JPH11267222A - Airway securing tool for emergency anabiosis - Google Patents

Abstract

PROBLEM TO BE SOLVED: To prevent erroneous swallow by providing a pharynx cuff on the outer surface of a slide tube provided slidably in a longitudinal direction at a main body tube and providing a ventilating-side hole communicated with a ventilating lumen beside an esophagus cuff so as to insert an air tube without pulling away an airway securing tool. SOLUTION: An esophagus cuff 5 is provided on the tip side of a main body tube 1 equipped with a ventilation lumen, an airway lumen for the esophagus cuff and a endogastric pressure releasing lumen. A ventilating-side hole 6 communicating outside and the ventilating lumen is provided on its rear tip side. A slide tube 11 covering the main body tube 1 and capable of sliding smoothly is provided on a rear tip side compared with the hole 6 of the tube 1. A pharynx cuff 7 is added on the outer surface of the tube 11 to close a wall from the upper part of the pharynx to an oral cavity airtight. As an esophagus and a pharynx are closed by the cuff 5 and the cuff 7, exhalation is sent to a lung by way of the air tube through a ventilation connector 8, the ventilation lumen and the hole 6, thereby erroneous swallow is prevented.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an airway securing device used for securing an airway necessary for breathing a patient. More specifically, patients who are under general anesthesia or in a coma, or who have difficulty helping to maintain the airway and have difficulty keeping the upper airway open without using an endotracheal tube or face mask (muscular helplessness) Airway of the patient from the larynx to the trachea and lungs, and from the oral cavity to the throat where air or oxygen or anesthetic gas can be easily inhaled or exhaled. The present invention also relates to a medical airway securing device through which intermittent pressurized respiration can be performed.

[0002]

2. Description of the Related Art Conventionally, medical instruments for securing an airway for anesthesia, emergency resuscitation or management of severe patients include endotracheal tubes, oral nasal airways, esophagus-tracheal airways, laryngeal masks (LM), esophagus Closed airway (EOA), airway with esophagogastric tube (EGT)
A).

[0003] If an endotracheal tube is orally or nasally inserted into a patient's trachea and connected to an anesthesia machine, a ventilator, or a resuscitation device, the airway can be reliably secured, and the endotracheal suction can be appropriately performed. It has been most widely used because it is easy to perform, reflux from the stomach and esophagus is isolated from the respiratory tract, and pressurized artificial respiration can be performed without any trouble as needed.

[0004] However, if this method is to be performed in an emergency for the purpose of emergency lifesaving, the operation of endotracheal intubation with direct laryngeal expansion may cause serious complications such as occurrence of arrhythmia and reflux of gastric contents. It is a medical procedure that is easy to cause, high risk, and highly invasive.It is difficult for a doctor who is familiar with this operation to actually perform it, depending on the environment, patient's posture, etc. Stimulation of the villous epithelium on the strong larynx or delicate tracheal lining with the endotracheal tube or its cuffs may cause side effects such as foreign body sensation and difficulty in sputum later, leading to serious complications such as glottic edema and tracheitis It is a serious drawback that there is a high risk of causing bleeding, and it is an urgent medical need to avoid foreign objects in the larynx and trachea as much as possible to secure an airway for ventilation. It has become. In other words, endotracheal intubation is desirable only when it is unavoidable, such as thoracotomy and upper cervical surgery, and it has never been possible if there is a reliable alternative to the endotracheal tube.

[0005] On the other hand, oral airways and nasal airways have been widely used for many years, but they merely support the tongue base mechanically at the tip of the inserted airway and try to help prevent airway obstruction by sinking. In many cases, it is not useful because it cannot support the periphery of the tip,
It is also a major disadvantage that it does not prevent reflux from the esophagus to the trachea, and that it is required to hold the face mask airtight when performing artificial respiration, and the range of usable cases and the available time are generally Limited. However, it is an important advantage that it can be widely used by nurses and rescue workers as well as doctors who are skilled in handling such endotracheal tubes.

A device capable of performing ventilation by selecting an air supply route regardless of whether the tube is inserted into the esophagus or the trachea is disclosed in JP-A-5-269204, US Pat. No. 4,688,568.
And Japanese Unexamined Patent Publication No. 7-213614, which has been put to practical use. Even if this device is inserted into the esophagus or trachea, if the insertion place can be confirmed, the air supply route can be selected and ventilation can be performed, but if the confirmation is incorrect and the air supply route is incorrect, ventilation will not be possible Therefore, it is necessary to promptly and accurately confirm and diagnose whether it has been inserted into the esophagus or trachea. Also, like the endotracheal tube, if it is inserted into the trachea, there is a high possibility that serious complications will occur, and it may be difficult to do this unless a physician who is skilled in this operation is practical. Although this device is used by paramedics as a tool to secure the airway, the fact is that paramedics are not allowed to ventilate the trachea.
Also, when inserting into the esophagus, the length is adjusted to the bifurcation of the trachea, so it does not reach the deep part of the esophagus. Due to the curved shape, the front of the esophagus is easily damaged, and it is particularly dangerous to perform resuscitation by closed heart massage.

[0007] In addition, a rubber cushion (mask) invented by Brain, a doctor in London, UK (UK Patent No. 2,111,394), attached to the tip of a large-diameter arcuate tube, was used for the laryngeal opening. Laryngeal mask used over the place (L
What is referred to as M) has recently been introduced into Japan and is used for anesthesia and emergency resuscitation. In Japan, 1983 Br.
J. Anaesth. Brain's Laryn in
A paper entitled "geal mask", which was made public by the introduction of Amaga et al. in the journal "Anesthesia" in 1989, etc., was added to this invention. Although disclosed in Japanese Unexamined Patent Publication No. 2-283378, this form is not yet commercially available.

[0008] The use of LM eliminates the need to insert a foreign body into the trachea. If inserted properly, it is convenient for general anesthesia under spontaneous breathing except for prone position, and without complications after surgery. It is something that can be used with your heart and is attracting worldwide attention. The drawback is that when inserted without spontaneous breathing, it is not possible to immediately observe the ventilation and determine whether it is in the proper position, and the cushion (mask) needs to be oriented, but calm down to the correct position. Is not always easy, the cushion (mask) shifts when the patient changes position or carries,
On the contrary, there is a risk that a large inflated cushion (mask) may obstruct the airway. In addition, there is not enough pressure to press the cushion (mask) tightly against the larynx and mouth in the throat,
When performing pressurized respiration, airway pressure above a certain level (about 20 c
gas pressure around the cushion, it is difficult to perform sufficient pressurized respiration, and the degree of closure of the upper esophagus is insufficient, so that the contents of the stomach reflux and flow into the trachea (accidental ingestion). Is also inevitable. In Japan, not only doctors but also nurses and paramedics can use LM. However, for emergency resuscitation, there is a limit to pressurization by positive pressure artificial respiration, and it is difficult to determine the correct insertion depth and position. In some cases, misalignment occurs during transportation at an emergency site or an ambulance.

Furthermore, there is no need to perform laryngeal expansion as in the case of endotracheal intubation, and it is inserted blindly and quickly into the esophagus, and a balloon attached near the distal end of the tube is inflated in the esophagus and adheres to the esophageal wall. At the same time, the lower part of the esophagus is closed with the tip of the tube, which is a blind end, to prevent reflux of the stomach contents and ensure airtightness. Esophageal closure airway (EOA), which pushes into the trachea and performs artificial respiration
And the end of the tube is opened so that the contents of the stomach can be aspirated with the attached stomach tube, and the ventilation gas flows through the ventilation opening of the mask,
An esophagogastric tube-equipped airway (EGTA) that passes through the nose, through the outer circumference of the tube, to the esophagus → larynx → trachea is widely used for paramedics.

[0010] However, this is a drawback that airtightness cannot be maintained unless the face mask is held in close contact with the patient's face with both hands simultaneously with the artificial respiration, so that pressurized respiration cannot be sufficiently performed in an ambulance while traveling. there were. Recently, a strap has been attached to a mask to improve the adhesion to the face. Also,
It has been pointed out that, due to its structure, compared with endotracheal tubes, laryngeal masks, etc., there are more dead spaces for ventilation gas, so that it is difficult to discharge carbon dioxide from patients.

[0011] Further, in order to improve these drawbacks of the esophagus-closed airway and to replace the mask with a pharyngeal balloon, JP-A-6-142205 and JP-A-9-24102 disclose devices.
Gazette, Japanese Patent Application No. 8-343895, Japanese Patent Application No. 8-343
No. 899 is disclosed. These do not require fixation of the mask, and the dead space is smaller than that of the mask type, so that they are considerably improved and operability is also improved. However, the emergency squad inserts these conventional esophageal closed airways into patients with cardiopulmonary arrest, transports the patient to the hospital while performing appropriate emergency treatment such as securing the airway, etc., because the doctor performs emergency surgery. When inserting the endotracheal tube into the trachea, the pharyngeal cuff closing the pharynx hinders the insertion of the endotracheal tube,
These airway devices had to be removed prior to insertion of the endotracheal tube. At this time, closing the esophagus may cause the contents of the stomach held by the esophagus to flow back to the oral cavity side, enter the trachea, and cause swallowing (aspiration of the oral or stomach contents into the trachea and lungs). there were.

[0012]

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and enables a doctor to easily, quickly and reliably insert an endotracheal tube without having to remove an airway securing device during insertion. An object of the present invention is to provide an emergency resuscitation airway securing device capable of preventing accidental swallowing.

[0013]

According to the present invention, there is provided a curved main body tube, an esophageal cuff provided on a distal end side of the main body tube, and an esophageal cuff provided on the main body tube so as to cover a rear end side of the esophageal cuff. Optionally comprising a slide tube slidable in the longitudinal direction of the main tube, a pharyngeal cuff attached to the outer surface of the slide tube, and a ventilation connector attached to the rearmost end of the main tube. Is an airway securing device for emergency resuscitation characterized by having a ventilation lumen and having a ventilation side hole between the esophageal cuff and the pharyngeal cuff that communicates with the ventilation lumen. Further, it is an airway securing device for emergency resuscitation having a fixed cuff fixed to the inner surface of the slide tube in a gap between the slide tube and the main tube.

[0014]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be specifically described below with reference to the drawings. First, the contents of each drawing will be described. FIG. 1 is a side view of an airway securing device for emergency resuscitation which is an embodiment of a normal state of the present invention, and FIG. 2 is a cross-sectional view near a ventilation side hole of the present invention. , (A) are AA ′ sectional views of the embodiment shown in FIG. 1, (b), (c), and (d) show other embodiments. FIG. 3 is a cross-sectional view of the vicinity of the pharyngeal cuff of the present invention, and is a cross-sectional view taken along the line BB 'of the embodiment shown in FIG. FIG. 4 is a side view of the embodiment of the present invention shown in FIG. 1 when the slide portion is shifted to the rear end side. FIG. 5 shows a side view of an emergency resuscitation airway securing tool when a fixed cuff is provided on the inner surface of the slide tube of the present invention, and FIG. 6 shows a case where a fixed cuff is provided on the inner surface of the slide tube of the present invention. FIG. 2 is a cross-sectional view of the vicinity of a pharyngeal cuff, and is a cross-sectional view taken along line BB ′ of the embodiment shown in FIG. 1.

As shown in FIG. 1, the main body tube (1) is an arcuately curved tube inserted from the oral cavity into the esophagus, and may have an elliptical cross-section in some cases. The esophagus is originally flattened back and forth and, if necessary, stretched back and forth to form a cylinder, so it can be said that it makes sense to insert a flattened oval tube on the side. As shown in FIG. 2A, the main body tube (1) includes a ventilation lumen (2), an airway lumen for esophageal cuff (3), and a gastric pressure release lumen (4). The arrangement of the respective lumens is determined in consideration of the necessary cross-sectional area, strength, processing efficiency, and formability, but the arrangement itself is not limited as long as these necessary elements are satisfied. In FIG. 2A or FIG. 2B, each of the lumens is a single multi-lumen tube. However, as shown in FIG. 2C or FIG. It is good also as a structure which combined multiple. At the rear end side of the esophageal cuff (5), a ventilation side hole (6) for communicating the outside with the ventilation lumen (2) is provided, and the tip of the ventilation lumen (2) is sealed. The gastric pressure releasing lumen (4) has an open end, and is opened to the outside by a vent (9) provided between the pharyngeal cuff (7) and the ventilation connector (8). In addition, swelling gas and contents in the stomach and esophagus can be released outside the body. On the rear end side of the pharyngeal cuff (7) of the main body tube (1), a scale means (10) for grasping the insertion position of the body tube (1) into the patient is provided.
By aligning this scale means (10) with the incisor,
It is intended to be a measure of the depth of insertion into the patient. Here, the graduation means (10) may be a concave groove, a convex step, printing, or the like to the main body tube (1), but is not limited thereto. The main body tube (1) is formed to have a length and thickness appropriate for the patient's physique, has appropriate flexibility and elasticity at normal room temperature and body temperature, and is usually formed of a synthetic resin such as a soft resin. Vinyl chloride resin, silicone rubber, polyurethane and the like are preferably used.

The slide tube (11) is provided on the rear end side of the ventilation side hole (6) of the main body tube (1). The slide tube (11) is installed so as to cover the main body tube (1) as shown in FIG.
Considering that sufficient lubricity to slide arbitrarily on top and sufficient fixing force not to shift the position at the time of insertion and ventilation operation of the present invention are required, the material for forming the same is usually a synthetic resin. For example, a soft vinyl chloride resin, silicone rubber, polyurethane or the like is preferably used.

A ventilation connector (8) is attached at the rear end of the ventilation lumen (2) of the main tube (1),
Its rear end is open. Ventilation connector (8)
Is generally made of a synthetic resin (internationally determined to have a diameter of 15 mm and a taper of 1/40) so that a resuscitator or the like can be directly connected. Although the material of the ventilation connector (8) is not limited, it is preferable that the material has hardness and strength such that it does not deform even when an anesthesia device is connected. In this embodiment, the material is hard vinyl chloride resin, polycarbonate, polyethylene, PET, or the like. I have.

The esophageal cuff (5) is attached to the distal end side of the ventilation side hole (6) of the main body tube (1), and hermetically closes the lower part of the esophagus. It is formed in a cylindrical shape using an elastic body such as synthetic rubber such as natural rubber, synthetic rubber such as isoprene rubber, silicone rubber, urethane rubber and ethylene-propylene rubber, and other synthetic resins such as soft vinyl chloride resin. Also,
When the membrane is inserted without internal pressure, it is important that the membrane adheres to the wall of the main body tube (1) and does not hinder the insertion into the esophagus.

The pharyngeal cuff (7) is connected to the slide tube (1).
It is attached to the outer surface of 1) and airtightly closes this part along the wall from the upper part of the pharynx to the oral cavity. When the part is inflated, it follows the complicated shape of the pharynx and closely adheres to the wall. However, so as not to squeeze the wall strongly,
It is formed in a cylindrical shape using a relatively soft resin such as a synthetic resin such as polyethylene, polyester, soft vinyl chloride resin, silicone resin, and polyurethane. The pharyngeal cuff (7) is made of a material having a smaller rubbery elasticity than the esophageal cuff (5) so that when inflated, the pharyngeal wall is strongly pressed against the pharyngeal wall so as not to damage the tissue of the pharyngeal wall. When the intermittent pressurized respiration is performed, the balloon is deformed so that the internal pressure of the soft and large balloon does not defeat the positive airway pressure. Each time the positive pressure of the intermittent ventilation reaches a peak, the gas is slightly distorted and does not leak or shift. Therefore, the pharyngeal cuff (7) is formed so as to swell more in the longitudinal and lateral directions than the esophageal cuff (5) in order to improve airtightness and fixability. The volume of the space between the pharyngeal cuff (7) and the main body tube (1) is sized to be just full when a volume of air determined by the physique is injected at a pressure of 20 to 40 cmH2O. I have. Although not limited, the amount of air at a pressure of 20 to 40 cmH2O injected into the pharyngeal cuff (7) may be, for example,
50-150 ml for adults and 3 for children
It is 0 to 60 ml.

The tip (12) is a main tube (1).
May be attached to the tip of This is intended to prevent the tip of the present invention from damaging the oral cavity and the esophageal wall when the present invention is inserted into a patient. In the present embodiment, the shape of the distal tip (12) is as rounded as possible, and communicates with the intragastric pressure releasing lumen (4) of the main body tube (1), and the flow opening at the distal end. There is a road. If the opening is provided at the end, an acute angle is generated. Therefore, it is desirable to arrange the opening at the center so that the angle is hardly generated. In addition, the paramedic who is assumed to be the main user of the present invention has a background in which the insertion of tools into the trachea is prohibited by law in the specific act. The distal end tip (12) has a larger outer diameter than the main body tube (1) so as not to enter the trachea when inserted into a patient. Its shape is a cross-sectional elliptical cross section that cannot be inserted into the laryngeal opening, which is the entrance of the trachea, and can be inserted into the esophagus without resistance. The material of the tip 12 is preferably a relatively soft soft vinyl chloride resin, silicone rubber, urethane resin or the like.

The airway tube (13) for the esophageal cuff is connected to the body tube (1) on the rear end side of the slide tube (11), and the lumen thereof has an airway lumen (3) for the esophageal cuff.
Communicate with The other end of the esophageal cuff airway tube (13), which is connected to the main tube (1), is connected to a pilot balloon (15) provided with a plug means (14). The distal end side of the airway lumen (3) for the esophageal cuff is sealed, and air injected from the plug means (14) is supplied to the pilot balloon (1).
5), the side that passes through the airway tube for esophageal cuff (13), the airway lumen for esophageal cuff (3), and opens into the esophageal cuff (5) for closing the esophagus attached to the main body tube (1). It is discharged into the esophagus cuff (5) through the hole. The pilot balloon (15) is used to check the degree of inflation of the balloon due to the injected air outside the body. The airway tube (13) for the esophageal cuff is formed of a synthetic resin, for example, a soft vinyl chloride resin, silicone rubber, polyurethane, polyethylene, or the like, and has a small diameter. As a material for forming the pilot balloon (15), a synthetic resin such as a soft vinyl chloride resin, silicone rubber, polyurethane, polyethylene, or polyester is generally suitable. Plug means (14)
In order to prevent the injected air from flowing back, backflow prevention means such as a check valve, a stopcock or a stopcock is used. Example FIG.
Shows the one with one-way valve attached.

The pharyngeal cuff airway tube (16) is connected to the rear end side of the slide tube (11), and its lumen communicates with the inside of the pharyngeal cuff (7). The other end of the pharyngeal cuff airway tube (16), which is connected to the slide tube (11), is connected to a pilot balloon (15) having a plug means (14). It passes through the balloon (15) and the pharyngeal cuff airway tube (16) and flows out into the pharyngeal cuff (7) attached to the slide tube (11). The pilot balloon (15), like the esophageal cuff (5), is used to check the degree of inflation of the balloon by the injected air outside the body. The connecting means of the pharyngeal cuff (7) and the pharyngeal cuff airway tube (16) is a pharyngeal cuff airway tube (1).
6) is sandwiched between the adhering margins of the pharyngeal cuff (7) and the slide tube (11), and a gap is filled with an adhesive or the like so as to maintain airtightness, and the end of the pharyngeal cuff airway tube (16) has a pharyngeal cuff (7). ) The slide tube (11) can be installed so as to protrude inside, or the slide tube (11) with airway lumen.
A method of forming a lumen structure, sealing the front end side of the airway lumen, connecting the airway tube for pharyngeal cuff (16) to the rear end side, and providing a side hole for communicating the inside of the pharyngeal cuff (7) with the airway tube. However, there is no particular limitation. The pharyngeal cuff airway tube (16) is formed of a synthetic resin, for example, a soft vinyl chloride resin, silicone rubber, polyurethane, polyethylene, or the like, and has a small diameter.

With the above arrangement of the parts, the inhalation sent from the resuscitator connected to the ventilation connector (8) is sent from the ventilation lumen (2) to the larynx from the esophagus through the ventilation side hole (6). Since the esophagus is closed by the esophageal cuff (5) and the pharynx is closed by the pharyngeal cuff (7), the inhalation sent to the larynx is sent to the lungs via the trachea and is sent to the lungs The air will be sent as expiration from the ventilation lumen (2) to the resuscitator through the ventilation side hole (6) on the reverse route to inspiration.

The reason why the slide tube (11) is provided in the present invention is that the pharyngeal cuff (7) is directly attached to the main body tube (1) when the present invention is inserted into the endotracheal tube after performing a ventilation operation. If so, the pharyngeal cuff (7) is in a position that does not block the epiglottis and allows pharyngeal closure, even if the air in the pharyngeal cuff (7) is evacuated. It gets in the way. If the slide tube (11) is provided and the pharyngeal cuff (7) is attached to the slide tube (11) as in the present invention, when the endotracheal tube is inserted, the air in the pharyngeal cuff (7) is evacuated and the pharynx is removed. Pull the cuff airway tube (16) to the rear end side, etc.
This is to allow the endotracheal tube to be easily inserted into the state shown in FIG. This allows the operator to insert the endotracheal tube into the patient without removing the present invention from the patient and without worrying about accidental swallowing.

In the embodiment shown in FIGS. 1 and 3, the slide tube (11) has a loose fitting dimension to slide the body tube (1) arbitrarily, and the pharyngeal cuff (7) during the ventilation operation. Is inflated, the internal pressure of the pharyngeal cuff (7) pushes the slide tube (11) toward the center and presses the main body tube (1) to thereby slide the slide tube (11).
Then, a frictional force is generated in the main body tube (1), and the slide tube (11) is fixed to the main body tube (1). At the same time, this compression closes the gap between the slide tube (11) and the main body tube (1), so that it is possible to obtain the airtightness required for pharyngeal closure. In addition, when the slide tube (11) with the pharyngeal cuff (7) is displaced during insertion of the present invention, the surgeon may use a finger to slide the slide tube (1).
1) Press down or press into place to inflate the pharyngeal cuff (7).

When inserting the slide tube (1) according to the present invention,
In order to obtain the fixing force of 1), a method of providing a fixing cuff (17) between the slide tube (11) and the main tube (1) as shown in FIGS. 5 and 6 is also suitably used. The fixed cuff (17) is fixed to the inner surface of the slide tube (11), and like the pharyngeal cuff (7), a plug means (14) and a pilot balloon (15) are provided at the rear end side of the slide tube (11). Airway tube for fixed cuff with cap (18)
And air injected from the plug means (14) is supplied to the pilot balloon (15) and the airway tube for fixed cuff (18).
And flows out into the fixed cuff (17) attached to the inner surface of the slide tube (11). Like the pharyngeal cuff (7), the pilot balloon (15) is used to check the degree of inflation of the balloon due to the injected air outside the body. With the fixed cuff (17) installed in this way,
At the time of insertion of the present invention and at the time of ventilation operation, air is introduced into the fixed cuff (17), and internal pressure is applied to the fixed cuff (1).
7) The body tube (1) in contact with the body tube (1) is pressed and adhered to generate a frictional force between the fixed cuff (17) and the body tube (1), and the slide tube (11) is attached to the body tube (1). Fixed. In addition, since the fixing cuff (17) and the main body tube (1) are in close contact with each other, airtightness when the pharynx is closed can be obtained. When inserting the endotracheal tube,
The air of the fixed cuff (17) is released, the frictional force between the fixed cuff (17) and the main body tube (1) is reduced, and the slide tube (11) is moved to the rear end side of the present invention.

The fixed cuff (17) obtains a frictional force with the main body tube (1) when inflated, and a rubber-like elastic body such as natural rubber that has a degree of friction that does not hinder the sliding of the slide tube (11) when contracted. It is formed in a cylindrical shape using rubber, synthetic rubber such as isoprene rubber, silicone rubber, urethane rubber, ethylene-propylene rubber, and other synthetic resins and elastomers such as soft vinyl chloride resin.

The airway tube (18) for the fixed cuff is made of a synthetic resin such as a soft vinyl chloride resin, silicone rubber, polyurethane, polyethylene or the like, similarly to the airway tube (13) for the esophageal cuff or the airway tube (16) for the pharyngeal cuff. And is formed in a small diameter.

Slide tube (11) when inserting the present invention
In addition to the fixing cuff (17) described above, the fixing means may be a mechanical fixing means that can be detachably operated from the outside, for example, a means for attaching a clamp to the slide tube (11) itself, or the slide tube (11). ) Is long at the rear end side, and when inserting the present invention, the surgeon can use the slide tube (1).
There are means for directly picking and fixing 1) by hand.

[0030]

By using the airway securing device for emergency resuscitation according to the present invention, it can be easily inserted from the oral cavity to the esophagus.
Selectively inflates the balloon, the lower part closes the esophagus, the upper part closes the oral and nasal passages with the pharynx for ventilation, making it safer, more secure, easier to use, and an endotracheal tube. When replacing the pharyngeal cuff, the doctor can slide and insert the endotracheal tube easily and quickly and securely without removing the present invention while inserting the pharyngeal cuff, and preventing accidental swallowing. This is extremely useful as an easy-to-insert airway securing device for use in an emergency.

[Brief description of the drawings]

FIG. 1 is a side view of an airway securing device for emergency resuscitation according to an embodiment of the present invention in a normal state.

FIG. 2 is a sectional view showing the vicinity of a ventilation side hole according to the present invention;
(A) is AA 'sectional drawing of the Example shown in FIG. 1, (b), (c), (d) is another Example.

3 is a cross-sectional view of the vicinity of the pharyngeal cuff according to the present invention, and is a cross-sectional view taken along the line BB 'of the embodiment shown in FIG.

FIG. 4 is a side view of the embodiment of the present invention shown in FIG. 1 when the slide portion is shifted to the rear end side.

FIG. 5 is a side view of the airway securing device for resuscitation when a fixed cuff is provided on the inner surface of the slide tube of the present invention.

6 is a cross-sectional view of the vicinity of the pharyngeal cuff when a fixed cuff is provided on the inner surface of the slide tube of the present invention, and is a cross-sectional view taken along the line BB 'of the embodiment shown in FIG.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Body tube 2 Ventilation lumen 3 Airway lumen for esophageal cuff 4 Gastric pressure release lumen 5 Esophageal cuff 6 Ventilation side hole 7 Pharyngeal cuff 8 Ventilation connector 9 Vent 10 Scale means 11 Slide tube 12 Tip tip 13 Airway tube for esophageal cuff 14 Plug Means 15 Pilot balloon 16 Airway tube for pharyngeal cuff 17 Fixed cuff 18 Airway tube for fixed cuff

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[Procedure amendment]

[Submission date] June 18, 1998

[Procedure amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0011

[Correction method] Change

[Correction contents]

[0011] Further, in order to improve these drawbacks of the esophagus-closed airway and to replace the mask with a pharyngeal balloon, JP-A-6-142205 and JP-A-9-24102 disclose devices.
Gazette, Japanese Patent Application No. 8-343895, Japanese Patent Application No. 8-343
No. 899 is disclosed. These do not require fixation of the mask, and the dead space is smaller than that of the mask type, so that they are considerably improved and operability is also improved. However, the emergency squad inserts these conventional esophageal closed airways into patients with cardiopulmonary arrest, transports the patient to the hospital while performing appropriate emergency treatment such as securing the airway, etc., because the doctor performs emergency surgery. When inserting the endotracheal tube into the trachea, the pharyngeal cuff closing the pharynx hinders the insertion of the endotracheal tube,
These airway devices had to be removed prior to insertion of the endotracheal tube. At this time, closing the esophagus may cause the contents of the stomach pressed by the esophagus to flow back to the oral cavity, enter the trachea, and cause aspiration (aspiration of the oral or stomach contents into the trachea and lungs). there were.

[Procedure amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0012

[Correction method] Change

[Correction contents]

[0012]

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and enables a doctor to easily, quickly and reliably insert an endotracheal tube without having to remove an airway securing device during insertion. It is an object of the present invention to provide an airway securing device for emergency resuscitation that can prevent aspiration.

[Procedure amendment 3]

[Document name to be amended] Statement

[Correction target item name] 0024

[Correction method] Change

[Correction contents]

The reason why the slide tube (11) is provided in the present invention is that the pharyngeal cuff (7) is directly attached to the main body tube (1) when the present invention is inserted into the endotracheal tube after performing a ventilation operation. If so, the pharyngeal cuff (7) is in a position that does not block the epiglottis and allows pharyngeal closure, even if the air in the pharyngeal cuff (7) is evacuated. It gets in the way. If the slide tube (11) is provided and the pharyngeal cuff (7) is attached to the slide tube (11) as in the present invention, when the endotracheal tube is inserted, the air in the pharyngeal cuff (7) is evacuated and the pharynx is removed. Pull the cuff airway tube (16) to the rear end side, etc.
This is to allow the endotracheal tube to be easily inserted into the state shown in FIG. This allows the operator to insert the endotracheal tube into the patient without removing the present invention from the patient and without worrying about aspiration.

[Procedure amendment 4]

[Document name to be amended] Statement

[Correction target item name] 0030

[Correction method] Change

[Correction contents]

[0030]

By using the airway securing device for emergency resuscitation according to the present invention, it can be easily inserted from the oral cavity to the esophagus.
Selectively inflates the balloon, the lower part closes the esophagus, the upper part closes the oral and nasal passages with the pharynx for ventilation, making it safer, more secure, easier to use, and an endotracheal tube. By replacing the pharyngeal cuff with a doctor when replacing it, the endotracheal tube can be inserted quickly and securely easily without removing the present invention while it is still inserted, preventing aspiration. This is extremely useful as an easy-to-insert airway securing device for use in an emergency.

Claims (2)

[Claims] 1. A curved main tube, an esophageal cuff provided on the distal end of the main tube, and an esophageal cuff provided on the main tube so as to cover the rear end of the esophageal cuff. A slide tube slidable on the outer surface of the slide tube, a pharyngeal cuff attached to the outer surface of the slide tube, and a ventilation connector attached to the rearmost end of the body tube. The body tube has a ventilation lumen. A rescue respiratory airway securing device, characterized in that there is a ventilation side hole communicating with the ventilation lumen between the esophageal cuff and the pharyngeal cuff. 2. The airway securing device for resuscitation according to claim 1, further comprising a fixing cuff fixed to an inner surface of the slide tube in a gap between the slide tube and the main tube.