JP2022090726A - Medical assistive device - Google Patents

Abstract

To provide a medical assistive device having a simple configuration and capable of reliably detecting insertion of a trachea introduction member into the trachea.SOLUTION: A medical assistive device 1 comprises a cylindrical connector 10 for connecting a trachea introduction member, and airflow detecting means 20 having a whistle part 21. The cylindrical connector includes: a first connecting part 11 having a first connection 11a for connecting the trachea introduction member to one end side of a first flow path 11h; a second connecting part 12 connected to the first connecting part, having a second flow path 12h communicated with the first flow path and having a second connection 12a for connecting airflow supply means; a third connecting part 13 connected to the first connecting part, having a third flow path 13h communicated with the first flow path, and having a third connection 13a for connecting the airflow detecting means; and a fourth connecting part 14 connected to the other end side of the first flow path in the first connecting part and having a fourth connection 14a for connecting a surgical instrument 200. The airflow detection means detects introduction of a tip end of the trachea introduction member into the trachea, by sound from the whistle part.SELECTED DRAWING: Figure 1

Description

The present invention relates to a medical assist device that informs whether or not a tracheal introduction member for ventilation of a patient is correctly introduced into the trachea.

Conventionally, for example, when general anesthesia is applied to a patient during surgery, a tracheal tube is inserted into the trachea during general anesthesia, and oxygen is supplied to the lungs through the tracheal tube. However, the entrance of the trachea of the human body and the entrance of the esophagus are adjacent to each other, and it is very difficult to distinguish between them from the outside. Therefore, the operator may mistakenly insert the tracheal tube into the esophagus. Moreover, the condition of such esophageal intubation is often unnoticed, which may impose a burden on the patient. Therefore, various studies have been made on methods for preventing esophageal intubation of the tracheal tube.

For example, Patent Document 1 describes whether or not a tracheal introduction member for ventilation of a patient, such as a tracheal tube or a piercing device, is correctly introduced into the trachea with a relatively simple device configuration. Auxiliary equipment is listed.

Japanese Patent No. 6245684

Medical assistive devices that assist the introduction of such tracheal introduction members into the trachea become difficult to handle when the structure becomes complicated. It is desired that it can be inserted into the tube.

The present invention has been made to solve the above-mentioned problems, and an object of the present invention is to provide a medical auxiliary device having a simple structure and capable of reliably detecting the insertion of a tracheal introduction member into the trachea. And.

In order to solve the above problems, the present invention is a medical auxiliary device for detecting whether or not a tracheal introduction member for ventilation of a patient is correctly introduced into the trachea, and connects the tracheal introduction member. The tubular connector comprises a tubular connector and an airflow detecting means having a whistle portion, and the tubular connector has a first flow path extending in a first direction and is provided on one end side of the first flow path. A first connection portion having a first connection port for connecting a trachea introduction member, a second flow path connected to the first connection portion and communicating with the first flow path, and a second flow path connecting the air flow supply means. A second connection portion having two connection ports, a third flow path connected to the first connection portion and communicating with the first flow path, and a third connection port for connecting the airflow detecting means. A second connection portion having a fourth connection port connected to the third connection portion and the other end side of the first connection portion opposite to the one end side of the first flow path and connecting a surgical tool to be inserted into the trachea introduction member. The airflow detecting means has four connection portions, and the airflow detecting means has a state in which the tip of the tracheal introduction member is correctly introduced into the trachea and is open, and a state in which the tracheal introduction member is not introduced into the trachea and its tip is not introduced. It is characterized in that the closed state is detected by distinguishing it from the sound from the whistle portion.

According to the present invention, it is possible to provide a medical auxiliary device having a simple structure and capable of reliably detecting the insertion of a tracheal introduction member into the trachea.

It is a perspective view which illustrates the medical assist device which concerns on this embodiment. It is a side view which illustrates the medical assist device which concerns on this embodiment. It is sectional drawing of the cylindrical connector of the medical auxiliary instrument which concerns on this embodiment. It is a schematic diagram which shows the example of the trachea introduction member attached to the medical auxiliary instrument which concerns on this embodiment. It is a schematic diagram which illustrates the determination method by the medical assist device which concerns on this embodiment. It is a schematic diagram which illustrates the determination method by the medical assist device which concerns on this embodiment. It is a schematic diagram which illustrates the determination method by the medical assist device which concerns on this embodiment. It is a perspective view which shows the example of the other trachea introduction member attached to the medical auxiliary instrument which concerns on this embodiment. It is a schematic diagram which illustrates the determination method by the medical assist device which concerns on this embodiment. It is a schematic diagram which illustrates the determination method by the medical assist device which concerns on this embodiment. It is a schematic diagram which illustrates the determination method by the medical assist device which concerns on this embodiment.

Hereinafter, embodiments of the present invention will be described with reference to the drawings.

(Medical aid)
FIG. 1 is a perspective view illustrating the medical auxiliary device according to the present embodiment.
FIG. 2 is a side view illustrating the medical auxiliary device according to the present embodiment.
FIG. 3 is a cross-sectional view of a tubular connector of the medical auxiliary device according to the present embodiment.
Note that FIGS. 1 to 3 show a state in which the airflow detecting means 20 is separated from the third connecting portion 13 for convenience of explanation.

In the present embodiment, the medical auxiliary device 1 is a device for detecting whether or not the tracheal introduction member for ventilation of the patient is correctly introduced into the trachea. The medical auxiliary device 1 includes a tubular connector 10 for connecting a tracheal introduction member, and an airflow detecting means 20 having a whistle portion 21.

The tubular connector 10 has a first connection portion 11, a second connection portion 12, a third connection portion 13, and a fourth connection portion 14. That is, the tubular connector 10 has a so-called four-pronged structure and is made of synthetic resin. As the tubular connector 10, the first connection portion 11, the second connection portion 12, the third connection portion 13 and the fourth connection portion 14 may be integrally molded, or at least one of these may be molded separately. It may be ready to be assembled.

As the material of the tubular connector 10, a synthetic resin having excellent injection moldability is preferable, and for example, polyvinyl chloride, polycarbonate, ABS resin, polypropylene, polyethylene, polystyrene, fluororesin, polyethylene terephthalate, methyl methacrylate, polyamide, etc. Polyetherstyrene, polysulfone, polyurethane, ethylene / vinyl acetate copolymer resin, silicon resin, thermoplastic elastomer, and liquid silicon rubber are desirable.

The first connection portion 11 corresponds to the main body portion of the tubular connector 10 and is provided in a cylindrical shape so that the operator can easily hold it. The first connection portion 11 is also used as a holding portion for the tubular connector 10. The first connection portion 11 has a first flow path 11h extending in the first direction D1. A first connection port 11a for connecting a trachea introduction member is provided on one end 111 side of the first flow path 11h.

The tracheal intubation member connected to the first connection port 11a is a commercially available member such as a tracheal tube or a puncture device (ring-shaped thyroid puncture device) for piercing and inserting into the trachea from the front surface of the neck to secure the airway. Can be exemplified. Therefore, it is preferable that the shape and size of the first connection port 11a are designed according to the type and standard of the tracheal intubation member.

The second connection portion 12 is a cylindrical portion connected to the first connection portion 11. The second connection portion 12 has a second flow path 12h communicating with the first flow path 11h of the first connection portion 11, and has a second connection port 12a for connecting the airflow supply means.

The airflow supply means connected to the second connection port 12a is not particularly limited. The airflow supply means may exemplify, for example, one or more of a ventilator, an automatic or manual oxygen bag, an oxygen cylinder, an oxygen pipe, an oxygen flow meter, a ventilator, an anesthesia machine, and the like (these). (Including the connection tube attached to), oxygen and other airflow can be supplied continuously or intermittently. Specifically, for example, a mode in which the airflow from the ventilator is supplied from the second connection port 12a of the second connection portion 12 to the second flow path 12h via the connection tube is exemplified.

As a particularly preferable air flow supply means, a ventilator capable of high-frequency ventilation by connecting to an anesthesia machine, a respirator, or the like can be exemplified. High frequency ventilation (HFV) is artificial respiration that ventilates a small amount of one-time ventilation (approximately 1 to 4 ml / kg of body weight) at a rate that greatly exceeds the physiological breathing rate (approximately 1 to 40 Hz). It is a general term for. High-frequency ventilation includes, for example, high-frequency positive pressure ventilation (HFPPV), high-frequency jet ventilation (HFJV), high-frequency vibration ventilation (HFO), and the like. When high frequency ventilation is adopted, the detection sensitivity by the whistle portion 21 can be further improved. The airflow from the airflow supply means may be oxygen itself or a mixture of oxygen and another gas. Further, a gaseous anesthetic or the like may be mixed.

The second flow path 12h of the second connection portion 12 is provided so as to communicate with the first flow path 11h in the middle of the first flow path 11h of the first connection portion 11. As a result, the airflow supplied to the second flow path 12h is sent to the first flow path 11h from the middle of the first flow path 11h (between one end 111 and the other end 112 of the first connection portion 11).

Further, the communication angle of the second flow path 12h with respect to the first flow path 11h is an acute angle at the angle on the other end 112 side of the first flow path 11h (angle θ1 shown in FIG. 3). The angle θ1 is, for example, about 45 degrees. Since the angle θ1 is an acute angle, the air flow can be rationally sent from the second flow path 12h to the first flow path 11h.

It is preferable that the outer periphery of the second connecting portion 12 is provided with a wave shape for preventing the connection tube of the airflow supply means from being inserted.

The third connection portion 13 is a cylindrical portion connected to the first connection portion 11. The third connection portion 13 is connected to the first connection portion 11 at a position opposite to the second connection portion 12, for example. The third connection portion 13 has a third flow path 13h that communicates with the first flow path 11h of the first connection portion 11, and has a third connection port 13a that connects the airflow detecting means 20.

The third flow path 13h of the third connection portion 13 is in the middle of the first flow path 11h of the first connection portion 11, and the connection position thereof is from the connection position with the second flow path 12h in the first flow path 11h. Is proximal to the other end 112 of the first flow path 11h.

Further, the communication angle of the third flow path 13h with respect to the first flow path 11h is an acute angle at the angle on the other end 112 side of the first flow path 11h (angle θ2 shown in FIG. 3). The angle θ2 is, for example, about 25 degrees. The connection position of the third flow path 13h with the first flow path 11h is proximal to the other end 112 of the connection position of the second flow path 12h with the first flow path 11h, and the third flow path 13h. Since the angle θ2 is an acute angle, it is possible to prevent the airflow sent from the second flow path 12h to the first flow path 11h from directly flowing into the third flow path 13h. Further, as will be described later, when the airflow to the trachea introduction member is cut off, the airflow can be rationally sent from the first flow path 11h to the third flow path 13h.

The fourth connection portion 14 is connected to the other end 112 side of the first connection portion 11 opposite to the one end 111 side of the first flow path 11h. The fourth connection portion 14 has a fourth connection port 14a for connecting the surgical tool 200 to be inserted into the tracheal introduction member. That is, the first connection portion 11 and the fourth connection portion 14 are arranged linearly (coaxially) with each other in the first direction D1. As a result, the communication is linearly communicated in the first direction D1 from the fourth connection port 14a to the first connection port 11a via the first flow path 11h.

The surgical tool 200 connected to the fourth connection port 14a of the fourth connection portion 14 can exemplify commercially available members such as needles, stylets, and video laryngoscopes. When the surgical tool 200 is connected to the fourth connection port 14a, the surgical tool 200 can be brought into close contact with the fourth connection port 14a. As a result, the airflow sent to the first flow path 11h is suppressed from leaking to the outside from the fourth connection port 14a.

A spout 15 may be detachably attached to the fourth connection port 14a of the fourth connection portion 14. The spout 15 is provided with a through hole 15h, and by inserting the surgical tool 200 into the through hole 15h with the spout 15 attached to the fourth connection port 14a, the fourth connection portion 14 to the first connection portion are provided. The surgical tool 200 can be inserted into 11. The spout 15 is configured so that when the surgical tool 200 is inserted into the through hole 15h, the surgical tool 200 and the spout 15 can be brought into close contact with each other.

The through hole 15h of the spout 15 is formed of a highly flexible material (for example, an elastomer resin) that can correspond to the cross-sectional diameter of the surgical tool 200, and the flexibility of the spout 15 when the surgical tool 200 is inserted is used. The surgical tool 200 and the spout 15 are in close contact with each other to prevent airflow from leaking from the through hole 15h.

Further, when the surgical tool 200 is inserted into the through hole 15h of the spout 15, the sealing function can be maintained even if the surgical tool 200 moves three-dimensionally. The spout 15 may have a flexible and flexible shape, for example, a substantially bellows shape. When such a spout 15 is provided, the adhesion between the fourth connection portion 14 and the surgical tool 200 is not necessary.

When the surgical tool 200 is not inserted into the through hole 15h of the spout 15, the through hole 15h can be closed by the plug 151. By closing the through hole 15h with the plug 151, it is possible to prevent the airflow from leaking from the through hole 15h of the spout 15 when the surgical tool 200 is not inserted.

The airflow detecting means 20 has a whistle portion 21 and a mounting portion 22 for connecting the whistle portion 21 to the third connection port 13a of the third connection portion 13. The structure of the whistle portion 21 is not particularly limited as long as it emits a sound when an air flow passes through it. Specifically, for example, the whistle portion 21 has a flake-shaped lead that vibrates and emits a sound, or has an air lead structure, and the air (air flow) is narrowed into a beam shape and vibrated against an edge to make a sound. It is possible to exemplify what causes the above.

The sound emitted by the whistle unit 21 should have a frequency that can be detected by the operator at an airflow supply flow rate of 6 L / min and 9 mmHg by the airflow supply means, and in particular, according to an equal loudness curve that is optimal for the human ear's hearing, 2000 Hz or higher. It is optimal that the sound pressure is 90 dB or more at a frequency of 4000 Hz or less.

Further, the attachment portion 22 of the whistle portion 21 may be configured so that the whistle portion 21 can be rotatably attached to the third connection port 13a of the third connection portion 13. As a result, the whistle portion 21 can be rotated to a position where the operator can easily hear the sound emitted from the whistle portion 21.

In the medical auxiliary device 1 having such a configuration, the airflow detecting means 20 has a state in which the tip of the tracheal introduction member is correctly introduced into the trachea and is open, and a state in which the tracheal introduction member is not introduced into the trachea. The state in which the tip is closed is detected by distinguishing it from the sound from the whistle portion 21.

(Judgment method using medical aids)
Next, a determination method using the medical auxiliary device 1 according to the present embodiment will be described.
FIG. 4 is a schematic view showing an example of a trachea introduction member attached to the medical auxiliary device according to the present embodiment.
FIG. 4 shows a case where the trachea tube M is used as the trachea introduction member 100.
The tracheal tube M is, for example, a tube that is inserted into the trachea Q from the mouth of a patient who needs respiratory management for anesthesia or intensive care and sends oxygen or the like. A cuff K that can be inflated by injecting air may be provided on the tip end side of the tracheal tube M. A metal or plastic stylet J that retains the shape of the tracheal tube M is previously inserted into the tracheal tube M. Stylet J is an example of the surgical tool 200.

The rear end of the tracheal tube M is connected to the first connection port 11a of the first connection portion 11. This connection may be made via a connector (not shown). The stylet J is inserted from the fourth connection portion 14 to the tracheal tube M through the first flow path 11h of the first connection portion 11.

The stylet J is inserted into the fourth connection portion 14 through the through hole 15h of the spout 15. The spout 15 is attached to the fourth connection portion 14, and the fourth connection port 14a of the fourth connection portion 14 is closed by the spout 15, and the stylet J and the spout 15 are brought into close contact with each other from the through hole 15h. Prevents airflow from leaking.

5 to 7 are schematic views illustrating a determination method using the medical auxiliary device according to the present embodiment.
Here, a method of determining whether or not the tracheal tube M as the tracheal introduction member 100 is correctly introduced into the trachea Q of the patient is exemplified by using the medical auxiliary device 1 exemplified in FIG. ..

As illustrated in FIG. 5, when the medical auxiliary device 1 according to the present embodiment and the tracheal tube M as the trachea introduction member 100 are connected to treat the patient, the operator performs oxygen from the airflow supply means S. Continue to supply. At this time, since the airflow supplied from the second flow path 12h to the first flow path 11h reaches the tracheal tube M and continues to be discharged from the tip, the airflow sent from the first flow path 11h to the third flow path 13h is It is weak and no sound is generated from the whistle portion 21.

Then, the operator expands the patient's larynx using the laryngoscope 300, and inserts the tracheal tube M through the mouth while checking the approach path. If the tip of the tracheal tube M is not closed at the stage of inserting the tracheal tube M, no sound is generated from the whistle portion 21.

On the other hand, when the tip of the tracheal tube M hits a wall near the neck (so that the tip is closed) and the amount of airflow discharged from the tip decreases, the internal pressure of the first flow path 11h increases and the second flow The airflow supplied from the road 12h to the first flow path 11h flows into the third flow path 13h. Sound is generated from the whistle portion 21 by the air flow flowing into the third flow path 13h. The operator can grasp that the amount of airflow discharged from the tip of the tracheal tube M is weakened by the sound generated from the whistle portion 21.

The operator proceeds to insert the tracheal tube M while confirming the presence or absence of sound generated from the whistle portion 21. Then, as illustrated in FIG. 6, when the tip of the tracheal tube M is appropriately introduced into the trachea Q, the tip of the tracheal tube M remains open in the trachea Q. Therefore, as oxygen is supplied into the trachea Q, oxygen continues to flow into the lungs. As a result, the airflow enough to generate sound from the whistle portion 21 does not flow into the third flow path 13h, and the state in which the sound from the whistle portion 21 is not generated is maintained.

On the other hand, as illustrated in FIG. 7, when the tip of the tracheal tube M is inserted into the esophagus R instead of the trachea Q, the amount of airflow discharged from the tip of the tracheal tube M is higher than when it is inserted into the trachea Q. Is reduced. That is, because the stomach is bag-shaped, it cannot send as much oxygen as the lungs. As a result, the internal pressure of the first flow path 11h increases, and the airflow supplied from the second flow path 12h to the first flow path 11h flows into the third flow path 13h. Sound is generated from the whistle portion 21 by the air flow flowing into the third flow path 13h.

As described above, in the medical auxiliary device 1, when the tip of the tracheal tube M is appropriately introduced into the trachea Q, the whistle portion 21 is in a muffled state, and the tip of the trachea tube M is inside the trachea Q. The whistle portion 21 emits a sound when the tip is blocked or inserted into the esophagus R by hitting a wall or the like near the neck without reaching. Therefore, the operator can determine the state of the tip of the tracheal tube M by the generation of the sound of the whistle portion 21.

Then, after the tracheal tube M is inserted to an appropriate position in the trachea Q, the stylet J inserted from the fourth connection portion 14 is pulled out. After that, air is sent to the cuff K to inflate it, and the tracheal tube M is fixed in the trachea Q. When the introduction of the tracheal tube M into the trachea Q is completed, the oxygen released from the tip of the tracheal tube M can be immediately supplied into the patient's body.

Here, in the present embodiment, in order to distinguish whether or not the sound of the whistle portion 21 is generated depending on whether the tip of the tracheal tube M is inserted into the esophagus R or the trachea Q, the whistle portion 21 is used in advance. You can set the pressure at which the sound starts to be generated. That is, the pressure of the third flow path 13h when the tip of the tracheal tube M is inserted into the esophagus R is relatively higher than the pressure of the third flow path 13h when the tip of the trachea tube M is inserted into the trachea Q. If the pressure at which the sound of the whistle portion 21 starts to be generated is set with the pressure difference as a threshold value, the difference between the two can be determined by the presence or absence of the sound of the whistle portion 21.

As described above, in the medical auxiliary device 1, when the tracheal tube M is properly inserted into the trachea Q, the whistle portion 21 is in a muffled state, and the tracheal tube M is intubated into the esophagus R or a wall. When the tip is blocked due to such a hit, the whistle portion 21 emits a sound. That is, it is notified that the whistle portion 21 makes a sound to indicate that the esophagus is intubated or the tip is blocked. Therefore, when the operator determines that the esophageal intubation or the tip is blocked when the sound is generated from the whistle portion 21, the tracheal tube M is pulled out and the sound from the whistle portion 21 is heard again. It is possible to confirm that the sound is muted and insert it into the trachea Q by changing the insertion position. If the tracheal tube M can be inserted into the trachea Q, it can be determined that the tracheal tube M has been properly inserted into the trachea Q because the sound of the whistle portion 21 is maintained in a mute state.

The medical auxiliary device 1 according to the present embodiment is provided with an airflow detecting means 20 having a whistle portion 21 in a tubular connector 10, and is used in a state where the airflow from the airflow supply means S is supplied. Therefore, the supply of oxygen to the lungs and the confirmation of the insertion position of the tracheal tube M can be simultaneously realized by the air flow flowing out from the tip of the tracheal tube M. Further, the whistle section 21 can directly detect whether or not the air flow (oxygen) is appropriately supplied to the patient by turning on / off the sound of the whistle section 21 accompanying the flow of the air flow. Therefore, no special operation is required, and the state of esophageal intubation can be avoided only by paying attention to the sound emitted from the whistle portion 21, so that the operator's work load is small and there is a risk of operation error. There is little sex.

As described above, in the medical auxiliary device 1 according to the present embodiment, for example, as compared with the conventional device for detecting the amplitude of the frequency and the reflection of the sound wave, the tracheal tube M is simply and surely correctly inserted in the trachea. Since it is possible to determine whether or not the device is inserted into the device and the structure of the device is relatively simple, the manufacturing cost can be kept low and the maintenance burden can be reduced.

(Example using other trachea introduction members)
Next, an example using another trachea introduction member will be described.
FIG. 8 is a perspective view showing an example of another tracheal introduction member attached to the medical auxiliary device according to the present embodiment.
FIG. 8 shows a case where a cricothyroid puncturing device E provided with a needle N is used as the trachea introduction member 100.

Here, for the cricothyroid puncturing device E (referred to as a tracheostomy cannula or the like), for example, a commercially available product such as "Quick Track" manufactured by Smith Medical Japan can be appropriately used. The cricothyroid puncturing device E is provided with a substantially cylindrical cannula Y and a hollow, conical needle N inside the cannula Y. The tip of the cannula Y serves to secure the airway by being placed in the body after the needle N is punctured into the cricothyroid muscle.

A hose H is connected to the rear end of the cricothyroid puncturing device E instead of a syringe, and this hose H is connected to the first connection port 11a of the first connection portion 11. As a result, the first flow path 11h of the first connection portion 11 and the needle N can be communicated with each other. Then, an air flow supply means (ventilator) is connected to the second connection port 12a of the second connection portion 12 of the tubular connector 10.

Further, a surgical tool can be inserted into the fourth connection portion 14 as needed. Note that FIG. 8 shows an example in which the surgical tool 200 is not inserted into the fourth connection portion 14. When the surgical tool 200 is not inserted, the spout 15 is attached to the fourth connection port 14a of the fourth connection portion 14, and the plug 151 is used to prevent airflow leakage.

9 to 11 are schematic views illustrating a determination method using the medical auxiliary device according to the present embodiment.
Here, an example of a method of determining whether or not the cricothyroid puncture device E as the trachea introduction member 100 is correctly introduced into the trachea Q of the patient by using the medical auxiliary device 1 exemplified in FIG. is doing.

As illustrated in FIG. 9, when the medical auxiliary device 1 according to the present embodiment and the cricothyroid piercing device E as the trachea introduction member 100 are connected to treat the patient, the operator is the airflow supply means. Continue to supply oxygen from S. At this time, the airflow supplied from the second flow path 12h to the first flow path 11h reaches the cricothyroid puncturing device E and continues to be discharged from the needle N, so that the airflow is continuously discharged from the first flow path 11h to the third flow path 13h. The airflow sent is weak, and no sound is generated from the whistle portion 21.

Then, the operator continues to supply the airflow from the airflow supply means S, punctures the needle N together with the cannula Y with the cannula Y in a state where no sound is generated at the whistle portion 21, and pushes the needle N into the tracheal Q direction. At this time, as illustrated in FIG. 10, in the process of penetrating the needle N through the cricothyroid muscle C, the tip of the needle N is closed by the soft tissue near the neck and the flow of oxygen supplied is stagnant. As a result, the internal pressure of the first flow path 11h increases, and the airflow supplied from the second flow path 12h to the first flow path 11h flows into the third flow path 13h. Sound is generated from the whistle portion 21 by the air flow flowing into the third flow path 13h. Here, sound is temporarily generated from the whistle portion 21 even when the operation is proceeding normally.

Then, as illustrated in FIG. 11, when the needle N penetrates the cricothyroid membrane C and the tip is appropriately introduced into the trachea Q, the tip of the needle N is released in the trachea Q. Therefore, oxygen is supplied into the trachea Q, and the oxygen continues to flow into the lungs. As a result, the airflow sent to the third flow path 13h is weakened, and no sound is generated from the whistle portion 21.

On the other hand, when the needle N is punctured into the cricothyroid muscle C, if the tip of the needle N enters the subcutaneous soft tissue or the like and does not reach the inside of the trachea Q, the tip of the needle N is obstructed (Fig. The state illustrated in 10), the flow of supplied oxygen is stagnant, and the state in which sound is generated from the whistle portion 21 continues.

That is, the sound from the whistle portion 21 is not generated before the needle N is punctured, and when the needle N is punctured into the cricothyroid membrane C in this state, the sound is temporarily generated from the whistle portion 21. After that, when the needle N is inserted and the tip of the needle N penetrates the cricothyroid membrane C and is appropriately introduced into the trachea Q, the sound from the whistle portion 21 disappears. On the other hand, while the tip of the needle N is not properly introduced into the trachea Q, the sound from the whistle portion 21 continues to be emitted.

As described above, in the medical auxiliary device 1, when the needle N of the annular thyroid puncturing device E is introduced into the trachea Q, the whistle portion 21 is in a muffled state, and the needle N is inside the trachea Q. If it has not been reached, the whistle portion 21 makes a sound. Therefore, the operator can determine that the needle N has not yet reached the inside of the trachea Q due to the generation of the sound of the whistle portion 21. When the introduction of the needle N into the trachea Q is completed, the sound of the whistle portion 21 disappears, so that it can be recognized by the sound that the needle N has been introduced at an appropriate position, and the needle N is discharged from the tip of the needle N. The oxygen that is produced can be immediately supplied to the patient's body.

The medical auxiliary device 1 can easily and surely detect the introduction of the needle N into the trachea Q by the sound from the whistle portion 21 of the tubular connector 10. Therefore, for example, as in the conventional case, it does not take time and effort to apply negative pressure to the syringe to suck air in the trachea Q and confirm the introduction of the needle N into the trachea Q. In particular, the cricoid thyme puncturing device E is used for the purpose of emergency resuscitation in an emergency, and the medical auxiliary device 1 reliably determines the introduction of the needle N into the trachea Q and informs the patient. It is extremely useful in that oxygen supply and ventilation can be performed quickly.

Conventionally, in the cricoid thyme puncturing device E, when the needle N is introduced into the trachea Q, the needle N may penetrate the trachea Q, reach the posterior wall of the trachea Q, and pierce the soft tissue. It has been pointed out as a problem. On the other hand, in this medical auxiliary device 1, when such a situation occurs, the tip of the needle N is closed and the whistle portion 21 is in a muffled state, so that the operator immediately notices the abnormality and the needle. Measures such as pulling out N can be performed.

As described above, the medical auxiliary device 1 according to the present embodiment is the medical auxiliary device 1 that detects whether or not the trachea introduction member 100 for ventilation of the patient is correctly introduced into the trachea Q. , A tubular connector 10 for connecting the trachea introduction member 100, and an airflow detecting means 20 having a whistle portion 21. The tubular connector 10 has a first flow path 11h extending in the first direction D1, and has a first connection port 11a provided on one end 111 side of the first flow path 11h and connecting the trachea introduction member 100. A second connection portion having 1 connection portion 11 and a second flow path 12h connected to the first connection portion 11 and communicating with the first flow path 11h, and having a second connection port 12a connecting the airflow supply means S. 12 and a third connection portion 13 having a third flow path 13h connected to the first connection portion 11 and communicating with the first flow path 11h and having a third connection port 13a connecting the airflow detecting means 20. A fourth connection having a fourth connection port 14a connected to the other end 112 side of the first connection portion 11 of the first flow path 11h opposite to the one end 111 side and connecting the surgical tool 200 to be inserted into the trachea introduction member 100. It has a portion 14 and. The airflow detecting means 20 has a state in which the tip of the trachea introduction member 100 is correctly introduced into the trachea Q and is open, and a state in which the trachea introduction member 100 is not introduced into the trachea Q and the tip is closed. It is characterized in that it is detected separately by the sound from the whistle portion 21.

According to such a configuration, the airflow detecting means 20 is in a state where the tip of the trachea introduction member 100 is correctly introduced into the trachea Q and is open, and the trachea introduction member 100 is not introduced into the trachea Q and the tip thereof. It is possible to distinguish and detect the closed state by the sound from the whistle portion 21.

In the medical auxiliary device 1, the second flow path 12h of the second connection portion 12 communicates with the first flow path 11h in the middle of the first flow path 11h, with respect to the first flow path 11h of the second flow path 12h. The communication angle is preferably an acute angle at the angle θ1 on the other end 112 side of the first flow path 11h. As a result, the airflow supplied to the second flow path 12h can be sent to the first flow path 11h from the middle of the first flow path 11h. Further, since the communication angle θ1 of the second flow path 12h with respect to the first flow path 11h is an acute angle, the air flow can be rationally sent from the second flow path 12h to the first flow path 11h.

In the medical auxiliary device 1, the third flow path 13h of the third connection portion 13 is proximal to the other end 112 of the first flow path 11h rather than the connection position with the second flow path 12h in the first flow path 11h. The communication angle of the third flow path 13h with respect to the first flow path 11h is preferably an acute angle at the angle θ2 on the other end 112 side of the first flow path 11h. As a result, it is possible to prevent the airflow sent from the second flow path 12h to the first flow path 11h from directly flowing into the third flow path 13h. Further, when the airflow to the trachea introduction member 100 is cut off, the airflow can be rationally sent from the first flow path 11h to the third flow path 13h.

In the medical auxiliary device 1, the first connection portion 11 and the fourth connection portion 14 are preferably arranged linearly with each other in the first direction D1. As a result, the surgical tool 200 inserted from the fourth connection port 14a of the fourth connection portion 14 can be linearly introduced to the first connection portion 11.

In the medical auxiliary device 1, the whistle portion 21 is preferably rotatably attached to the third connection port 13a. As a result, the whistle portion 21 can be rotated to a position where the operator can easily hear the sound emitted from the whistle portion 21.

The medical assistive device 1 further includes a spout 15 that can be detachably attached to the fourth connection port 14a of the fourth connection portion 14, and the spout 15 is a surgical tool in a through hole 15h provided in the spout 15. It is preferable that the surgical instrument 200 and the spout 15 can be brought into close contact with each other by inserting the 200. As a result, when the surgical tool 200 is inserted, the surgical tool 200 and the spout 15 are in close contact with each other, and it is possible to prevent the airflow from leaking from the through hole 15h.

In the medical auxiliary device 1, the trachea introduction member 100 is a ring-shaped thyroid puncture device E provided with a needle N, and the whistle portion 21 silences the sound while supplying airflow from the airflow supply means S through the second flow path 12h. When the needle N of the annular thyroid puncture device E connected to the tubular connector 10 in the state is pierced from the front surface of the neck toward the inside of the trachea Q through the annular thyme C, the tip of the needle N is the soft tissue near the neck. In the closed state, the supplied airflow flows into the third flow path 13h to generate a sound from the whistle portion 21, and the tip of the needle N reaches the inside of the trachea Q and is opened. In this case, it is preferable that the sound from the whistle portion 21 disappears so that it is possible to detect whether or not the needle N is correctly introduced into the trachea Q. As a result, the operator can determine that the needle N has not yet reached the inside of the trachea Q due to the generation of the sound of the whistle portion 21, and when the introduction of the needle N into the trachea Q is completed, the operator can determine. Since the sound of the whistle portion 21 disappears, it becomes possible to recognize by sound that the whistle portion 21 has been introduced at an appropriate position.

In the medical auxiliary device 1, the sound emitted by the whistle portion 21 has a sound pressure of 90 dB or more at a frequency of 2000 Hz or more and 4000 Hz or less when the air flow supply flow rate by the air flow supply means S is 6 L / min and 9 mmHg. Is preferable. As a result, the operator can effectively hear the inserted state of the tracheal introduction member 100 by the sound according to the equal loudness curve which is optimized for the human ear's hearing.

As described above, according to the present invention, it is possible to provide a medical auxiliary device 1 having a simple structure and capable of reliably detecting the insertion of the tracheal introduction member 100 into the trachea Q.

As described above, the present invention can provide a medical auxiliary device 1 having a simple structure and capable of reliably detecting the insertion of the tracheal introduction member 100 into the trachea Q. Therefore, it is suitable as a medical auxiliary device 1 capable of quickly and accurately inserting the trachea introduction member 100 into the trachea Q in a medical field where an urgent need is particularly required.

1 Medical auxiliary equipment 10 Cylindrical connector 11 1st connection part 11a 1st connection port 11h 1st flow path 12 2nd connection part 12a 2nd connection port 12h 2nd flow path 13 3rd connection part 13a 3rd connection port 13h 3rd flow path 14 4th connection part 14a 4th connection port 15 Mouth plug 15h Through hole 20 Airflow detection means 21 Whistle part 22 Mounting part 100 Trachea introduction member 111 One end 112 One end 151 Plug 200 Surgery 300 Laryngeal mirror C Ring-shaped shell Membrane D1 First Direction E Ring-shaped thyroid puncture device H Hose J Stylet K Cuff M Tracheal tube N Needle Q Tracheal R Esophagus S Air flow supply means Y Cannula θ1, θ2 Angle

Claims (8)

It is a medical auxiliary device that detects whether or not the tracheal introduction member for ventilation of the patient is correctly introduced into the trachea.
A cylindrical connector for connecting the trachea introduction member and
Airflow detection means with a whistle and
Equipped with
The cylindrical connector is
A first connection portion having a first flow path extending in the first direction and having a first connection port provided on one end side of the first flow path and connecting the trachea introduction member.
A second connection portion connected to the first connection portion, having a second flow path communicating with the first flow path, and having a second connection port for connecting the air flow supply means.
A third connection portion connected to the first connection portion, having a third flow path communicating with the first flow path, and having a third connection port for connecting the air flow detection means.
A fourth connection portion of the first connection portion, which is connected to the other end side of the first flow path opposite to the one end side and has a fourth connection port for connecting a surgical tool to be inserted into the trachea introduction member. Have,
The airflow detecting means has a whistle in which the tip of the tracheal introduction member is correctly introduced into the trachea and is open, and the tip of the tracheal introduction member is not introduced into the trachea and the tip is closed. A medical auxiliary device characterized by distinguishing and detecting by the sound from the part. The second flow path of the second connection portion communicates with the first flow path in the middle of the first flow path.
The medical auxiliary device according to claim 1, wherein the communication angle of the second flow path with respect to the first flow path is an acute angle at an angle on the other end side of the first flow path. The third flow path of the third connection portion is proximal to the other end of the first flow path with respect to the connection position with the second flow path in the first flow path.
The medical auxiliary device according to claim 2, wherein the communication angle of the third flow path with respect to the first flow path is an acute angle at an angle on the other end side of the first flow path. The medical auxiliary device according to any one of claims 1 to 3, wherein the first connection portion and the fourth connection portion are arranged linearly with each other in the first direction. The medical auxiliary device according to any one of claims 1 to 4, wherein the whistle portion is rotatably attached to the third connection port. Further provided with a spout that can be detachably attached to the fourth connection port of the fourth connection portion.
Claim 1 is characterized in that the spout is configured so that the surgical tool and the spout can be brought into close contact with each other by inserting the surgical tool into a through hole provided in the spout. The medical auxiliary device according to any one of claims 5. The tracheal introduction member is a cricothyroid puncturing device equipped with a needle.
While supplying airflow from the airflow supply means through the second flow path, the needle of the cricothyroid puncturing device whose whistle portion is connected to the tubular connector in a muffled state is aired from the front surface of the neck through the cricothyroid membrane. When puncturing into the tube
When the tip of the needle is closed by the soft tissue near the neck, the supplied airflow flows into the third flow path to generate a sound from the whistle portion.
When the tip of the needle reaches the inside of the trachea and is opened, the sound from the whistle portion disappears, so that it is possible to detect whether or not the needle is correctly introduced into the trachea. The medical auxiliary device according to any one of claims 1 to 6, wherein the medical auxiliary device is characterized. Claim 1 is characterized in that the sound emitted from the whistle portion has a sound pressure of 90 dB or more at a frequency of 2000 Hz or more and 4000 Hz or less when the air flow supply flow rate by the air flow supply means is 6 L / min and 9 mmHg. The medical auxiliary device according to any one of claims 7.

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