CA1178868A - Esophageal-endotracheal airway - Google Patents

Esophageal-endotracheal airway

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Publication number
CA1178868A
CA1178868A CA000401914A CA401914A CA1178868A CA 1178868 A CA1178868 A CA 1178868A CA 000401914 A CA000401914 A CA 000401914A CA 401914 A CA401914 A CA 401914A CA 1178868 A CA1178868 A CA 1178868A
Authority
CA
Canada
Prior art keywords
tube
trachea
esophagus
longer
lungs
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired
Application number
CA000401914A
Other languages
French (fr)
Inventor
Patrick A. Wallace
Paul A. Bronson
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to CA000401914A priority Critical patent/CA1178868A/en
Application granted granted Critical
Publication of CA1178868A publication Critical patent/CA1178868A/en
Expired legal-status Critical Current

Links

Abstract

ABSTRACT

The novel esophageal-endotracheal airway has a shorter outer tube and a longer inner tube. The airway is adapted to become inserted into either the trachea or into the esophagus. Each tube carries an expandable member on its outer wall and near its distal end. The outer wall of the inner tube and the inner wall of the outer tube form an annular passageway therebetween. Suction tubes can be inserted through this passageway for pumping out either the stomach or the lungs. This annular passageway cannot become totally occluded by any tissue from an adjacent body channel because the inner tube, as it exits from the annular passage-way, acts to prevent tissue encroachment. By having the longer tube inside the shorter tube, which terminates in the posterior pharynx, a suction tube can be advanced through the annular passageway exiting at the outlet of the shorter tube in an anatomical position to be advanced directly into the esophagus without any interruption of artifical respiration

Description

7~3868 ESOPHAGEAL-ENDOTRACHEAL AIRWAY

An early airway for assisting in artificial respira-tion was made of an arcuate, open-ended tube which was adapted to be inserted into the trachea. This tube carried an external, inflatable, resilient sleeve near its distal end. The sleeve, when inflated, made a seal with the inner wall of the trachea.
Moving air through the trachea into and out of the respiratory orifices with this early airway required trained personnel, such as is normally found in hospital emergency rooms.
In U.S. Patents Nos. 3,683,908 and 3,841,319 is described an airway whose tube has a closed distal end. A
plurality of openings are provided in the wall of the tube between its distal and proximal ends. The proximal end is the mouthpiece of the airway. The tube is shaped to become inserted into the esophagus which leads to the stomach. The tube carries near its distal end an inflatable sleeve. The slee~e, when inflated, can make a seal with the esophagus.
~orced air passes from the inside to the outside of the tube through its openings and into the lungs of the patient. A
mask is used to prevent the forced air from escapin~ through the patient's nose and mouth and to force the air to flow into the lungs But, if this close-ended tube of the airway were to be accidentally inserted into the trachea, as it ma~ occa-sionally happen, the inflatable sleeve would seal off the trachea and the pumped air would flow into and inflate the stomach instead of the lungs. When depriving the lungs of :1~7~868 air, the patient may die. Also, inflating the stomach may result in vomiting which alerts the attendant that the tubular member is in the trachea. The attendant will attempt to deflate the sleeve, remove the tube from the trachea, and insert it into the esophagus. sut, even if this rescue operation is timely and successful, the vomiting from the patient's stomach can penetrate into the lungs and the patient may become seriously hurt or even die.
Also, when the tube is in the esophagus, the required mask for the nose and mouth may not provide an effective seal with the patient's face because face dimensions vary with every patient.
A problem can be also encountered even when the tube is inserted into the esophagus. If vomiting occurs during resuscitation, then high pressures become exerted from the stomach up through the esophagus. If the tube is in the esophagus with its sleeve inflated, vomitus cannot exit.
Excessive pressure then becomes exerted at the junction zone between the stomach and esophagus. This high pressure can tear the esophagus away from the stomach which results in severe hemorrhaging.
Other airways are described in U.S. Patents Nos.
3,322,126, 3,788,326, 3,905,361, 4,090,518, 4,231,365 and East German Patent No. 68,597.
The novel airway of this invention comprises an elongated inner tube which is mounted inside a shorter outer tube. Both tubes form a passageway therebetween. On the outer ~all near the distal end of each tubular member is disposed an inflatable sleeve. The inner tube extends through the wall of the outer tube near the proximal end of the outer tube. The proximal end of each tube is adapted to accept an air pump. Suction tubes can be inserted either 1:17~68 through the inner tube or through the passageway formed between the walls of the tubes for pumping out the contents of the stomach or the lungs.
Broadly speaking, therefore, the present invention may be considered as providing an esophageal-endotracheal, flexible, tubular airway device adapted for insertion through the mouth, in normal use, into the esophagus and, in abnormal use, into the trachea of a patient, the device being adapted to provide separate passages for administering artificial respiration both when the device is lodged in the esophagus or in the trachea, the device comprising (a) a larger-diameter, shorter flexible tube having an open-ended proximal end portion and an open-ended distal end portion;
~b) a smaller-diameter, longer flexible tube having an open-ended proximal end portion and an open-ended distal end portion, the longer tube being disposed inside the shorter tube whereby the outer wall of the longer tube and the inner wall of the shorter tube define therebetween an annular fluid passageway wherein a suction tube could be extended through the passageway into the trachea or the esophagus ~~or evacuating fluid contents therefrom while administering artificial respiration to the lungs, the annular passageway having an open outlet port at the distal end portion of the shorter tube, and the longer tube having a suficient length adapted, in use, to reach into the esophagus below the mouth of the trachea, and the port of the annular passageway to become disposed above the mouth of the trachea; (c) an inflatablé-and-deflatable tubular balloon extending about and sealed to the distal end portion of the longer tube for sealingly engaging, in normal use, upon inflation thereof the wall of the esophagus below the mouth of the trachea and upon abnormal use, for sealingly engaging the wall of the trachea, ' '~.~;
!-...... . . . - :

sd/~ 3-1~'7~868 and (d) an inflatable-and-deflatable tubular balloon extending about and sealed to the distal end portion of the shorter tube for simultaneously sealing off, in normal use, upon inflation thereof, the air passageways leading to the nose and to the m~outh of the patient, thereby allowing, in normal use, with the twD balloons inflated, air to flow through the annular passageway into the patient's lungs.
~ ays of carrying out the invention are described with reference to the drawings which illustrate specific preferred embcdiments and in which:
Fig. 1 is a perspective view of the novel double-tuke ai~way of the present invention;
Fig. 2 is a transverse sectional view taken on line 2-2 of Fig. l;
Fig. 3 is an enlarged, longitudinal, sectional view of a portion of the airway near the junction between both tukes;
Fiqs 4 and 5 are fraamentary sectional views showing the air channels leading to the sleeves carried by the inner and outer tubes, respectively;
Fig. 6 shows the novel airway with its inner tube accidentally lodged in the trachea;
Fig. 7 shows the novel airway with its inner tube in the trachea for a~inistering artificial resuscitation and carrying a suction tube for simultaneously suctioning the patient's stomach;
Fig. 8 shows the novel airway in its normal use while administer-ing artificial resuscitation with its inner tubs in the esophagus and both sleeves of the airway being inflated;
Fig. 9 is similar to Fig. 8 and in addition the airway ries a suction tube for suctioning the patient's lungs;
Fig. 10 is similar to Fig. 9 except that the stornach is now being suctioned;
Fig. 11 is similar to Fig. 8 except that vomitus is expelled to the atmosphere thereby preventin~ a dan~erous pressure build up;

.
sd/~ 3A-li7~386~3 Fig. 12 is similar to Fig. 8 except that the proximal sleeve on the outer tube is deflated and a mask is used instead to cover the nose and mouth; and Fig. 13 is similar to Fig. 2 but showing the airway's tubes as being eccentric.
Figs. 1-5 show the novel esophageal-endotracheal air-way of the present inventionj generally designated as 10.
It includes an inner, elongated, flexible tube 11 having a longitudinal bore B whose distal end 12 (Fig. 1~ is open.
An outer, shorter flexible tube 9 is concentrically mounted with the inner tube 11 (~ig. 2). The concentricity between tubes 9, 11 is maintained by radial ribs 13. The distal end 9a of tube 9 is also open. Both'tubes 9, 11 define an annular passageway 9b therebetween.
An expandable member, such as an inflatable sleeve 15a, is mounted externally near the distal'end 12 on inner tube 11. ~nother inflatable sleeve 15b is mounted on tube 9 near its distal end 9a. Small-diameter hoses 14a and 14b are adapted to carry pressurized air for inflating sleeves 15a and 15b, respectively. Each hose 14a or 14b is coupled to a check valYe 16 (Fig. i). When slee~es 15a, 15b expand, - as represented by the dotted lines, they form effective seals with the adiacent surrounding wall of the body channel.
~s will be subsequently described, the novel airway 10 can seal o~f the nose and mouth without the assistance of a facial mask.
The inner tube 11 extends through an opening 9c (~ig.
3) in the wall of the outer tsbe 9 near its proximal end 9d.
Tubes 9 and 11 form a fluid-tight joint 9f therebetween.
The proximal ends'9d and lld of the tubes 9 and 11 are coupled to adapters 19 and 18, respectively. ~ach adapter`
can recei~e the outlet of a con~entional air pump 17 (Figs.
- 6-12~. Tube 11 has'a'hole 8 therethrough in a direction perpendicular to its longitudinal axis in order to make its distal end 12 more flexible.

1~7~86~

In use, when inner tube 11 by accident becomes inserted into the trachea (Fig. 6~, the attendant need only inflate sleeve 15a. Resuscitation with pump 17 can be produced through bore B (Fig. 2~ of tube 11.
Fig. 7 shows that while resuscitation is being administered to the patient, the contents of the stomach can be emptied by inserting into the esophagus, through the annular passageway 9b, a suction tube 21 suitably coupled to a conventional suction pump (not shown~.
Fig. 8 shows the normal position of airway 10 for administering artificial resuscitation. Tube 11 is inserted into the esophagus. Both sleeves 15a, 15b are inflated.
Air is pumped by pump 17 into tube 9. This ~orced air ` passes from the distal end 9a of outer tube 9 through the trachea and into the lungs.
Fig. 9 is similar to Fig. 8 e~cept that a suction tube 21 is now inserted through a T-coupling member 22 into tube 9 and exits from its distal end 9a into the trachea o~
the patient. The T-coupling 22 has a packing gland 23. In this manner, artificial resuscitation takes place simultan-eously with the suctioning of the lungs.
As an immediate advantage of the novel airway 10~
even when the inner tube 11 by accident becomes inserted into the trachea ~Fig. ~, the respiratory function of the airway can still be carried out, and in addition, the contents of the lungs and the contents of the stomach (Fig. 7) can be suctioned out. Also, during normal use of the airway (Fig.
8?, artificial respiration can be maintained, while the contents of the lungs (Fig. 9) or the contents of the stomach (Fig. 10~ are being suctioned out.

Fig. 11 is similar to Fig. 8 except that regurgita-tion has taken place already with vomitus pouring out from the proximal end of the inner tube 11. sut this vomitus neither produces contamination o~ the posterior pharynx nor increases the pressure at the junction between the stomach ~ and the esophagus.
Instead of inflating sleeve 15b as in Fig. 8, a mask 29 (Fig. 12) can be employed. No excessive pressure will then develop at the union between the stomach and the esophagus during Yomiting, because bore B (Fig. 2) of tube 11 remains open to the atmosphere while tube 11 is being inserted into the esophagus.
When sleeve 15a is inflated it creates a seal against the esophageal wall and yomitus cannot contaminate the posterior pharynx.
In Fig. 13 is shown a modification of the airway structure wherein the same numerals followed by a prime (') are used to designate the same or similar members. Each thusly designated member serves a function as previously descrihed. It will be noted that tubes 9' and 11' are not concentrically mounted. In fact, the tubes can have their walls in touching relation as shown.

Claims (4)

THE EMBODIMENTS OF THE INVENTION IN WHICH AN EXCLUSIVE
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. An esophageal-endotracheal, flexible, tubular airway device adapted for insertion through the mouth, in normal use, into the esophagus and, in abnormal use, into the trachea of a patient, said device being adapted to provide separate passages for administering artificial respiration both when said device is lodged in the esophagus or in the trachea, said device comprising:
(a) a larger-diameter, shorter flexible tube having an open-ended proximal end portion and an open-ended distal end portion;
(b) a smaller-diameter, longer flexible tube having an open-ended proximal end portion and an open-ended distal end portion, said longer tube being disposed inside said shorter tube whereby the outer wall of said longer tube and the inner wall of said shorter tube define therebetween an annular fluid passageway wherein a suction tube could be extended through said passageway into said trachea or said esophagus for evacuating fluid contents therefrom while administering artificial respiration to the lungs, said annular passageway having an open outlet port at the distal end portion of said shorter tube, and said longer tube having a sufficient length adapted, in use, to reach into the esophagus below the mouth of the trachea, and said port of said annular passageway to become disposed above the mouth of the trachea;
(c) an inflatable-and-deflatable tubular balloon extending about and sealed to said distal end portion of said longer tube for sealingly engaging, in normal use, upon inflation thereof the wall of the esophagus below the mouth of the trachea and, upon abnormal use, for sealingly engaging the wall of the trachea; and (d) an inflatable-and-deflatable tubular balloon extending about and sealed to the distal end portion of said shorter tube for simultaneously sealing off, in normal use, upon inflation thereof, the air passageways leading to the nose and to the mouth of the patient, thereby allowing, in normal use, with said two balloons inflated, air to flow through said annular passageway into the patient's lungs.
2. The airway device of claim 1, and further including a suction tube removably extending through said longer tube and positioned for suctioning the stomach when said longer tube is in the esophagus while administering artificial respiration to the lungs through said annular passageway.
3. The airway device of claim 1, and further including a suction tube removably extending through said annular passageway and positioned for suctioning the stomach when said longer tube is in the trachea while administering artificial respiration to the lungs through said longer tube.
4. The airway device of claim 1, and further including a suctioning tube removably extending through said annular passageway and positioned for suctioning the lungs when said longer tube is in the esophagus while administering artificial respiration to the lungs through said annular passageway.
CA000401914A 1982-04-29 1982-04-29 Esophageal-endotracheal airway Expired CA1178868A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CA000401914A CA1178868A (en) 1982-04-29 1982-04-29 Esophageal-endotracheal airway

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CA000401914A CA1178868A (en) 1982-04-29 1982-04-29 Esophageal-endotracheal airway

Publications (1)

Publication Number Publication Date
CA1178868A true CA1178868A (en) 1984-12-04

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Family Applications (1)

Application Number Title Priority Date Filing Date
CA000401914A Expired CA1178868A (en) 1982-04-29 1982-04-29 Esophageal-endotracheal airway

Country Status (1)

Country Link
CA (1) CA1178868A (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4836204A (en) * 1987-07-06 1989-06-06 Landymore Roderick W Method for effecting closure of a perforation in the septum of the heart

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4836204A (en) * 1987-07-06 1989-06-06 Landymore Roderick W Method for effecting closure of a perforation in the septum of the heart

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