RU2524300C1 - Syringe-trocar and kit for pleural cavity drainage and pneumothorax and hemopneumothorax elimination - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention can be used for emergency actions in penetrating wounds and closed chest injuries with the pulmonary injury accompanied by a developing pressure pneumothorax followed by intrapleural haemorrhages both in time of peace, and in time of war on the battlefield. A kit for the pleural cavity drainage and pneumo- and hemopneumothorax elimination contains a drainage unit, a disposable package and an anaesthetic bottle. As the drainage unit, the kit contains a syringe-trocar comprising a drain tube with a side hole at the working end. Inside the drain tube, there is a piston cylinder having a hollow intermediate portion at the end with a blade with sharp outer edges passing a hollow injection needle of the syringe.

EFFECT: invention provides the fast, painless, effective pneumo- and hemopneumothorax elimination in injured people with chest cases or closed chest injuries with the pulmonary injury followed by intrapleural haemorrhages in the field, in sites of crash, in ambulance cars, at medical evacuation or in hospitals.

5 cl, 2 dwg

Description

The invention relates to medicine, in particular to the field of disaster medicine and field surgery, can be used to provide emergency care for penetrating wounds and closed chest injuries with lung damage, ongoing intrapleural bleeding both in peacetime and in wartime on the field battlefield.

Known devices for drainage of the pleural cavity, such as: trocar, puncture needle, etc.

(“National Leadership”, under the editorship of prof. I.Yu. Bykov, prof. N.A. Efimenko, prof. E.K.Gumanenko, Moscow. GEOTAR-Media, 2009, p. 550)

The disadvantages of these devices is the low efficiency, the complexity of their use in the field and the length of time during the manipulation of these funds.

It is known to use disposable trocars in providing the first doctor at the stages of medical evacuation.

A known set for drainage of the pleural cavity, including a catheter, trocar, valve, adapter, characterized by the connection of the catheter with the valve, the valve is fixed in the catheter on the thread (RF patent for PM No. 68286, A61M 27/00, A61B 17/34, publ. 10.05 .2007).

The disadvantage of this device is the inability to conduct simultaneous anesthesia, drainage of the pleural cavity with the elimination of pneumothorax, the further elimination of hemothorax with the ability to connect a device to collect and save the blood spilled into the pleural cavity for reinfusion.

The basis of the invention is the task of providing quick, painless, effective elimination of pneumo- and hemopneumothorax in patients with chest injuries or closed chest injuries with lung damage, ongoing intrapleural bleeding in the field, at the scene of accidents, in ambulances, at the stages medical evacuation or in hospitals with the possibility of connecting a "Gemakon" or other disposable device in order to collect and preserve the blood that has poured into the pleural cavity for reinfection sion in the future.

The technical result is achieved by the fact that in a syringe trocar containing a drainage tube with a lateral hole at the working end, a cylinder with a piston is placed inside the drainage tube, ending with a hollow intermediate part with a blade with sharp outer edges, letting the hollow injection needle of the syringe with edges at the end shortened hollow injection needle. A kit for draining the pleural cavity and eliminating pneumo- and hemopneumothorax, containing a drainage device and a disposable package, includes, as a device for draining, the trocar syringe according to claim 1 and a bottle with an anesthetic.

A valve in the form of a “petal” of corrugated polyethylene or rubber, provided with a ring at the free end, can be installed on the drainage tube.

Sterile wipes with an antiseptic may be included in the kit.

A device may be included in the kit for collecting and preserving blood spilled into the pleural cavity.

The trocar syringe is painlessly inserted into the pleural cavity due to the presence of an anesthetic and a needle for its administration in the kit. The presence of a side hole on the drainage tube at the working end increases the aspiration properties of the entire device. The use of an elastic valve in the form of a “petal” made of corrugated polyethylene or rubber with a ring on the free edge of the “petal” placed on the drainage tube surrounding the trocar provides the possibility of eliminating pneumothorax, and when connecting the device included in the kit to collect and store the spilled into pleural cavity makes it possible to provide reinfusion.

The invention is illustrated in figure 1 and figure 2. Figure 1 presents a General view of the device, and figure 2 shows the device after drainage of the pleural cavity with the possibility of venting air out through the valve "petal" or connecting a device for collecting blood.

The trocar syringe is located in the kit, including sterile packaging (1), and contains a drainage tube (2) with a side opening at the end, to increase the aspiration properties (3), and the drainage tube is connected to an elastic valve in the form of a “petal” made of corrugated polyethylene or rubber (4) and a ring on the free edge of the “petal” (5), a “syringe-trocar” is placed inside the drainage tube - a cylinder (6) with a piston (7) ending at the working end with a hollow intermediate part, placed on her triangular-shaped blades with sharp outer edges (8), and passing into a shortened hollow injection needle at the apex (9), and the cylinder is filled with anesthetic from the bottle (10), before performing drainage and is removed through the valve after penetrating the pleural cavity, the valve (5) at the same time straightens and becomes ready to vent air or connect a blood collection device (either Gemacon or another disposable blood collection system) (12).

The kit also includes 3rd sterile wipes with an antiseptic (11).

The device works as follows: the package of the set is opened, wipes 11 with an antiseptic are removed, which process the surgical field. Then, a device for draining the pleural cavity is taken and the preparation of the device and drainage of the pleural cavity are performed in stages:

1. the advancement of the working part of the cylinder 6 inside the bottle 10 with anesthetic through the tube;

2. filling cylinder 6 with anesthetic by reverse movement of piston 7;

3. removal of an empty bottle 10;

4. treatment of the surgical field with antiseptic wipes and intradermal administration of 0.5 ml of anesthetic;

5. puncture-cutting of the skin with a triangular blade 8 of the working end of the device;

6. puncture-cutting of the superficial fascia, muscles, fascia of the intercostal spaces, pleura with preliminary layer-by-layer administration of portions of anesthetic;

7. the introduction of the remainder of the anesthetic into the pleural cavity;

8. holding the cylinder 6 by 0.5 cm into the pleural cavity;

9. the simultaneous introduction of the drainage tube 2 into the pleural cavity and removing the cylinder 6 with the piston 7 (essentially a trocar);

10. removing the cylinder 6 with the piston 7 and straightening the corrugated valve 4;

11. control of air intake;

12. when blood appears, a blood collection device 12 is connected through a ring 5 located on the free edge of the valve 4 to the lumen of the drainage tube 2.

Thus, the use of a “Trocar Syringe” and a kit for drainage of the pleural cavity and elimination of pneumo- and hemopneumothorax provides quick, painless, effective elimination of pneumo- and hemopneumothorax in patients with chest injuries or closed chest injuries with lung damage that continues with intrapleural bleeding in field conditions, at the scene of disasters, in ambulances, at the stages of medical evacuation or in hospitals, and has the ability to connect a Gemakon or other a disposable device for the purpose of collecting and preserving blood spilled into the pleural cavity for reinfusion in the future. Perhaps a separate use of a trocar syringe for drainage of the pleural cavity and the elimination of pneumo-and hemopneumothorax.

Patient Sh., 31 years old, diagnosis: left-sided intense pneumothorax. Performed drainage of the left pleural cavity using a set. Consistently held events. Disclosed set. The working part of the cylinder (6) is advanced into the bottle with anesthetic (10). The reverse movement of the piston (7) filled the cylinder (6) with anesthetic. Empty bottle (10) discarded. One after another, packages of napkins with an antiseptic were opened (11) and the surgical field was treated in area 2 of the intercostal space on the left in the mid-axillary line. By injecting the needle intradermally (9), a “lemon peel” was created and the skin was punctured by cutting the blade (8). In succession portions of the injected anesthetic are infiltrated and the blade at the end of the working part of the cylinder (8) punctured-cut through the layers:

superficial fascia, pectoralis major muscle, pectoralis minor muscle, fascia 2 intercostal space, muscles of the intercostal space, pleura. The remainder of the anesthetic is introduced into the pleural cavity. After introducing the working part of the cylinder (6) into the pleural cavity, determined by the characteristic "dip" by 0.5 cm, the drainage tube (2) is further advanced. The “trocar syringe” (6.7) was removed through the valve (4) and the valve straightened out. There was a characteristic "hiss-rattle" as air passed through it. The patient began to breathe more actively. When blood appears in the valve (4), a Gemakon package is connected to the rubber ring at the end of the valve (5) and 173 ml of blood is collected. Blood was suitable for reinfusion.

Claims (5)

1. A trocar syringe containing a drainage tube with a side opening at the working end, while a cylinder with a piston is placed inside the drainage tube, ending with a hollow intermediate part with a blade with sharp outer edges, allowing the syringe to pass through the hollow injection needle. 2. The trocar syringe according to claim 1, characterized in that a valve in the form of a “petal” of corrugated polyethylene or rubber equipped with a ring at the free end is installed on the drainage tube. 3. A kit for draining the pleural cavity and eliminating pneumo- and hemopneumothorax, containing a drainage device and a disposable package, characterized in that the syringe trocar according to claim 1 and an anesthetic vial are included in the kit as a drainage device. 4. The kit according to claim 3, characterized in that the kit includes sterile wipes with an antiseptic. 5. The kit according to claim 3, characterized in that the kit further includes a device for collecting and storing the blood that has poured into the pleural cavity.

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