JP3224470U - Nasal Airway - Google Patents

Abstract

A nasal airway for intubation under a bronchial fiberscope guide is provided. A pipe section and a flange section provided integrally with one end of the pipe section, and a pipe section slit is formed in the pipe section in a longitudinal direction of the pipe section. The flange portion 14 is provided with a flange portion slit 18 in the radial direction of the flange portion 14, and the tube portion slit 16 and the flange portion slit 18 are connected. The tube section 12 is curved, the tube section slit 16 is formed inside the curve of the tube section 12, and the slits 16 and 18 are provided on substantially the same plane. [Selection diagram] Fig. 1

Description

  The present invention relates to an airway securing device for securing an airway by physically opening an obstructed airway, and relates to a nasal airway for securing an airway by inserting from the nasal cavity side.

  For patients with obstructed airways or at the start of general anesthesia, first secure the airway through temporary rescue treatment, such as raising the back of the head and raising the lower jaw, that is, open the obstructed airway. .

  If the airway is insufficiently opened by this temporary rescue procedure, the airway is inserted orally or nasally, and the obstructed part is physically lifted at the tip of the airway to secure the airway. The principle of securing an airway using an airway is as follows.

  In other words, when the airway is inserted orally to secure the airway, the airway is inserted from the opened mouth, and the vicinity of the tongue base is lifted at the tip of the airway to avoid dropping of the tongue base that blocks the pharynx. , Open the airway.

  In addition, when the airway is inserted through the nose to secure the airway, the nasal cavity is not blocked by secretions by inserting the tube of the airway into the nasal cavity through the nostrils, and the pharynx is blocked. Avoid the depression of the tongue base and open the airway.

  After the airway is established by these methods using an airway, blood oxygen concentration is increased by mask ventilation, and then an endotracheal tube is inserted into the tracheal intubation, that is, the trachea. When the endotracheal tube is inserted, air supply from the trachea to the lungs is cut off by the endotracheal tube, and the blood oxygen concentration decreases.

  After inserting the endotracheal tube into the trachea, a ventilator is connected to the end of the endotracheal tube, and air is sent to the lungs of the patient via the endotracheal tube to perform artificial respiration.

  The endotracheal tube is inserted orally or nasally. If you are injured or want to perform another procedure from the mouth, insert the endotracheal tube intranasally. As a method for inserting an endotracheal tube into the trachea, a method called intubation under a bronchial fiberscope guide is known.

  This method uses a bronchial fiberscope as a guide when inserting an endotracheal tube into the trachea. Intratubular intubation using a bronchial fiberscope is performed without a nasal airway.

  The nasal airway tube hole is not large enough to insert the endotracheal tube and the tracheal tube is intubated through the nasal airway tube hole under a bronchial fiberscope guide Because they can't do that.

  The procedure for performing intranasal intubation under a bronchial fiberscope guide is as follows.

  First, the bronchial fiberscope is inserted into the endotracheal tube from the distal end, the endotracheal tube is moved to the base side of the bronchial fiberscope, and temporarily fixed with tape.

  The distal end of the bronchial fiberscope in this state is inserted into the nasal cavity from the nostril and reaches the trachea via the pharynx.

  The bronchial fiberscope observes the nasal cavity, pharynx, and trachea with a monitor, and controls the distal end portion to proceed in an appropriate direction, while passing through the nasal cavity and pharynx to reach the trachea.

  After allowing the distal end of the bronchial fiberscope to reach the trachea, peel off the tape temporarily fixing the endotracheal tube to the base side of the bronchial fiberscope, and use the bronchial fiberscope as a guide for the distal end of the endotracheal tube. Pass through the nasal cavity and pharynx to reach the trachea.

  After the distal end of the endotracheal tube reaches the trachea, the bronchial fiberscope is removed from the endotracheal tube with the distal end of the endotracheal tube remaining in the trachea.

  In this way, the endotracheal tube is transnasally intubated.In this bronchial fiberscope-guided intubation, while the bronchial fiberscope is being inserted into the trachea from the nostrils, the lens at the tip of the bronchial fiberscope is Mucus, secretions, blood, etc. of the nasal cavity and pharynx adhere, and a good visual field cannot be obtained, and it may take time to intubate the endotracheal tube.

  In bronchial fiberscope-guided intubation, if it takes time to insert the bronchial fiberscope or intubate the endotracheal tube, the blood oxygen concentration decreases, and there is a possibility that trouble may be left after the operation.

  Before inserting the tip of the bronchial fiberscope into the nostril, insert a nasal airway into the nostril in advance, and insert the bronchial fiberscope into the trachea through this nasal airway, and the tip of the scope and the nasal cavity or pharynx Contact with the mucous membrane can be avoided.

  However, if the nasal airway was inserted in advance in the nostrils and bronchial fiberscope guide intubation was performed, even after the distal end of the bronchial fiberscope reached the trachea, even trying to advance the endotracheal tube toward the trachea, The tube of the nasal airway is not large enough to insert the endotracheal tube, so that the endotracheal tube cannot be advanced to the trachea through the nasal airway.

  If the nasal airway is to be removed from the bronchial fiberscope after the end of the bronchial fiberscope reaches the trachea, it cannot be removed because the nasal airway is in the middle of the bronchial fiberscope.

  Therefore, when the intubation under the bronchial fiberscope guide is performed nasally, it has to be performed without the nasal airway. For this reason, when performing endotracheal tube transnasal intubation and bronchial fiberscope guide intubation, it may take time to intubate the endotracheal tube, leaving the patient in anoxic condition beyond the permissible time.

JP-A-2019-010354 JP 2009-72465 A

  The problem to be solved by the present invention is to make it possible to intubate an endotracheal tube into a trachea in a nasal bronchial fiberscope-guided intubation.

  The present invention includes a tube portion and a flange portion integrally provided at one end of the tube portion, and a tube portion slit is provided in the tube portion in a longitudinal direction of the tube portion. The most main feature is that a flange slit is provided on the flange in the radial direction of the flange, and the pipe slit and the flange slit are connected.

  Here, the tube is gently curved. The nostrils, nasal passages, pharynx and trachea are not linear but are present on substantially curved lines, respectively. Can be inserted smoothly in order.

  The tube slit is provided inside the curve of the tube. This is because if the tube slit is formed inside the curve of the tube, the nasal airway can be easily removed from the bronchial fiberscope.

  The pipe section slit is provided on substantially the same plane as the flange section slit. The end face of the other end of the tube intersects a line extending in the longitudinal direction near the other end at an acute angle, and the other end of the tube is sharp. If the other end of the tube is sharp, it can be easily inserted into the gap between the nasal cavity and the pharynx.

  The tube has a length such that the other end reaches the vicinity of the pharynx when inserted into the trachea nasally. The outer diameter of the tube is smaller than the inner diameter of the patient's nostril, and the outer diameter of the flange is larger than the inner diameter of the patient's nostril.

  A plurality of filaments are provided on the inner surface of the tube section over the entire circumference in a direction substantially parallel to the longitudinal direction of the tube section. Since a plurality of ridges are provided on the inner surface of the tube section of the nasal airway, when the bronchial fiberscope is inserted into the tube section of the nasal airway, the bronchial fiberscope is connected to the tube section of the nasal airway. Proceed smoothly inside.

  The outer surface of the tube is matte. This is to prevent sticking to the surface of the nasal cavity or pharynx. An R is provided at a corner of the tube and the flange. The tube and the flange are made of soft plastic. This is for opening the slit so that the bronchial fiberscope can be taken out. As the soft plastic, a soft polyvinyl chloride resin can be used.

  Since the airway according to the present invention is provided with a continuous slit in the tube and the flange, the distal end of the bronchial fiberscope is made to reach the trachea using the nasal airway, and then the nasal airway is passed through the bronchial fiber. There is an effect that it can be removed from the middle of the scope.

  With the airway according to the present invention, after the distal end of the bronchial fiberscope reaches the trachea using the nasal airway, the nasal airway can be withdrawn from the middle of the bronchial fiberscope. An advantage is that the nasal airway can be used when inserted into the tube.

  Since the airway according to the present invention can use the nasal airway when inserting the bronchial fiberscope into the trachea, the lens at the tip of the bronchial fiberscope is contaminated with mucus, secretions, blood, etc. of the nasal cavity and pharynx. This has the effect of eliminating the need.

  The airway according to the present invention does not require the lens at the distal end of the bronchial fiberscope to be contaminated with mucus, secretions, blood, etc. of the nasal cavity and pharynx, so that the effect of being able to quickly insert the bronchial fiberscope into the trachea is achieved. is there.

  The airway according to the present invention has the effect that the time of the apnea state can be shortened because there is no need to take time to insert the bronchial fiberscope, and the endotracheal tube can be safely inserted into the trachea.

FIG. 1 is a perspective view of the nasal airway according to the present invention. FIG. 2 is an explanatory view showing a use state of the nasal airway according to the present invention.

  After intubating the bronchial fiberscope into the trachea via the nasal airway, the nasal airway can be removed from the middle of the bronchial fiberscope, and the intubation of the endotracheal tube under the bronchial fiberscope guide via the nasal airway. The goal was to be able to perform this without sacrificing the function of the nasal airway.

  FIG. 1 is a perspective view of the nasal airway according to the present invention. In FIG. 1, the nasal airway 10 includes a substantially cylindrical tube portion 12 and a flange portion 14 integrally formed at one end (base end) of the tube portion 12. The tube portion 12 is gently curved, and the tube portion 12 has a shape like an elephant's nose when the inside of the curve (ventral side) faces downward.

  The tube portion 12 has a length such that the other end reaches the vicinity of the pharynx when inserted into the trachea through the nose. The outer diameter of the tube 12 is smaller than the inner diameter of the patient's nares. The length and thickness of the tube portion 12 can be appropriately changed according to the length and thickness required by the age and gender of the user.

  The outer diameter of the flange 14 is larger than the inner diameter of the patient's nares. The inner diameter of the tube portion 12 is formed larger than the outer diameter of the inserted bronchial fiberscope. The tube portion 12 has such a thickness that it does not deform or break when the tube portion 12 is inserted into the trachea through the nose. The outer diameter of the tube portion 12 is an outer diameter obtained by adding this thickness to the inner diameter of the tube portion 12.

  A tube slit 16 is provided inside the curve of the tube 12 in the longitudinal direction of the tube 12. The flange 14 is provided with a flange slit 18 in the radial direction of the flange 14. The tube slit 16 and the flange slit 18 are provided on substantially the same plane.

  The end face of the other end (tip) of the tube 12 intersects a line extending in the longitudinal direction near the other end at an acute angle, and the other end of the tube 12 is sharp. A plurality of filaments are provided on the inner surface of the tube portion 12 over the entire circumference in a substantially parallel manner in the longitudinal direction of the tube portion. The outer surface of the tube portion is processed into a satin finish so that it can be smoothly inserted into the trachea. An R is attached to the corner of the tube and the corner of the flange so that the corner does not hit.

  The nasal airway is formed of a soft plastic. When the nasal airway is inserted into the nasal cavity and the vicinity of the pharynx through the nose, the tube is inserted while deforming the gap near the nasal cavity and the pharynx flexibly. The nasal airway is made of a soft plastic, and can be withdrawn from the middle of the bronchial fiberscope by opening the tube slit and the flange slit. Soft polyvinyl chloride resin can be used as the soft plastic.

  Next, how to use the nasal airway 10 according to the present invention will be described with reference to FIG.

  A lubricant is applied to the bronchial fiberscope 20, and the bronchial fiberscope 20 is passed through the endotracheal tube 22. The endotracheal tube 22 is temporarily fixed to the root of the bronchial fiberscope 20 with tape or the like so as not to slide down from the bronchial fiberscope 20.

  After enriching the blood by mask ventilation, the distal end of the bronchial fiberscope 20 is inserted into the opening of the nasal airway 10 (a hole at one end of the tube section 12), and the inserted distal end is inserted through the nasal airway. Pass through the airway 10 to near the pharynx. The distal end of the bronchial fiberscope 20, which has come out near the pharynx from the distal end of the nasal airway 10 (the hole at the other end of the tube portion 12), is intubated toward the trachea.

  After the distal end of the bronchial fiberscope 20 is inserted into the trachea, the slits 14 and 16 of the nasal airway 10 are opened while holding the bronchial fiberscope 20 by hand so that the bronchial fiberscope 20 does not fall out of the nose. From here, the bronchial fiberscope 20 is taken out of the nasal airway 10, and the nasal airway 10 is removed in this state.

  The tape temporarily attached to the endotracheal tube 22 at the base of the bronchial fiberscope 20 is removed, and the endotracheal tube 22 is inserted along the bronchial fiberscope 20 into the nostril, passed through the nasal cavity and pharynx, and passed through the trachea. send.

Here, when the endotracheal tube 22 is caught, turn the bronchial fiberscope 20 rightward or leftward and then pull back the endotracheal tube 22 slightly to proceed without any resistance. It is confirmed by ventilation that the tracheal intubation has been performed at an appropriate position, that is, by calling EtCO ₂ (End-tidal CO ₂ ), raising the rib cage, and auscultating the chest at five points.

Reference Signs List 10 nasal airway 12 tube part 14 flange part 16 tube slit 18 flange part slit 20 bronchial fiberscope 22 endotracheal tube

Claims (12)

  A pipe part, and a flange part integrally provided at one end of the pipe part, wherein a pipe part slit is provided in the pipe part in a longitudinal direction of the pipe part, and the flange part A nasal airway, wherein a flange portion slit is provided in a radial direction of the flange portion, and the tube portion slit and the flange portion slit are connected to each other.   The nasal airway according to claim 1, wherein the tube is curved.   The nasal airway according to claim 2, wherein the tube slit is provided inside a curve of the tube.   The nasal airway according to claim 3, wherein the tube slit is provided on substantially the same plane as the flange slit.   The end face of the other end of the tube section and a line extending in the longitudinal direction near the other end intersect at an acute angle, and the other end of the tube section is sharp. 2. The nasal airway according to 1.   The nasal airway according to claim 1, wherein the tube has a length such that the other end reaches near the pharynx when inserted into the trachea through the nose.   The nasal airway according to claim 1, wherein the outer diameter of the tube portion is smaller than the inner diameter of the patient's nostril, and the outer diameter of the flange portion is larger than the inner diameter of the patient's nostril.   The nasal airway according to claim 1, wherein a plurality of filaments are provided substantially in parallel with a longitudinal direction of the tube portion over the entire circumference of the inner surface of the tube portion.   2. The nasal airway according to claim 1, wherein the outer surface of the tube portion is matted.   The nasal airway according to claim 1, wherein R is provided at a corner of the tube and the flange.   The nasal airway according to claim 1, wherein the tube portion and the flange portion are formed of a soft plastic.   The nasal airway according to claim 11, wherein the soft plastic is a soft polyvinyl chloride resin.

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