DE2365725A1 - PRESSURE LIMITING DEVICE - Google Patents

Description

The invention relates to a pressure limiting device in particular for anesthesia equipment, with an inlet chamber for under pressure! standing fluids, with an outlet opening for flow _{; (} medium and with a variable throttle valve that is acted upon by the fluid and is preloaded into a closed position

furnishings.

Usual anesthesia machines have a supply unit that an air mixture of oxygen and anesthetic gas used for anesthesia is generated. As a rule, this is what the patient exhales partially used air mixture is collected in a breathing bag when exhaling, by means of the air supply unit Gas mixture prepared again and then made available again for inhalation. The breathing bag of such in DT-As 1 904 The anesthesia machine described is made of elastic rubber. In order to avoid the transmission of pathogens from one patient to another it has already been proposed that the

609821/0371

Breathing bag as a disposable part made of cheap material, especially plastic material. Such breathing bags can suddenly : Occur pressure fluctuations in the associated with the breathing mask

I working lines of the anesthesia machine that lead to damage

; the patient's lungs, practically cannot catch,

J because its maximum volume is given; also elastic breathing j bags can only increase pressure to a limited extent under elastji

reduce i 'shear expansion of the outer skin. !

The invention is therefore intended to provide a pressure limiting device

! which are an inadmissible increase in pressure ; prevent in the work lines of an anesthesia council.

This object is achieved according to the invention in that the throttle device has an elastic molded part which is elastically prestressed blocked the inlet chamber in which it was compared to one

! with the molded part rests against the rigid wall of the inlet chamber.

Advantageous further developments of the invention are set out in the subclaims described.

With the development of the invention according to claim 2, a simple attachment of the pressure-limiting device to a working line, namely also to a working line that has already been found, is possible. Depending on the elasticity of the hose used , a pressure limitation is also obtained at the same time by creating an elastically expandable storage volume. Such a pressure-limiting device works together with a non-elastic breathing bag

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just like or similar to an elastic breathing bag. The according to the invention Pressure relief device and a non-elastic breathing-I However, bags are overall cheaper than a conventional elastic breathing bag alone. ■ ί

! With. The development of the invention according to claim 3 is a special good sealing of the pressure limiting device to the outside; as there are large sealing surfaces. At the same time becomes a get smooth outer shape; the pressure relief device carries only a little on the work management.

In a pressure limiting device according to claim 4 can with a given ring part the closing force of the throttle device, adjust and reinforce.

The development of the invention according to claim 5 provides a simple acoustic display for the response of the pressure limiting device obtain. This means that the anesthesia machine does not work properly and that the operating personnel are at risk indicated by escaping anesthetic mixture.

In the development of the invention according to claim 6 takes place Pressure limitation as close as possible to the patient, d. H. depending on

i. the actual pressure exerted on the patient's breathing system. This can be accomplished with little additional effort, since the modification of the shape of the injected usually branching piece only require additional costs for the tool and otherwise only from stem d Te un arterial best immediate Ventilte il

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is additionally required.

: According to the embodiment of the invention. Claim 7 is in turn:

I receive a warning in a simple manner and at no additional cost.

^: th, the response of the pressure limiting device and the ί

: - ■ 1

■ Acoustically indicates the leakage of the e-narcosis mixture.

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The invention is illustrated below using several examples in Connection described with the drawings. Ea beige "

/ ig · 1 a perspective exposure of anesthesia =

beacmungsvorrichtung gemlii of the invention wherein both the disposable and the remaining part of the device is shown ι

rig. 2 is an enlarged perspective view in which the part of the disponible in Ji ¹ Ig, the device shown 1 is better illustrated and "was the Zwiachenflache between the disposable and the remaining part;

a schematic flow diagram of an anesthesia circle according to the invention

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IAD ORIGINAL

a schematicchea flow diagram of a single Rohrea (^ astlltyp) one
S of the invention;

rig ·. > a side view partially broken away, with specifically the interfacial zone of the device after * ig. 2 is shown between the disposable and the remaining part;

KIg. 6 a plan view, "partially, broken away, whereby the interfacial zone of the device shown in FIG. 5 is shown ι

rig. 7 * and 7b section along line 7-7 of FIG. 5, where two different positions of the 3 control valves are shown to connect the device pressure and the Vfentilaterdruck with the control port of the blow-off valve see below!

ir ig »8 an intersection essentially along line 8-8 of the rig «5t whereby a third position of the tax valve is shown;

JfIg. 9 shows a section essentially according to iAnie 9-9 of FIG rig. 5, whereby the valve in the control valve is available for * Change of the blow-out opening of the blow-out valve shown is ι

FIG. TO shows a development in which the relationship between the control valve valve and the exhaust port the control valve® g © s © Igt isst ι

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! «Ig · 11 a ^: eitenanbicht, in which aas Äinatm_ung3« valve and the fastening unit to connect the disposable Knäathesiekreisea riding the remaining part of the device are shown »

a perspective view of the in .Hg. 11 shown fastening device;

a perspective view of the in A'ig. 11 ednatmungsventilsi shown

.fc'ig · 14 a Jeitenaneicht, partly broken away, in which the end of the face turned towards the patient Circle and in particular a preferred Ϊ-otückauführungung that the Auaatsiungsventil and containing the overpressure safety valve is shown are ι

, 15 a .ichnitt essentially along line 15-15 the #ig. 141

16 is an enlarged section essentially after line 16-16 of the iig. 15 # being details of the overpressure safety valve are shown;

· 1? a section essentially along lines 17-17 the Jf'ig 141

# ^N · ig 18 is a sectional view of a preferred of a rorns Reservoir according to the invention for separating a mechanical ventilator from the gas of a battery;

Fig. ₉ 19 a -section la essential after line 19-19 of the irig · 18 |

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! «■ ig, 2υ an open view, in which the manner and manner of how the huge volume of the. Figures 18 and 19 is structurally arranged in the device and with the arrangement of an Aaniaters with C0 ₂ absorption material is shown between the reservoir and the inhalation valve;

yig. 21 shows an enlarged vertical section through the CU ₂ absorption channel in FIG. 2ü;

22 shows a horizontal section in the normal direction line 22-22 of the * ig. 211

Fig. 23 is a perspective view similar to Fig. 2, with the exception of the use of an elastic section to prevent sudden jerks increases within the device}

, 24 a section essentially η along line 24-24 the jfig. 23;

Jfig. 25 an ochnltt essentially along line 25-25 the JTig. 24;

. 26 shows a vertical section similar to FIG. 24 however, a modified version aform dee elastic section, which allows "overpressure release";

. 27 shows a section essentially along line 27-27 the JfIg. 26th

is now on J ¹ Ig. 1 referred to, in the one

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Aniötheaiebeatirmnßsvorrichtung according to the invention is shown. In short, the in irig. 1 used a commonly used ArcK achine 10 to measure and mix the anesthetic agent / general anesthetic agent and then feed it to a supply hose 12 with a suitable pressure up to 5ü paig ssuzu * lead. The supplied through the hose "12 gases are then fed via a so-called Anäathe3iekrei3 14 to the patient, ϋβτ Anäethediekreia 14 works to firstly the gases to wear to the patient and she aske a ^ or to bring a ündotrachealrohr with the airway dea patient in conjunction. Secondly, it serves as a reservoir between the variable flow rates in and out of the patient and the constant delivery rate. Thirdly, to eliminate excess gas from the device, and fourthly, to reduce the inhaled COpionic concentration to an acceptable level of the patient or the oteuenmg by manual or mechanical means.

The fcaachlne 10 normally has sockets 15 for mounting Strand a fastening arm 16 which serves as a support for the Anä3the3iekreia and the pressure gauge 18 is used.

-ie earlier benerk-fe _t it is difficult and impractical to completely sterilize auSerordentlieh all exposed to the Fatienten parts of a Anästhesievorrlchtuns after use. Accordingly, it has long been known that the use of anesthesia equipment represents a great risk of mutual contamination between patients.

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MAD

In the face of this great danger, efforts have already been made to manufacture the parts that come into contact with the patient cheaply enough to make throwing away after a single use economically viable, and so far only these bookings have been made has been moderately successful, since the necessary change in cost was achieved at the expense of the method of operation and reliability. Me ürfindung is sfcheaievorrichtunn to An>: directed that I3T designed so that the effort and fcoaten de "fortzuwerfenden part mini nisi ^concerning:. 'Rt, the f ^ rt; 7ntwerfende part of all the ^ eni ^ s r contains .leicent * that may be the the patients' breathing: "SSAS contaminate / uick specifically, the invention discloses two Ausffihrungsfonnea of disposable ^to: isthe3lekrei3en, which are mutually austau3chbar easy to couple with a joint permanent device part. Both versions of the anesthesia circles represent modifications of the circles that are known once as anesthesia circle and others as an anesthesia circle old to a single head (itagill type) the free end of the mounting arm a t6. & the disposable part of the device can easily be attached to the free end of the fastening assembly 16 by means of a quick-release coupling

More specifically, with reference to the iig. attached by means of a Befestigungiivorriehtimg 2Ü on Befeotignngsana 16 ,, the rtachf will be described in greater detail olgend "3 bracket 16 has a blow-out valve 22 eat \ dae naheaeinenL freiea äad® Is angpfeeacht ·" 1 @ below

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As will become apparent, the anesthetist can operate the valve 22 optionally via a manually operated valve 24.

The type of attachment !! 16 and the attached parts, 2, B, the inflation valve 22, form a part with the permanent, reusable part of the device of the preferred embodiment of the invention. The free 14 forms the disposable part and has all the elements between the fastening device 20 and the connections with the patient's airway, for example a facial neck 26. The fastening device 20 can be quickly connected to the fastening arm 16 or be released from it and forms a gas flow path to the gas supplied through the hose 12 through Λθπ. Krela 14 to the mask 26 and CD. " Enriched gas" exhaled by the patient to the

Blow out valve 22 to direct. The in iig. 2 ltreia shown

forms an anesthetic circle, with the otröimmgsweg leading through in connection with tfig. 3 should be described. In order to facilitate the designation of the elements eu, it is pointed out that the circle 14 of the Jrig, 2 has a n.inatrmng3ventll 28, through which aaie the an 16 of the hose 12 pulls a friecb.es gas via a breathing tube 30 to a Y- Jtück 32, which is connected to the V, a3ke 26, is fed. A in the gas reservoir or breathing bag 3 * is also connected to the Sin · IaTseit β of the inhalation ventila 28.

The Y-piece 32 also has an "exhalation tube 36 connected to the inviting person, in which an exhalation valve is not arranged (not shown in * lg. 2), inter alia, an exhalation tube

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BAO ORIGINAL

dea breathing tube 36 is with the fastening device 2 U coupled and stands - with the inlet side * of the reservoir in Link.

The circle shows how the beaser will be understood in the following geaü3 an important feature of the invention, an inflation tube 33 on, which stands out from the ϊ-otüek 32 suriick Eur attachment * · device 20 extends, where βα to the inlet opening of the Au «· blow valve 22 is connected '

Ka is now referred to the figures 3 and ₉ 4, the schematize *! show the otröimingswege of the two Äreisausungen according to the invention, namely first © inen Anäatheüjie · circle (Kig · 3) and secondly a circle with a single drill of the Äfagilltype (i? 'ig · 4). Before the Gasströiaungswege these are iireise considered two, it iet seen * get to it, that exhaled by a patient Gaa can be considered dead · space gas and Alveolargaa · uas Totraumgas occurs tiei & ir only in the tnrncS, nose and large imrchgänge in of the lungs and does not react with the blood flowing through the lungs. Therefore, the dead space gas leaves the patient as it enters him, with the exception of changes in temperature and humidity ₂ ) nor anesthetics and does not absorb any carbon dioxide (CJ (^).

On the other hand, the alveolar gaa reacts with the blood of the lungs and leaves the patient poor in O ₂ and rich in ϋυ ₂ · In an adult with a breathing volume of 500 cm, 15 ° car is normally dead space gas and 350 cm * is normally alveolar gas · DIb circles of the young . 3 and 4 are according to

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ORIGINAL BATHROOM - 15 -

Invention designed in such a way "that they keep dead space and not eat" in gases within the system, while they preferably discharge the C0-> rich alveolar gas through the blow-out valve 22. In a yrischgaseinatröinung 4 per 1 Äfinute thus the inhaled Cu ₂ remains concentration acceptably low, ta make it necessary in the device without the use of Cu ₂ absorbing material.

f ', 3 is now referred specifically to FIG. 3, the ötrö "mun ^ AWEG through an anesthesia circuit according to the invention · The dot-dash line 40 in Fig. 3" shares the interface between the disposable part of the left and the permanent' hawks on the right. irrischgaa is supplied via the riohr 42 in fig, 3 of the aiin · IaS held 43 of the J?; inatmuns3ventila 28. Fresh gas enters through a small Drosael opening (not shown) with a high pressure drop and thus prevents any flow to the remaining part and thus contamination with the exhaled Gza dea patient. The KinlaSaeite cleüe, in the breathing valve 28 is also marked with the. Äeservoir 34- in connection. Jas frinataunijäventil allows a flow only in the sighting indicated by the arrow on the outside, so that a patient can breathe in gas from the tinatation tube 30. Gas exhaled by the patient from the first inlet of the 3 exhalation valve. jjie iiuslaßöeite dea Auaatimingsventils 44 communicates with U aforementioned blow pipe 38 and the Aucatüiungsrohr 36 in connection. The other end of the exhalation tube 36 communicates with the reservoir at the end of the anesthesia machine of the device. JJas naschinenende dea AUüblaarohree 3ö is in connection with the blow-out valve 22 and forms a part

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dee permanent '!' © ils dsr performance »

Hein; Operation of the Ana-itheslekreiaei * der J ^1- Ig, 3 Jb'r nitrous oxide flows through the tube 42 into the circle, whereby the inhalation and exhalation valve 28 and 44 keep the flow in the circle in the same direction when the patient is breathing or the water reservoir 54 is pressed, the rinse valve 28 opens, while the discharge valve 44 closes _e with exhaust gas and gas from the · *? Reservoir 34 and the inhalation tube 30 in the. Airway dea patients via the .vaeke 26 etrcait. hen the ^ patient- "usatFöt either fjpontan or because the Hruck has waned in the reservoir, the Aunatrrangsventil ^ 4" opens during the äinatmungsventil 2Ö schlie3t, eo da3 Gis from. latienten "around the discharge pipe 36 and into the reservoir 54 flows. At the same time, the exhaust gas enters the fresh gas inlet 42 and flows primarily into the keservoir.

At some point during de λ Ausatitena during a spontaneous VENTILA ^ ieation fills eJfCh dae aeäervoir.34, wherein the gas near the Fatientenende dea circle starts by the Äusblaarohr 38 and aue to flow the purge valve 22, which during spontaneous ventilation only as a pressure «Valve with variable throttle with an opening pressure of one Intiraeter ^ O-.jäule works. Pieces of gas which is the last to burden the patient is alveolar gas, since it is rich in OC ^. The dead space gas exhaled by the patient before exhaling the alveolar gas is either further upstream in the exhaust tube or the expandable reservoir where the alveolar gas is exhaled.

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Operation during manually assisted ventilation, ie when the air reservoir is being pressed, is similar to the operation for spontaneous ventilation, but the flow from the air blow tube 38 occurs during breathing, ie when the air reservoir is depressed as a result of the pressure . * print »in the device. An optional and preferred operating method during the manually assisted and controlled ventilation consists in the automatic forced opening of the discharge valve 22 during inhalation when the Keaervoir is depressed, it being possible for ea to open during exhalation. The following is a description of the mode of operation of the blow-off valve in connection with Jj ¹ Ig. 5, the anesthetist can select such a mode of operation for the blow-out valve that the blow-out valve 22 closes tightly when the device pressure rises in response to the pressing of the Heservoir. ruckea reduces the pressure within the circle 3, so that when the patient exhales, the dead space gas initially flows through the breathing tube into the Heservoir 3 ^, the subsequently exhaled alveolar gas then flowing through the exhaust tube and out of the blow-out valve 22.

In summary, it can thus be said that the blow-out valve preferably only during spontaneous ventilation a variable throttle opening as i; jerk relief3ventll forms, which opens in response to the pressure inside the device · during the manually assisted or controlled Ventilation preferably closes the exhaust valve in

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Z3657Z5 _

Addressed © to the pressure within the device, ie. the Kinatnrung

As will be seen below, the mode of operation of the blow-out valve 22 is determined by the pressure which is supplied to a control opening 47.This control pressure is selected by the anesthetist by manual control through a three-way control valve 24 three Jteuerdrücken at the Auslaßöff · voltage 49 is available to be supplied to 47 and determine DI® B®tri © prove the Äusblasven "tile ₉ to the Ausblasventi! tax mouth. Briefly, the;. T @ u @ r®inlaßöffaung 47 of the blow-out valve 22 through as "valve 24 and the pressure Kohr 50 dem'umgebenden exposed w @ rd®a _s Ie this position of the three-way valve operates the drain valve only .22 ala A pressure relief valve sits with a variable throttle opening. A'hrend the aauell supported. or controlled ventilation is the valve 48 so that the _f duabalsventll during inhalation tight sehließt set "so""da3 the Kohr 52 is connected to the Aueblaaventileteueröffnung 47, aussuführen to yorrlchtungsdruck. taxrn. ®in used mechanical ventilator and the preferred iieservolraueführung, As will be described below in connection with Figures 18-26, the pressure supplied by the fan can be connected to the blow-out valve control opening 47 via the valve 24 and the blow-out valve, in order to ensure that the blow-out valve 22 is closed 1st when the device is pressurized during inhalation

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ra becomes nim & efir on iig. 4, in which a visual image of an anaesthetics is shown with a single ear, which is often referred to as the so-called ragill-type circle. bin Magilltypkreis is ».jekennjiehnet through the use of a single AtsDungurohre-j 6ü instead of the & in and ATiüatmungjröhre 30 and 36 of the in * ig. 3 price shown, each gas solution through the respiratory tube 6ü der * ig. thus takes place alternately towards the patient when breathing in and away from the patient when breathing out. The «.iagilltypkreis der J? Ig. 4 does not require the use of the inhalation and exhalation pressure relief valves, as is characteristic of the body of the invention.

v.if the patient ends the circle after * ig. 4 during who breathes in spontaneous ventilation, he sucks out nitrous oxide the inlet tube 6u and the reservoir 64. Exhale home flows the initially exhaled Gaa that the dead space gas forms, back through the Atraunga tube 6ü into the Hedervoir If the reservoir 64 is full, the following flows exhaled alveolar gases via the exhaust pipe 66 to the exhaust valve 22. As previously noted, the permanent device part interchangeable with both shown in figures 3 and 4 Areisen are used

During spontaneous ventilation, when using the circle according to J ¹ Ig. 4 the previously described inflation valve? 2 aid overpressure valve with variable oil orifice was used and? By supplying the ambient pressure via the tube 50 and the three-way valve 24 to the air orifice 47

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2385725.

Ausblaeventils, ventilation IENN supported or is controlled by printing dea reservoirs 64 "rre, it is necessary to go to press dnc purge valve ?? ά & Ί it would increase in response to a pressure during the. *; Inatr.ens closes because Otherwise COp enriched gas is retained in the device while fresh gas is exhausted through the blow-off valve.Various mode of operation is selected by either applying device pressure from Kohr ^ 2 via valve 24 of blow-off valve control port 47 or fan pressure via pipe 54 and valve 24 of vent port 47 is fed.

ts will now refer to the tfiguten 5 and 6 genonuren, ia which structural details of the free andea dea fortification » low-movement 16 and the ijreisabachnitt of the fastening device » device 2ü, which is connected to deo arm 16, is shown.

The Befeetigungaam ü 16 is provided with a nipple?, Extending from the bottom and serves for connection to the aforementioned Frischgaazufuhrschlauch 12th The Mppel 70 is connected to an irriach gas channel 72 which extends parallel to the longitudinal axis of the arm 16. tier K-mel ^f; 2 opens out at the end face 74 of the arm 16.

A ring 76 is fönnise Ausnehsiung i ^w channel 72 near the

otrirnflache 74 is provided in which a u-ring 78 is received which is a head piece of the fastening device 2u sealing that engages in the itanal 72

In addition to dea & anal 72, the arm 16 has a channel 8U, the Also in the end face 7 * dea arm 16 opens out.

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60982 1/037 1

bine rinsiüricige iat recess 82 in the channel near the 8UE otirn i laugh 74 is provided, in which a u-Hing 84 au * fgenoair, en is the üohrstäck ain the iJefestigungsvorrichtuns "2R sealingly which are described in more detail below 3 oll. ·

^{1 As} already noted in relation to Figures 4 and 5, the three-way control valve 24 is used to control the .H drive units of the Auüblaaventils 2? .. The control valve 24 i ^ .- vai% nd actuable »bar, ur optionally any of the three previously «» nrihntea control sources with the control opening of the blow-off valve 7? In a first position the ambient pressure is supplied to the control opening, in a second position the circuit pressure is supplied to the control opening. suggests. In a third position, the fan pressure is fed to the control opening, which can still be seen, are means provided, tin? automatically ₉ that the 4ualsü3drossel «opening of the exhaust valve fully g @ offset is ₉ when the -ituer ·» opening is supplied either / Ventilation is used. If, on the other hand, ambient pressure is supplied to the control opening, which is in the first line during the spontaneous ventilation of the whole. Means for changing the size of the outside area are automatically moved to the corresponding position.

■ Pi'ie also evident from Figures 5 and 6, does the inflation valve 22 have a sinlaßöffnun? 9? which extends through an externally threaded nipple 93

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ORIGINAL BATHROOM

Furthermore, the blow-out valve 22 has a discharge opening 94 and the aforementioned tax opening 4? on. about Äippsl 92 is screwed into the arm 16 and connects the inlet opening 92 with the circular pressure in the A.anal Bo. The outlet port 94 is A short tube 95 rides an outer blue opening 96 connected in the housing of the control valve 24-. The tax opening 47 eats through a short tfohr 97 »it of the opening mentioned above 49 of the control valve 24 connected.

The blow-off valve 22 has a housing, the upper outlet of which cut 98 into the lower section 99 screwed ii't which the latter in turn is screwed into the nipple 93, Between the facing -.stirnflächeη of the housing " sections 98 and 99, an elastic membrane 1CÜ is inserted » tense. iJine Jcheibe 101 lies on the underside of the aieaibrane 1üü an and a plunger 1ü2 extends from the eye plate 1ü1 downwards, uer otößel 1ü2 extends sealed by a feate "and 1üj9 in a recess, which is in an approach 104 of a valve plate 105 is provided between the frand 1U3 and outer washer 101 worn down screw compression spring 106 surrounds the oleobel 102.

If during operation the exhaust valve «» 22 ambient pressure on the upper surface of the diaphragm 100 acts, pushes the spring

106 insert the slide 102 into the in iig. 5 position shown in

the one at a distance from the bottom of the recess; in the Anaatx 104 dea valve plate «105 has. As a result, the Valve disk 105, which is normally close to the sea edge

107 dea nipple 93 rests, raised when the pressure in the canal

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a first * 'aS, ε, Β. 1 cm ". Column of water by one To allow gas flow through the channel 80 from the opening 94.

If, on the other hand, the surface of the diaphragm 100 is subjected to excess pressure (from the circuit or the fan via the plate valve.? 4, as will be described below), the diaphragm 100 is bent downwards until the tappet 10 ?. is seated in the recess of the ankle 104, while the valve disk 105 is in tight engagement with the esser · could 107 korwt. It is pointed out that the effective length of the membrane 100 is greater than the effective length! "" Laugh the valve disk 105, ao that the valve disk 105 closes tightly when the same pressures are supplied via the control opening 47 and the inlet opening 92 and the.> jerk on the Lombrane crosses a second dimension, eg 5 cm> aaaeraäule.

fc-.it the;> control valve 24, an anesthesiologist selectively either ambient pressure circuit pressure or fan pressure of the control port 47 out to actuate the Ausbla3VentilG in the aforementioned ".'eise, ^s Venn seen to ambient pressure 25Urief \ is 5hrt allows Since the control valve 24 also allows the air outlet 94 to change the size of the air outlet 94 and thus the air flow rate from the air outlet valve, if air pressure or fan pressure is supplied, the air outlet 9 * remains fully open.

Control valve 24 also consists of a wrehachieberventil with a housing, the upper part 107 ^{1 of} which is screwed into a lower part 1C8. The under part · 1 Ü8 weiet to a nipple provided ^with% AuSengewinde 109 which is screwed into the arm sixteenth A central bore extends through the nipple 109 and extends over the exhaust inlet opening 96

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the arm 16 connects to an iron nipple 110. Sin outlet hose 111 let connected to the nipple 110 to remove used gas preferably sue sem exercise space to carry out to any Prevent harmful effects on the personnel present.

A ₁₁ β described above, it is apparent that (einachlieBlich ambient pressure) alt the inlet "three different pressure sources eel te dee control valve 24 are connected, which are of anesthetists selectively with the opening 49 connectable via the pipe 9? to establish communication with the exhaust valve control port 47. One of these three waves has circular pressure (corresponding to the tube 52 in FIG. 3), which can be brought into connection with the channel 80 of the arm 16 via the nipple 112, a hose 113 connecting the nipple 112 to the nipple 114. The fan delivers pressure (corresponding to the pipe 54 in FIG. 3) via a nipple 115, which will be explained in more detail in connection with the description of FIGS. 18-20.

No connection either wipe the nipple 112 or the Nipple 115 »it the opening 49 is determined by the position of the Rotary slide 116 controlled, which is rotatably arranged in the lower housing part 108. The rotary valve 116 is with a Connected shaft 117, on which a button 118 is attached, which we use manual operation by the anesthetist. the The inner surface of the housing section 108 is provided with hanging grooves 119, which each receive an O-ring 120. Of the Rotary valve 116 is provided with a Jc hl it ε 121, the • I extend “in part of the scope” of the same over “ine”

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A sufficient length extends to bridge the distance between the nipples 112 and 115 and the opening 49, when the rotary valve 116 is in the position; e'er jfig. 7A is rotated, the slot 121 connects the NIPP = I 115 with the opening 49. When the rotary slide 116 is rotated into the position shown in FIG. 7B, the slot 121 connects the nipple 112 of the opening 49. ITm de * In order to make it easier for anesthetists to adjust the dial 108, the button 108 is preferably provided with an indicator 122 which snaps into two positions in a suitable manner. "

To the opening 4 "optionally with a third pressure source, ie the ambient pressure ^ corresponding to the ear 50 of the Jrig. 3) to bring in connection, the urehschieber 116 is provided with a further Jllitz 123, which extends by more than 180 ° in the area of the same. The slot 123 is vertically offset with respect to the slot 121, but it is still in a position to establish a connection with the opening 49 (see Fig. 8) via a vertical opening 124 which establishes a connection to the opening 49. The ... slot 123 is connected to the ambient pressure via an iCanal 126 extending through the rotary slide 116, the part 117 and the iLnopf 108. Since it is necessary to prevent communication between the .Schlitzen 121 and 123 au, which is i; reh3chieberumfang3fläche and l _n inner face dea lower Gehäuseteila formed corresponding konlach, wherein a Ji'eder 127 surrounds the corrugated · 117 to the rotary slide in to press the conical housing so that the οchiitze are sealed with respect to each other

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ν. as mentioned above _g is ®s desirable _β . that the anesthetist can change the flow out of the blow-out opening 94 of the blow-out valve when the blow-out valve operated as an overpressure valve to ensure that a sufficient supply of gas is maintained within the circuit. will race on the other hand -Ausblasventil in the balanced ■ '.eise operated ₉ © s desirable "dad is the Auablaaöffnung the purge valve is open ^ far · To au achieve this, the rotary valve is provided with a VentiLteil'128 extending from the lower iinde of the same extends downwards and is shaped so that it variably covers the opening ψζ, vs & aa the knob 18 and the rotary slide 116 are rotated. The changeable covering of the opening 96 can be seen on the beaten from the development in FIG. 10, in which it is shown how the valve part 128 moves over the opening 96. to observe & s- ± zt, that the valve member only covers the opening $ 6, -VBTOt of-3ehllte 123 is in communication with the opening 49 and remote from the opening - is 96, and has no isinwirkung it, when the slot 121 in conjunction with the opening 49 stands. . '■.'

The end face 74 dea fastening armea 16 is with two forwardly protruding pins 130, each of which with a hanging groove 131 arranged at the front end is. These pins 130 are used for alignment and support the attachment device 20 on the arm 16 to provide mechanical support and an air flow connection.

fcii reference is now made to Figures 11 and 12,

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«Ν

in which the fastening device 20 is shown more clearly. The fastening device 20 has inner Channels that end with cherries, those with matching parts can be brought into connection. The fastening device 20 has a large vertical bore 132, which in N'ippel 133 and 134 opens, which preferably have a conically tapering outer diameter of 22 mm. The nipple 134 is in the upper opening of Heaervoira 34 (see Jr'ig. 5 and 7) insertable, while the nipple 133 engages in a correspondingly conical bore of the housing of the iilinatbungventils 28, as is also shown in FIGS. Kin Nipple 136, which also has an outer diameter of 22 minutes, is also in communication with the large bore 132. This nipple extends into the exhalation tube 36 as shown in Figure 3 in Figures 2, 5 and 6. Sin nipple 135 » which is also connected to the large bore 132, engages to establish a connection in the channel 72 im ■ Irm 16, as shown in FIG. The attachment; * « The device 20 is also provided with a nipple 138 which engages in the channel 80 of the fastening arm 16 to establish a connection. The nipple 138 stands with a Channel 140 in connection, which extends through the fastening device 20 and ends with a nipple 142, the can be connected to the blow-out pipe 3β, as shown in the figures 2 and 6 is shown

Fastening device 20 is parallel with ewei recesses extending along the underside of the same

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ee.

150, as can be seen from iigiir 12. in springy fingers 15? is provided in the fastening device 20 immediately adjacent to the recess 150, which engages lockingly in the hooking groove 131 provided on the pins 130 of the 3 fastening arm 16, that is to say, the 3 for connecting the disposable anesthesia circuit with the lead-required function The recesses 150 of the fastening device 20 are placed on the pins 130, and then the ti gunga device 20 is pushed towards the end face 74 of the mounting device 16 until the resilient fingers 152 of the manufacturing device 20 lock into the annular grooves 131 of the Engage pins 130. This brings the nipples 135 and 138 of the fastening device 20 into engagement with the channels 72 and 80 of the fastening arm 3, whether the seal is effected by the O-rings 78 and 84.

It can be seen from FIG. 5 that the inhalation valve 28 is a non-return valve which allows air flow directed upwards from the nipple 135 of the reflection device 20 through the inhalation valve 28 and also through the outlet opening in the nipple 160. The inlet valve nipple 160 has just falls preferably 22 mm üurchmeaser to iRungerohr tv be taken on as DIEA shown in Figures 2 and 5 * in -ln_it * 30 *

The Kinat _inungsventil 28 has a two-part housing a leak part 162 and a lower part 164. Jer lower part 164 is provided with a cylindrical, tapering feaad 168 which has an opening

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in which the nipple 133 is inserted with freedom, as shown in FIG. 5. The beef edge -and 168 is designed as an "esserkante 170" and works "with a valve plate 172, pin the" and 168 surrounding trough 174 is in connection with the outlet opening which is provided in the conical nipple 160 * During operation of the injection valve 28, the valve disk 172 is raised in response to a pressure difference between the lower and the upper part of the valve disk 172 (see Fig. 5.), so there is a connection between the bore 152 of the ventilation device 2υ and AusIaBÖffnung 'in Kinatirungsventilnippel 160 is formed. i> he üinatniungaventildeckel 162 is provided with a located wait-extending otift 176 provided the movement dea valve disk _t limited 172nd the edges en-3 Deckelteila 162 engage in a · annular Ausnehimang 178 of the lower Gehäuaeteils of the breathing valve sealed a «

From the foregoing, the dividing line between the disposable one is Anesthetics and the remaining part at az-aechinenende clearly visible. The formation of the disposable oefeation device 20 is in such a way that it can be carried along easily and quickly connected to the remaining part or removed from it can if the remaining · part successive in patients is used «

lh "IRAE now to jfiguren 14-17 reference is made, in which a preferred · · Auaführungeform an X ^ tiickes shown iet 32 which in the apparatus of GOT & B isrfindung

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is used, uae the preferred tee 32 is used to connect a Kaskenkrtn- * ere 2'J (J or an endotracheal tube connection with the atciunga tubes 30 and 36 and the exhaust tube 38. ie from Ji ¹ Ig. 14. the nasal crater ends with a 15 square conical cup which engages sealingly in a hole 2, which forms the inlet to the I-piece 32, the y joint 32 forms an ecrown canal 2u4 , which ends in a nipple 206, which can be attached to the patient end of the breathing tube 3u · ^ he upper section of the Y - :. tückee 32 ", as can be seen from Figure 14, both the opening valve and an overpressure valve.

The bore 2½2 of the. Y -. "Section 32 is via a channel 210 in connection with an Aanner 2U8. The Ka ^ ner 2ü8 is through three fixed ■ lands 212, 214 and 216 and a fourth, a valve disk 218 forming> .and limited. On the valve disc 218 two pins 220 and 222 are attached, which are in bores 224 d «3 ϊ-piece housing are received and held, uie The end face 226 of the ends 212 and 214 is kinked and forms a valve face. When the valve disk 218 is in the is located, as shown in Figure 15, is He's about an axis going through pins 22u and 222 bent. As a result, the valve head 21S fits into Attachment to the Ventiloit «226. The valve disc 218, of course, prevents gas flow from right to left in Kigur 15, there is a pressure on the right oil of the valve disc « 218 causes a better fit of the valve divider. .; hen on the other hand an overpressure differential from the left to the right 3 side of the valve disk 218, in iig. 15 seen, consists,

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- in -

blest the valve disc 218 going to the tifte by the "2? 2 and 224 axis and allows gas to flow un> the η ante η dea valve disc approach ;, ^ s sieve of the valve body 218 under uruck opens, it connects the Ka ^ r * he? U8 with the nipples 230 and? 32. * As can be seen in figure 15, the Nippil 23u matures sealingly into the exhaust pipe 36 and the 2J2 sealingly into the outlet pipe 38 »

In a preferred embodiment of the valve, the Y-piece also has an overpressure valve 240 which is arranged close to the patient and thus asks maximum protection against ruptured lungs, which would otherwise occur as a result of an overpressure error in the device (note) · I ^ a pressure relief valve 2 ^ ü is in connection with the Karger and has a cup-shaped recess 2Λ4, which is formed in the outer surface of the v.and 216 (iig.16). Openings 242 extend through the "and 216 of the Cup-shaped recess 244 in the door 2C8. An elastic valve element 246 is provided, which has a central Jchaftabachnitt 248, which extends through the * and 216 in the 2nd of the cup-shaped openings 244. To one hand of the Jchaftea 243 is a small iflenisch 250 and on the other f.nä ^ a larger jrlanscb 252. £, iu ^l Zuglarren 2 ^ 3 extends axially from the small flange 250 away from the shaft 248 shown in iri ^ ur 16, installed by sucking the flap 253 to the right through the central opening in the cup-shaped section 244. over the outer surface 254 of the flange * 250 conical

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and dad Ventilelamsut iatj elastic, the flange 2S0 by da3 center hole "can be: βzogen, \ vn assume the position shown in Fig. 16. In this position, the tflanr.ch 250 fits the cup shape of the recess; 244 at. In the restoration shown in Figure 16, the shaft 248 de3 valve element 246 is under low tensile stress and pulls the valve flange 252 against the recess 244 to seal the opening 242 externally (to linka in irig, 16) on the valve flange 252. This effect distorts the irorsi of the valve flange 252 and stretches the shaft 240, so that one flows through the opening 242 and a pressure relief of the chamber 28 and then the whole areiaea can be done Gna -enn through the opening 242 of the valve flange 252 passing entflicht produces an audible ee camouflage, because eggs vibrates ilan3ch 252 ×

Ks is now referred to Figures 18 and 19, in which a preferred Keaervoir training Gjeinäß der ät " finding is shown. vie noticed before, "dae can go so far Heservoir mentioned a usual exercise with a Form chamber. Although such a ack for a spontaneous and manually assisted ventilation is sufficient. however, he would not be required for controlled ventilation be peaceful when the reservoir is replaced by a mechanical one Fan is pressed, as this then droi gas des to be exposed to patients and a -eg for each other « Contagion would form Swiss patients

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We have provided a hot water reservoir, as shown in Figures 18-20, which insulates the ventilator from the latient Qns ; the ^on; ijtheiiiekreis and the other luifc the fan in connection eteht üae loaervoir 300 benteht vorzu ^ ev / eiü · of three;. chichten, a vinyl sheet 302, 304- and 306, and with each other Anschlüusen>) 8 and 310. The connector 310 is connected to a connector number 312 between the foils J02 and 304 and the tear connector 308 ″ with a connector 314 between the foils 304 and 306. Ler. / \ nschlu3 308 has 22 mm i) through! seiser and eats with an ireööitz on the conical nipple 32 of the fastening device 20, as shown in the lines 5 and 7 - ^ he connector 310 has a ^c . zidkonu3 311 _t of ir.it Ireßsitz in the inde a i'alten "tubes is printed 320, ÖSM in turn with the ·, mechanical ventilator (not shown) is connected.

With the use of the "ventilated" eservoir 300 of Figures 18-20, the ventilator now periodiechs the Cairo 312. The pressure acting on the insulating septum 304 is transmitted to the chamber 514 and generates a corresponding pressure within the inner breathing tubes 30. Never outer foils 302 and 306 of the iiee reservoir 300 should be thin, flexible and non-elastic. The outer contour of the reservoir is preferably similar to the contour of a conventional atera aack, so that the feeling is similar. The partition 304 preferably has a contour similar to the foils, 302 and 306, so that it fits the whole

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Volume can act deo ^ ^ eaervoir 5Ow rait gerinjjer pressure difference * On-'z-ugaveiae the I'rennv / 304 and a täichfbare .J'arbe should have and at least one outer great should be transparent AIN ₉ βρ άΆλ the hewegunij by the partition caused voluqenanderuns can easily be observed by the Arnatheuist. Due to the design of the ^ e ^ orvoira ⁵ JCO Kit 3ν1ηη · η, fleyibl »n \ u2eß- * dnfl #» n it works like a usual .it ^ rrsack, while the manually assisted .ventilation so that it through den 'misthejiaten without veitorea rar: ar .. "!; on29drMckt where" with the usual feeling only slightly changed by the presence of the partition 3U4 ulrd.

. "" Has already been mentioned earlier with reference to the work of the .aus "blue valve 22, that in the case of controlled ventilation it is desirable to make the AUablaa valve" pressure responsive to the fan. There "means how to will remember that it is desirable to close the blow-out valve when the device is pressurized through the ventilator while breathing in. It may furthermore be inwardly that for this purpose a: iohr 54 in Figure 2 Hezu * 5 taken, which is connected to the ^ inlaSieite of the ireiwegeateuerventils 2 *, ie ir.it the Hippel 115 in Fig. 6. To supply fan pressure to the nipple 115 is a with the Kaauuer 312 in Connecting nipple 522 is provided in the i-.and 302 of the Reaervoir.3 300, -in the end of the tube 54 fits on the nipple 322. Alternately, the tube 54 pressure from a duct opening nipple from the cone, 22 nan adapter 311 »oil be that of the pleated tube

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320 jr.it of the Veatilatorkir.Ksr 312 d «3 neaervoirü?;. ■! ■ pre-binds.

It was previously pointed out that when using the AUoblaörohras in the described manner to ventilate the Alvaolargaae, the need to use CO-? \ beorptionsir.material among the tenants ^; Jmat linden in Üort »case korOT.t. "; Jt however been also recognized da3. 3 i" titer ge "wisaen circumstances (eg Friachgatieinlaa of vreniger 4 1 per minute can prescribe ^s or personal desire dea inästheoiatcn than that CO2 is used Abeorption3iaaterial G'iETiiJ a preferred embodiment.. There is no canister 350 (Jig.20) for optional arrangement between the nipple 133 of the fastening device 20 and the conical socket in the valve 28.

:. ύ is now referred to Figures 21 and 22 v. The details of the canister 350 containing the OO2 absorbent material are shown. The canister 35u has a cylindrical central section 352, as shown by the bottom wall 354 being perforated at 356 around an unperforated central section 36u. -sin JtrSarungsBiittelfiittelfiliriincr ^ riiig 361 iefc en the lower yi <4Ch · the -and 35% including the middle cut 360 around, tine perforated flatte 362 fits over the cylindrical container 352. Jie; Slat 362 is held in position by a cover 364 which has a downwardly extending flange 366 which forms an inwardly protruding ring 368, here with a non-protruding ring 370 at the central section 352, iafc lockable. The lid 364 has a conical

Addition 372 of 22 ma provided, which equals <3 including 130

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of the fastening device 20 and therefore in the opening dea housing of the binatmungeventila 28 can be added can·

.-. in annular flange 374 eats on the lower surface of the ι and 354 formed, as shown in FIG. The outer surface of flange 374 faces outward protruding annular rim 376 which rests on an inwardly protruding annular hand 378 of a Jumpfoanniel unit 380 fits and can be locked with this i3t. The Jumpfaammeleinheit 380 has a housing that delimits a cylindrical opening 382 which is used to receive the conical Connection I30 of the fastening device 20 serves «Um a trough 384 is provided around the connector 382, ala .] umpf acts to collect ura caustic liquids that generated during operation and to prevent accidental spillage around patients. Through this, that the middle section of the ν and 354 is fixed and that the ■ jtröimmgsn & t te! Guide ring 361 is provided, any caustic liquid in the body and not in the at mungsaystera headed

Although the use of the oyatems according to the invention, in which preferably alveolar _{gas is removed, practically eliminates the need for CO 2} adsorption material, it has been shown that such material can easily be arranged in the systems if this is desired. If GO ₂ absorption amattrial is used, it will of course be exhausted very slowly. Se will continue to point out «

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3Γ

indicated that, if desired, two or more GO ₂ canisters of the type shown in FIGS.

In order to keep the costs of the waste part of the anesthesia device as low as possible, the reservoir is preferably made of plastic and not of rubber. However, because plastics are not elastic, they allow rapid and excessive pressure build-up in the patient's airway. Recognizing this danger, respected authorities have suggested that only rubber breathing bags should be used. The advantage of using a gun breathing back i ?! In contrast to a bag made of non-elastic material, when the pressure in the breathing circuit increases, the rubber bag stretches so that the pressure increase is less rapid, while the anesthetist has more time to recognize and recognize the developing danger to turn off. La also increases addition dl "size of a rubber bag, achieved a maximum pressure causes beyond which a larger extent, a decrease in pressure in · οack and thus within the airway of the patient. Precise dimensioning of the jacket volume, the thickness of the needle and the elasticity of the material can ensure that the pressure is within the safe range.

Although the above advantage of breathing bags is recognized, but it has also been recognized that such

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difficult to manufacture and expensive. With regard thereto will now aufi Figures 23-25 pointed, in which is shown the use of construction _p DIE non-els * stischen material for Atmungssack® permitted and that nevertheless the characteristic Vorteil® d®r Gummiatmungasäcke has.

“As can be seen in detail from Figures 23-25, is a Section of elastic Bohr®a 400 around one of the breathing tubes attached around, with the ends of the elastic tube are tightly connected to breathing tube 402 at 404 and 406. An opening 408 provided in a breathing tube 402 represents an opening Connection between the interior of the elastic ear portion 400 with the inside of the breathing tube Construction, the elastic Jtohr 400 acts as a pressure vessel, being through proper selection of the physical parameters (Length, material thickness and elasticity) the elastic section protects the patient in the same way as a non-elastic breathing bag. The cost of the elastic section 4üO plus a plastic breathing bag are however significantly lower than the cost of an elastic breathing bag the elastic drill 400 lighter in one position To be attached, in the ee observed by the anesthetist can be·

Geaäö a further modification shown in FIGS The subject of the invention can be the elastic tube 400 of FIg * 24 can be modified so that ee as overpressure « valve acts so that there is an alternative su the arrangement of the pressure relief valve in the one shown in Figures 14-16

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ϊ-otiickes forms. In order to have a « An overpressure relief device is to be provided with an elastic band 410 between the tightly closed ends 4υ4 and 406 are placed around section 400 and between them at 412 the tape 410 and one end slit. Preferably let * 'üll material 411 between the positions under the belt 410 see, .if the pressure inside the 4G2 Atmunagrohra rises, the tube 400 stretches and stretches at a certain point If the elastic band 410 points away from the breathing tube, so that 3 leakage beyond tape 410 can take place "That Gas leaking via band 410 then passes through the ichlite 41? the end. When the gas exits through slot 412, it works the material adjacent to the slot as a tongue and creates a herable “warning for the anesthetist, the“ in overprint to et and consists.

An anesthetic ventilation device is described above, those made up of a disposable part and a permanent part and which is designed in such a way that the costs and effort of the disposable part are minimal, whereby all « those x & eaente are included, dl · possibly a Could cause contagion.

609821/0371 _B ad original

Claims (7)

P_a_t_e_n_t_a_n_s_j3_r_u_c_h_e_ Pressure limiting device, in particular for anesthesia equipment with an inlet chamber for pressurized fluid, with an outlet opening for fluid and with one acted upon by the fluid resiliently in a closed position biased variable throttle device, characterized in that the throttle device is a having elastic molded part (244, 410) which is elastically pretensioned the inlet chamber (208, 400, 402) is blocked by being on a wall that is rigid compared to the molding (244, 410) (216, 402) the inlet chamber rests. 2. Djruckbegrenzungseinrichtung according to claim 1, characterized in that the relatively stiff wall is formed by an inner tube (402) that the inlet chamber by a. section of the elastic tube (400) surrounding the inner tube (402), which section is provided with an outlet opening (408), one end of which is delimited in a fluid-tight manner with the outside 609821/0371 of the inner tube is connected, and that the molded part is connected by> one attached to the opposite end of the hose elastic ring part (411) is formed, which under überwindungj its elastic bias from the outside of the inner. Rohres {402) can be lifted off. 3. Pressure relief device according to claim 2, / wherein the inner Tube is designed in the form of a bellows, characterized in that that the elastic ring part (411). the complementary form of a! Has pipe constriction and is seated in such a. 4. Druckbegrenztingseinrichtung according to claim 2 or 3, marked. characterized by an elastic surrounding the ring part (411) Pre-tensioning ring (41O) ', which is pushed onto the hose (400) is. 5. Pressure limiting device according to one of claims 2 to 4, characterized in that the hose (400) is also guided over the ring part (411); that the end lying on the other side of the ring part (411) is in the middle of the flow tightly connected (406) ^{to the} inner tube (402); and that in the section of the hose (400) lying on the other side of the ring part (411) a cut (412) is provided so that when the pressure - Limiting device an audible signal is generated. 6. Pressure limiting device according to claim 1, characterized in that that the relatively stiff wall of the section - 3 609821/0371 a wall (216) of a branch piece connected to a breathing mask (32) is; that the elastic molded part has a central shaft (248) and a plate section formed thereon (252), which in the wall section (216) from formed channels (242) normally covered; and that the shaft (248) has an integrally formed annular shoulder (250) over which he is under train to the interior of the branching piece (32) facing side of the wall section (216) is set. 7. Druckbegrenzungseinrichtxing according to claim 6, characterized in that that the channels (242) in the wall section (216) and the plate section (252) are formed and the plate section (252) Tanter so strong pressure covers the canals (242) ■, that upon leakage of fluid through the channels j (242) overcoming the bias of the plate section . .. ■■ " (252) an audible warning signal is generated. 609 821/0371