DE1566579B1 - Anesthesia and / or resuscitation equipment - Google Patents

Description

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F i g. 2 shows the air pocket arrangement between the exhalation time and the third the flow of the shown in section, the gas equilibrium speed and the pressure on the downstream side holding valve assembly and also allowed in to regulate.

Section shown Venturi arrangement; The outlet port 54 is through a line 62

F i g. 3 shows schematically and partially in section 5: .lit connected to a T-piece 61, one of which is Schenein Device according to the invention when used as a kel leads to a line 63 which is connected to the anesthesia resuscitation device; gas valve is connected. The other leg of the

F i g. 4 is a side view of the FIG. 3 dar- T-piece is connected to a line 64, which at

provided resuscitation device in operation. a venturi arrangement 66 is connected. These

The in Fig. 1 consists of an anesthesia device with one end of the air pocket 28

individual from a line system 11, which is connected. The other end of the air pocket 28 is standing

closed loop, the anesthetic breathing circuit, with a line piece 68 in connection, the to

forms. The line system 11 contains a section which leads to the pipe cross 14.

13, which is connected to one arm of a four-armed pipe. The gas balance valve 48 is shown in detail in FIG

cross 14 is connected. That which is to be given to the patient. 2 shown. His valve body 71 has a

supplying anesthetic gas is an inlet port annular beveled seat 72 and an outlet

16 fed to the pipe cross, so that it opens through the opening. Furthermore, the valve body is with a

the line system 11 is provided via a control valve 17 to the extension 71 α , which is on a leg

Patient. This contains a between one of the pipe cross 14 fits. In the valve body 71 is

open and a closed position movable 20 a membrane housing 76 screwed. A piston

Valve member 18 and is adjustable so that it is the pull 77 is slidably disposed in the housing 76,

guidance of the anesthetic gas to the airways of the

Patient over the connection fittings 19 during bran 78. The annular outer edge of the mem-

the inhalation phase. In the case of the inhalation branch 78 is between the diaphragm housing 76 and

phase, the exhaled gases flow over a regulating device 25 a screwed-in cap 79 clamped,

valve 21 with one between an open and one and the piston 77 and the one carried by it

closed position movable valve member 22, inner part of the membrane is through a to the

which is adjustable so that there is the flow of the piston concentrically in a bore 82 of the

breathed gases in the clockwise direction in the membrane housing arranged helical spring 81

1 is pressed against the cap 79 in an open 3 ° direction. One end of the

Section 23 of the line system 11 is permitted. The Ven spring is supported against the housing 76, the other

Tiles 17 and 21 prevent the outflow against a flange 83 on the piston 77. The drilling

breathed gases within the circuit. The abutment 82 in the housing 76 opens out via a

Section 23 of the line system 11 leads to an outlet passage 84 in the valve body 71.

sorber 24 of the usual type. The absorber is 35. The valve member 86 is in the valve body against

through a section 26 of the conduit system with the seat 72 and arranged to be movable away from it,

connected to one of the arms of the tube cross 14, so it is carried by a valve stem 87, the

that a closed circuit for the gases is formed within the piston 77 and is movably guided. He

will. is elastic against the seat by a spring 88

An air pocket assembly 28 is pushed through a passage 40 which includes the plunger 87 which has a drilling

device 68 to an open arm of the cross tube 14 tion 90 penetrated. One end of the spring touches

(Fig. 1) connected. It consists of an inner, a shoulder 89 in the bore 90, the other end

flexible, expandable and foldable bag 21 and the valve member 86. The interior of the valve body 71

an essentially inextensible, expediently communicates through openings 91 with the free atmosphere

made of clear plastic outer 45 in connection.

Bag32. As can be seen in Fig. 1, a screw 92 with a twist grip is in the cap Pockets 31 and 32 approximately egg-shaped. The inner pocket 79 is screwed in. She carries a turn into her considerably smaller than the outer one. The outer pocket screwed screw 93 that holds the membrane 79 is provided with connecting pieces 33, 34 in which and the piston 77 can touch. Into the cap 79 their outer ends converge. One end of the 50 is an inlet port 96 with a passage 97 inside Pocket 31 also opens into the screwed-on, which has a passage 98 in the Conclusion 34. The connection 34 is through the already mentioned cap and with the space 99 between the meme Line 68 is connected to the pipe cross 14. bran 78 and the cap 79 is in communication.

A ventilation device 51 effects a periodic venturi. The venturi arrangement 66 includes a venturi intermittent movement of the gaseous tube 101 with a nozzle-like passage 102. Medium in the space between the inner pocket As F i g. 2 shows the tube is with an annular 31 and the outer pocket 32. This device has recess 104, suitable for receiving an consist of a blower through which the borrowed 15 mm pipe entry and air pipe medium this wall gap is provided with cut-to-size accessories under pressure, and its external guidance will. The ventilator 51 can of 60 diameter is dimensioned so that it is suitable for the usual be of any kind. You can, for example, a breathing mask and for the air bag arrangement Blower with pressure limitation or with volume 28 is suitable. The venturi 101 is in a be limitation. Jet nozzle cap 106 is screwed into this ventilation device. it consists of operated by compressed air, which is an inlet port a body 107, which is with a cylindrical outlet

53 is supplied and is provided via an outlet connection 65 recess 108, which is axially connected to the nozzle

54 periodically from compressed air. The venturi-like shaped venturi passage 102 in the tube device 51 here has three control buttons 56, 57 and 58, 101 is aligned. A jet nozzle 109 is in the the first of which is the inhalation time, the second is screwed in body. She has a central one, in one

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Nozzle IU opening passage 110, which expands with maximum restriction and then axially out of the passage 102 in the pipe 101. Pressure is applied to the inner pocket 31 so that it is directed. In the body 107 an anesthetic gas inlet connection is screwed into the breathing 112, which is driven with an annular passage 113 provided in the nozzle 109 and the airways of the patient are breathed into. The lower and upper pressure limit is binding. Several additional passages 114 can be established by connecting the line 64 to the central passage in the nozzle 109 surrounding the central passage passages 110 and 113 via their nipple 110 and supply jets with high flow pressure connections IU and 112. The venturi arrangement next to the lower flow pressure of the main nung66 serves as a pressure limiter, because only a blasted from the passage IjLO, you cause * <? certain predetermined safety pressure caused by a rousing flow through the Ventm-jdurcll ·. The air jets in the venturi 102 can be wound so that the volume and the A cylindrical tube 116 is limited to a certain value on the jet nozzle inhalation time cap 106 and are arranged with an end cap 117, which is suitable for the patient and for the one provided, which has two holes 118 and 119, the breathing phase is decisive. Any excess gas, open to the free atmosphere and sufficiently large, which may be present in the pocket 31 above a certain value to allow the introduction of to the nozzle 109 and pressure value, is passed through a port 112 or the central passage HO (not shown) safety valve, as it is present in every pipe or hose to be connected to the anesthetic gas machine, ins. Free but possible. As shown in Fig. 2, the line w blown through it. The patient can breathe spontaneously without the bore 119 and is connected to the converging high pressure jet passages of the nozzle 109 because of the space between the inner walls. and the outer pocket through the valve assembly. The body 107 of the cap 106 is provided with (not shown vented to the outside. This vent acts as provided) flat gates, which a§ safety valve for the mechanical fan circuit, (also not shown) passages A possible particularly high pulmonary resistance open into the space 121 inside the tube H6, in the case of the patient, through the use of the two auxiliary beams, the venturi passage 102 can be overcome by the line 64 through the body 107, via the space 121 and which is connected to the connector 112. Then, to holes 118, 119 provided in the cap 117, additional air jets into the venturi 102 are communicated with the free atmosphere. The operation of the device shown in FIGS. 1 and Z developed by the valve assembly 66 is as follows: It is assumed that in FIG. This is more than enough to get every fig. 1 is to be overcome with the patient's lung resistance, no matter how high it may be, and with a source of anesthetic gas.

the. Then the time ratio of inhalation can be determined.

easily by simply setting the control buttons valve 48 in the closed position of the handle screw 92 56,57 and 58 affect. In this way it will be locked, otherwise anesthetic gas will be available controlled breathing rate at the beginning of the inhalation phase released from the system mechanical ventilation established. The maximum would be 40 if the pressures had a value of Male inhalation pressure can easily be regulated in such a way that § cm WS is exceeded, instead of the gas equilibrium By setting the button 58 on the weight valve 48, an anesthetic gas can then * * existing lung resistance is met, can be used with a blow-off valve of the usual type. The Luftder Inhalation phase becomes air with a positive pocket arrangement 28 can be easily removed at any time the T-piece 61 fed, the air under 45 NEN and sterilized.

Pressurize line 63 to gas balance valve, if desired, place the device by hand

48 conducts, whereby this is closed, It. flows automatically with the aid of the ventilation device 51 Pressurized gas into the room 99 and presses the mem- brane to operate, the handle screw 92 is turned so, bran 78, so that the piston 77 is opposite to that it touches the membrane 78 and the piston 77 Force of the spring 81 moved upwards (Fig, 2) and 59 (Fig, 2) moved upwards, so. that the valve member a force exerted on the spring 88 which holds the valve 86 in the closed position. The anesthetic limb 86 against the seat 72 of the valve body 71 doctor can then work as usual and press the inside, so that the valve is kept closed, move ren pocket space 31 by hand by When the valve is in this position, the clear pocket 32 can compress and the nen anesthetic gases, which from the gas source in the 55 supply of the anesthetic gases to the patient, the Pipe cross 14 are introduced, not from which it is visually observed, checked. The closed loop 12 into the free atmosphere, degassing the patient by periodic contraction. That. Valve is delivered to inner pocket 31 during inhalation push. The pageclosed held, because the upper end of the piston tient can spontaneously and unhindered in ^ and out the valve member 86 pushes. Breathe 6q. For this reason, the use of air

Furthermore, pressurized gas is fed to the line 64, pocket arrangement 28 quite compatible with the which is connected to the jet nozzle 109, which is the usual anesthetic practice if the anesthetist directs a jet of air through venturi 102, desires to apply it.

In a known manner, this air jet also affects the mechanical operation of the device.

Starting additional atmospheric gases into the 65 through the. The ventilation device 51 can _{compress the venturi tube 102 Λ} by hand around the inner pocket 31, the wall space, the air pockets 31 and 32 or the outer pocket, if desired, under positive pressure in the aesthetic physician. conduct. As a result, the outer pocket becomes too. her or hand pressure on the die. Bags 31 and

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32 separating gas volumes are superimposed in order to this bens the gas is ent-way into the wall space to compress the inner pocket 31. Who pulled to initiate a rapid exhalation outer pouch 32 is less stretchy than the inner pouch. It may be desirable to have a check valve in front of the pouch 31, but it is foldable in almost the same way that a predetermined maximum such as z. B. bar and therefore gives the anesthesiologist the possibility of 5 2 cm WS or even less as the differential pressure between the pressure without any major expansion of the external environment and the pressure in the wall twisting Enlarge bag. The outer pocket 32, which allows space.

is preferably transparent, so that the after completion of the inhalation phase is provided visually

Operation of the inner pocket 31 can be observed, intermittently working blower 51 no longer allows the anesthesiologist to perform an immediate io under positive pressure to the T-piece 61, but rather control the ventilation of the patient by hand, it releases the positive pressure to the outside air During each work phase of the ventilation device, the exhalation phase is initiated and device 51 to be exercised, even if the patient himself does not empty the wall space between the or breathes spontaneously, ie according to his own rhythm. inner and outer pocket over the venturi north

The air pocket arrangement 28 can produce an opening 66 in connection. This makes it possible for the Pamit Any ventilator used tient exhales into the inner pocket. Which are exhaled. The inner pocket 31 can, apart from the gases, open the valve member 22 of the direction of, that it is caused by a positive gas pressure in the valve 21, so that it is in the line section 23 Wall gap is compressible, also and flow through the soda-lime absorber 24, in are compressed by negative pressure. 20 which the carbon dioxide is eliminated. Then pour this can be done in such a way that gas from the men the gases in the tube cross 14, fill the inner outer pocket 32 is pulled out to the at pocket space 31 again, and get over the glue atmosphere pressure to cause the outer bag device 11 to recirculate. The anesthetic gases 32 surrounding the inner pocket 31 will be pressed together at a continuous speed while applying pressure to the inner pocket 25 during the inhalation and exhalation phases exert to the gases introduced therefrom in the same way the pipe cross 14. However, that does Expel like when the outer pocket 32 gas balance valve 38 is balancing the on-gas would be fed with positive pressure. These esthetic gases correspond to the breathing process in order to the latter effect could not be achieved by the mere fact that the anesthesia circuit was overcrowded without reuse a rigid outer container that does not look to the inflow of anesthetic gases can be collapsed is to be brought about. prevent.

When the outer bag 32 is inflated, the valve 48 is opened during the inhalation phase

if it does a coupling process at the beginning of the pneumatically closed and in the closed position breathing phase, which is then held by the coupling so that the anesthetic gases do not go out of circulation the venturi arrangement is completed. To 35 loops can escape. At the beginning of the off-start to the inhalation phase, the coupling or breathing phase is the under positive pressure ste-entrainment effect the venturi arrangement blown off its current gas. The removal of the positive minimum value. It gradually increases as the pressure of the space 99 completes in the gas valve thereby the coupling effect, which by the outer it is possible that the spring 81 the piston 77 (F i g. 2) Pocket is evoked. The venturi clutch 40 pushes down and it out of contact with the the effect of the outer pocket 32 can bring valve member 86 even more intensely. For example, the force are reduced by the outer pocket 32 more elastic so that the valve member 86 against the is made. Pressure of the small spring 88 opens and gas out of the

The Venturi arrangement constantly acts as a pressure-closed loop loop as soon as the limiting valve and very greatly reduces the exhaust 45 pressures in the system above a pressure value breathing resistance. Instead of the only one described here, there are 5 cm WS. The weaker spring 88 leads beneath Venturi system can also a double valve the valve 86 in the closed position as soon as the turisystem, d. H. one with two opposing pressures in the system under predetermined pressures Venturi or a positive and a value falling. The excess gas produced by the negative venturi used to release the 50 valve member 86 escapes through the Wall gap 28 between the two pockets, openings 91 in the valve body 71 to the outside. 31 and 32 to ventilate, and at the breathing tip the femer is during the exhalation phase of the

Evacuate volume in order to initiate rapid exhalation of inner pocket space 31 again under pressure. Optionally, a mechanical anesthetic gas can also be filled from the line 11, since weight at the end of the air bag arrangement 28, in a vertical position in which it is suspended from the previously applied pressure of the gases, is relieved around the outer pocket space 32. When the one side force component on the inner pocket of the exhalation phase is over, the inhalation 31 is allowed to act and an exhalation resistance phase is initiated again by forming air under a positive state. Similarly, pressure can be applied to the T-piece 61 and the same mechanical delay device repeated on the openings as previously described 51 with the venturi arrangement 66 can be created. This can be in the form of a cap, also used as a simple resuscitation device, which can be placed on the end of the line 116 of the exhalation, only the open end of the venturi 101 with the valve. 65 of a breathing mask for the patient in the form of a

Optionally, a piston pump can also be used for the filling face mask, a mouthpiece or an air tube The interspace between the pockets is connected to the insertion catheter. After operating the 31 and 32 can be used. During the return stroke of the co-operation of the breathing device in the above-described

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In this way the patient can be ventilated in advance in the body 133 establishes the connection with the patient. Air is drawn in from the blower mask 131 and an opening 143 opens to the outside air exposed through the line 64 to the valve assembly 66. Furthermore, one is provided for enriching the, which through the nozzle arrangement 109 and air in the inner pocket 31 with oxygen a venturi passage 102 in the breathing mask of the 5 line 46 , which flows to an oxygen patient and from there into his airways. The source is connected. The line 146 is supplied with air and is connected to the patient's respiratory tract via the Venturi passage 102 , a soft plastic tube 147 , until a predetermined one is attached to the valve device 132. A ter clutch pressure is reached or the end of the folding • exhalation phase attached to the end of the line 147 by the fan 51 has taken place. IO barer end connection 148 prevents escape. The periodic volume is against the supply of oxygen through line 147 when the patient's pulmonary resistance is either through inner pocket 31 under pressure. For an automatic mode of operation half-reaching the clutch pressure of the Venturi tube, the air pocket 28 is set in phase with or by mechanical termination of the inhalation of the Venturi arrangement 66 by the ring 149. The patient breathes passively through the bond.

Venturi tube 101 from which during exhalation with the device shown in Fig. 3 can be done by hand

phase is open to the open air. An adjustment or automatic ventilation or resuscitation

to the spontaneous breathing of the patient can be carried out by the patient. The inner air

the open venturi 101 take place. pocket 31 can be added manually or automatically.

It can easily be seen that this device is very compressed by having the wall partition and avoids any possible disturbance of the airway space between the pockets 31 and 32 by air through mechanical failure of a valve entering this space from the breathing fan 51 as there are no valves that could fail are pressurized during the inhalation phase. The device is therefore very simple and will. As a result, the device for controlling the air retained in the inner pocket 31, which is still reliable, is forced against the valve member 138 and during a temporary respiratory obstruction brings it into its closed position. The air then flows through the mask 131 into the airways of the pa-

The ventilation device 51 with the venturi-patient. When the exhalation phase is initiated by the arrangement 62, the breathing fan 51 can also be used together with the wall space with an air pocket arrangement 28 of the described here 30 between the pockets 31 and 32 is evacuated; the benen type can be used that the Lufttaschenanord- bladder 31 can automatically be filled from the open air voltage 28 directly to the face mask 131 of the patient, as soon as the valve member 138 of the valve 132 th is connected, as shown in FIGS. 3 and 4 shows. see opens. The valve member 138 remains to the environment. In this embodiment of the invention, it is open when the exhalation phase ends. When the inner pocket 31 is in the form of an automatically filling 35 beginning of the new inhalation phase, the working loin becomes a pressure bladder. She is repeated at one with the face game. The cyclically controlled re- mask 131 connected valve device 132 catching up ventilation process of the patient is therefore brought to a standstill. The body 133 of the device 132 is through the control of the fan 51 but may each have a ring 134 attached to the pockets 31 and 32 . time also by squeezing the pocket 28 It contains 40 enclosed by a seat ring 137 to be overrun by hand.
Flow channel 136, which is closed by a valve member 138 which rests against the seat ring 137 and which can be used both for anesthesia and for. The valve member 138 is usable by a resuscitator. The device is surprisingly simple and cheap via the piston 139 which is displaceable in the body 133 , and it can be tolerated. A spring 141 presses the valve member 138 45 similarly less trained personnel operated elastically into its open position. A hole 142 will be.

1 sheet of drawings

Claims (5)

"" "ί 2 ■■■ -" ■ Devices of this type are already known (paragraph 1 patent claims: and 3 of the German Auslegeschrift 1 214 833). With two air pockets arranged one inside the other or pressure 1. Anesthesia and / or resuscitation bellows, which lie in a gas flow circuit, which connects the device with a breathing mask, which connects via a lung of the patient with a source for the binding opening to the interior of a breathing gas, and a is connected via the bellows compressible air pocket, the working device for generating overpressure and within a manually compressible, negative pressure is generally achieved the task of creating a practically inextensible material consisting of a respirator, which is optionally arranged as a Beden, outer air pocket is, which io deaf device, resuscitation device and for others a closed against the inner pocket, this gas therapy purposes can be used, with the encompassing opening, so that a wall- the necessary pulsation in a simple way, to the space between the inner and the respective Purpose and the individual outer pocket is formed, which is e The constitution of the patient can be adapted in that, in addition to the connection opening in the outer pocket, a direct ventilation ventilation device can also be connected to a pressure medium control, thereby enabling the patient to operate manually. characterized in that between the opening (33) of the outer pocket (32) there is a valve Functions of the inner and the turi arrangement (66) is switched on, which interchanges an outer air pocket in such a way that the inner venturi tube (101), a jet nozzle (109) and a bellows with the device for generating the over-connecting line (64) to this Source of and negative pressure and the outer bellows over the medium, and that one end of the flow circuit is with the lungs of the patient in Venturi tube in the wall space of the connection. Air bag arrangement and the other in FIG. 25 The invention is based on the object of a free atmosphere flows. Device of the type mentioned in the way 2. Apparatus according to claim 1, characterized in that it enables the patient to further improve shows that the venturi arrangement (66) will allow you to breathe spontaneously during operation, connected to the additional opening (33) without being disruptive due to the air pocket arrangement Ventilation device (51) to be influenced cyclically to 30. guiding a medium under pressure into the wall This goal is achieved according to the invention, Space serves. that between the Beatmungsemrichtung and the comparison 3. Device according to claim 1, characterized in that the connection opening of the outer pocket has a Venturi drawing, that the on the Venturi arrangement (66) is switched on, the one Venturi tube, one to the additional opening (33) connected 35 jet nozzle and a connecting line this to Has ventilation device (51) for the cyclical source of the medium, and that one end is used to apply a vacuum to the room. of the venturi into the space between the wall of the 4. Apparatus according to claim 2, characterized marked air pocket arrangement and the other in the free shows that the ventilator opens to the atmosphere. Decycle the venturi Application of the medium under pressure 40 wraps a kind of during the inhalation phase to the wall space from an intermittent coupling or entrainment effect. In addition, editing Fan (51) with a controllable it acts a pressure limitation and, since it is after the Inhalation time and a controllable outdoor atmosphere is vented, a very small one breathing time exists. Expiratory resistance for the patient. 5. Apparatus according to claim 2, characterized in that 45 which draws on the venturi arrangement with the additional that the ventilation device connected to the borrowed opening ventilation device cyclic application of the medium an input can be designed in different ways: device for the time control of the mode of operation, it is the one for the cyclical feed and for limiting the pressure of the medium, it comprises guiding a medium under pressure into the wall. 50 space between the air pocket arrangement is used. One Another preferred ventilator is designed to be used for cyclic application of a Vacuum to the room is used and in particular as Piston pump is designed. 55 Becomes one for the cyclical creation of the medium The invention relates to an anesthesia device that is used to apply pressure to the space between the walls and / or resuscitation device with a respiratory ventilator is used, it can be a mask, which via a connection opening to the intermittently working blower with controllable interior a compressible air pocket breathing time and controllable exhalation time, is closed, which can be closed by hand within a 60 According to a further embodiment of the invention compressible, practically non-stretchable, the ventilation system can be used for cyclical AnMaterial existing, outer air pocket arranging the medium a device for temporal net is which one against the inner pocket down- controlling the work cycle and limiting the has closed, this encompassing opening, so have medium pressure. that a wall gap between the inner 6g In the following the invention is based on the drawing and the outer pocket is formed, which is explained in more detail via a openings, for example. Connection opening in the outer pocket with a Fig. 1 is a schematic representation of a Ventilation device is connectable. Anesthesia machine according to the invention;