AU622440B2 - Nasal tube holder - Google Patents

Description

~t~";le i; OPI DATE 16/10/89 APPLN. ID 31997 89 'V PCIT 6

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2 rE 4 9/A/8 0 PCT NUMBER PCT/AU89/00096 INTERNATIONAL APPLICATION ruo.ionrLj uiNL n. inn rtmiL1n i I. i,-Lm Viu, mn AI .I l t (51) International Patent Classification 4 (11) International Publication Number: WO 89/ 09043 A61J 15/00 Al (43) International Publication Date: 5 October 1989 (05.10.89) (21) International Application Number: PCT/AU89/00096 (81) Designated States: AT (European patent), AU, BE (European patent), CH (European patent), DE (Euro- (22) International Filing Date: 10 March 1989 (10.03.89) pean patent), FR (European patent), GB (European patent), IT (European patent), JP, KR, LU (European patent), NL (European patent), SE (European pa- (31) Priority Application Numbers: PI 7390 tent), US.

PJ 1788 (32) Priority Dates: 23 March 1988 (23.03.88) Published 1 December 1988 (01.12.88) With international search report.

(33) Priority Country: AU (71X72) Applicant and Inventor: PALFY, Christa, Ursula [AU/AU]; c/o Mrs. A. Mason, 45 Lemon Crescent, Noble Park, VIC 3174 (AU).

(74) Agent: EDWD. WATERS SONS; 50 Queen Street, Melbourne, VIC 3000 (AU).

(54) Title: NASAL TUBE HOLDER (57) Abstract The present invention relates to a nasal tube L holder which provides a comfortable and close fit- ting holder assembl- capable of use for reasonably long periods of time, the holder comprising a head attachment means (25, 26) with flexible arms (33) adapted to conform to a patient's face, the attachment means having central tube holder clip ele- S ments (41, 42) at a forward position adapted to be worn in close proximity to the patient's nose and further tube holder clip elements (61) carried by the flexible arms (33) for movement therealong so that the tube can be clipped through the central 61 tube holder clip elements (41, 42) and thereafter through one of the side tube holder clip elements 33 (61) with the side tube holder clip -lements (61) be- 28 S ing movable to enhance patient mfort. I 49i 31 41 42

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t WO 89/09043 PCT/AU89/00096 1/4i It 89/09043 PCT/AU89/00096 1 NASAL TUBE HOLDER The present invention relaces to devices for holding tubes especially for gastric feeding tubes once they have been inserted into the nasal passages of patients.

Such tubes must be secured to prevent them from falling out or being inadvertently pulled out by a patient. Often such tubes remain in use for quite long periods of time and the means for securing such tubes can therefore cause discomfort to the patient and sometimes, complicating medical 10 conditions.

The most common method of securing nasal tubes for gastric feeding purposes to patients is via the use of adhesive tape. The tape is either placed on top of the nose or placed on the upper lip of the patient where it can cause perspiration and as a result capable of collecting germs.

The tubes fastened in this way often become loose and can easily be detached. Moreover such tape, when used over long periods of time causes discomfort to the patient and considerable pain when it is removed. Moreover the tape is continually touched by patients when being worn. The area to which the tape is adhered over a period of weeks often becomes very irritated and sore. Vomitting in such patients is not infrequent necessitating a change of tube and of adhesive tape. If this is not done the tape tends to smell unpleasantly. It should of course be appreciated that gastric feeding tubes are stronger and heavier than oxygen..

supply tubes and as such any means for holding gastric tubes must be physically stronger than that which might beused for oxygen supply tubes.

30 There have been other means developed for supplying a patient with gases or fluids through the nose. United States Patent No. 4465067 by Koch et al discloses a holder which is similar to a pair of spectacles. The holder consists of two temple portions designed to rest on the patient's ears which join a front portion substantially at right angles similar to a pair of spectacles. Such a holder 3 r

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t: WO 89/09043 PCT/AU89/00096 -2 would rest on the nose and has a downward extending member which engages the patient's nostril.

The disadvantages of such a holder are clearly apparent. The right angle formed by the front and temple portions justs out from the face providing ample opportunity for the holder to be knocked from the face and possibly injuring the patient. The obstrusive nature of the downward extending member would also be subject to being knocked. In addition the front portion which rests on the nose is likely to cause pressure sores in patients and irritate an area which is not generally padded with subcutaneous fat.

The objectives of the present invention are to provide a comfortable and safe means of securing nasal tubes and particularly gastric feeding tubes to patients. It is the inventors objective to do this by minimizing risk of pressure sores developing, providing a more hygenic means by which tubes can be secured and which facilitates frequent cleaning without patient discomfort. Additionally, it is the inventor's objective to provide a means by which nasa' tubes can be secured to patients with highly sensitive -kin such as infants and old people.

comprises a head attachment means associated"with a bri ging means wherein, when in use, said bridging means t averses the face and is composed of flexible material to conform to facial contours of the patient, said brid gng means carrying adjacent to the patient's nose a firsfnasal connector means.

Preferably the invenion includes second nasal tube connector means carried o the bridging means or head attachment means and/w ere two are present, these are located on eithe pside of thexfirst nasal tube connector means. It ia further preferred embodiment that the second nasal tu connector means are movable along the bridging meansLo the head attachment means so that they can be adjeivel movable to re eent pressure sores. ns c ma te a a m mn s t 3 Accordingly, the present invention provides a nasal tube holder comprising: a structural member, adapted to be positioned between a patents nose and mouth; a first nasal tube connector means for connecting a nasal tube to said structural member, said first nasal tube connector means including a first outwardly facing clip means for releasably holding at least one nasal tube, said structural member having a substantially flat surface for engagement with the patient's skin between the patient's nose and mouth; elongated flexible members extenoing from opposed ends of said first nasal tube connector means, each of said elongated flexible members terminating :1 a closed loop adapted to surround a patient's ear; and at least one second nasal tube connector means for connecting a nasal tube to said at least one elongated flexible member for selective movement therealong, said second •nasal tube connector means including a substantially flat surface for contacting against the patient's skin and a second outwardly facing clip means for releasably holding said 15 nasaltube.

Preferably each of the elongated flexible members comprise a single element having two free ends joined to said structural member. Conveniently the second nasal tube connector means is slidably connected to adjacent lengths of said single element forming said elongated flexible member.

Advantageously, the nasal tube holder further includes strap means for connecting one of said closed loops to the other of said closed loops, said strap means o: having a first strap end, said first strap end of said strap means including releasable fastening means for releasable connection with one of said closed loops. Preferably the releasable fastening means includes adjustment means for enabling said closed loops to 25 be lifted off a rear zone of the patients ears.

In a preferred construction the substantially flat surface of said structural member includes a peripheral edge and at least one groove having a first end, said groove formed into said substantially flat surface with said first end of said groove terminating at a peripheral edge of said substantially flat surface.

Several preferred embodiments of the present invention will hereinafter be described with reference to the accompanying drawings.

BRIEF DESCRIPTION Figure 1 represents a perspective view of one preferred embodiment of a holder in accordance with the present invention; S 4 -3i 0/ K~Bi 4 Figure 2 represents a perspective view of a further preferred embodiment of the invention; Figure 3A shows a perspective view of tube holder body as represented in Figure 2; Figure 3B shows a front perspective view of a backing plate as represented in the embodiment of Figure 2; Figure 3C shows a rear view of the backing plate of Figure 3B; Figures 3D and 3E show perspective views of the side plates shown in Figure 2; Figure 3F shows a perspective view of a further tube holder body capable of use in the embodiment of Figure 2; Figure 3G represents nasal tube holder connector means plate for use in the tube holder body shown in Figure 3F; and o Figure 4 is a perspective view of a further possible variant capable of use in the performance of the present invention.

15 DETAILED DESCRIPTION Figure 1 represents a first preferred embodiment of a tube holder with head attachment means in the form of o :2 004 600 r W~ i~4 i WOui~ 89/09043 PCT/AU89/00096 IFigure3showsa nasalcnnector means whicfunctions in the same way as that of Figure 1B however retainer member instead of being a ring is attache directly, or moulded onto the bridging means The embodiment illustrated in Figure 2 sho s a bridging.member and part of the hook members/ 1) as being elliptical or flattened in cross-section so that the flat portion is in contact with the fa of the patient. This embodiment also shows a ra chet clip tube connector means (11) for both the cheek and nasal zones.

The tube connector means (11) compri s a fixed portion (12) connected to the holder and a mova e portion The fixed and movable portions (12, are joined by a hinge means (14) and have teeth-like structures at the ends opposite to the hinge means 14). The fixed portion (12) for the cheek zone has on groove (15) of a suitable diameter to accommodate the nasal tube. The fixed portion (12) in the nasal zo may have two grooves (15) as illustrated. If i is desired to minimize the number of mouldings, a con ector with two grooves (15) could be used for both the sal and cheek zones.

Th connector means has a tab-like protrusion (16) adjacent o the teeth of the movable portion' (13) of the clip t enable the teeth to be opened out to facilitate matipg with the teeth of the fixed portion of the clip.

S/ Figure 3 represents a further embodiment of the a strap retainer member Said retainer member advantageously has a means by which the length can be Sadjusted such as "Velcro" fastener. The cheek connector means (18) is an integral part of a side plate (19) providing a flat surface for engagement with the patient's face. The cheek connector means (18) illustrated is of a simple clip-like construction.similar to that of nasal Sonnctot men hown in Figure= The cheek connector means (18) provides for the nasal tube to be secured in such a manner that it runs parallel to the bridging member ih 1 WO 89/09043 PCT/AU89/00096 bK at the point of its attachment. Moreover, it may be appropriate to arrange the connector means (18) to be movable along member Hook or partial hook members might also be provided to engage a patient's ears. The embodiment also provides for a backing plate (21) onto which a tube holder body (22) may be connected. The body (22) includes the nasal connector means (23) and may be produced from a relatively strong plastics material. The backing plate (21) may be made of a softer and more resilient 10 material. The backing plate also has two wings (24) which, i0 when the arrangement is properly secured on a patient, would sit flat on the face one either side of the nose. Said wings (24) assist in locating the correct position of the nasal connector means and maintaining its position under the nose.

Figure illustrates a still further embodiment of the present invention. In this embodiment the holder includes a central tube holder body with lateral ends (31, 32). A tube loop (33) is secured to each of the 20 lateral ends (31, 32) of the holder body (30) to form looped ends (25) that are adapted to fit over the ears of a patient. Adjustment of the length of the tube loops (33) to fit patients with different head sizes might-be achieved by producing different tube lengths. The tube is conveniently produced from a material similar to the gastric tubes (T) but is of a relatively small diameter. Alternatively a separate fastening strap (26) might be employed adapted to Sconnect the loops around the back of a patient's head. The strap 26 might employ adjustable fastening systems such as a velcro fastener means (40) or any other convenient fastening means. The strap (26) may have the effect of slightly i lifting the loops (25) from a patient's ears to prevent pressure sores.

The central tube holder body (30) is conveniently produced of a light weight but relatively strong flexible plastics material including a pair of resilient clips (41, 42) at its forward face to enable a tube to be secured thereto. The tube holder body (30) has a backing plate (27)

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T 0 2 ~)Vr o~ i ~1 i I a~ WO 89/09043 PCT/AU89/00096 r releasably attached thereto. The backing plate (27) may be of a lighter, softer and possibly more resilient plastics material than the body In addition, the rear surface (43) of the plate (27) is essentially flat to minimize any patient discomfort. As shown in figure 3C, the rear face (43) of the backing plate (27) has a plurality of shallow grooves (44) formed therein, the purpose of which is to promote air flow to minimize patient discomfort by perspiration build up. The backing plate (27) may include 10 nose engaging members (28) in the form of wings having a i0 rear edge (45) essentially flush with the rear face (43) of the backing plate The wings (28) have no sharp edges and may generally extend perpendicularly from the plate (27) forwardly of the rear face (43) and include a C-shaped opening (46) adapted to provide a releasable clip to fit over the tube holder body The wings when connected to the body (30) fit on either side of the clips (41, 42) to provide a firm and rigid assembly. The provision of the wings (28) extending upwardly as 20 illustrated enable the wings to engage a patient's nose with 2O the clips (41, 42) thereby being held firmly in position.

In consequence a firm positioning of the tube is achieved regardless of the probable movement'of a patient's head.

25 It will of course be appreciated that if the backing plate (27) proves to be too heavy for long term use, it might be easily removed. Moreover, it would also be possible to provide the wings (28) such that they have a rear surface generally in the plane of the rear surface (43) 30 of the plate (27) such that inner edges form the engagement means with the patient's nose.

As is further shown in figure Z, a pair of cheek area connector means (61) are provided. Each of the connector means (61) comprises a facial engagement plate preferably produced from a firm smooth plastics material. It is advantageous to produce the connector means (61) in a single moulding operation to minimize assembly andi n=A, 1 B F1 1 I ~u WO 89/09043 PCT/AU89/00096 9-a production costs. The rear surface (48) of the plate (47) may include a padding material such as a sponge material although it is believed this should not be required. The cr.,nector means (61) includes an outer body part (49) that has a through opening adjacent to the plate The opening (50) is of a size sufficient to accommodate two lengths of the tubing forming the loops (33) so that the connector means (61) may be moved therealong for reasons which will be explained hereinafter. Arranged outwardly of the opening (50) is a resilient clip opening (51) which may be vertically arranged as in figures 0U and 3D or generally horizontally arranged as in figure 3E. As is shown the tube passes from the patient's nose through the central clip 41 (or 42) to one of the side clips (61) to ensure that the tube does not hang down in front of the patient. This arrangement minimizes the risk of a patient pulling the tube out involuntarily. Provision for the side clips (61) being movable along the tube loops (33) provides the option of positioning the clips on a patient's face at a location where it is unlikely to press against a bone or the like and provide discomfort to the patient. Moveover, if the clips (31) are located in a fixed position, it is likely over long term use, that pressure sores will result. Movement of the clips (31) periodically will prevent such sores developing.

Finally, the clips (31) on either side of the face, can be separately adjusted depending on which side the patient is lying. The arrangement thus described and illustrated in figures 1, and 3A to 3.E provide a relatively comfortable nasal tube holder, particularly for gastric feeding purposes, which is adapted for use over relatively long periods, the holder being simply produced from a minimum of parts and using a minimum of .plastic mouldings.

The item may be reused or be disposable after use by anj particular patient.

Figures 3F and 3G illustrate a possible modification of the arrangement shown in figures Z and 3A to 3E. In this embodiment the central tube holder body -0 I- 0f\ \ii f lo *G j i.

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W(CS89/09043 PCT/AU89/00096 may be formed with a through opening or blind recess (52) enabling a separate retainer clip plate (53) to be secured therein. The clip plate (53) may include resilient clip elements (54) moulded to the plate with an end free enabling a tube to be clipped therethrough. The body (30) may be adapted to receive a backing plate as described aforesaid with reference to figure 5, or not, as desired. Moreover the body (30) might be produced from relatively soft resilient plastic with the clip plate (53) produced from a stronger plastic.

Figure 4. illustrates a further alternative embodiment that might be employed. The drawing illustrates a portion of a holder adapted for attachment to a patient's ears, the remainder of the holder comprising a bridging section and a second ear attachment portion as illustrated.

The holder includes a tube element (70) formed into an ear engaging loop The tube element (70) includes a zone (72) prepared to have a portion (73) of a tube connector means (74) bonded or fastened thereto. The portion (73) includes a tube engaging clip (75).constructed in a manncr previously described in relation to -f-ige- Below the portion a partial tubular section (76) is secured so that the end (77) of the tube element (70) can be passed therethrough. The portion 76 enables the tube element to be pulled therethrough to adjust its length and be retained in the adjusted length. It will of course be apparent that any form of nasal tube holder means as described previously with reference to the other embodiments may be used on the bridging section of this embodiment.

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Claims (11)

1. A nasal tube holder comprising: a structural member, adapted to be positioned between a patient's nose and mouth; a first nasal tube connector means for connecting a nasal tube to said structural member, said first nasal tube connector means including a first outwardly facing clip means for releasably holding at least one nasal tube, said structural member having a substantially flat surface for engagement with the patient's skin between the patient's nose and mouth; elongated flexible members extending from opposed ends of said first nasal tube connector means, each of said elongated flexible members terminating in a closed loop adapted to surround a patient's ear; and at least one second nasal tube connector means for connecting a nasal tube to said 94 9 at least one elongated flexible member for selective movement therealong, said second nasal tube connector means including a substantially flat surface for contacting against 0. the patient's skin and a second outwardly facing clip means for releasably holding said nasal tube.

2. A nasal tube holder according to Claim 1 wherein each of said elongated flexible members comprise a single element having two free ends joined to said structural .00 member.

3. A nasal tube holder according to Claim 2 wherein said second nasal tube connector means is slidably connected to adjacent lengths of said single element forming said *elongated flexible member. .00.

4. A nasal tube holder according to Claim 1 further including strap means for connecting one of said closed loops to the other of said closed loops, said strap means having a first strap end, said first strap end of said strap means including releasable fastening means for releasable connection with one of said closed loops. A nasal tube holder according to Claim 4 wherein said releasable fastening means includes adjustment means for enabling said loops to be lifted off a rear zone of the patients ears.

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6. A nasal tube holder according to Claim 1 wherein said substantially flat surface of said structural member includes a peripheral edge and at least one groove having a first end, said groove formed into said substantially flat surface with said first end of said groove terminating at a peripheral edge of said substantially flat surface.

7. A nasal tube holder according to Claim 1 wherein said first clip means of said first nasal tube connector means comprises two clip devices, each of said clip devices being adapted to releasably hold a nasal tube.

8. A nasal tube holder according to Claim 1 wherein said first nasal tube connector means includes a pair of spaced and upwardly directed projections, each of said projections adapted, in use, to be located on opposed sides of the patients nose. 9

9. A nasal tube holder according to Claim 1 wherein said second clip means of said second nasal tube connector means includes means for connecting a nasal tube to lie parallel to said elongated flexible member.

A nasal tube holder according to Claim 1 wherein said second clip means of said second nasal tube connector means includes means for connecting a nasal tube to lie at 900 to said elongated flexible member. .0000

11. A nasal tube holder according to Claim 1 wherein said structural member further comprises first and second parts, said first part carrying said substantially flat surface and said second part carrying said first clip means of said first nasal tube connector means, said first and second parts being releasably engageable with each other. 9 DATED this 21st day of October, 1991 CHRISTA URSULA PALFY WATERMARK PATENT TRADEMARK ATTORNEYS THE ATRIUM 290 BURWOOD ROAD HAWTHORN VICTORIA 3122 AUSTRALIA ,i=RAi a QJ