CN221618236U - A disposable negative pressure isolation cover for tracheal intubation - Google Patents
A disposable negative pressure isolation cover for tracheal intubation Download PDFInfo
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- CN221618236U CN221618236U CN202322076326.XU CN202322076326U CN221618236U CN 221618236 U CN221618236 U CN 221618236U CN 202322076326 U CN202322076326 U CN 202322076326U CN 221618236 U CN221618236 U CN 221618236U
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Abstract
本实用新型公开了一种一次性气管插管用负压隔离罩,涉及医用器材技术领域,包括支撑架通过管套套设于隔离罩本体外部;隔离罩本体开设有头部放置区的头顶侧开设有两个头端操作孔,隔离罩本体开设有头部放置区的左侧面开设有一个辅助操作孔,两个头端操作孔与辅助操作孔内侧均设有密闭连接的橡胶手套;隔离罩本体开设有头部放置区的顶面设有特殊插管工具置入通孔;隔离罩本体开设有头部放置区的右侧面设有负压吸引器置入通孔和呼吸管路置入通孔;特殊插管工具置入通孔、负压吸引器置入通孔和呼吸管路置入通孔外侧均连接有保护密封套,保护密封套的顶端开口处设有密封装置。本实用新型能够将病人头面部完全隔离,达到良好的隔离效果。
The utility model discloses a disposable negative pressure isolation cover for tracheal intubation, which relates to the technical field of medical equipment, including a support frame arranged on the outside of the isolation cover body through a tube sleeve; the isolation cover body is provided with a head placement area, the top side of the head is provided with two head end operation holes, the left side of the isolation cover body is provided with a head placement area, and the two head end operation holes and the inner sides of the auxiliary operation holes are provided with rubber gloves that are tightly connected; the top surface of the isolation cover body is provided with a head placement area, and a special intubation tool insertion through hole is provided; the right side of the isolation cover body is provided with a negative pressure suction device insertion through hole and a breathing tube insertion through hole; the special intubation tool insertion through hole, the negative pressure suction device insertion through hole and the breathing tube insertion through hole are all connected to the outside of the through hole, and a sealing device is provided at the top opening of the protective sealing cover. The utility model can completely isolate the patient's head and face, and achieve a good isolation effect.
Description
技术领域Technical Field
本实用新型涉及医用器材技术领域,尤其涉及一种一次性气管插管用负压隔离罩。The utility model relates to the technical field of medical equipment, in particular to a disposable negative pressure isolation cover for endotracheal intubation.
背景技术Background Art
呼吸道病毒是以一类以呼吸道为主要侵入途径,可以在呼吸道黏膜上皮细胞中大量增殖,从而引起呼吸道局部感染或呼吸道以外组织气管病毒的病毒。常见呼吸道病毒类型包括正黏病毒科、副黏病毒科等。Respiratory viruses are a type of virus that invades through the respiratory tract as the main route and can proliferate in large numbers in the epithelial cells of the respiratory mucosa, thereby causing local respiratory infections or tracheal viruses in tissues outside the respiratory tract. Common respiratory virus types include Orthomyxoviridae, Paramyxoviridae, etc.
在对感染呼吸道病毒患者进行气管插管、气道内操作以及麻醉管理时,医生近距离直面患者呼吸道,患者的分泌物、血液或产生的飞沫或气溶胶对于医生以及手术室内的其他人员是一个极大的病毒传播威胁。或者未感染呼吸道病毒患者面对手术室内有其他感染患者或医护人员时,在其呼吸道暴露以及围手术期免疫低下的状态下,极易感染呼吸道病毒,造成术后愈后不佳。When performing tracheal intubation, airway operations, and anesthesia management on patients infected with respiratory viruses, doctors face the patient's respiratory tract at close range. The patient's secretions, blood, or droplets or aerosols produced are a great threat to virus transmission to doctors and other personnel in the operating room. Or when patients who are not infected with respiratory viruses face other infected patients or medical staff in the operating room, they are very likely to be infected with respiratory viruses due to their respiratory exposure and perioperative immunosuppression, resulting in poor postoperative recovery.
目前对于麻醉医生气管插管的保护基本都注重医生本身的二级防护或者患者使用的采用常规气管插管方法的普通的负压隔离罩,包括操作孔,供氧通道,以及负压吸引孔。然而,对于,需要使用视可尼、光棒、纤支镜等特殊插管工具的合并困难气道的患者以及胸外科手术或者术中发生气道并发症需要使用纤支镜检查的患者,此类隔离罩使用还是受限的。而且在此类患者的气道操作过程中,患者发生呛咳导致飞沫以及气溶胶扩散的风险更高。At present, the protection of anesthesiologists for tracheal intubation basically focuses on the secondary protection of the doctors themselves or the ordinary negative pressure isolation hoods used by patients using conventional tracheal intubation methods, including operation holes, oxygen supply channels, and negative pressure suction holes. However, for patients with difficult airways who need to use special intubation tools such as visual contraceptives, light sticks, and fiberoptic bronchoscopes, and patients who need to use fiberoptic bronchoscopes for thoracic surgery or intraoperative airway complications, the use of such isolation hoods is still limited. Moreover, during airway operations on such patients, the risk of choking and coughing, resulting in droplet and aerosol diffusion, is higher.
因此,提出一种降低呼吸道病毒传染的一次性气管插管用负压隔离罩。Therefore, a disposable negative pressure isolation cover for endotracheal intubation is proposed to reduce respiratory virus infection.
实用新型内容Utility Model Content
本说明书提供一种一次性气管插管用负压隔离罩,能够将病人头面部完全隔离,达到良好的隔离效果。The present specification provides a disposable negative pressure isolation cover for endotracheal intubation, which can completely isolate the patient's head and face to achieve a good isolation effect.
本申请提供的一种一次性气管插管用负压隔离罩采用如下的技术方案,包括:The present application provides a disposable negative pressure isolation cover for endotracheal intubation, which adopts the following technical solutions, including:
用于罩在病人头部上方的隔离罩本体、用于垫在病人头部下方的隔离底垫、用于支撑所述隔离罩本体的支撑架,所述隔离罩本体与所述隔离底垫可拆卸密封连接,所述隔离罩本体的外边缘设有与支撑架匹配的管套,所述支撑架通过所述管套套设于所述隔离罩本体外部;An isolation cover body for covering the patient's head, an isolation bottom pad for padding the patient's head, and a support frame for supporting the isolation cover body, wherein the isolation cover body and the isolation bottom pad are detachably and sealedly connected, and a pipe sleeve matching the support frame is provided on the outer edge of the isolation cover body, and the support frame is sleeved on the outside of the isolation cover body through the pipe sleeve;
所述隔离罩本体开设有头部放置区,所述隔离罩本体开设有头部放置区的头顶侧开设有两个头端操作孔,所述隔离罩本体开设有头部放置区的左侧面开设有一个辅助操作孔,两个头端操作孔与辅助操作孔内侧均设有密闭连接的橡胶手套;所述隔离罩本体开设有头部放置区的顶面设有特殊插管工具置入通孔;所述隔离罩本体开设有头部放置区的右侧面设有负压吸引器置入通孔和呼吸管路置入通孔;所述特殊插管工具置入通孔、所述负压吸引器置入通孔和呼吸管路置入通孔外侧均连接有保护密封套,所述保护密封套的顶端开口处设有密封装置。The isolation cover body is provided with a head placement area, and two head end operation holes are provided on the top side of the head of the isolation cover body where the head is placed, and an auxiliary operation hole is provided on the left side of the isolation cover body where the head is placed, and rubber gloves that are tightly connected to the two head end operation holes and the inner sides of the auxiliary operation hole are provided; the top surface of the isolation cover body where the head is placed is provided with a special intubation tool insertion hole; the right side of the isolation cover body where the head is placed is provided with a negative pressure suction device insertion hole and a breathing tube insertion hole; the outsides of the special intubation tool insertion hole, the negative pressure suction device insertion hole and the breathing tube insertion hole are all connected to a protective sealing sleeve, and a sealing device is provided at the top opening of the protective sealing sleeve.
可选的,所述支撑架由若干根可拆卸连接的支撑杆组成。Optionally, the support frame consists of a plurality of detachably connected support rods.
可选的,所述隔离底垫包括熔喷布底垫。Optionally, the isolation base pad includes a meltblown cloth base pad.
可选的,所述隔离罩本体包括透明薄膜隔离罩。Optionally, the isolation cover body includes a transparent film isolation cover.
可选的,所述特殊插管工具置入通孔连接的保护密封套的长度不小于0.8米。Optionally, the length of the protective sealing sleeve of the special intubation tool inserted into the through-hole connection is not less than 0.8 meters.
可选的,所述负压吸引器置入通孔、所述呼吸管路置入通孔连接的保护密封套的长度不小于2米。Optionally, the length of the protective sealing sleeve connected to the negative pressure suction device insertion hole and the breathing tube insertion hole is not less than 2 meters.
综上,本申请能够将病人头面部完全隔离,达到良好的隔离效果。In summary, the present application can completely isolate the patient's head and face, achieving a good isolation effect.
附图说明BRIEF DESCRIPTION OF THE DRAWINGS
为了更清楚地说明本实用新型实施例或现有技术中的技术方案,下面将对实施例或现有技术描述中所需要使用的附图作简单地介绍,显而易见地,下面描述中的附图仅仅是本实用新型中记载的一些实施例,对于本领域普通技术人员来讲,在不付出创造性劳动的前提下,还可以根据这些附图获得其他的附图。In order to more clearly illustrate the embodiments of the utility model or the technical solutions in the prior art, the drawings required for use in the embodiments or the description of the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments recorded in the utility model. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative work.
图1为本实用新型实施例中的一种一次性气管插管用负压隔离罩的结构示意图一;FIG1 is a structural schematic diagram of a disposable negative pressure isolation cover for endotracheal intubation in an embodiment of the present utility model;
图2为本实用新型实施例中的一种一次性气管插管用负压隔离罩的结构示意图二;FIG2 is a second structural schematic diagram of a disposable negative pressure isolation cover for endotracheal intubation in an embodiment of the present utility model;
图3为本实用新型实施例中的一种一次性气管插管用负压隔离罩的结构示意图三;FIG3 is a third structural schematic diagram of a disposable negative pressure isolation cover for endotracheal intubation in an embodiment of the present utility model;
图4为本实用新型实施例中的一种一次性气管插管用负压隔离罩的结构示意图四。FIG. 4 is a fourth structural schematic diagram of a disposable negative pressure isolation cover for endotracheal intubation in an embodiment of the present utility model.
附图标识:1、隔离罩本体;2、隔离底垫;3、头端操作孔;4、辅助操作孔;5、特殊插管工具置入通孔;6、负压吸引器置入通孔;7、呼吸管路置入通孔;8、保护密封套;9、密封装置;10、支撑架;11、管套;12、头部放置区。Illustrations: 1. Isolation cover body; 2. Isolation base pad; 3. Head end operation hole; 4. Auxiliary operation hole; 5. Special intubation tool insertion hole; 6. Negative pressure suction device insertion hole; 7. Breathing tube insertion hole; 8. Protective sealing sleeve; 9. Sealing device; 10. Support frame; 11. Tube sleeve; 12. Head placement area.
具体实施方式DETAILED DESCRIPTION
下面将结合本实用新型实施例中的附图,对本实用新型实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅仅是本实用新型一部分实施例,而不是全部的实施例。The technical solutions in the embodiments of the present invention will be described clearly and completely below in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, rather than all of the embodiments.
如图1-图4所示的一种一次性气管插管用负压隔离罩,包括:用于罩在病人头部上方的隔离罩本体1、用于垫在病人头部下方的隔离底垫2、用于支撑隔离罩本体1的支撑架10,隔离罩本体1与隔离底垫2可拆卸密封连接,隔离罩本体1的外边缘设有与支撑架10匹配的管套11,支撑架10通过管套11套设于隔离罩本体1外部。隔离罩本体1包括透明薄膜隔离罩,采用透明薄膜制成,方便医护人员插管操作。此外,由于透明薄膜价廉易得,可用后即弃,避免交叉感染。隔离底垫2包括熔喷布底垫,采用熔喷布制成,成本低廉,隔离效果好,可用后即弃,避免交叉感染。隔离罩本体1与隔离底垫2的边缘通过双面胶粘合连接,成本低廉,操作简单,且能够根据病人的头部及颈部进行调节,使用灵活,效率高。支撑架10通过管套11于隔离罩本体1外部支撑隔离罩本体1,形成足够容纳患者头部及方便插管的操作空间,支撑架10设置于隔离罩本体1的外部可以减少安装过程对隔离罩内部的污染。支撑架10由若干根可拆卸连接的支撑杆组成,支撑架10的形状和材质不限,方便支撑架10的安装与拆卸。优选地,支撑架10为轻质塑料框架,可用后即弃,避免交叉感染。A disposable negative pressure isolation cover for tracheal intubation as shown in Figures 1 to 4 comprises: an isolation cover body 1 for covering the patient's head, an isolation bottom pad 2 for padding the patient's head, and a support frame 10 for supporting the isolation cover body 1. The isolation cover body 1 and the isolation bottom pad 2 are detachably sealed and connected, and the outer edge of the isolation cover body 1 is provided with a pipe sleeve 11 matching the support frame 10, and the support frame 10 is sleeved on the outside of the isolation cover body 1 through the pipe sleeve 11. The isolation cover body 1 includes a transparent film isolation cover, which is made of a transparent film to facilitate the intubation operation of medical staff. In addition, since the transparent film is cheap and easy to obtain, it can be discarded after use to avoid cross infection. The isolation bottom pad 2 includes a melt-blown cloth bottom pad, which is made of melt-blown cloth, has low cost, good isolation effect, can be discarded after use, and avoid cross infection. The edges of the isolation cover body 1 and the isolation bottom pad 2 are connected by double-sided adhesive bonding, which is low in cost, simple to operate, and can be adjusted according to the patient's head and neck, flexible to use, and high in efficiency. The support frame 10 supports the isolation cover body 1 outside the isolation cover body 1 through the pipe sleeve 11, forming an operating space sufficient to accommodate the patient's head and facilitate intubation. The support frame 10 is arranged outside the isolation cover body 1 to reduce the contamination of the inside of the isolation cover during the installation process. The support frame 10 is composed of a plurality of detachably connected support rods. The shape and material of the support frame 10 are not limited, which facilitates the installation and disassembly of the support frame 10. Preferably, the support frame 10 is a lightweight plastic frame that can be discarded after use to avoid cross infection.
隔离罩本体1开设有头部放置区12,隔离罩本体1开设有头部放置区12的头顶侧开设有两个头端操作孔3,隔离罩本体1开设有头部放置区12的左侧面开设有一个辅助操作孔4,可供助手手伸入隔离罩内辅助操作,两个头端操作孔3与辅助操作孔4内侧均设有密闭连接的橡胶手套,可供主治医生手伸入隔离罩内进行操作;隔离罩本体1开设有头部放置区12的顶面设有特殊插管工具置入通孔5,可供置入特殊插管工具(视可尼、光棒、纤支镜等);隔离罩本体1开设有头部放置区12的右侧面设有负压吸引器置入通孔6和呼吸管路置入通孔7;特殊插管工具置入通孔5、负压吸引器置入通孔6和呼吸管路置入通孔7外侧均连接有保护密封套8,保护密封套8的顶端开口处设有密封装置9。保护密封套8为长筒状,可供特殊插管工具及管路置入,能够通过将长筒状保护密封套8顶端边缘固定在特殊插管工具及管路起到密封作用,避免病人呼出的气溶胶或飞沫从特殊插管工具及管路延伸部泄露出去。保护密封套8材质不限,能够起到隔离效果即可。优选地,采用塑料薄膜和/或熔喷布制成,价廉易得,柔韧性好,易于密封。特殊插管工具置入通孔5连接的保护密封套8的长度不小于0.8米;负压吸引器置入通孔6、呼吸管路置入通孔7连接的保护密封套8的长度不小于2米,保证视可尼、光棒、纤支镜等特殊插管工具以及吸引管路和呼吸管路的完全密封。The isolation cover body 1 is provided with a head placement area 12, and two head end operation holes 3 are provided on the top side of the isolation cover body 1 where the head placement area 12 is provided. An auxiliary operation hole 4 is provided on the left side of the isolation cover body 1 where the head placement area 12 is provided, so that an assistant can put his hand into the isolation cover for auxiliary operation. The two head end operation holes 3 and the inner sides of the auxiliary operation holes 4 are both provided with rubber gloves that are tightly connected, so that the attending doctor can put his hand into the isolation cover for operation; the top surface of the isolation cover body 1 where the head placement area 12 is provided with a special intubation tool insertion hole 5, so that special intubation tools (visual conduit, light rod, fiber bronchoscope, etc.) can be inserted; the right side of the isolation cover body 1 where the head placement area 12 is provided with a negative pressure suction device insertion hole 6 and a breathing tube insertion hole 7; the outer sides of the special intubation tool insertion hole 5, the negative pressure suction device insertion hole 6 and the breathing tube insertion hole 7 are all connected with a protective sealing sleeve 8, and a sealing device 9 is provided at the top opening of the protective sealing sleeve 8. The protective sealing sleeve 8 is in the shape of a long tube, which can be inserted into special intubation tools and pipelines. It can play a sealing role by fixing the top edge of the long tube-shaped protective sealing sleeve 8 on the special intubation tools and pipelines to prevent the aerosol or droplets exhaled by the patient from leaking out from the special intubation tools and pipeline extensions. The material of the protective sealing sleeve 8 is not limited, as long as it can play an isolation effect. Preferably, it is made of plastic film and/or meltblown cloth, which is cheap and easy to obtain, has good flexibility and is easy to seal. The length of the protective sealing sleeve 8 connected to the through hole 5 for the special intubation tool is not less than 0.8 meters; the length of the protective sealing sleeve 8 connected to the through hole 6 for the negative pressure aspirator and the through hole 7 for the breathing tube is not less than 2 meters, ensuring the complete sealing of special intubation tools such as visual conni, light stick, fiberoptic bronchoscope, and suction and breathing tubes.
工作原理:患者仰卧将头通过隔离罩本体1开设有头部放置区12搁置于熔喷布隔离底垫2上,将一次性口咽通气道,一次性鼻咽通气道、可视喉镜、一次性可视喉镜片、石蜡油、氧气面罩、气管导管、吸痰管等插管需要的工具置于熔喷布隔离底垫2上,将氧气回路经加长保护密封套8及呼吸管路通过呼吸管路置入通孔7置入隔离罩本体1内,向患者供氧,并将加长保护密封套8顶端开口边缘的双面胶固定密封在呼吸管路上,将负压吸引管路经加长保护密封套8通过负压吸引器置入通孔6置入隔离罩本体1内,并将加长保护密封套8顶端开口边缘的双面胶固定密封在负压吸引器管路上,将支撑架10置于患者头部上方,隔离罩本体1罩在支撑架10上,然后将隔离罩本体1与熔喷布隔离底垫2边缘用双面胶粘合固定,从而将患者头部隔离。此时,隔离罩本体1上的两个头端操作孔3在患者头端,隔离罩本体1上的辅助操作孔4在患者头部左侧端,由于这三个通道均自带有密闭连接的橡胶手套,在不使用时通过密封盖处于闭合状态,使用时,医生打开密封盖,伸手入隔离罩内佩戴橡胶手套进行操作。隔离罩本体1上的特殊插管工具置入通孔5位于患者头部上方,将纤支镜、光棒、视可尼等特殊插管工具经加长保护密封套8及特殊插管工具置入通孔5置入,置入完成后,将加长保护密封套8顶端开口边缘的双面胶固定密封在特殊插管工具上,达到隔离的效果,麻醉医生可以在隔离罩外操作特殊插管工具,完成插管操作。插管完毕,手术结束后,关上密封装置9,撕下隔离罩本体1与隔离底垫2边缘的双面胶,使污染的特殊插管工具、负压吸引管路等可以完全密封于隔离罩本体1内并送于消毒,减少病毒传播。Working principle: The patient lies on his back and places his head on the melt-blown cloth isolation base pad 2 through the head placement area 12 provided on the isolation cover body 1. The disposable oropharyngeal airway, disposable nasopharyngeal airway, visual laryngoscope, disposable visual laryngoscope blade, paraffin oil, oxygen mask, endotracheal tube, suction tube and other tools required for intubation are placed on the melt-blown cloth isolation base pad 2. The oxygen circuit is placed in the isolation cover body 1 through the extended protective sealing sleeve 8 and the breathing tube through the breathing tube insertion hole 7 to supply oxygen to the patient, and the extended protective sealing sleeve is placed. The double-sided adhesive tape at the top opening edge of the seal 8 is fixed and sealed on the breathing tube, and the negative pressure suction tube is placed in the isolation cover body 1 through the through hole 6 of the negative pressure suction device through the extended protective seal sleeve 8, and the double-sided adhesive tape at the top opening edge of the extended protective seal sleeve 8 is fixed and sealed on the negative pressure suction device tube, and the support frame 10 is placed above the patient's head, and the isolation cover body 1 is covered on the support frame 10, and then the isolation cover body 1 and the edge of the melt-blown cloth isolation pad 2 are bonded and fixed with double-sided adhesive, so as to isolate the patient's head. At this time, the two head end operation holes 3 on the isolation cover body 1 are at the patient's head end, and the auxiliary operation hole 4 on the isolation cover body 1 is at the left end of the patient's head. Since these three channels are equipped with rubber gloves with closed connections, they are in a closed state through the sealing cover when not in use. When in use, the doctor opens the sealing cover, reaches into the isolation cover and wears rubber gloves to operate. The special intubation tool insertion hole 5 on the isolation cover body 1 is located above the patient's head. The special intubation tools such as fiberoptic bronchoscope, light stick, and visual conduit are inserted through the extended protective sealing sleeve 8 and the special intubation tool insertion hole 5. After the insertion is completed, the double-sided tape at the top opening edge of the extended protective sealing sleeve 8 is fixed and sealed on the special intubation tool to achieve the isolation effect. The anesthesiologist can operate the special intubation tool outside the isolation cover to complete the intubation operation. After the intubation is completed and the operation is over, the sealing device 9 is closed, and the double-sided tape at the edge of the isolation cover body 1 and the isolation bottom pad 2 is torn off, so that the contaminated special intubation tools, negative pressure suction pipelines, etc. can be completely sealed in the isolation cover body 1 and sent for disinfection to reduce virus transmission.
本实用新型中,以上所述所有部件的安装方式、连接方式或设置方式均为常见机械方式,并且其所有部件的具体结构、型号和系数指标均为其自带技术,只要能够达成其有益效果的均可进行实施,故不在多加赘述。In the present invention, the installation method, connection method or setting method of all the components mentioned above are common mechanical methods, and the specific structures, models and coefficient indicators of all its components are its own technology. As long as it can achieve its beneficial effects, it can be implemented, so it will not be elaborated.
上述实施例为本实用新型较佳的实施方式,但本实用新型的实施方式并不受上述实施例的限制,其他的任何未背离本实用新型的精神实质与原理下所作的改变、修饰、替代、组合、简化,均应为等效的置换方式,都包含在本实用新型的保护范围之内。The above embodiments are preferred implementation modes of the present invention, but the implementation modes of the present invention are not limited by the above embodiments. Any other changes, modifications, substitutions, combinations, and simplifications that do not deviate from the spirit and principle of the present invention should be equivalent replacement methods and are included in the protection scope of the present invention.
本实用新型中,在未作相反说明的情况下,“上下左右、前后内外以及垂直水平”等包含在术语中的方位词仅代表该术语在常规使用状态下的方位,或为本领域技术人员理解的俗称,而不应视为对该术语的限制,与此同时,“第一”、“第二”和“第三”等数列名词不代表具体的数量及顺序,仅仅是用于名称的区分,而且,术语“包括”、“包含”或者其任何其他变体意在涵盖非排他性的包含,从而使得包括一系列要素的过程、方法、物品或者设备不仅包括那些要素,而且还包括没有明确列出的其他要素,或者是还包括为这种过程、方法、物品或者设备所固有的要素。In the present utility model, unless otherwise stated, the directional words contained in the terms such as "up, down, left, right, front, back, inside, outside, vertical, horizontal" only represent the orientation of the term in normal use, or are common names understood by those skilled in the art, and should not be regarded as limitations on the term. At the same time, number series nouns such as "first", "second" and "third" do not represent specific quantities and orders, but are merely used to distinguish names. Moreover, the terms "include", "comprise" or any other variations thereof are intended to cover non-exclusive inclusion, so that a process, method, article or equipment that includes a series of elements includes not only those elements, but also includes other elements that are not explicitly listed, or also includes elements inherent to such process, method, article or equipment.
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