GB2369061A

GB2369061A - A tube retainer device containing a conformable material for fixation to the teeth or gums

Info

Publication number: GB2369061A
Application number: GB0120972A
Authority: GB
Inventors: Giles Andrew Bishop
Original assignee: Smiths Group PLC
Current assignee: Smiths Group PLC
Priority date: 2000-09-13
Filing date: 2001-08-30
Publication date: 2002-05-22
Also published as: GB0022631D0; GB0120972D0

Abstract

A tube retainer device includes an elongate tray 1 containing a conformable material 14 and securing means 2 by which a tube can be secured to the tray. The tray 1 is bendable about its length so that it can be shaped to fit on a patient's teeth or gums (Fig. 6) with the conformable material 14 moulding about the teeth or gums to provide a secure fixation. The tube may be an endotracheal tube. The tray may have a removable cover strip 15 which protects the conformable material 14 before use. The securing means 2 may be a catch and may have a hinged arm adapted to embrace the tube. The conformable material 14 may be a putty-like material such as dental impression material or may be provided as two substances which are mixed in the tray such as an alginate and water. The tray may be axially compressible to enable mixing of the conformable material prior to use.

Description

MEDICO-SURGICAL RETAINERS This invention relates to medico-surgical retainers.

The invention is more particularly concerned with retainers for retaining in place an endotracheal tube or similar device extending through a patient's mouth.

Endotracheal tubes are used to supply gases to and from the trachea of a patient. The patient end of the tube is located in the trachea below the vocal folds and often has an inflatable cuff or balloon forming a seal between the outside of the tube and the trachea. The machine end of the tube projects through the patient's mouth where it may be left open or connected to a ventilation system. The machine end of the tube is usually fixed in position by means of adhesive tape wrapped around the tube where it emerges from the mouth, the tape being secured around the head of the patient. Alternatively, a flange extending from a coupling may be used, which is attached with the machine end of the tube and fastened by means of a tape wrapped around the patient's head.

These prior arrangements may work satisfactorily in some circumstances for short periods but, in prolonged use, they may lead to skin damage, especially around the mouth.

Similar problems exist with other devices extending through the mouth, such as feeding tubes, sensor cables or the like. US5638811 describes a respiratory mouthpiece that fits between the patient's teeth. US5941246 describes a device having a tray that fits around the upper teeth and that has a clip for securing a tube. In US5626128 there is proposed a tube fixation device located within the mouth and secured to the hard palate by means of a dental fixative. One problem with such an arrangement is the need for many different sizes for different patients and the need to prepare and handle an adhesive.

It is an object of the present invention to provide an alternative retainer for retaining in place a tube extending through the mouth of a patient.

According to one aspect of the present invention there is provided a tube retainer device including an elongate tray containing a conformable material, and securing means by which a tube can be secured with the tray, the tray being bendable about its length so that it can be shaped to fit on the patient's teeth or gums with the conformable material moulding about the teeth or gums to provide a secure fixation.

The tray preferably has a cover strip protecting the conformable material before use, the strip being removable from the tray. The tray may have a concertina construction an may be axially compressible. The tray preferably includes a key formation to key into the conformable material and retain it in the tray. The securing means is preferably a catch, which may have a hinged arm adapted to embrace the tube. The securing means may be located closer to one end of the tray. The conformable material is preferably a putty-like material and may be a dental impression material. The conformable material before use is preferably provided as two different substances separated from one another, the substances being mixed together before use to form the conformable material. One substance may be a powder, such as an alginate, and the other substance may be a liquid, such as water. The liquid may be contained in a compressible bulb removably connected with the tray.

According to another aspect of the present invention there is provided a tube retainer device including an elongate tray containing a conformable material, securing means by which a tube can be secured with the tray, and a strip secured across an open face of the tray to contain and protect the conformable material before use, the strip being removable such that the face of the tray can be exposed for fitting onto the teeth or gums of the patient.

According to a third aspect of the present invention there is provided a tray containing a material for conforming about the teeth or gums of a patient, the tray having a removable cover strip for containing the material, and the tray being bendable about its length to the shape of the gums and being compressible axially such as to enable mixing of the material prior to use.

According to a fourth aspect of the present invention there is provided a method of preparing a device of the kind for securing a tube in the mouth of a patient, the device comprising a tray adapted to fit on the patient's teeth or gums and having securing means for retaining the tube, the tray containing a powder substance and the method including the steps of adding a liquid to the powder substance, compressing the tray axially repeatedly to mix the liquid and powder to form a conformable, putty-like material, removing a cover member from the tray to expose the conformable material along the length of the tray and bending the tray into a horse-shoe shape prior to insertion into the mouth, such that the conformable material holds the tray in position on the teeth or gums.

A tube retainer 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 perspective view of the retainer before use; Figure 2 is an enlarged perspective view of a section through the tray of the retainer with the cover strip removed; Figure 3 is a perspective view illustrating mixing of the contents of the retainer tray; Figure 4 shows the cover strip being removed; Figure 5 shows the retainer tray being bent to shape; Figure 6 is a perspective view of the retainer fitted over the teeth; Figure 7 is a view of the patient's mouth with an endotracheal tube protruding; Figure 8 is an enlarged perspective view showing the catch by which the tube is secured with the retainer; and Figure 9 is a perspective view illustrating an alternative way of securing the tube with the retainer.

With reference first to Figures 1 and 2, the retainer includes an elongate tray 1 with securing means in the form of a catch 2 on its lower surface and a bulb 3 connected with the tray at one end.

The tray 1 is moulded of a plastics material and has a U-shape in section, with walls 10 and a base 11, which are pleated or of concertina shape, apart from a central region 12, so that the ends of the tray are compressible axially. Inside the tray 1, the base 11 has a pair of projecting ribs 13, the purpose of which will become apparent later. The catch 2 is located closer to one end of the tray 1 so that a tube can be secured to either the right or left of the mouth depending on the user's preference. Alternatively, the catch could be located centrally.

The catch 2 may take various different forms but in the present example, as shown most clearly in Figure 8, it is formed integrally as a part of the tray and comprises a rigid curved arm 20 formed with ribs 21 on its inner surface. At one end, the arm 20 is connected with the tray 1 by a flexible web or living hinge 22, the other end of the arm having an aperture 23, which receives a projection 24 on the tray, so that the arm snaps closed when pushed down.

The catch 2 also includes a resilient pad 25 secured to the tray 1 beneath the arm 20 to accommodate tubes of different diameters.

The tray I contains a material 14, which, when prepared for use, is a conformable, putty-like substance. In particular, the material 14 is of the kind used for taking dental impressions. Prior to use, the material in the tray 1 is in powder form, such as an alginate powder, which may be flavoured or contain a fluoride, antibiotic or other additive. The tray 1 is covered before use by a flexible cover strip 15, which can be peeled off from one end when necessary. The bulb 3 is compressible and is connected to one end of the tray by a narrow tube 30. The bulb 3 contains water, the internal diameter of the tube 30 being such that the water does not flow out of the bulb until it is squeezed. Prior to use, the tray 1 and bulb 3 are contained in a protective packaging, not shown.

To use the device, the bulb 3 is first squeezed, as shown in Figure 1, so that the water it contains flows via the tube 30 into the tray 1. The bulb 3 is then snapped off. Next, the user compresses the tray 1 axially, as shown in Figure 3, by pushing opposite ends of the tray towards one another. The user alternately compresses and extends the tray 1, by pushing and pulling opposite ends, like a concertina, so that the powder contents of the tray are mixed thoroughly with the water and the substance becomes the conformable, putty-like material 14.

The water need not be contained in a separate bulb, it could be contained within the tray in, for example, a bag that is ruptured as a result of squeezing the tray. Alternatively, the water could be separated from the powder by a membrane that could be slid out by the user to allow the two to mix. Other two-part substances could be used.

After mixing, the user peels off the cover strip 15, as shown in Figure 4, and bends the tray 1 into a horse-shoe shape to fit the teeth or gums of the patient, as shown in Figure 5.

Figure 5 shows the tray 1 inverted, with the open side of the tray facing down for use with the lower set of teeth. The ribs 13 within the tray 1 key into the material 14 to ensure that it remains in the tray. The device, with the catch 2 facing upwards, is then inserted into the patient's mouth and the tray 1 is pressed down firmly onto the lower set of teeth 50, or the lower gums, of the patient, so that the material 14 moulds about the teeth or gums to provide a secure retention. An endotracheal tube 40, which may have been previously inserted in the usual way, is placed on the pad 25 of the catch 2 and the arm 20 of the catch is pushed down to snap closed and secure the tube in position extending from the patient's mouth, as shown in Figure 7. Instead of the mechanical catch 2, the securing means 2'could be provided in the

manner shown in Figure 9. In this arrangement, the tray 1'has a tube receptacle 20'of semicircular section with slots 21'through it into the interior of the tray so that the material 14' oozes through the slots and provides a secure retention with the tube 40'.

The device could instead be secured to the upper teeth or gums, without the need for any modification. It will be appreciated that the device could be used to secure any elongate device extending through the mouth, and is not restricted to endotracheal tubes. For example, the device could be used to secure a laryngeal mask or a cable or probe in position.

The present invention enables a small number of different size devices to be used to fit a variety of different patients. The invention also avoids the need for the user to handle or measure out material or to transfer material between receptacles.

Claims

CLAIMS 1. A tube retainer device including an elongate tray containing a conformable material, and securing means by which a tube can be secured with the tray, and wherein the tray is bendable about its length so that it can be shaped to fit on the patient's teeth or gums with the conformable material moulding about the teeth or gums to provide a secure fixation.
2. A device according to Claim 1, wherein the tray has a cover strip protecting the conformable material before use, and wherein the strip is removable from the tray.
3. A device according to Claim 1 or 2, wherein the tray has a concertina construction.
4. A device according to any one of the preceding claims, wherein the tray is axially compressible.
5. A device according to any one of the preceding claims, wherein the tray includes a key formation to key into the conformable material and retain it in the tray.
6. A device according to any one of the preceding claims, wherein the securing means is a catch.
7. A device according to Claim 6, wherein the catch has a hinged arm adapted to embrace the tube.
8. A device according to any one of the preceding claims, wherein the securing means is located closer to one end of the tray.
9. A device according to any one of the preceding claims, wherein the conformable material is a putty-like material.
10. A device according to any one of the preceding claims, wherein the material is a dental impression material.
11. A device according to any one of the preceding claims, wherein the conformable material before use is provided as two different substances separated from one another, and wherein the substances are mixed together in the tray before use to form the conformable material.
12. A device according to Claim 11, wherein one substance is a powder and the other is a liquid.
13. A device according to Claim 12, wherein the powder is an alginate and the liquid is water.
14. A device according to Claim 12 or 13, wherein the liquid is contained in a compressible bulb removably connected with the tray.
15. A tube retainer device including an elongate tray containing a conformable material, securing means by which a tube can be secured with the tray, and a strip secured across an open face of the tray to contain and protect the conformable material before use, wherein the strip is removable such that the face of the tray can be exposed for fitting onto the teeth or gums of the patient.
16. A tube retainer device substantially as hereinbefore described with reference to the accompanying drawings.
17. A tray containing a material for conforming about the teeth or gums of a patient, wherein the tray has a removable cover strip for containing the material, and wher the tray is bendable about its length to the shape of the gums and is compressible axially such as to enable mixing of the material prior to use.
18. A tray substantially as hereinbefore described with reference to the accompanying drawings.
19. A method of preparing a device of the kind for securing a tube in the mouth of a patient, the device comprising a tray adapted to fit on the patient's teeth or gums and having securing means for retaining the tube, wherein the tray contains a powder substance and wherein the method includes the steps of adding a liquid to the powder substance, compressing the tray axially repeatedly to mix the liquid and powder to form a conformable, putty-like material, removing a cover member from the tray to expose the conformable material along the length of the tray and bending the tray into a horse-shoe shape prior to insertion into the mouth, such that the conformable material holds the tray in position on the teeth or gums.
20. A method substantially as hereinbefore described with reference to the accompanying drawings.
21. Any novel and inventive feature or combination of features as hereinbefore described.