GB2082071A

GB2082071A - Chest drainage apparatus

Info

Publication number: GB2082071A
Application number: GB8117339A
Authority: GB
Original assignee: Individual
Current assignee: Individual
Priority date: 1980-06-06
Filing date: 1981-06-05
Publication date: 1982-03-03
Also published as: DE3122509A1; ZA813769B; DE3122509C2; CA1178866A; JPS6258263B2; GB2082071B; JPS5749458A

Abstract

A chest drainage apparatus comprises a bottle housing a fluid collection chamber (26) having a fluid inlet connectable to receive fluid and air from a chest cavity to be drained, an air chamber (20) having an inlet from an air space above the fluid level in the collection chamber and an outlet for connection to a negative pressure source, a U-tube in the fluid inlet to the fluid collection chamber to provide a visual indication of any airflow into the system; the air chamber having a check valve (14) effective to prevent the backflow of air through said airspace and a negative pressure relief valve (60) connected to the air chamber to limit the negative pressure, if any, in the air space above the fluid to a predetermined maximum. A rate of flow indicator (24) and a positive pressure check valve (16) are connected to the air chamber. The air chamber and said valves and flow indicator form a unit which is detachable from the fluid collection chamber. <IMAGE>

Description

SPECIFICATION A chest drainage apparatus This invention relates to chest drainage apparatus.

According to the present invention there is provided apparatus for draining a chest cavity comprising a fluid collection chamber and a chamberfor containing air and for connection to a negative pressure source, the air chamber being connected to receive airfrom an air space above the fluid level in the collection chamber, and a onewayvalve interposed between an outlet of said air space and said air chamber through which air can pass from said air space to said air chamber although reverse flow therebetween is prevented.

In particular, the apparatus can also comprise a transparent U-tube connectable to receive fluids and air from a chest cavity to be drained and deliver the same to the fluid collection chamber while retaining a portion of the drained fluid in said U-tube, said U-tube and retained fluid forming a visual indicator of air passing therethrough.

The apparatus can also comprise a transparent upwardly-flared conical tube open to the atmosphere at the bottom and having an opening at the top communicating with the interior of the air chamber, a ball housed within said tube for floating movement in response to an upward flow of air therethrough, and scale-forming indicia provided on the outside of said tube to provide a visual indication of the negative pressure existent within said air chamber by reference to the level at which the ball floats.

These and other features of the invention will now be described, by way of example, with reference to the accompanying drawings in which: Fig. 1 is a front elevation, part sectioned, of a chest drainage apparatus according to the present invention; Fig. 2 is a horizontal section on the line 2-2 of Fig.

1; Fig 3 shows a portion of the elevation of Fig. 1 with the apparatus in a different state of operation; Fig. 4 is a section taken along line S4 of Fig. 1; and Fig. 5 is an elevational view corresponding to that of Fig. 1 but showing different parts broken away.

As shown in the drawings, the chest drainage apparatus 8 comprises a bottle 10 and a control subassembly 12. Subassembly 12 is detachably connectable to the bottle and it includes a check valve 14, a positive pressure relief valve 16 and a control valve 18 that regulates the negative pressure in the system. The subassembly 12 also comprises a negative pressure gauge 24 that also opens onto the interior of air chamber 20 within subassembly 12.

Bottle 10, in the embodiment of Figs. 1 and 2, comprises a unitary blow-molded reservoir defining a series of three fluid collection chambers 26A, 26B and 26C separated from one another by partitions 28A and 28B that contain openings 30A and 30B, respectively, near the top thereof that permit the chest drainage fluids to overflow from the first to the second when the first is full and from the second to the third when both of the first two are full. These partitions 28 are shown as being double walled. An integrally-formed web 32 bridges the gap between the walls and extends along the bottom of the bottle and across the top except for the notched-out portion 34 into which subassembly 12 is inserted.

Vertically-slotted clips 36 on opposite ends of subassembly 12 slide down the opposed margins 38 of web 32 that border the sides of notch 34 thus detachably-mounting subassembly 12 within the confines of the latter. When thus mounted, tubular air inlet 40 opening into the bottom of air chamber 20 through check valve 14 will be axially aligned with the air outlet 42 in the top of bottle 10. A short hose connection 44 completes the air connection between bottle 10 and the air chamber 20 of subassembly 12.

The bottle is molded from a transparent material that will show the level of the fluid in any of the fluid chambers 26. Each of these three chambers has the front face thereof covered by an adhesivebacked paper label 46 or other scale-carrying member having a vertical slot 48 therein through which the fluid level is visible. The label has printed upon its surface a volumetric scale 50 indicating the total volume of fluid stored at the liquid level visible through slot 48 in the last of the chambers containing fluid. For instance, chambers 26A, 26B of the illustrated bottle will each hold a maximum of 700 cc's of fluid before overflowing into the next adjacent chamber.

Whereas chamber 26B fills to a level lower than 26A, it holds the same amount due to the truncated corner 52 of 26A. The third chamber 26C is similarly truncated and is designed to fill to the same level as chamber 26B and thus holds less than the other two, specifically, 600 cc's giving a total fluid storage capacity of 2000 cc's. The paper label also provides the nurse with a convenient way of recording thereon the fluid level in the bottle at any observed time.

It should be noted that recess 54 in the back wall of chamber 26A has an opening 56 at its deepest point sealed by a puncturable grommet 58. If the bottle is filled to near full capacity, a sterile needle (not shown) can be introduced into chamber 26A through conventional resealable grommet 58 and used to withdraw a considerable quantity of the fluid contained therein thus extending the normal maximum capacity of the bottle. If the capacity of the bottle is too large, such as when draining fluid from the chest cavity of an infant, it may be desirable to introduce sterile water or saline into one or more of the chambers through grommet 58. The recessed nature of the grommet makes it easy to keep clean and free of contaminants.

The three serially-connected chambers 26A, B and C are the full equivalent of a single thin chamber three times as deep because both provide precise volume control unattainable with a single shallow chamber of the same capacity, and provide spacesaving advantages. These three chambers 26 are used exclusively as reservoirs for the storage of fluid and they have no other function whatsoever. The bottle 10 is not a precision instrument and can be disposed of following a single use.

The bottle also comprises a transparent U-tube 62 formed at the entrance to the fluid collection and storage area defined by compartments 26. The entrance 64 to this U-tube is also the single fluid inlet to the system and it is connected directly to the patient's chest cavity by drainage tube 66. Tube 66 is connected to inlet 64 of the bottle by a connector 68.

Fig. 1 shows that a small volume offluid 70 will be trapped within U-tube 62 once fluid begins flowing from the patient, thus avoiding the need for priming of the bottle. Grommet 72 in U-tube 62 can be used for the purpose of aspirating or otherwise withdrawing a sample of drained fluid to be cultured.

The fluid 70 contained within U-tube 62 is not a water seal effective to prevent the return of air to the patient and, in fact, the chest drainage assembly will perform quite adequately whether there is any fluid in the U-tube or not and irrespective of its level.

Nevertheless U-tube 62 performs two very significant functions. Namely, as both an air leak detector and an indicator of the inhalations and exhalations of the patent as the fluid fluctuates and alternately rises higher in one leg of the U-tube than the other.

As a leak detector, the U-tube 62 provides the observer with an instant visual indication of either an air leak in the system or the more serious consequence of an air leak originating in the patient's chest.

If, perchance, air bubbles are detected bubbling in a downstream direction through the fluid in the U-tube, the drainage tube 66 should not be either clamped off or removed from the patient until the source of the leak is located. Other than a system leak, the source of air entering bottle 10 comes either from air leaking from the patient's lungs or, alternatively, from air displaced from the chest cavity by the draining fluid.

In the present chest drainage system, the fluid in U-tube is fully capable of passing air in either direction, but to prevent air passing back into the patient a high precision flapper-type check valve 16 is located at the interface between fluid collection chambers 76 and the air chamber 20 of subassembly 12. Valve 16 responds to an opening pressure of approximately 0.5 cm H20 in the particular embodiment illustrated and itfunctions completely independent of anyfluid present in either the fluid collection chambers or the U-tube.

The full line position of Fig. 1 is the normal operating condition of the system, assuming some air is being evacuated from the patient's chest cavity.

Fluids, mostly blood, enter the system through tube 66 and are collected in chambers 26. The air which passes through the fluid in the U-tube into the fluid collection chambers exits the latterthrough check valve 14 directly into air chamber 20. Under normal operating conditions, a negative pressure exists in chamber 20 due to a vacuum being drawin therein by vacuum line 22. Line 22 may, however, be left open to the atmosphere for gravity operation. Positive pressure relief valve 16 in the top of chamber 20 will normally remain closed. When maintaining a sub-atmospheric pressure in chamber 20, the fluids and air are aspirated from the patient without he or she having to exert the positive pressure required to force them out.

Vacuum line 22 is connected directly into a vacuum source which will usually provide negative pressures of a magnitude well in excess of that required for chest drainage purposes. Accordingly the outlet 74 of air chamber 20 is provided with a screw-type pressure regulator 18 to control the pressure within the latter and thus the opening pressure of check valve 16 within carefully controlled rather narrow limits.

In the rare event of a malfunction resulting in a positive pressure build-up in air chamber 20, indicated by the kinking of the vacuum line 22 shown in phantom lines in Fig. 1, such a positive pressure could blow out check valve 16 thus releasing this pressure back into the chest cavity of the patient with the attendant serious consequences. To prevent this from ever happening, positive pressure relieve valve 14 is provided in subassembly 12 for the purpose of venting any positive pressure above a predetermined value to the atmosphere before it can re-enter the system. Valve 14 like valve 16 is of the flapper type and set to open at a pressure well below that were valve 14 would be over-ridden and allow air back into the system. The phantom line position of valve 16 represents the abnormal positive pressure relief condition just described.The open positions of both valves 14 and 16 have been highly exaggerated in Fig. 1 for purposes of illustration.

A feature of the chest drainage system is the negative pressure indicator 24 shown in Figs. 1 and 3. A frusto-conical tube 76 containing a ball 80, opens into the bottom of the air chamber 20 through a restricted opening 78 too small to pass the ball 80. A second opening 82 in the small end of tube 76 is also smaller than ball 80. Air is aspirated from atmosphere through opening 82 at a velocity sufficient to lift ball 80. The outside of tube 76 is provided with scale-forming indicia 84 reading directly in negative pressure measured in cm H20 or some other suitable set of values.

The attending physician is thus provided with an easily readable pressure gauge constantly monitoring the negative pressure within chamber 20.

Excess negative pressures are rare but could, conceivably, result from a so-called "milking" or stripping of chest drainage tube 66. If any abnormal negative pressure is present in air chamber 20, such a condition will immediately exist also in the fluid collection chambers 26. If the negative pressure condition occurs upstream of the system, the fluid in U-tube 20 would be sucked out into the discharge tube and ultimately back into the patient's chest cavity if it were not for the presence of negative pressure relieve valve 60. Likewise, if a sudden high negative pressure were to occur in air chamber 20, relief valve 16 will be closed and check valve 14 will be open exposing the fluid collection chambers 26 and everything upstream thereof including the patient to this abnormal condition. Relief valve 60 connected into the fluid free air space 86 above the fluid contained within the fluid collection chambers 26 will respond by opening as illustrated to admit air from the atmosphere thus limiting the maximum negative pressure that can exist in the system to a predetermined level well below that where any backflow to the patient can take place. Negative pressure relief valve 60 is of poppet-type but incorporates bacterial filter 88 (Fig. 3) which filters the incoming airto prevent contamination of the fluids in the fluid collection chambers. Valve 60, which is connected to neck 90 of the bottle by hose 92, is conveniently set to open at a maximum negative pressure of-50 cm H2O which is entirely adequate to protect the patient.

Fig. 3 illustrates diagrammatically an excessive negative pressure condition in air chamber 20 that has caused the valve element 94 of valve 60 to move off its apertured seat 96 in opposition to the bias of spring 98 and thus open to maintain the system pressure at a maximum of-50 cm H20.

Fig. 5 illustrates the use of the bottle in an inverted position as a reservoir to return the previously drained chest fluids back into the patient's chest cavity. After clamping drainage hose 66 by clamp 100, subassembly 12 is removed and a fluid delivery tube 102 fitted in its place to air outlet 42. Valve 60 need not be removed since it will remain in its normallyclosed condition. After tube 102 has been inserted into the patient's chest cavity, the bottle can be inverted to dispense the fluids stored therein by gravity flow.

Claims

1. Apparatus for draining a chest cavity comprising a fluid collection chamber having a chamber for containing air and for connection to a negative pressure source, the air chamber being connected to receive air from an air space above the fluid level in the collection chamber, a one-way valve interposed between an outlet of said air space and said air chamber through which air can pass from said air space to said air chamber although reverse flow therebetween is prevented.

2. Apparatus according to claim 1 having a transparent U-tube connectable to receive fluids and air from a chest cavity to be drained and deliver the same to the fluid collection chamber while retaining a portion of the drained fluid in said U-tube, said U-tube and retained fluid forming a visual indicator of air passing therethrough.

3. Apparatus according to claim 2 wherein said U-tube at a position below the normal fluid level therein is provided with drainage means through which a portion of the fluid in the U-tube can be drained to the outside of the apparatus.

4. Apparatus according to claim 3 wherein said drainage means comprise a releasable puncturable plug.

5. Apparatus according to any preceding claim having a flow control valve connected between said air chamber and said source of negative pressure downstream of said one-way valve, said flow control valve being operative to control the level of negative pressure within said air space and air chamber.

6. Apparatus according to any preceding claim having a transparent upwardly-flared conical tube open to the atmosphere at the bottom and having an opening at the top communicating with the interior of the air chamber, a ball housed within said tube for floating movement in response to an upward flow of air therethrough, and scale-forming indicia provided on the outside of said tube to provide a visual indication of the negative pressure existent within said air chamber by reference to the level at which the ball floats.

7. Apparatus according to any preceding claim having a vent open to the atmosphere and located downstream of the one-way valve and a pressure relieve valve operative to open at a predetermined pressure above atmospheric pressure to admit air through said vent into said air chamber.

8. Apparatus according to any preceding claim wherein the fluid collection chamber has drainage means adjacent the bottom thereof and accessible from the outside thereof for removing a portion of the fluid collected therein.

9. Apparatus according to any preceding claim wherein said fluid collection chamber, upon inversion and detachment from said negative pressure source, forms a reservoir for returning the collected fluids to the patient through said outlet of said air space.

10. Apparatus according to any preceding claim wherein said air chamber, said one-way valve and parts of the apparatus downstream of said one-way valve form a unit which is detachable from the fluid collection chamber.

11. Apparatus for draining a chest cavity, said apparatus being substantially as herein described with reference to the accompanying drawings.