CN115445043A - Fine adjustment type tracheal catheter - Google Patents

Abstract

The invention particularly discloses a fine adjustment type tracheal catheter which comprises a catheter body, a primary corrugated pipe, a telescopic hose and a driving device for driving the telescopic hose to stretch, wherein the primary corrugated pipe is arranged at the front end of the catheter body, the wave crests on one side of the primary corrugated pipe are gathered and fixed at a gathering point, the wave crests on the other side of the primary corrugated pipe are in an involute shape, the end part, far away from the catheter body, of the primary corrugated pipe forms an oblique section to form a tip, one end of the telescopic hose is connected with one end, far away from the catheter body, of the primary corrugated pipe, the other end of the telescopic hose is connected with the catheter body, the telescopic hose is located in the primary corrugated pipe, and a hydrophilic coating is coated on the outer side of the primary corrugated pipe. Utilize drive arrangement to change most advanced orientation to aim at the glottis mouth that shows, avoid fish tail glottis mouth, can intubate fast, and the doctor is according to the most advanced resistance of hand perception, in order to be adapted to the trachea trend through adjusting most advanced nimble diversion.

Description

A fine-tuned endotracheal tube

technical field

The invention relates to the technical field of medical facilities, in particular to a fine-tuning tracheal tube.

Background technique

Endotracheal intubation is an important medical device in the process of cardiopulmonary resuscitation and rescue of critically ill patients with respiratory dysfunction. Endotracheal intubation can provide sufficient oxygen for patients and keep the airway open at any time. The most effective and quickest way to establish an artificial airway.

In the process of tracheal intubation, video laryngoscope is generally used to assist the patient's glottis to be exposed, and then the endotracheal tube can be intubated at the glottis with its assistance, but there are the following disadvantages:

1) There is a retroflexion in the direction of the subglottic airway, which forms a curved channel with the forward curvature of the pharynx. Because the head end of the conventional tracheal tube is hard and not easily deformed, it is not flexible when entering the trachea Change direction, so that when the catheter is pushed forward, the tip of the catheter will touch the upper front wall of the trachea and encounter resistance. inflamed;

2) When the patient's glottis is not fully exposed, due to the space limitation of the inner wall of the oral cavity, the doctor cannot quickly and accurately align the tip of the endotracheal tube with the glottis, and needs to adjust the position of the endotracheal tube several times, resulting in low intubation efficiency. During the process, it is easy for the tip to scratch the glottis.

Contents of the invention

In view of the problems in the prior art, the purpose of the present invention is to provide a fine-tuning endotracheal tube, which can flexibly change the direction of the tip to align with the exposed glottis, avoid scratching the glottis, and realize rapid intubation, and the doctor can According to the tip resistance sensed by the hand, the tip can be flexibly changed to adapt to the direction of the trachea and improve the efficiency of intubation.

In order to achieve the above object, technical scheme of the present invention is:

A fine-tuning tracheal catheter is designed, which includes a catheter body, a first-stage bellows, a telescopic hose, and a driving device for driving the telescopic hose to expand and contract. The first-stage bellows is arranged at the front end of the catheter body, and the The wave peaks on one side of the first-stage bellows are gathered and fixed at one place to form a converging point, and the wave peaks on the other side of the first-stage bellows are involute, so that the end of the first-stage bellows is far away from the catheter body A chamfered surface is formed to form a tip, and the tip is configured as a closing structure, and one end of the telescopic hose is connected to an end of the primary bellows away from the catheter body, and the other end of the telescopic hose is connected to the catheter body, and The telescopic hose is located in the inner hole of the primary bellows, wherein the outer side of the primary bellows is coated with a hydrophilic coating.

Further, the outer fixed sleeve of the primary bellows is provided with a soft film cover, the hydrophilic coating is provided on the outer surface of the soft film cover, and the soft film cover is in a tight state.

Further, it also includes a guide pipe for passing through the patient’s oral cavity, the outer end of the guide pipe is provided with a flange portion, and the outer end of the guide pipe is provided with a hard sleeve, and the outside of the guide pipe is provided with a An annular groove extending circumferentially, the inner wall of the hard sleeve cooperates with the annular groove to form a closed annular air passage, wherein the hard sleeve and the guide pipe are fixed by bonding or thermoplastic molding, and the flange It is integrally formed with the guide pipe, and the annular air passage is evenly distributed along its circumference with a plurality of suction holes for communicating with the inner hole of the guide pipe, the annular air passage is connected with a suction device, and the flange part is provided with There is a strapping mechanism that binds to the patient's face.

Further, the side of the flange part close to the patient's lip is provided with an annular first airbag, and the first airbag is provided with an inflation port.

Further, the suction device includes a filter assembly, a sterilization assembly, a vacuum pump, and an air storage tank that are sequentially connected by pipes, and the filter assembly is connected to the annular air channel through a first pipeline.

Further, the filter assembly includes a coarse-effect filter, a medium-effect filter and a high-efficiency filter connected in sequence;

The sterilizing component includes an ultraviolet sterilizing lamp and a disinfectant atomizing spraying device.

Further, the telescopic hose is a secondary corrugated tube, the crest of the secondary corrugated tube is located in the trough of the primary corrugated tube at the corresponding position and the two are connected, one end of the secondary corrugated tube is closed, and the other end It is connected with the second pipeline provided in the catheter body, and the second pipeline is connected with the driving device, and the driving device is used to inflate and deflate the second pipeline.

Further, the driving device includes a syringe, the end of the second pipeline away from the secondary bellows extends along the catheter body and extends out of the catheter body to connect with the first medical injection joint, and the first medical injection joint is connected to the nipple of the syringe. Then cooperate.

Further, the end of the primary corrugated tube is sleeved on the catheter body, and the end of the primary corrugated tube is bonded to the catheter body, and the cuff installed on the catheter body and the end of the primary corrugated tube Department conflicts.

Further, the catheter body is covered with a ring-shaped second air bag, and one end of the third pipe provided in the inner hole of the catheter body is connected to the second air bag, and the other end extends along the catheter body and extends out of the catheter body and the second air bag. The second medical injection joint is connected, and the second medical injection joint is inserted into the nipple of the syringe, and the second air bag is evenly distributed with atomizing holes.

Compared with the prior art, the fine-tuning tracheal tube provided by the present invention has a different structure and is easy to operate. The head end is formed by adding a corrugated tube at the front end of the tube body, and one side of the primary corrugated tube is The crests are gathered at the converging point and fixed, so that the first-stage corrugated tube is in a curved state as a whole, and the end of the first-stage corrugated tube away from the catheter body forms an oblique cut surface, forming a tip, through which the first-stage corrugated tube and the catheter body can be easily inserted into the glottis and the trachea; use the driving device to control the expansion and contraction of the telescopic hose, so as to drive the first-stage bellows to bend and rotate around the convergence point, and then change the orientation (or inclination angle) of the tip, so as to achieve precise adjustment of the orientation of the tip to the exposed glottis and avoid scratching The opening of the wound can be intubated quickly, and during the intubation process, the doctor can flexibly change the direction of the tip according to the tip resistance sensed by the hand to adapt to the retroflexion of the subglottic airway and the forward curvature of the pharynx. The curved channel effectively prevents the head end of the catheter from colliding with the upper front wall of the trachea with high strength, resulting in a hard and difficult-to-deform head end that damages the tracheal mucosa, greatly improving the intubation efficiency.

Description of drawings

In order to more clearly illustrate the technical solutions in the embodiments of the present invention or the prior art, the following will briefly introduce the drawings that need to be used in the description of the embodiments or the prior art. Obviously, the accompanying drawings in the following description are only These are some embodiments of the present invention. Those skilled in the art can also obtain other drawings based on these drawings without creative work.

Accompanying drawing 1 is the front view of a fine-tuning type endotracheal tube.

Accompanying drawing 2 is the full sectional view of accompanying drawing 1.

Accompanying drawing 3 is the enlarged view of A in accompanying drawing 2.

Accompanying drawing 4 is the structural schematic diagram of guiding pipeline.

In the figure: 1. First pipe, 2. Catheter body, 3. Cuff, 4. Second air bag, 5. Third pipe, 6. Fourth pipe, 7. Guide pipe, 8. Annular groove, 9. Hard Quality pipe sleeve, 10. Flange, 11. Suction hole, 12. First medical injection connector, 13. Syringe, 14. Second medical injection connector, 15. Lace, 16. Primary bellows, 17. Convergence point, 18. Tip, 19. Diffuser, 20. Secondary bellows, 21. First air bag.

detailed description

The following will clearly and completely describe the technical solutions in the embodiments of the present invention with reference to the drawings in the embodiments of the present invention. Apparently, the described embodiments are only some of the embodiments of the present invention, not all of them. Based on the embodiments of the present invention, all other embodiments obtained by persons of ordinary skill in the art without making creative efforts belong to the protection scope of the present invention.

As shown in Figures 1 to 4, as a preferred embodiment of the present invention, a fine-tuning tracheal tube includes a tube body 2, a primary bellows 16, a telescopic hose, and a driving device that drives the telescopic hose to expand and contract. The first-stage corrugated pipe 16 is arranged at the front end of the catheter body 2, and is the head end, and the peaks on one side of the first-stage corrugated pipe 16 are gathered and fixed at one place to form a converging point 17, specifically, the peaks on this side It can be fixed by glue or thermoplastic technology. The wave crest on the other side of the first-stage bellows 16 is involute and not constrained, so that the end of the first-stage bellows 16 away from the catheter body 2 is formed The oblique cut surface forms the tip 18, and the tip 18 is configured as a closed structure to reduce the cross-sectional area of the head end of the catheter body 2 in conjunction with the oblique cut surface, so as to facilitate insertion into the incompletely exposed glottis, and one end of the telescopic hose and the first-stage corrugated tube 16 is connected to one end away from the conduit body 2, and the telescopic hose can be pasted on the inner wall of the first-stage corrugated pipe 16, and the other end of the telescopic hose is connected to the conduit body 2, and the telescopic hose is located on the first-stage corrugated pipe. The inner hole of the tube 16, wherein the outer side of the primary corrugated tube 16 is covered with a hydrophilic coating, and the surface of the primary corrugated tube 16 is modified. The hydrophilic coating has good biocompatibility Functional coating, in a dry state, the thickness of the coating is within 5 microns, and has good toughness. It is evenly attached to the surface of the primary bellows 16, and is colorless and transparent, which is difficult to be observed by the naked eye; The water coating is activated by water to form a colorless and transparent hydrogel, which is highly lubricated and can withstand repeated friction, further reducing friction damage to the inner wall of the trachea during intubation, and facilitating the insertion of the head into the trachea.

When applying the fine-tuning type endotracheal tube provided by the present invention, a first-stage corrugated tube 16 is added to the front end of the catheter body 2 to form the head end, and the peaks on one side of the primary corrugated tube 16 are gathered at the converging point 17 and fixed, so that The primary corrugated tube 16 is in a curved state as a whole, and the end of the primary corrugated tube 16 away from the catheter body 2 forms an oblique cut surface, forming a tip 18, through which the primary corrugated tube 16 and the catheter body 2 can be easily inserted into the glottis and trachea ; use the driving device to control the expansion and contraction of the telescopic hose to drive the primary bellows 16 to bend and rotate around the convergence point 17, and then change the orientation (or inclination angle) of the tip 18 to achieve precise adjustment of the orientation of the tip 18 to align with the exposed glottis, Avoid scratching the glottis, and can intubate quickly. During the intubation process, the doctor can flexibly change the direction of the tip 18 according to the resistance of the tip 18 sensed by the hand to adapt to the retroflexion of the subglottic airway and the pharynx. The curved channel formed by the forward curvature effectively prevents the tip of the catheter from colliding with the upper front wall of the trachea with high strength, resulting in a hard and difficult-to-deform tip that damages the tracheal mucosa, greatly improving the efficiency of intubation.

It should be noted that, when the telescopic hose is stretched, the inclination angle of the tip 18 can be increased; when the telescopic hose is shortened, the inclination angle of the tip 18 can be decreased.

On the basis of the above-mentioned embodiments, the outer fixed sleeve of the first-stage bellows 16 is provided with a soft film cover 19, and the hydrophilic coating is arranged on the outer surface of the soft film cover 19, and the soft film cover 19 is used to block the trachea. The inner wall tissue enters the folds of the first-stage bellows 16 to reduce the frictional resistance between the outer wall of the first-stage bellows 16 and the inner wall of the trachea, and effectively prevent the folds of the first-stage bellows 16 from scratching the trachea. In addition, the soft The film cover 19 has elasticity, and by controlling the length of the soft film cover 19, the soft film cover 19 is kept in a tight state, thereby preventing the soft film cover 19 from being trapped in the trough of the first-stage bellows 16, and utilizing the tight soft film cover 19 The film cover 19 blocks the trough of the first-stage bellows 16, effectively preventing the side of the soft film cover 19 from being sunken. Similarly, the elasticity of the soft film cover 19 can be used to drive the first-stage bellows 16 to reset.

For better technical effects, on the basis of the above-mentioned embodiments, a guide pipe 7 for passing through the patient's oral cavity is also included, and the outer end of the guide pipe 7 is provided with a flange part 10, which is close to the On the patient's lip, the guide tube 7 inserted into the patient's mouth is limited to prevent it from sliding down the patient's trachea, and the guide tube 7 is covered with a hard sleeve 9, and the outside of the guide tube 7 is provided with a An annular groove 8 extending circumferentially, the inner wall of the hard sleeve 9 cooperates with the annular groove 8 to form a closed annular air passage, wherein the hard sleeve 9 and the guide pipe 7 are fixed by bonding or thermoplastic molding , the flange and the guide duct 7 are integrally formed, and the annular air channel is evenly distributed along its circumference with a plurality of suction holes 11 for communicating with the inner hole of the guide duct 7, specifically, the suction holes 11 are located at At the bottom of the annular groove 8, the annular airway is connected with a suction device, the suction device can be selected as a negative pressure suction device, and the negative pressure suction device is used to suck the gas in the guiding pipe 7, thereby preventing the patient from The gas in the oral cavity and trachea overflows to block the spread of germs, and the flange part 10 is provided with a binding mechanism for binding the flange part to the patient's face. The head or ears are used to fix the flange part 10 and the guide pipe 7 to prevent them from shifting or falling off.

It should be noted that the gas in the guiding pipe 7 is sucked through the negative pressure suction device to avoid the overflow of the gas carrying the germs exhaled by the patient, and to block the spread of the germs, and then this device can be applied to the treatment of new crown patients. When performing tracheal intubation on patients with new crowns, the chain of transmission between patients and medical staff can be effectively blocked, which can not only achieve effective treatment of patients, but also protect medical staff.

The negative pressure suction device can be a negative pressure system of a hospital, or a negative pressure suction pump.

In addition, during specific intubation, the video laryngoscope can be inserted into the patient's oral cavity from the inner hole of the guiding duct 7, and then follow the normal intubation steps. The size of the inner hole of the guiding duct 7 is sufficient for the visual laryngoscope Interspersed with the catheter body 2.

On the basis of the above-mentioned embodiments, the side of the flange part 10 close to the patient's lip is provided with an annular first airbag 21, and the first airbag 21 is provided with an inflation port. 21 is inflated to inflate the first air bag 21 to eliminate the gap between the flange portion 10 and the patient's lips to achieve sealing and prevent the gas in the patient's oral cavity from exhaling from the gap between the flange portion 10 and the patient's lips.

On the basis of the above embodiments, the suction device includes a filter assembly, a sterilizing assembly, a vacuum pump and an air storage tank connected in sequence, the filter assembly is connected to the annular airway through the first pipeline 1, and the vacuum pump is used to The gas in the patient's mouth is pumped out, so that the gas is temporarily stored in the gas storage tank after passing through the filter component and the sterilization component in sequence, and the gas is filtered and sterilized successively, and the gas in the gas storage tank can be further processed subsequently In order to completely eliminate the germs carried in the gas, the filter components include a coarse filter, a medium filter and a high efficiency filter connected in sequence, all of which are common filters in the medical field. The specific structure and principle will not be described in detail. In addition, the above-mentioned sterilization components can use ultraviolet sterilization lamps and disinfectant atomization spraying devices. Then only by suctioning the patient's mouth, the gas in the patient's mouth can be prevented from overflowing. Since the oral cavity is in a negative pressure state during the suction process, the gas in the oral cavity will not be exhaled from the nasal cavity, but the outside gas will be exhaled from the nasal cavity. The nasal cavity enters the oral cavity; however, in order to be more secure, the patient's nose can be clamped with a nose clip to seal the patient's nasal cavity during the intubation process.

On the basis of the above embodiments, the telescopic hose is a secondary corrugated tube 20, the crest of the secondary corrugated tube 20 is located in the trough of the primary corrugated tube at the corresponding position and the two are bonded, the One end of the secondary bellows 20 away from the conduit body 2 is closed, and the other end close to the conduit body 2 is connected to a second pipeline provided in the conduit body 2, the second pipeline is connected to a driving device, and the driving device is used to Inflate and deflate the second pipeline, and then use the driving device to inflate and pump the second pipeline to drive the expansion and contraction of the secondary bellows 20, thereby driving the expansion and contraction of the side of the primary bellows 16 away from the convergence point 17, and because the primary corrugated The wave crest on one side of the tube 16 is fixed at the converging point 17, and the process of the expansion and contraction of the other side of the primary corrugated tube 16 is that the secondary corrugated tube 20 drives the end of the primary corrugated tube 16 away from the conduit body 2 to rotate around the converging point 17 , so as to adjust the orientation of the tip 18; during work, the tip 18 can be turned according to the position of the exposed glottis, and then the inclination angle of the tip 18 can be adjusted to align with the glottis, so that the catheter body 2 can enter the glottis and greatly improve the intubation efficiency And precision, to avoid scratching the inner wall of the trachea.

On the basis of the above embodiments, the driving device includes a syringe 13, and the end of the second pipeline away from the secondary bellows 20 extends along the catheter body 2 and extends out of the catheter body 2 to connect with the first medical injection joint 12. The medical injection joint 12 and the nipple of the syringe 13 are plugged together. When working, insert the nipple of the syringe 13 into the first medical injection joint 12, push and pull the syringe 13 to inflate the second pipeline, thereby driving the secondary bellows 20 telescopic.

On the basis of the above-mentioned embodiments, the end of the primary bellows 16 is sleeved on the conduit body 2, and the end of the primary bellows 16 is bonded to the conduit body 2 to realize the primary bellows 16 and the conduit body 2. The connection of the catheter body 2 is not limited to this method, and the cuff 3 installed on the catheter body 2 is in conflict with the end of the primary bellows 16, and the end of the primary bellows 16 can effectively block The cuff 3 is detached from the catheter body 2, which solves the risk that the cuff 3 is detached from the human trachea during the use of the existing endotracheal catheter.

On the basis of the above-mentioned embodiments, the catheter body 2 is sleeved and fixed with an annular second air bag 4, and one end of the third pipe 5 provided in the inner hole of the catheter body 2 is connected to the second air bag 4, The other end extends along the catheter body 2 and extends out of the catheter body 2 to connect with the second medical injection joint 14. The second medical injection joint 14 is mated with the nipple of the syringe 13, and the second air bag 4 is evenly distributed with mist The atomizing hole can inject liquid anesthetic into the second airbag 4 through the syringe 13 during work, so that the liquid anesthetic can be sprayed on the patient's throat through the atomizing hole, so as to relieve the pain of the patient's throat.

After the intubation is completed, the catheter body 2 can be fixed to the flange part 10 by adhesive tape, without being fixed on the patient's face, which improves the comfort of the patient. The flange part 10 is used to support the catheter body 2 to ensure its stability and prevent the catheter body from 2 shaking.

It should be noted that the second pipe, the third pipe 5 and the fourth pipe 6 connected to the cuff 3 all protrude from the side of the catheter body 2, so as not to interfere with the connection of the oxygen supply device at the tail end of the catheter body 2. The structure is common knowledge in this field, and details are not repeated here.

Finally, it should also be noted that in this text, relational terms such as first and second etc. are only used to distinguish one entity or operation from another, and do not necessarily require or imply that these entities or operations, any such actual relationship or order exists. Furthermore, the term "comprises", "comprises" or any other variation thereof is intended to cover a non-exclusive inclusion such that a process, method, article, or apparatus comprising a set of elements includes not only those elements, but also includes elements not expressly listed. other elements of or also include elements inherent in such a process, method, article, or apparatus. Without further limitations, an element defined by the phrase "comprising a ..." does not exclude the presence of additional identical elements in the process, method, article or apparatus comprising said element.

Each embodiment in this specification is described in a progressive manner, each embodiment focuses on the difference from other embodiments, and the same and similar parts of each embodiment can be referred to each other.

The above description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the general principles defined herein may be implemented in other embodiments without departing from the spirit or scope of the invention. Therefore, the present invention will not be limited to the embodiments shown herein, but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.

Claims (11)

1. The utility model provides a fine setting type endotracheal tube, includes the pipe body, its characterized in that still includes one-level bellows and the flexible drive arrangement of drive bellows, the one-level bellows is located the front end of pipe body, just a plurality of crests of one-level bellows one side are gathered together and are fixed in a department, form the convergent point, a plurality of crests of the opposite side of one-level bellows are the form of opening gradually, and then make the tip that the pipe body was kept away from to the one-level bellows forms the scarf to constitute most advanced, most advanced sets up to the binding off structure, just the one end that the pipe body was kept away from to the one end of bellows and one-level bellows is connected, the other end and the pipe body coupling of bellows, just the bellows is located the hole of one-level bellows, wherein, the outside cladding of one-level bellows has hydrophilic coating.

2. The fine-tuning endotracheal tube according to claim 1, wherein the primary bellows is fixedly sleeved with a flexible membrane sleeve, the hydrophilic coating is disposed on an outer side surface of the flexible membrane sleeve, and the flexible membrane sleeve is under tension.

3. The fine-tuning endotracheal tube according to claim 1, further comprising a guiding tube for inserting into the mouth of the patient, wherein a flange portion is provided at an outer end of the guiding tube, and the guiding tube is sleeved with a hard tube sheath, an annular groove extending along a circumferential direction of the guiding tube is provided at an outer side of the guiding tube, an inner wall of the hard tube sheath and the annular groove cooperate to form a closed annular airway, wherein the hard tube sheath and the guiding tube are bonded or fixed by thermal molding, the flange and the guiding tube are integrally formed, and a plurality of suction holes for communicating with an inner hole of the guiding tube are uniformly distributed along the circumferential direction of the annular airway, the annular airway is connected with a suction device, and the flange portion is provided with a binding mechanism for binding the patient's face.

4. The fine-tune endotracheal tube of claim 3, wherein the binding mechanism includes a strap.

5. The fine-tuning endotracheal tube according to claim 3, wherein a first annular cuff is provided on a side of the flange portion adjacent the patient's lips, the first cuff being provided with an inflation port.

6. The fine-tuning endotracheal tube according to claim 3, characterized in that the suction device comprises a filtering assembly, a sterilization assembly, a vacuum pump and an air storage tank which are sequentially connected through a pipe, and the filtering assembly is connected with the annular air passage through a first pipe.

7. The fine-tuning endotracheal tube of claim 6, wherein the filter assembly comprises a coarse filter, a medium-efficiency filter and a high-efficiency filter connected in series;

the sterilization assembly comprises an ultraviolet sterilization lamp and a disinfectant atomization spraying device.

8. The fine-tuning type endotracheal tube according to claim 1, wherein the flexible tube is a secondary corrugated tube, the peaks of the secondary corrugated tube are located in the valleys of the primary corrugated tube at corresponding positions and are connected to each other, one end of the secondary corrugated tube is closed, the other end of the secondary corrugated tube is connected to a second tube disposed in the endotracheal tube body, the second tube is connected to a driving device, and the driving device is used for charging and discharging air into the second tube.

9. The fine-tuning endotracheal tube according to claim 8, characterized in that the driving means includes an injector, and an end of the second tube, which is remote from the secondary bellows, extends along the tube body and extends out of the tube body to be connected with a first medical injection connector, which is fitted to a nipple of the injector.

10. The fine-tuning endotracheal tube according to claim 9, characterized in that the end portion of the primary bellows is fitted to the tube body, and the end portion of the primary bellows is bonded to the tube body, and the cuff fitted to the tube body abuts against the end portion of the primary bellows.

11. The fine-adjustment type endotracheal tube according to any one of claims 1 to 10, characterized in that an annular second air bag is fixedly sleeved on the tube body, one end of a third tube arranged in the inner hole of the tube body is connected with the second air bag, the other end of the third tube extends along the tube body and extends out of the tube body to be connected with a second medical injection connector, the second medical injection connector is in plug-in fit with a nipple of an injector, and atomization holes are uniformly distributed on the outer side of the second air bag.

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