GB2309907A

GB2309907A - Tracheal tube and connector therefor

Info

Publication number: GB2309907A
Application number: GB9701172A
Authority: GB
Inventors: Eric Pagan
Original assignee: Smiths Group PLC
Current assignee: Smiths Group PLC
Priority date: 1996-02-08
Filing date: 1997-01-21
Publication date: 1997-08-13
Anticipated expiration: 2017-01-21
Also published as: GB2309907B; GB9701172D0

Abstract

An oral or nasal tracheal assembly has an endotracheal tube 1 and a mount device 2, the machine end 13 of the tube being slidable along the inside of the mount device and sealed with it by a slidable stopper 14 or flexible bellows 50 (Figure 7). Gas connection is made to the machine end of the mount device, which is formed as a connector 26.

Description

TRACHEAL TUBE ASSEMBLIES This invention relates to tracheal tube assemblies.

The patient end of an endotracheal tube is inserted through the mouth or nose of a patient to extend beyond the vocal folds and to locate in the trachea, just above the carina.

When correctly positioned, a cuff surrounding the tube, close to its tip, is inflated to seal with the trachea. The machine end of the tube protrudes from the mouth or nose and may be trimmed in length before connecting to ventilation equipment. The machine end of the tube is usually secured where it emerges from the patient by means of a tape or strap secured to the tube and fastened about the patient's head.

Although the tube may be correctly positioned initially, and the machine end is securely fastened in position, it is, nevertheless, possible for the patient end of the tube to become displaced as a result of changing the angle of the head or other manipulation. This can cause the patient end of the tube to be moved further into the patient, thereby damaging the carina. Alternatively, it may result in the tube being pulled outwardly, causing the inflated cuff to damage the vocal folds.

It is an object of the present invention to provide an improved tracheal tube assembly.

According to the present invention, there is provided a tracheal tube assembly comprising a tube and a mount device for securing where the tube emerges from the patient's body, the machine end of the tube extending within the mount device, the tube being slidable along the mount device, and the assembly having a seal between the tube and the mount device such that gas connection to the tube can be made by connection to the mount device and such that the machine end of the tube can move relative to the mount device during use.

The tracheal tube assembly may include a sliding seal between the patient end of the mount device and the outside of the tube, which preferably includes a sealing ring around the inside of the patient end of the mount device. The seal may include a sliding seal between the inside of the mount device and the machine end of the tube, which is preferably provided by a hollow stopper inserted in the machine end of the tube. The hollow stopper may be retained in the machine end of the tube by means of barbed ribs on the stopper. The stopper may have an external cylindrical sleeve, the outer surface of which is a sliding seal with the inside of the mount device. The machine end of the tube preferably has a flared opening to facilitate entry into the tube.Alternatively, the seal may include a flexible seal, such as a bellows, extending between the mount device and the machine end of the tube. The mount device preferably has an outwardly-projecting flange, the flange having means for retaining a tape by which the assembly can be secured about the head of the patient. The mount device preferably has a strengthened region along its length that serves as a bite guard. The mount device may have a male connector or swivel connector at its machine end.

Oral and nasal endotracheal tube assemblies according to the present invention will now be described, by way of example, with reference to the accompanying drawings, in which: Figure 1 is a sectional side elevation view of the oral assembly; Figure 2 shows a part of a modified forrn of the assembly of Figure 1; Figures 3 to 6 illustrate different stages in use of the assembly of Figure 1; Figure 7 is a sectional side elevation of a modified part of the assembly of Figure 1 or 2; and Figure 8 is a side elevation view of a nasal assembly in use.

With reference first to Figure 1, the assembly comprises a tube 1 and a mount device 2 at the machine end of the assembly.

The tube 1 is similar to a conventional endotracheal tube, being circular in section, being curved along its length to follow the anatomy of the patient and having an inflatable cuff 10 embracing the tube close to its patient end 11. The cuff 10 can be inflated or deflated via an inflation line 12 in the usual way. The machine end 13 of the tube 1 differs from conventional endotracheal tubes in that it is located within the mount 2 and is terminated by a hollow stopper 14 fixed securely within the end of the tube. The stopper 14 has a hollow bore 15 opening into the bore of the tube 1 and flaring outwardly at its machine end. The flared shape makes it easier to insert a suction catheter into the tube 1.The outer surface of the stopper 14, where it is inserted in the tube 1, is provided with barbed ribs 16, or similar surface formations, to ensure that the stopper cannot easily be removed. An annular flange 17 projects radially outwardly of the stopper 14 beyond the tube and forms a sliding seal with the inside of the mount 2.

The stopper 14' could be modified, as shown in Figure 2, so that it is formed with a cylindrical sleeve 18'. The outer surface of the sleeve 18' contacts, and is slidable along, the inside of the mount 2, thereby improving the seal with the mount.

The mount device 2 is moulded from a rigid plastics material and has a generally cylindrical shape. At its patient end, the mount 2 has a neck portion 20 of reduced diameter closely embracing the tube 1. One or more sealing rings 21 around the inner surface of the neck 20 contact the outer surface of the tube 1 and allow longitudinal displacement of the tube relative to the mount but prevent gas passing around the outside of the tube.

The central portion 22 of the mount 2 has an increased diameter with a smooth internal surface of circular section. The internal diameter of the central portion 22 is equal to the external diameter of the stopper 14 so that it can slide freely along the inside of the mount. The periphery of the flange 17 of the stopper 14 may be provided with a sealing rib or the like to improve the seal with the inside of the mount 2.

A flange 23 projects outwardly from the machine end of the central portion 22. The flange 23 is formed with slots, or the like, (not shown) by which a tape can be attached to the mount 2 and secured about the patient's head. Just forwardly of the flange 23, the wall of the mount 2 is thickened to form a strengthened bite guard region 25, which resists deformation caused by pressure from the patient's teeth.

The mount 2 is completed at the machine end by a 15mum male tapered connector 26.

which can make a mating connection with a female 15mum connector 40 (Figure 6) connected to ventilation tubing 41. Alternatively, the connector on the mount could be a female connector. The connector could be fixed or have a swivel mount enabling it to rotate about the axis of the mount.

Prior to use, the mount device 2 and tube 1 are supplied disassembled, with the stopper 14 loose. As shown in Figure 3, the tube 1 is inserted to the trachea 30 in the usual way, with the cuff 10 deflated, but it is only partially inserted until the patient end 11 is located through the vocal chords about 50 mm above the desired final location.

The mount 2 is then slid on the machine end of the tube 1, as shown in Figure 4, until its flange 23 lies against the lips of the patient. The machine end of the tube 1 is then trimmed in length to leave about 20mm protruding from the machine end of the mount 2, as shown in Figure 4.

The stopper 14 is then pushed firmly into the machine end of the tube 1 and the tube is pushed in by a total distance of about 50mm so that it lies about 30mm within the mount 2 and locates its patient end in the desired position, as shown in Figure 5.

The cuff 10 is then inflated, as shown in Figure 6, so that it contacts the wall of the trachea and secures the patient end of the tube 1 in the correct location. The connector 40 is pushed onto the connector 26 of the mount 2, so that the mount is connected to ventilation apparatus 42 via the ventilation tubing 41.

Ventilation gases supplied to the mount 2 pass through the stopper 14 and into the bore of the tube 1 to ventilate the patient. Leakage of gas from the mount 2 is prevented by the sealing rings 21 and by engagement of the periphery of the stopper 14 with the inside of the mount.

The tube 1 is effectively fixed in location at its patient end by the cuff 10 but has a range of movement at its machine end, as indicated by the two extreme positions of the stopper 14 shown in Figure 1. Thus, for example, if the angle of the patient's head should change so that the distance between his mouth and the location of the patient end of the tube changes, this would be accommodated by sliding of the machine end 13 of the tube 1 within the mount 2.

It is not essential for the tube 1 to seal with the mount 2 both at the sealing rings 21 and at the flange 17. Alternative seals are also possible, as shown in Figure 7. In this arrangement, the stopper 14 is replaced with a hollow, cylindrical bellows assembly 50. The bellows assembly 50 has a rigid tubular extension 51 at its patient end, which is pushed securely into the tube 1 after it has been cut to length. The machine end of the bellows assembly 50 has a fitting 52 sitting within the machine end of the mount 2. Between the extension 51 and the fitting 52, the assembly has a series of annular corrugations 53, which enable the two ends of the assembly 50 to move axially relative to one another, and hence enable the machine end of the tube 1 to move along the mount 2. A female connector (not shown) at the end of ventilation tubing is attached to the mount 2 by pushing it into the machine end of the mount and the fitting 52, so that it sandwiches the fitting securely between the connector and the inside of the mount. In alternative arrangements the fitting at the machine end of a bellows assembly could extend back around the outside of the mount, and a male ventilation connector could be fitted over this.

The invention is not confined to cuffed tubes but can also be used with uncuffed tubes. A modified form of the mount 2" could be used with a nasal tube 1", as shown in Figure 8, the mount being shaped to conform with the anatomy of the patient around the nose.

The assembly of the present invention reduces the risk of trauma to the patient by reducing the risk of the patient end of the tube being displaced.

Claims

1. A tracheal tube assembly comprising a tube and a mount device for securing where the tube emerges from the patient's body, wherein the machine end of the tube extends within the mount device, wherein the tube is slidable along the mount device.

and wherein the assembly has a seal between the tube and the mount device such that gas connection to the tube can be made by connection to the mount device and such that the machine end of the tube can move relative to the mount device during use.

2. A tracheal tube assembly according to Claim 1, wherein the seal includes a sliding seal between the patient end of the mount device and the outside of the tube.

3. A tracheal tube assembly according to Claim 2, wherein the sliding seal between the outside of the tube and the patient end of the mount device includes a sealing ring around the inside of the patient end of the mount device.

4. A tracheal tube assembly according to any one of the preceding claims, wherein the seal includes a sliding seal between the inside of the mount and the machine end of the tube.

5 A tracheal tube assembly according to Claim 4, wherein the sliding seal between the inside of the mount and the machine end of the tube is provided by a hollow stopper inserted in the machine end of the tube.

6. A tracheal tube assembly according to Claim 5, wherein the hollow stopper is retained in the machine end of the tube by means of barbed ribs on the stopper.

7. A tracheal tube assembly according to Claim 5 or 6. wherein the stopper has an external cylindrical sleeve, and wherein the outer surface of the cylindrical sleeve is a sliding seal with the inside of the mount device.

8. A tracheal tube assembly according to any one of the preceding claims, wherein the machine end of the tube has a flared opening to facilitate entry into the tube.

9. A tracheal tube assembly according to any one of Claims 1 to 3, wherein said seal includes a flexible seal extending between the mount device and machine end of the tube.

10. A tracheal tube assembly according to Claim 9, wherein said seal includes a bellows.

11. A tracheal tube assembly according to any one of the preceding claims, wherein the mount device has an outwardly-projecting flange, and wherein the flange has means for retaining a tape by which the assembly can be secured about the head of the patient.

12. A tracheal tube assembly according to any one of the preceding claims, wherein the mount device has a strengthened region along its length that serves as a bite guard.

13. A tracheal tube assembly according to any one of the preceding claims, wherein the mount device has a male connector at its machine end.

14. A tracheal tube assembly according to any one of the preceding claims, wherein the mount device has a swivel connector at its machine end.

1 5. A tracheal tube assembly substantially as hereinbefore described with reference to Figure 1 and Figures 3 to 6 of the accompanying drawings.

16. A tracheal tube assembly substantially as hereinbefore described with reference to Figure 1 and Figures 3 to 6, as modified by Figure 2 of the accompanying drawings.

17. A tracheal tube assembly substantially as hereinbefore described with reference to Figure 1 and Figures 3 to 6 as modified by Figures 7 and 8 of the accompanying drawings.

18. Any novel feature or combination of features as hereinbefore described.