DE9208860U1 - Portable treatment unit for oxygen therapy of a diver suffering from decompression sickness - Google Patents

Description

DESCRIPTION

The present innovation concerns a portable treatment unit for oxygen therapy, in particular for divers suffering from decompression sickness, i.e. patients. However, the innovation can also be used in the field of rescue services (NAW, air rescue, etc.).

In the case of so-called decompression sickness, the diver's body has absorbed too much nitrogen (N2), which is excreted from the body under normal pressure conditions (i.e. atmospheric pressure). The treatment unit is used to administer pure O2 to the patient as a breathing gas, which effectively washes out the N2 dissolved in the body and thus immediately begins to dissolve N2 bubbles.

To date, no portable treatment units for the breathing/ventilation of divers suffering from decompression sickness have been known. In the event of such a diving accident, patients have regularly been transported to the nearest decompression chamber or to the nearest hospital. There is a risk that the patient's condition will worsen due to the length of the transport, or, particularly if the patient is transported by helicopter or plane, that further N2 will be released into the body due to the decreasing ambient pressure at higher altitudes, which will make the patient's situation even worse and may cause permanent damage.

The aim of this innovation is to create a portable treatment unit of the generic type, which is easy to transport, can be used on site and also requires a small amount of O2.

This task is solved in accordance with the innovation in that the unit is designed as a closed system in which the air exhaled by the patient is returned to the system, a CO2 absorber is provided to remove the CO2 contained in the patient's breathing gas and the used O2 is replaced by O2 supply from the O2 source.

Because the treatment unit works as a rebreathing system, its use is particularly economical in comparison to conventional open systems in terms of the O2 supply. In open systems, on the other hand, around 95% of O2 is exhaled into the environment and is thus lost. During metabolism, the body uses O2 and produces CO2, which is exhaled into the system and then separated out by the CO2 absorber. The O2 requirement is determined solely by the patient's (^ consumption plus any leaks in the breathing mask. The innovation ensures that a patient can breathe pure O2 for several hours using a relatively small O2 bottle. Another advantage is that breathing in the closed circuit system and the constant CO2 absorption causes heat and moisture to be generated. The breathing gas is slowly warmed up and has a 100% water vapor saturation. The high humidity in the breathing air has the advantage that the respiratory tract does not dry out (in comparison to inhaling pure O2 from the O2 bottle) and thus the typical irritation of the respiratory tract can be prevented.

As already mentioned at the beginning, the new treatment unit can also be used in the field of rescue services (NAW, air rescue, etc.) to supply patients with oxygen in a gas-saving manner. The oxygen supply that has to be carried can be reduced many times over.

The subclaims concern expedient embodiments of the innovation.

During the exhalation process, the exhaled gas should first pass through the tube connection to the reservoir bag and from there be inhaled again by the patient through the CO2 absorber. The consumption of O2 due to the metabolism in the patient's body and possible leaks is compensated by a regulated, coordinated supply of O2.

The subject matter of claim 3 shows a simple possibility of passing the exhaled gas over the CO2 absorber and then feeding it back to the patient.

The outlet and inlet valves of the CO2 absorber are, according to the design according to claim 4, easily connected to a T-piece via two hose connections, whereby the T-piece is in turn connected to the ventilation part on the patient, e.g. to the breathing mask. This design ensures, on the one hand, a simple construction and, on the other hand, an arrangement that does not cause interference during the patient's breathing/ventilation.

The subject matter of claim 5 is advantageous in that the flow regulator provided therein offers the possibility of setting different flow rates of O2 as required. For example, the (^ supply can be higher at the beginning for flushing purposes than during normal breathing or ventilation.

If, due to the deterioration of a patient's condition, there is a need for assisted ventilation, e.g. by an assistant, via the reservoir bag or even controlled ventilation, then according to claim 6, by inserting a pressure relief valve, for example at the base of the reservoir bag, ventilation can be carried out using the reservoir bag as a ventilation bag with the system unchanged and maximum (^ supply. In addition, there is the possibility of the patient breathing spontaneously in the event of overpressure.

According to claim 7, the opening pressure can be set in the range of 0-40 mbar. For manually assisted or manually controlled ventilation, an opening pressure of 10-40 mbar is expediently set, for spontaneous breathing, and for positive pressure (CPAP) an opening pressure of 5-10 mbar is expediently set.

In order to carry out a leak test on the system, it is necessary to carry out a leak test before ventilation. To do this, the breathing mask is removed from the system and the system is preferably closed at the T-piece.

The embodiment according to claim 8 brings about a quick and secure connection of the treatment unit with the (^ source.

According to claim 9, a special embodiment of the innovation can also have a shut-off valve, which avoids the need to constantly remove the breathing mask.

In order to be able to replace the CO2 absorber as early as possible, it has a so-called exhaustion indicator according to claim 10. If the CO2 absorber consists of soda lime, for example, the color of the

soda lime from initially white to later violet indicates that the absorption level of the C02 absorber is exhausted.

The C02 absorber can then be replaced with a new C02 absorber - even during breathing/ventilation. The connections comply with ISO standards.

In order to keep the manufacturing costs of the new treatment unit low, the C02 absorber is designed as a disposable item.

The treatment unit is further designed according to claim 12 such that at the beginning of breathing/ventilation for filling an increased (^ supply (flush function) can be set and subsequently the 02 supply can be reduced for continuous breathing.

The subject matter of claim 13 shows appropriate adjustment ranges of the C>2 supply during flushing and during continuous breathing.

According to claim 14, a (^ bottle with a volume of 1.5 - 2.5 l, preferably 2 l, is used as the O2 source, the bottle having a filling pressure of 160 - 240 mbar, preferably 200 mbar. This design has the advantage that the O2 bottle and thus the entire unit is very easy to handle, very compact, very light and can be taken anywhere.

The entire system or the entire treatment unit is conveniently housed as a complete system in a case.

To describe the innovation, several designs are explained in more detail below using the drawings. They show:

Fig.l shows an embodiment of the treatment unit according to the innovation;

Fig. 2 shows a further embodiment of the treatment unit according to the innovation ;

Fig. 3 Individual parts for attaching the breathing mask to the patient;

Fig. 4 a CO2 absorber as used in the treatment unit according to the innovation;

Fig. 5 a representation of the respective treatment unit at the beginning of breathing/ventilation and

Fig. 6 shows a representation of the respective treatment unit during continuous ventilation.

The treatment unit 1 according to Fig. 1 is designed as a complete portable set and comprises a C^ source in the form of an O2 bottle with a container pressure of about 200 ata. The O2 bottle has a conventional pressure reducing valve 13, which reduces the bottle pressure from 200 ata to, for example, 5 ata in the feed 9. A valve 13 (pressure reducer/flow regulator) is arranged in the feed 9, which is designed to be adjustable. With this valve 13, the O2 in the feed 9 is decompressed to ambient pressure, whereby a different O2-FI0W, e.g. 0.5 l/min, can be set.

A CO2 absorber 3, which contains, for example, soda lime, is connected to the supply 9. The soda lime absorbs the CO2 in the system and thus ensures that the patient constantly inhales pure O2.

The CC>2 absorber contains a depletion indicator, which indicates in good time by changing color that the effectiveness of the absorption of CO2 is coming to an end. For example, the exhaustion phase of the soda lime is indicated by a change in color from white to violet.

The C02 absorber 3 comprises an outlet valve 5 on the side associated with the C02 bottle in Fig. 1, which is connected to a hose connection 7. On the opposite side, an inlet valve 6 is provided, which is connected to a hose connection 8. This valve arrangement results in the circulatory system (rebreathing system).

Both hose connections 7 and 8 are preferably designed as corrugated hoses and end in a T-piece 10, which in turn can be connected to the breathing mask/mouthpiece 11.

The breathing mask 11 must be firmly attached to the patient using a fastening part 12 in order to avoid leaks.

Fig. 2 shows a further embodiment of the innovative treatment unit 1, in which a pressure relief valve 15 is connected between the reservoir bag 4 and the CO2 absorber 3. The use of a pressure relief valve is particularly necessary under resuscitation conditions. If a deterioration in the patient's condition requires assisted or even controlled ventilation, e.g. by an emergency doctor, the pressure relief valve 15 can be connected to the system. The pressure relief system means that an opening pressure of, for example, 40 mbar can be set for manually assisted or manually controlled ventilation via the reservoir bag 4. If the pressure in the system is higher than 40 mbar, the pressure relief valve 15 opens and O2 can escape.

The pressure relief valve 15 is adjustable with regard to the overpressure range, so that, for example, spontaneous breathing can also take place at an opening pressure of, for example, 5 - 10 mbar, i.e. in the overpressure range.

Fig. 3 shows individual parts for fastening the breathing mask 11. The breathing mask 11 is adjusted to the face in such a way that it is tight when attempting to inhale and the opening is closed. It is then strapped using the fastening part 12, e.g. a retaining strap, to the hook of a fixing ring 18, which rests on the breathing mask 11.

Fig. 4 shows a detailed representation of the CO2 absorber to be used in the treatment unit 1. The representation in Fig. 4 clearly shows the direction of flow in the system during breathing. Breathing gas exhaled by the patient P flows through the inlet valve 6 first into the reservoir bag 4 and into the CO2 absorber 3, in which the CO2 produced in the breathing gas during metabolism is absorbed. Pure O2 then passes through the outlet valve 5 and is inhaled by the patient P. The losses of O2 in the system are compensated by a continuous supply of O2 from the O2 source 2. A hose connection 19 is arranged on the outlet valve 5, to which the supply 9 ((^ supply) is connected. The supply 9 has color marking means 16.

Fig. 5 shows the treatment unit at the start of treatment. According to the illustration in Fig. 5 shown at the top left, the cylinder valve 14 is opened and the flow regulator 13 is briefly set to an increased value, e.g. 3 l/min or flush, until the reservoir bag is filled with O2. During this phase, the T-piece 10 is sealed. The T-piece 12 is then connected to the breathing mask 11, with the patient breathing normally. The O2-FI0W is then reduced to e.g. 2 l/min via the flow regulator 13.

Due to the intended nitrogen flushing out of the patient's body, the excess breathing gas and thus N2 escapes through the seal of the breathing mask. During this phase it is particularly important that the reservoir bag 4 is filled. The O2 supply remains set at 2 l/min for a period of 10 minutes in order to ensure intensive flushing and to accelerate the nitrogen flushing out.

The two illustrations in Fig. 6 show the state of the treatment unit 1 during continuous breathing. For continuous breathing, after 10 minutes of flushing, the O2 supply is finally reduced to approx. 0.5 l/min via the flow regulator 13. In this case, the reservoir bag 4 must continually fill up in the rhythm of the patient's breathing frequency; it must under no circumstances collapse completely.

If the reservoir bag 4 gradually empties, the mask fit must be improved. If the leak cannot be completely eliminated, it is possible to increase the O2 supply, e.g. to 0.7 l/min.

After 30, 60 and 120 minutes, even if the system is functioning properly, a 5-minute flush with an O2 supply of 2 l/min should be carried out to wash out any nitrogen that may have accumulated.

The new treatment unit uses very little gas compared to other systems, where around 95% of O2 is exhaled into the environment and is thus lost. This ensures that relatively small O2 bottles can be used and the entire system can be handled as a complete set in a container, e.g. a suitcase. This means that effective measures can be taken directly on site to relieve a diver suffering from decompression sickness.

The innovation therefore represents a significant contribution in the technical field of rescue systems for diving accidents.

LIST OF REFERENCE SYMBOLS

1 portable treatment unit

2 C^-source

3 CO2 absorbers

4 reservoir bags

5 Exhaust valve

6 Inlet valve

7 Hose connection

8 Hose connection

9 Feeding

10 T-piece

11 Breathing mask/mouthpiece

12 Fastening part

13 Flow regulator

14 Bottle valve

15 Pressure relief valve

16 Color marking agents

17 Endotracheal tube

18 Fixing ring

19. Hose connection

Claims (16)

PROTECTION CLAIMS Portable treatment unit for oxygen therapy, in particular for a diver suffering from decompression sickness, i.e. patients, with which oxygen can be administered to the patient as a breathing gas, whereby the nitrogen dissolved in the body is washed out, with an O2 source, a reservoir bag and a ventilation part arranged on the patient, e.g. breathing mask, characterized, that the unit (1) is designed as a closed system in which the patient's exhaled air returns to the system, a CO2 absorber (3) is provided to remove the CO2 contained in the patient's breathing gas, and the used O2 is replaced by oil from the O2 source. 2. Treatment unit according to claim 1, characterized, that the CO2 absorber (3) and the reservoir bag (4) are arranged within the system in such a way that the patient exhales into the reservoir bag (4) and inhales from the reservoir bag (4) through the CO2 absorber (3). 3. Treatment unit according to claim 1 or 2, characterized, that the C02 absorber (3) has two valves (5, 6), of which one valve (5) is designed as an outlet valve and the other valve (6) as an inlet valve (5) and the inlet valve (6) is assigned to the reservoir bag (4). 4. Treatment unit according to claim 3, characterized, that the outlet (5) and inlet valve (6) of the C02 absorber (3) are connected to a T-piece (10) via two hose connections (7, 8), the latter being connectable to the breathing mask/mouthpiece (11). 5. Treatment unit according to claims 1-4, characterized, that a flow regulator (13) is provided in the system with which a desired O2 inflow from the O2 source can be set or regulated. 6. Treatment unit according to claims 1 -6, characterized, that a pressure relief valve (15) is preferably installed in the system between the reservoir bag (4) and the C02~absorber (3). is switched on, which enables manually controlled ventilation. 7. Treatment unit according to claim 6, characterized, that the opening pressure of the pressure relief valve (15) is adjustable in a pressure range of 0-40 mbar. 8. Treatment unit according to claims 1-7, characterized, that the system has a C>2 supply hose (9) provided with color marking means (16). 9. Treatment unit according to claims 1-8, characterized/ that a shut-off valve is provided with which the system can be closed towards the patient, i.e. towards the ventilation part arranged on the patient. 10. Treatment unit according to claims 1 -9, characterized, that the CO2 absorber (3) has a depletion indicator. 11. Treatment unit according to claims 1-10, characterized, that the CC>2 absorber (3) is designed as a disposable article. 12. Treatment unit according to claims 1-11, characterized, that at the beginning of breathing/ventilation an increased (^ supply can be set for filling/flushing and then the (^ supply can be reduced for continuous breathing. 13. Treatment unit according to claim 12, characterized, that during the flushing phase a C^ supply of 1.8 - 2.4 l/min, preferably 2.0 l/min, and during the ventilation phase an O2 supply of 0.3 - 0.7 l/min, preferably 0.5 l/min, can be set. 14. Treatment unit according to claims 1-13, characterized, that an O2 bottle with a volume of 1.5 - 2.5 l, preferably 2 l, is provided as the (^ source and the O2 bottle has a filling pressure of 160 - 240 ata, preferably 200 ata. 15. Treatment unit according to claims 1-14, characterized, that all individual parts of the treatment unit (1) are housed as a complete set in a case. 16. Treatment unit according to claims 1-15, characterized, that the pressure reducer (13) of the (^ source contains a flush function with automatic reset in order to quickly fill the complete treatment unit including the reservoir bag before treatment begins.