference to FIG. 3B, in a further embodiment, in addition to
or instead of the one or more light sources 140 being carried by
the blade portion 116, a black light source (e.g., black light
source 160) is carried by the bottom 124 of the handle 114 for
emitting black light from the bottom 124 of the handle 114. In such
an embodiment, a switch (e.g., switch 128) for controlling the
black light source on the bottom 124 of the handle 114 is
preferably located in a location other than the bottom 124 of the
handle 114.
With reference to FIG. 4, an embodiment of an endotracheal tube 200
that may be used with the laryngoscope 100 (as part of an
endotracheal intubation system) in performing endotracheal
intubation will be described. The endotracheal tube 200 includes a
clear plastic intubation tube 210 with an elongated central lumen.
The intubation tube 210 includes a larger-diameter open upper end
212, which may include a cap, and a pointed open lower end or tip
214. An elongated scope (e.g., a fiberoptic scope) 220 may be
received within the lumen of the intubation tube 210. The scope 220
includes a distal viewing tip 230. A plastic transparent holding
sheath may cover the scope 220. A longitudinally built-in narrow
malleable metal intubation stylet 240, which is a narrow piece of
flat metal, may be built into the holding sheath and adhered to an
outer wall of the holding sheath for controlling the geometry/shape
of the scope 220/endotracheal tube 200 to match the
physiology/anatomy of the patient during endotracheal
intubation.
In an alternative embodiment, one or more of the intubation tube
210 and the stylet 240 include a fluorescent color or other
color/substance that is enhanced by the black light or that reacts
to the black light (on the entire tube 210/stylet 240 or a portion
and/or component there of).
For example, but not by way of limitation, in one or more
embodiments, the intubation tube 200 includes a fluorescent
striping on the body of the ET tube 210, fluorescent coloring of
the balloon/cuff shown near the distal end of the tube 200, and/or
on the BVM connector near proximal end of tube 200 causes device to
naturally phosphoresce under black light, clearly identifying ET
tube tracking through the vocal cords into the trachea.
A method of performing endotracheal intubation using the
laryngoscope 100 and the endotracheal tube 200 will be described.
The black light source 160 of the laryngoscope 100 is activated
(e.g., when the laryngoscope 100 is clicked together/assembled).
The blade portion 160 of the laryngoscope 100 is inserted into the
patient's mouth and behind the patient's tongue and mandible 118.
By gripping the handle 114 with one's hand, the tongue and mandible
118 are lifted for viewing the vocal cords adjacent the larynx and
to aid in the insertion of the endotracheal tube 200 past the vocal
cords. The black light emitted from the laryngoscope 100 prompts
the visible effects of fluorescence and phosphorescence with
respect to the patient's vocal cords and the glottis, making the
patient's vocal cords and the glottis visible either directly by
the eyes of the medical provider or via the scope 220 of the
endotracheal tube 200. The endotracheal tube 200 is inserted into
the patient's mouth, between the patient's visible vocal cords into
the larynx, and then into the trachea of the patient in a usual
manner. The stylet 200 of the endotracheal tube 200 may be used to
shape the scope 220/endotracheal tube 200 to the individual
anatomy/pathology of the patient.
As discussed above, in the embodiment of the laryngoscope 100 shown
in FIG. 1, applying pressure to the push buttons 129, 130 causes
the respective light sources 150, 160 to be deactivated and
removing the pressure to the push buttons 129, 130 causes the
respective light sources 150, 160 to be re-activated. The medical
provider operates the push buttons 129, 130 of the switch 128
(e.g., to cause only black light to be emitted, only white light to
be emitted, or both types of light to be emitted) so that optimal
viewing of the vocal cords occurs. The medical provider may prefer
to use the black light condition and/or the white light condition,
depending on external lighting conditions, the individual
anatomy/pathology of the patient, the patient's condition, and
other factors.
With reference to FIG. 5, in another embodiment of the above
endotracheal tube 200, a kit 300 of endotracheal tubes 200,
intubation tubes 210, and/or stylets 240 of different sizes (e.g.,
different weight, height, and/or depth; adult version, pediatric
version) are color-coded with different fluorescent colors or other
color/substance that is enhanced by the black light or that reacts
to the black light. For example, but not by way of limitation, the
intubation tube 210 of each different endotracheal tube 200 is
coated with a unique fluorescent colored material or other
color/substance that is enhanced by the black light or that reacts
to the black light. The entire endotracheal tube 200 may include a
fluorescent color or one or more portions of the endotracheal tube
200 may include one or more fluorescent colors (or other
color/substance that is enhanced by the black light or that reacts
to the black light). For example, but not by way of limitation, a
cap of the endotracheal tube 200 may include a unique fluorescent
color (or other color/substance), the intubation tube 210 may
include a unique fluorescent color (or other color/substance),
and/or the stylet 240 may include a unique illuminating material or
substance, such as a fluorescent color (or other color/substance)
for identifying the proper size endotracheal tube 200, intubation
tube 210, and/or stylet 240, and for improving visualization of the
endotracheal tube 200, intubation tube 210, and/or stylet 240
during endotracheal intubation. Using the black light source 160 of
the laryngoscope 100, one may easily identify the correct-sized
endotracheal tube 200, intubation tube 210, and/or stylet 240 by
shining black light on the kit of endotracheal tubes 200,
intubation tubes 210, and/or stylets 240 identified by different
fluorescent colors (or other color/substance) so that the
proper-sized endotracheal tube 200, intubation tube 210, and/or
stylet 240 for the patient/application is selected. The
different-size/fluorescent-color endotracheal tubes 200, intubation
tubes 210, and/or stylets 240 are easy to identify with a black
light source, especially in no-light, low-light, or dark
conditions. Further, the fluorescent (or other color/substance)
endotracheal tube 200, intubation tube 210, and/or stylet 240, in
combination with the black light laryngoscope 100, improves
visualization of the endotracheal tube 200, intubation tube 210,
and/or stylet 240 passing the vocal cords during endotracheal
intubation.
With reference to FIG. 6, in another embodiment, the stylet 240
and/or the endotracheal tube 200 includes a black light source 350
that emits black light to enhance visualization of the vocal cords
during endotracheal intubation. For example, the stylet 240 and/or
the endotracheal tube 200 with black light source 250 may be used
in conjunction with the laryngoscope 100 discussed above with
respect to FIGS. 1-3, or in conjunction with a normal laryngoscope
that does not have a black light source 150.
With reference to FIG. 7, an embodiment of a pair of protection
intubation glasses 400 includes lenses 410 configured (e.g., tinted
to a particular shade) so that when used in conjunction with the
black light sources described above during endotracheal intubation,
the visibility of the vocal cords is intensified/enhanced.
With reference to FIG. 8, an embodiment of a separate laryngoscope
blade 500 that may be detachably connected to a separate
laryngoscope handle (e.g., handle 114) will be described. In the
embodiment shown, the blade 500 is a curved Macintosh blade;
however, in alternative embodiments, other types of blades (e.g.,
straight Miller/Robertshaw blade) may be used.
The blade 500 may be made of stainless steel, plastic, or a
combination of stainless steel and plastic. In other embodiments,
other materials are used.
The blade 500 includes a blade portion 516 with a distal portion
530 and a proximal portion 540. The blade portion 516 carries a
white light source 150 and a black light source 160. The black
light source 160 is located distally of (i.e., closer to the distal
portion 530 relative to) the white light source 150 on the blade
portion 516. The advantage of locating the black light source 160
distally of the white light source 150 is that, in use, the
proximal white light source 150 provides general illumination
(e.g., of the interior of the mouth and back of the patient's
throat) while the distal black light source 160, which is disposed
closer to the patient's vocal cords and the glottis, provides
directed black light illumination of the patient's vocal cords and
the glottis, prompting the visible effects of fluorescence and
phosphorescence with respect to the patient's vocal cords and the
glottis. In another embodiment (FIGS. 17-23), the distal black
light source 160 is disposed 1.5 to 2.0 inches in front of proximal
white light source 150. In alternative embodiments, the white light
source 150 and/or the black light source 160 are located at other
positions/locations/relative distances than those shown.
The blade 500 includes a connection section 550 for mechanically
coupling the blade 500 to a top of the separate laryngoscope handle
and electrically coupling the white light source 150 and the black
light source 160 to a power source in the laryngoscope handle.
Alternatively, the blade 500 carries its own power source for
powering the white light source 150 and the black light source 160.
When the blade 500 is connected to the laryngoscope handle, the
connection section 550 is configured so that both the white light
source 150 and the black light source 160 are automatically
activated and when the blade 500 is disconnected to the
laryngoscope handle, the white light source 150 and the black light
source 160 are automatically deactivated. This automatic
activation/deactivation may be achieved by electrical connectors
and/or switch(es) (e.g., an electrically conductive ball contact on
connection portion of handle and a cooperating electrically
conductive ball contact on connection portion of blade 500 that
contact each other to close the circuit when the blade 500 and the
handle are connected and lose contact with each other to open the
circuit when the blade 500 and the handle of disconnected). For
example, the mechanical connection between the connection section
550 and the laryngoscope handle may put the power source in the
handle in electrical communication with the white light source 150
and the black light source 160 or may cause a switch at the
interface of the connection section 550 and the laryngoscope handle
to be closed. In an alternative embodiment, the blade 500 and/or
laryngoscope handle carries a user controllable switch to control
activation/deactivation of the white light source 150 and the black
light source 160 (e.g., both on, both off, one on and one off).
FIG. 9 illustrates another embodiment of a separate laryngoscope
blade 600 that is the same as the blade 500, except the blade 600
includes only a black light source 160 instead of both a white
light source 150 and a black light source 160.
With reference to FIG. 10, an embodiment of a pair of stainless
steel disposable forceps 700 including distal portions 710 of jaws
720 coated with (e.g., dipped in) a fluorescent colored
material/substance (or other color/substance) that is enhanced by
the black light or that reacts to the black light is shown. In an
alternative embodiment, the forceps 700 are made of a plastic
material including the fluorescent colored material/substance (or
other color/substance) that is enhanced by the black light or that
reacts to the black light. The forceps 700 include a handle 730 at
a proximal end and the distal jaws 720 at an opposite end for
gripping an object. The forceps 700 pivot about a pivot section
740. In use, the forceps 700 are used to grip an object (e.g., to
remove an object from the patient's body). Black light (e.g., from
any of the black light devices described above and shown herein) is
directed at the object and the jaws 720 of the forceps 700. The
fluorescent colored material/substance is enhanced by the black
light, allowing the user to see exactly where to grab the object
and, most importantly, not cause damage to surrounding tissue. The
user then grabs the object with the jaws 720 of the forceps 700
and, if appropriate, removes the object from the patient's body.
Although the forceps 700 in the embodiment shown are Magill-type
forceps, in alternative embodiments, other types of forceps with
jaws 720 coated with a fluorescent material/substance may be
used.
FIGS. 11 to 14 illustrate another embodiment of a laryngoscope 800
having an ergonomically shaped handle 802 and a blade 804 pivotally
connected to a first/upper end of the handle via pivot pin 805. In
one embodiment, a connection portion 820 of the blade pivots into
latching engagement with a suitable conventional latching or
click-lock mechanism (not illustrated) at the top of the handle
when in the operative position shown in the drawings. In the
embodiment shown, the blade is a curved Macintosh blade; however,
in alternative embodiments, other types of blades (e.g., straight
Miller/Robertshaw blade) may be used. The blade 804 carries one or
more light sources (not illustrated) as illustrated and described
above in connection with the embodiments of FIGS. 1 to 10, such as
light sources 140 on a top surface of the blade as illustrated in
FIG. 2. As described in connection with the previous embodiments,
the one or more light sources may be a white light source, a black
light source, or a black light source and a white light source. The
one or more light sources may alternatively be disposed at one or
more of the following locations: a side of the blade, a bottom of
the blade, a top of the blade, a distal tip of the blade, and other
locations on or relative to the blade. The light sources may be any
of the alternative types of light sources as described above in
connection with the preceding embodiments.
In this embodiment, handle 802 is of a continuously curved,
ergonomic shape with a series of four finger grip indents 806 on
its inner, concave surface. A projecting blade stop 808 is also
located on the inner surface adjacent the first/upper end of the
handle. The blade stop 808 may be formed in a first/upper end cap
810 which incorporates the blade pivot mount, as illustrated in
FIG. 14. In an alternative embodiment, the blade 804 is directly
connected to the first/upper end of the handle 802, eliminating the
separate end cap 810 and replacing it with an integrally formed
first/upper end portion of the handle 802 of similar shape to end
cap 810, including blade stop 808. The handle 802 may be made of
any suitable rigid and lightweight material such as metal or
plastic.
The first/upper end cap 810 or end portion of the handle 802 is
pivotally assembled with the blade 804 in a similar or identical
manner to the previous embodiments, and a second/lower end cap 812
is threadably engaged with a lower second/open end of the handle
for access to a battery cavity containing a power source 814 (e.g.
one or more dry cell batteries such as a lithium battery, single
3.6 volt lithium battery battery powering a white light source and
a black light source carried by the blade 804 in a manner similar
to that shown in FIG. 8) which supplies power to the light source
or sources, as best illustrated in FIG. 14. As illustrated in FIG.
14, the battery is connected to contact pin 815 in end cap 810 via
spring loaded connector wire 816. Contact pin 814 projects into a
contact recess 818 in the pivotally mounted portion 820 of the
blade. Although not shown in the drawings, it will be understood
that the contact in recess 818 is suitably connected to a light
source or sources (not illustrated) mounted on the blade 804 in a
conventional manner, so that the light source or sources are
automatically placed in communication with the power source when
the blade 804 is assembled or clicked together with the upper part
of the handle 802 in the operative condition of FIGS. 11 to 14, and
are automatically turned off when the blade is released or
disassembled from the upper part of the handle for storage when not
in use, for example when the blade is released from the
conventional click lock or latching mechanism (not illustrated) at
the first/upper end of the handle and pivoted down towards the
handle. The blade stop 808 prevents the blade 804 from contacting
the handle when pivoted.
As in the previous embodiments, in alternative embodiments of the
laryngoscope 800, other types of switches may be used (e.g.,
push-button switch, a toggle switch) on the bottom of the handle
(or at other locations on the laryngoscope 800) to switch between
an "off" condition and one or more of a black light condition, a
white light condition, and a "both on" condition. In alternative
embodiments, the switch may switch between conditions in addition
to or other than an "off" condition, a black light condition, a
white light condition, and a "both on" condition.
The continuously curved handle along with the finger grips 806
which are gripped by the health care provider during intubation
provides an ergonomic design which is easier and more comfortable
to use and which is angled more efficiently for proper actuation.
As illustrated in FIGS. 11 and 12, the outer, convex surface of the
handle is smoothly curved apart from an elongate recessed region
822 in which an arrow sign 824 pointing to the second/lower end of
the handle is provided. The arrow 824 provides an indication of the
direction of use or manipulation of the handle in order to perform
the procedure. The finger grips help the health care provider to
hold the device securely and reduce the risk of the handle slipping
out of the health care provider's hand.
The handle curvature may be a continuous curve of constant radius
of curvature, or may be of varying curvature along at least part of
its length. Due to the handle curvature, when the blade 804 is
inserted into a patient's mouth as in FIG. 1, the second/lower end
portion of the handle 802 bends down rather than upwardly as is the
case with straight handle 114 of FIG. 1, making it easier and more
efficient for the health care provider to manipulate and position
the blade 804 while viewing the patient's trachea during the
procedure. The radius of curvature of the outside surface of the
handles (FIGS. 11-14, 17-23, and 39) is 4.1 inches. In a preferred
embodiment, the radius of curvature of the outside surface of the
laryngoscope handle is in the range from 3 to 5 inches. The
second/lower end portion of the handle may be bent or curved
through an angle of around 40 to 60 degrees relative to the
first/upper end of the handle which is attached to the blade.
FIGS. 15 and 16 illustrate a modified laryngoscope 900 in which the
handle 902 has an angled bend 904 at approximately the mid-point in
its length, separating it into an upper, straight portion 905 and a
lower straight portion 906 which is bent at an angle to the
first/upper end portion. The angle between the upper portion 905
and lower portion 906 may be of the order of 40 to 60 degrees, for
example 45 degrees. Apart from the handle being bent at an angle
rather than continuously curved as in the embodiment of FIGS. 11 to
14, other parts of the laryngoscope of FIGS. 15 and 16 are
identical to those of the previous embodiment, and like reference
numerals are used for like parts as appropriate. As in the previous
embodiment, the handle 902 has finger grip indents 806 and a blade
stop 808 on its inner surface, facing the blade 804. The finger
grip indents 822 allow the health care provider to grip the handle
902 more comfortably and securely, while the angled end portion
allows the health care provider to position the blade 804 more
efficiently during the procedure.
FIGS. 17-23 illustrate another embodiment of a laryngoscope 1000
that is generally similar to the laryngoscope 800 discussion above
with respect to FIGS. 11-14, which is incorporated herein, but
includes a distal black light source that is disposed 1.5 to 2.0
inches in front of a proximal white light source. In alternative
embodiments, the distance between the distal black light source and
the white light source is a distance other than 1.5 to 2.0 inches.
Portions of the distal black light source and the proximal white
light source are disposed through lateral holes in a curved
vertical wall of laryngoscope blade (e.g., distal/bulb ends of
black light source and white light source are disposed on one side
of vertical wall and proximal ends of black light source and white
light source are disposed on an opposite side of vertical wall).
The laryngoscope 1000, and handle 1005, in particular, increases
the effectiveness of blade insertion and placement through an
improved ergonomic design. The laryngoscope 1000 and handle 1005
improve entry angle and handle control (to allow more effective
tongue sweep and mandible lift). The laryngoscope 1000 and handle
1005 enable instinctive lift-direction to help avoid oral cavity
damage. The laryngoscope 1000 limits "fulcruming" of blade/handle
unit, which often leads to dental damage. In the past, the
laryngoscopes used handle devices consisting of straight
"flashlight-like" tubes that were non-ergonomic, difficult to
control, and may promote use that can injure structures in the oral
cavity.
The laryngoscope handle 1005 in FIGS. 17-23 is a
four-finger-grip-indented handle 1005 made of machined aluminum and
includes an ergonomic "pistol-grip" design that provides a proper
angle for mandible lift and tongue sweep used in laryngoscopy, and
provides ergonomical shape and design to prevent fulcruming and
breaking teeth.
In the four-finger-grip-indented handle 1005 shown and described
with respect to FIGS. 17-23, the laryngoscope is oriented in an
opposite manner than that shown in FIG. 22 (i.e., second/lower end
1002 of handle 1005 oriented up and blade 1004 oriented down). A
user grips handle 1005 by holding the handle 1005 in the palm of
one's hand and presses one's thumb against the arrow 824 (FIGS. 19,
21, 22) in a first thumb location 1010, with the arrow 824 facing
up (second/lower end 1002 oriented up) for proper orientation of
the handle 100 during normal laryngoscopic use as shown in FIG. 1.
The first thumb location 1010 is located in the elongate recessed
region 822, near the first/upper end of handle 1005. In this
position, the user's thumb is collinear with and longitudinally
aligned with the elongated recessed region 822 and the handle 1005.
The handle 1000 includes a second thumb location 1030 near a
first/upper end 1032 of the laryngoscope handle 1005 that is
engaged by the user's thumb during pediatric laryngoscopy. In this
position, the user's thumb is substantially perpendicular with the
handle 1005, giving the user a more delicate hold on the handle
1000 to help ensure that the child/toddler/baby is not injured
during the pediatric laryngoscopy procedure.
In the laryngoscope orientation described above, the user wraps
four fingers around and in four finger grip indents 1032, 1034,
1036, 1038. The user's index finger wraps around and in a first
finger grip indent 1032 closest to second/lower end 1002 of handle
1005, the user's middle finger wraps around and in a second finger
grip indent 1034 next closest to second/lower end 1002 of handle
1005, the third finger wraps around and in a third finger grip
indent 1036 next closest to second/lower end 1002 of handle 1005,
and the little finger wraps around and in a finger grip indent 1038
closest to first/upper end 1032 of handle 1005 (closest to where
blade 1040 connects to the handle 1005). This design is an
ergonomic design that provides a proper angle for mandible lift and
tongue sweep used in adult laryngoscopy, and helps to ensure the
right amount of torque/leverage in adult laryngoscopy to prevent
fulcruming and breaking teeth.
With reference to laryngoscope handle 1045 shown in FIGS. 39A-39G,
the description of the handles shown and described with respect to
FIGS. 11-14 and 17-23 is incorporated herein. The laryngoscope
handle 1045 is made of machined aluminum and includes an ergonomic
"pistol-grip" design that provides a proper angle for mandible lift
and tongue sweep used in pediatric laryngoscopy, and provides
ergonomical shape and design to prevent fulcruming and breaking
teeth. Although the laryngoscope handle 1045 shown in FIGS. 39A-39G
is designed for pediatric laryngoscopy use, in alternative
embodiments, the laryngoscope handle 1045 may be used for adult
laryngoscopy. A main difference between the laryngoscope handle
1045 shown in FIGS. 39A-39G and the handles shown and described
with respect to FIGS. 11-14 and 17-23 is that the laryngoscope
handle 1045 shown in FIGS. 39A-39G includes a series of three
finger grip indents on its inner, concave surface instead of a
series of four finger grip indents 806 on its inner, concave
surface (FIGS. 11-14 and 17-23).
In the three-finger-grip-indented handle 1045 shown with respect to
FIGS. 39A-39G, the laryngoscope/handle 1045 is oriented in an
opposite manner than that shown in FIG. 39A (i.e., second/lower end
1047 of handle 1045 oriented up and first/upper end 1049 of handle
1045 oriented down). A user grips handle 1045 by holding the handle
1045 in the palm of one's hand and presses one's thumb against
arrow 1050 (with second/lower end 1047/arrow 1050 facing up) for
proper orientation of the handle 1045 during normal laryngoscopic
use as shown in FIG. 1. The first thumb location 1055 is located in
elongate recessed region 1060, near second/lower end 1047 of handle
1045. In this position, the user's thumb is collinear with and
longitudinally aligned with the elongated recessed region 1060 and
the handle 1045. The handle 1045 includes a second thumb location
1065 at an opposite end of the elongate recessed region 1060, near
a first/upper end 1049 of the laryngoscope handle 1045, which is
engaged by the user's thumb during more-delicate pediatric
laryngoscopy. In this position, the user's thumb is substantially
perpendicular with the handle 1045, giving the user a more delicate
hold on the handle 1045 to help ensure that the child/toddler/baby
is not injured during this more-delicate pediatric laryngoscopy
procedure.
In the first laryngoscope orientation, the user wraps three fingers
(one's middle finger, third finger, and little finger) around and
in three finger grip indents 1070, 1072, 1074. The middle finger
wraps around and in a first finger grip indent 1070 closest to
second/lower end 1047 of handle 1045, the third finger wraps around
and in a second middle finger grip indent 1072 next closest to
second/lower end 1047 of handle 1045, and the little finger wraps
around and in a third finger grip indent 1074 closest to
first/upper end 1049 of handle 1045 (closest to where the blade
connects to the handle 1045). Because the user only grips the
handle 1045 with three fingers (compared to gripping the handle
1005 of FIGS. 17-23 with four fingers), the user has a more
delicate hold/grip on the handle 1045 and automatically provides
less torque/leverage, which is appropriate for pediatric use. Thus,
the handle 1045 shown in FIGS. 39A-39G includes an ergonomic design
that provides a proper angle for mandible lift and tongue sweep
used in pediatric laryngoscopy, and helps to ensure the right
amount of torque/leverage in child laryngoscopy to prevent
fulcruming and breaking teeth.
With reference to FIGS. 24 and 25, another embodiment of a
laryngoscope 1100 similar to that shown in FIGS. 17-23 will be
described. The above descriptions of the laryngoscopes, blades,
handles and light sources are in incorporated herein. The
laryngoscope 1100 includes a handle 1110 and a blade 1120 that
carries a proximal white light source 1150 and a distal black light
source 1160. The handle 1110 and the blade 1120 include an
electrical circuit 1165 that includes a power source 1170, a
resistor 1180, a resistor 1190, the proximal white light source
1150, and the distal black light source 1160.
In the embodiment shown, the white light source 1150 is a cool
white LED, with a mcd rating of 100-10,000 millicandela (mcd). In
the embodiment shown, the resistor 1190 is a 150 ohm resistor
behind the white light source to provide 5 ma at 2.9 volts. This
brightness of the white light source 1150 of the proximal white
light source 1150 is bright enough to provide general illumination
(e.g., of the interior of the mouth and back of the patient's
throat) while not being so bright as to overtake the effects of the
distal black light source 1160.
In the embodiment shown, the distal black light source 1160 emits
electromagnetic radiation including a wavelength in the range of
300 to 450 nm. In a more preferred embodiment, the distal black
light source 1160 emits electromagnetic radiation including a
wavelength in the range of 385 to 395 nm. In a most preferred
embodiment, the distal black light source 1160 emits
electromagnetic radiation including a wavelength at 395 nm. The
electromagnetic radiation works with the body to help illuminate
"vocal cords" or "vocal folds".
The combination of the black light source 1160 and white light
source 1150 as shown and described herein increases visualization
of airway anatomy during laryngoscopy procedures. An advantage of
locating the black light source 1160 distally of the white light
source 1150 is that, in use, the proximal white light source 1150
provides general illumination (e.g., of the interior of the mouth
and back of the patient's throat) while the distal black light
source 1160, which is disposed closer to the patient's vocal cords
and the glottis, provides directed black light illumination of the
patient's vocal cords and the glottis, prompting the visible
effects of fluorescence and phosphorescence with respect to the
patient's vocal cords and the glottis.
White incandescent light used in laryngoscopy in the past caused
glare, excessive reflectivity, and less differentiation of tissues
during procedures. The black light emitted from the black light
source 1160, and especially locating it distally of the white light
source 1150 as shown/described, causes vocal cords to naturally
phosphoresce, clearly identifying pathway to the trachea. The black
light and white light combination lighting produces "near-3D
optimization of viewing area, causing airway structures to stand
out via precision-shadowing effect. The black light and white light
wavelength mix dramatically improves discrimination of tissues,
field of view, reduces glare and creates better depth perception in
the airway.
In the embodiment shown, the resistor 1180 disposed in the handle
1110 is a 13 ohm resistor and the power source 1170 is a 3.6 volt
lithium battery power source to provide the distal black light
source 1160 at 49-50 ma at 3.6 volts.
FIG. 26 is an exemplary graph of Radiant Power versus Forward
Current, FIG. 27 is an exemplary graph of Radiant Power versus Wave
Length, FIG. 28 is an exemplary graph of Peak Wave Length versus
Forward Current, and FIG. 29 is an exemplary graph of Radiant Power
versus Time for the distal black light source 1160 of the
laryngoscope 1000 shown in FIG. 24. The above voltage, current,
resistor, radiant power, and wave length values for the distal
black light source 1160 are obtained from the graphs shown in FIGS.
26-29.
In alternative embodiments, values for voltage, current, resistor,
radiant power, wave length, and/or other values than those
described and/or shown herein may be used.
FIG. 30 illustrates an embodiment of an introducer 1200 (e.g.,
endotracheal tube polyethylene introducer) that may be used with a
black light source such as, but not limited to, the black light
source 160, 1160 of the laryngoscopes described and shown herein.
The introducer 1200 includes a distal portion 1210, an intermediate
portion 1220, and a proximal portion 1230. Opposite ends of the
introducer 1200 are smooth and, in the embodiment shown, the
introducer 1200 has a length of 50-70 cm. One or more of the distal
portion 1210, the intermediate portion 1220, and/or the proximal
portion 1230 include a fluorescent/phosphorescent color/coating or
other color/substance that is enhanced by the black light or that
reacts to the black light emitted by the black light source 160,
1160. Thus, the entire introducer 1200 or portion(s) of the
introducer 1200 includes a fluorescent/phosphorescent color/coating
or other color/substance that is enhanced by or reacts to the black
light source 160, 1160 for increased visualization of placement of
the introducer 1200 (e.g., endotracheal tube introducer) during the
medical procedure (e.g., intubation). The introducer 1200 can be
used for, but not by way of limitation, successful orotracheal
intubation and endotracheal intubation. The
fluorescent/phosphorescent coating on the introducer 1200 causes
the introducer 1200 to naturally phosphoresce under black light,
clearly identifying introducer tracking through the vocal cords
into the trachea.
In alternative embodiments, other types of insertions other than
those described/shown herein include a fluorescent/phosphorescent
color/coating or other color/substance that is enhanced by or
reacts to the black light source 160, 1160 for increased
visualization of placement of the insertion during the medical
procedure.
In a further embodiment, a camera, scope, or other imaging/viewing
device is used with the black light source 160, 1160 for increased
visualization during a medical procedure.
FIG. 31 illustrates an embodiment of a stylet 1300 (e.g.,
endotracheal tube stylet) that may be used with a black light
source such as, but not limited to, the black light source 160,
1160 of the laryngoscopes described and shown herein. The stylet
1300 includes a stylet body 1305 (See also FIGS. 32A, 32B) made of
a malleable, coated wire that holds a formed shape to facilitate
safe intubation. The stylet body 1305 includes a distal portion
1310, an intermediate portion 1320, and a proximal portion 1330,
and a plug connector 1340 slidably attached to the stylet body
1300. In the embodiment shown, the stylet 1300 has a length of 32
cm and a 6-French size.
An embodiment of the plug connector 1340 is shown in more detail in
FIGS. 33A, 33B, 33C. The plug connector 1340 includes an upper
circular flange portion 1342 having an outer diameter and a lower
cylindrical plug portion 1344 having an outer diameter that is less
than the outer diameter of the upper circular flange portion 1342.
The central cylindrical hole/bore 1350 extends through the plug
connector 1340 and slidably receives the stylet body 1305. An upper
hole/bore 1360 extends into an upper part of the plug connector
1240 and a lower hole/bore 1370 extends into the lower part of the
plug connector 1240.
One or more of the distal portion 1310, the intermediate portion
1320, and/or the proximal portion 1330 include an illuminating
material or substance such as a fluorescent/phosphorescent
color/coating or other color/substance that is enhanced by the
black light or that reacts to the black light emitted by the black
light source 160, 1160. Thus, the entire stylet 1300 or portion(s)
of the stylet 1300 includes a fluorescent/phosphorescent
color/coating or other color/substance that is enhanced by or
reacts to the black light source 160, 1160 for increased
visualization of placement of the stylet 1300 (or stylet 1300 and
endotracheal intubation tube) during the medical procedure (e.g.,
intubation). The fluorescent/phosphorescent coating on the stylet
1300 causes the stylet 1300 to naturally phosphoresce under black
light, clearly identifying stylet/intubation tube tracking through
the vocal cords into the trachea.
FIGS. 34-36C disclose another embodiment of a stylet 1300a that is
similar to the stylet 1300 described above except that it is a
larger size (45 cm length, 8 French). Elements of the stylet 1300a
that are similar to the elements of the stylet 1300 are identified
with the same reference number, but with an "a" suffix.
FIGS. 37A and 37B illustrate an embodiment of a movable, protective
cuff sheath 1400 that covers a distal endotracheal tube cuff 1410
(FIG. 37A) including an expandable body (e.g., balloon) 1430 during
insertion of an endotracheal tube 1420 (e.g., during intubation)
and moves to a retracted position (FIG. 37B) once the endotracheal
tube 1420 is in position to expand the expandable body 1430. The
movable protective cuff sheath 1400 reduces the profile and
visibility of the distal endotracheal tube cuff 1410 during
intubation. The movable, protective sheath covering the expandable
body 1430 (e.g., pre-inflated balloon) reduces the profile of the
expandable body 1430/cuff 1410 and aids physical visibility down
the airway during intubation. The movable, protective cuff sheath
1400 and/or distal endotracheal tube cuff 1410 includes a
fluorescent/phosphorescent color/coating or other color/substance
that is enhanced by or reacts to the black light source 160, 1160
to aid in visibility and positioning of the cuff 1410.
FIGS. 38A and 38B illustrate an embodiment of a low-profile,
low-visibility distal endotracheal tube cuff 1510 to reduce profile
and visibility during intubation. In one or more embodiments, the
low-profile, low-visibility distal endotracheal tube cuff 1510
includes one or more of a low-profile expandable body material 1530
(e.g., lower-profile, more-compliant balloon material utilized that
will lay flat against body 1540 of tube 1550 in non-inflated
state), a low-profile expandable body (e.g., balloon) packing
configuration, and/or an indented tube body 1540 in the balloon
cuff region (e.g., addition of indentation of tube body or smaller
diameter indented section 1550 versus larger diameter outer tube
section 1560 to enable further profile reduction of the
pre-inflated balloon) to reduce the cuff profile and aid physical
visibility down the airway during intubation procedures. The
expandable body material 1530 includes a diameter/dimension D2 that
is less than the diameter/dimension D1 of the outer tube section
1560 in the collapsed condition shown in FIG. 38A, and includes a
diameter/dimension D3 that is greater than the diameter/dimension
D1 of the outer tube section 1560 in the expanded condition shown
in FIG. 38B (the expandable body material 1530 is expanded to
secure the cuff 1510 in position in passageway). The expandable
body material 1530 includes a fluorescent/phosphorescent
color/coating or other color/substance that is enhanced by or
reacts to the black light source 160, 1160 to aid in visibility and
positioning of the cuff 1510.
Compared to current ET tube designs, which include distal cuffs
that, even in their non-inflated states, have a wide profile which
impedes visibility of the vocal cords and surrounding anatomy
during intubation, the low-profile, low-visibility distal
endotracheal tube cuff 1510 reduces the cuff profile and aids
physical visibility down the airway during intubation. The
fluorescent/phosphorescent color/coating on the expandable body
material 1530 is enhanced by or reacts to the black light source
160, 1160 to aid in visibility and positioning of the cuff
1510.
With reference to FIGS. 50A-C, an embodiment of a removable sheath
1600 for an endotracheal tube cuff 1610, which includes an
expandable body (e.g., balloon) 1620, will be described. The
endotracheal tube cuff 1610 and expandable body 1620 are disposed
at a distal portion of an endotracheal tube 1630. The endotracheal
tube 1630 includes an inflation mechanism 1635 for inflating (e.g.,
10-12 cc of air) the expandable body 1620. The removable sheath
1600 includes a substantially tubular portion 1650 and a finger
portion 1660 with a finger hole 1670 to receive a finger of a user
for removing the substantially tubular portion 1650 of the sheath
1600 from the endotracheal tube cuff 1610. The purpose of the
removable sheath 1600 is to protect the expandable body 1620 of the
cuff 1610 before use, to eliminate the need for pre-use
inflation/testing/checking of the expandable body 1620, and, in one
embodiment (e.g., FIG. 50B), as a possible site for a reservoir
1680 (e.g., lidocaine jelly reservoir, which may be popped
opened/closed) for peruse applications of gels or medicine (e.g.,
lidocaine jelly or similar substance for lubrication of
tube/cuff/expandable body) to the tube/cuff/expandable body.
FIGS. 39A-39G disclose another embodiment of laryngoscope handle
that is especially advantageous when used in endotracheal
intubation of children.
FIGS. 40A-49F disclose further embodiment of laryngoscope blades
including proximal white light source and a distal black light
source. The above descriptions of the laryngoscopes, blades,
handles and light sources are in incorporated herein.
FIGS. 40A-40F disclose an embodiment of a Size 00 Miller
laryngoscope blade.
FIGS. 41A-41F disclose an embodiment of a Size 0 Miller
laryngoscope blade.
FIGS. 42A-42G disclose an embodiment of a Size 1 Miller
laryngoscope blade.
FIGS. 43A-43F disclose an embodiment of a Size 2 Miller
laryngoscope blade.
FIGS. 44A-44G disclose an embodiment of a Size 3 Miller
laryngoscope blade.
FIGS. 45A-45G disclose an embodiment of a Size 4 Miller
laryngoscope blade.
FIGS. 46A-46F disclose an embodiment of a Size 1 Macintosh
laryngoscope blade.
FIGS. 47A-47F disclose an embodiment of a Size 2 Macintosh
laryngoscope blade.
FIGS. 48A-48F disclose an embodiment of a Size 3 Macintosh
laryngoscope blade.
FIGS. 49A-49F disclose an embodiment of a Size 4 Macintosh
laryngoscope blade.
FIGS. 51-52 discloses an embodiment of a modified laryngoscope
blade 1800, in pieces (FIG. 51) and assembled (FIG. 52), having a
distal blade portion 1820 and a proximal connector portion 1823
configured for attachment to handle 114 (FIG. 53) of the assembled
laryngoscope 1900. Handle 114 and connector portion 1823 are
identical or similar to the corresponding parts in the previous
embodiments and are therefore not described in detail. In this
embodiment, the laryngoscope blade is modified to include a
combined illumination and imaging unit 1810 mounted about 2/3 along
the longitudinal length of the blade portion 1820, closer to a
distal end 1821 of the blade portion 1820 than a proximal end 1822
of the blade portion 1820, as best illustrated in FIG. 51. Unit
1810 comprises an imaging/viewing device 1825 such as a miniature
video camera, a white light 1830, and an ultraviolet light 1835
which emits UV light of the same wavelength range as the previous
embodiments. The imaging/viewing device 1825 allows for increased
visualization into the trachea during medical procedures. In this
embodiment, the ultraviolet light 1835, white light 1830 and camera
1825 form a single integral unit and are all located at the same
distance relative to the distal end of the laryngoscope blade
portion 1820. Example white light sources include, but not by way
of limitation, a white LED, a white halogen light, and a white
incandescent light. In one or more embodiments, the image signals
from the imaging/viewing device 1825 are transmitted to a video
output screen/display screen/monitor that is either integral with
the blade portion 1820 and/or handle 114 or is separate from the
laryngoscope (e.g., separate standalone monitor).
FIG. 53 illustrates a schematic depiction of the laryngoscope in
FIGS. 51 and 52 being used to assist in removal of an obstruction
or foreign object such as a marble 1845 from a patient's trachea
1850. A marble is used by way of example in FIG. 53, but a large
range of different foreign objects including foods, toys and the
like may potentially become stuck in a patient's trachea 1850 and
partially or totally obstruct air flow to the lungs. The blade
portion 1820 of the laryngoscope 1900 is shown placed in the mouth
of a patient 112 for viewing the vocal cords adjacent the larynx
and to aid in the removal of the foreign object 1845. The medical
provider grips handle 114 while using blade portion 1820 to move
the tongue and mandible 118 out of the way and permit viewing past
the vocal cords into the trachea 1850 while attempting to remove
the foreign object 1845. In this embodiment, if the foreign object
1845 has a phosphor content, the illumination of the foreign object
1845 by the two light sources is increased. The combination of the
white light 1830 and UV light 1835 at an equal distance from the
opening into the trachea 1850 helps to create a three dimensional
image of the patient's airway, and may allow a medical provider to
see, in a preferred embodiment, as deep as four circoid rings 1855,
in an alternative preferred embodiment, as deep as three circoid
rings 1855, in a further alternative preferred embodiment, as deep
as two circoid rings 1855, and in a still further alternative
preferred embodiment, as deep as one circoid ring 1855 into the
trachea 1850. FIG. 53 illustrates foreign object 1845 trapped
between the third and fourth circoid rings, which is a common
location for trapped foreign objects in the trachea 1850. The UV
light is absorbed by the tissues in the trachea 1850 around the
obstruction, resulting in self-produced back light from the
resultant UV light induced fluorescence and phosphorescence, while
any phosphor content in the trapped object 1845 also results in
phosphorescence which further illuminates the object 1845 and helps
the provider in locating and attempting to remove the object 1845
using forceps 1860. The medical provider inserts the ends of
forceps 1860 into the trachea 1850 while viewing the illuminated
object 1845 directly or via a video output screen directly
connected or wirelessly connected to camera 1825, and advances the
ends of the forceps 1860 up to the object 1845. The combined white
and UV light sources 1830, 1835 together with the camera 1825
significantly improve visibility of the trapped object 1845,
similarly increasing the likelihood of the provider being able to
grasp and retrieve the object 1845 from the trachea 1850 using
forceps 1860 or similar retrieval instruments. The UV light helps
to create a three dimensional view inside the patient's mouth and
trachea 1850, and also significantly reduces glare.
Although the forceps 1860 shown in FIG. 53 are Magill-type forceps,
in alternative embodiments, other types of forceps, including but
not limited to forceps with jaws coated with a fluorescent
material, may be used. When forceps 1860 with coated jaws are used,
the fluorescent colored material is enhanced by the
fluorescent/black light, allowing the user to see exactly where to
grab the object and, most importantly, not cause damage to
surrounding tissue.
FIG. 54 is a combination ultraviolet/black light and white light
source 1872 that includes epoxy holding compartments 1870, 1871
that contain a white light source 1875 and a fluorescent/UV/black
light source 1880, respectively. The light sources 1875, 1880 and
epoxy holding compartments 1870, 1871 are integrated together into
a single unit/package. This combination light source 1872 can be
used in place of the separate black/fluorescent light source and
white light source in the embodiment of FIGS. 51 to 53 or in any of
the previous embodiments. In this device, the white light source
1875 can be a white LED diode and the ultraviolet light source 1880
can be an ultraviolet diode.
The above figures may depict exemplary configurations for the
invention, which is done to aid in understanding the features and
functionality that can be included in the invention. The invention
is not restricted to the illustrated architectures or
configurations, but can be implemented using a variety of
alternative architectures and configurations. Additionally,
although the invention is described above in terms of various
exemplary embodiments and implementations, it should be understood
that the various features and functionality described in one or
more of the individual embodiments with which they are described,
but instead can be applied, alone or in some combination, to one or
more of the other embodiments of the invention, whether or not such
embodiments are described and whether or not such features are
presented as being a part of a described embodiment. Thus the
breadth and scope of the present invention, especially in the
following claims, should not be limited by any of the
above-described exemplary embodiments.
Terms and phrases used in this document, and variations thereof,
unless otherwise expressly stated, should be construed as open
ended as opposed to limiting. As examples of the foregoing: the
term "including" should be read as meaning "including, without
limitation" or the like; the term "example" is used to provide
exemplary instances of the item in discussion, not an exhaustive or
limiting list thereof; and adjectives such as "conventional,"
"traditional," "standard," "known" and terms of similar meaning
should not be construed as limiting the item described to a given
time period or to an item available as of a given time, but instead
should be read to encompass conventional, traditional, normal, or
standard technologies that may be available or known now or at any
time in the future. Likewise, a group of items linked with the
conjunction "and" should not be read as requiring that each and
every one of those items e present in the grouping, but rather
should be read as "and/or" unless expressly stated otherwise.
Similarly, a group of items linked with the conjunction "or" should
not be read as requiring mutual exclusivity among that group, but
rather should also be read as "and/or" unless expressly stated
otherwise. Furthermore, although items, elements or components of
the disclosure may be described or claimed in the singular, the
plural is contemplated to be within the scope thereof unless
limitation to the singular is explicitly stated. The presence of
broadening words and phrases such as "one or more," "at least,"
"but not limited to" or other like phrases in some instances shall
not be read to mean that the narrower case is intended or required
in instances where such broadening phrases may be absent.
* * * * *