RU2621951C1 - Intranasal gauze to stop bleeding from front departments of nasal cavity - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: gauze to stop nasal bleeding from the front departments of the nasal cavity contains an elastic chamber and a tube to feed the chamber filler with a clamp and an end connector. The chamber consists of two parts, the first of which is made in form of the front department of the nasal cavity and has a length of 300±50 mm and the maximum transverse dimension of 300±50 mm, and the second part is made for installation under the secondary nasal cavity, has a length of 300±50 mm and the maximum transverse dimension of 200±50 mm. The lower part of the gauze forms an even surface along the nasal cavity bottom shape.

EFFECT: gauze allows to simply and quickly stop nasal bleeding from the front departments of the nasal cavity, does not require specialized tools and minimizes the risk of unwanted effects.

4 cl, 1 dwg

Description

The invention relates to medicine, in particular to otorhinolaryngology, and can be used in the treatment of patients with nosebleeds from the anterior parts of the nasal cavity.

Epistaxis is one of the most important problems of otorhinolaryngology. A variety of etiology, pathogenesis, features of diagnosis and therapy allows attributing nosebleeds to general clinical problems. According to recent literature, the number of patients with nosebleeds is 14.7-20.5% among all patients requiring emergency ENT care (A. Slavsky, Epistaxis. Russian Rhinology, 2012, No. 2).

As a rule, a patient with nosebleeds needs immediate medical attention and stopping hemorrhage. From this point of view, the most popular is the classification depending on the source of bleeding, on the basis of which nosebleeds are divided into anterior and posterior. Most often, nosebleeds occur from the anterior sections of the nasal cavity, from the Kisselbach-Little zone.

Arrangements for emergency stopping of nosebleeds begins with the front gauze tamponade according to Mikulich along with hemostatic therapy. If bleeding occurs only from the Kisselbach zone, the front of the nasal cavity is plugged. In cases of mild bleeding from the anterior sections of the nose, a tamponade technique is proposed with foam rubber tampons in glove rubber, which are inserted along the bottom of the nasal cavity with bayonet forceps. If the front tamponade is ineffective, the back tamponade is performed according to Bellock, which is always supplemented by a tight front tamponade. The optimal term for tamponade of the nasal cavity is considered to be from 4 to 6 days, exceeding these terms leads to the development of complications, for example, purulent sinusitis, otitis media. Patients endure tamponade of the nasal cavity, as it is accompanied by the impossibility of nasal breathing, a feeling of lack of air, severe headache and pain in the face.

It is known "Device for stopping nosebleeds", which can be used to stop nosebleeds as an alternative to standard nasal tamponade (RF Patent No. 2411918 C1, Palchun VT, Magomedov MM, Dibirovan T.A., 2009). This device consists of a tampon in the form of an elastic chamber, the shape of which corresponds to the sagittal section of the nasal cavity. The chamber has stiffening ribs at the edges and is equipped with a breathing tube with holes at the ends and a tube for supplying the filler of the chamber. The latter contains a clamp connected to the source of supply of the filler chamber, as well as a pneumatic balloon. The air spring provides pressure control in the chamber. A breathing tube passes through the chamber along the edge.

It is known "Device for stopping bleeding in the nasal cavity" (Patent No. 2331, M. Sulamanidze, July 16, 1996). The device comprises a streamlined elastic chamber with which the filler feed pipe is connected at one end. The other end of the tube is connected to a valve connected to a filler supply source of the chamber, such as a syringe. The camera is equipped with a breathing tube passed through the camera. This device is selected as a prototype.

The disadvantages of this device are:

1. When using such a device to stop nosebleeds due to its large size, the front and rear sections of the nasal cavity are completely compressed, even if the source of bleeding is located in the front section, which increases the headache and discomfort of the patient.

2. The existing breathing tube during operation after a while is filled with small crusts and clots and loses the ability to conduct air.

3. For the correct installation of the tampon, the doctor needs to place it correctly in the entire nasal cavity, which can be difficult if the patient has deviations of the nasal septum in the posterior sections. In this regard, a qualified otorhinolaryngologist can install a tampon, and it is extremely difficult for an ambulance doctor or paramedic in a community-based institution. As a result, this device did not find proper distribution when providing first aid, where they often use the front gauze tamponade according to Mikulich.

In connection with the foregoing, we were tasked with the development of an intranasal swab for the installation of nosebleeds in the anterior part of the nasal cavity, which does not have the disadvantages of analogues.

Achievable in the implementation of the device developed by us, the technical result is to ensure simple with t.z. the implementation and quick stop of nosebleeds from the anterior sections of the nasal cavity, which does not require specialized tools and minimizes the risk of unwanted effects of tamponade.

A tampon for stopping nosebleeds from the anterior parts of the nasal cavity contains a basis of elastic material - silicone rubber with a shore hardness of A-60. The basis is made in the form of a chamber (tampon) of small size (optimal size 600 × 300 mm) connected to a filler tube 2-3 mm thick and 1000 ± 50 mm long, at the distal end of which there is a clamp (for example, 250 × 100 mm) and an end connecting element, made with the possibility of connection with the supply source of the filler of the chamber (liquid or gas can be used as filler).

Moreover, the camera is made with decreasing width at the proximal end (for example, up to 200 mm). This configuration is most anatomically suitable for the nasal cavity and the protruding middle nasal concha in the middle sections of the nasal cavity. The chambers that we studied in the literature do not have such a shape, due to which, upon installation, they rest against the middle nasal concha and, with its possible injury, can aggravate existing bleeding.

The chamber sizes chosen by us are anatomical to the structure of the nasal cavity, which allows the camera to be installed quickly and painlessly for the patient.

The tampon can be divided into two parts: the first is made in the form of the anterior part of the nasal cavity and has a length of 300 ± 50 mm and a maximum transverse size of 300 ± 50 mm, and the second part is made for installation under the middle nasal concha, has a length of 300 ± 50 mm and maximum transverse dimension 200 ± 50 mm; while the lower part of the tampon form a flat surface in the shape of the bottom of the nasal cavity. When filling the swab, it tightly compresses all the anatomical structures (middle and lower nasal concha, nasal septum) of the front and middle sections of the nasal cavity, stopping the existing bleeding.

Figure 1 - swab for stopping nosebleeds from the front of the nasal cavity:

1 - swab chamber;

2 - tube for camera filler;

3 - clamp;

4 - end connecting element.

The installation of a tampon to stop nosebleeds from the front of the nasal cavity is as follows.

After local anesthesia with a solution of Lidocaine 10%, 2 ml, with the help of a nasal dilator and cranked forceps, a tampon is placed in parallel to the bottom of the nasal cavity in the patient's position, lying or sitting. Our proposed configuration of the swab allows you to install the swab along the bottom of the nasal cavity, and in the upper sections of the nasal cavity to install under the middle nasal concha. A liquid (water, saline, oil) or gas is introduced through the filler tube. After introducing the filler, close the tube with a clamp. The duration of the tamponade can be from 1 to 4 days, after which the clamp is opened and the filler is removed with a syringe. The swab is removed with cranked forceps from the nose.

Claims (4)

1. A tampon for stopping nosebleeds from the anterior sections of the nasal cavity, comprising an elastic chamber and a tube for supplying a camera filler with a clip and an end connecting element, characterized in that the chamber consists of two parts, the first of which is made in the shape of the anterior part of the nasal cavity and has a length of 300 ± 50 mm and a maximum transverse dimension of 300 ± 50 mm, and the second part is made for installation under the middle turbinate, has a length of 300 ± 50 mm and a maximum transverse dimension of 200 ± 50 mm, with the lower part of the swab t form a flat surface on the bottom of the nasal cavity. 2. A tampon according to claim 1, characterized in that the elastic chamber is made of silicone with shore hardness A-60. 3. The tampon according to claim 1, characterized in that the tube for supplying the filler of the chamber is made with a length of 1000 ± 50 mm and has an outer diameter of 2-3 mm 4. The tampon under item 1, characterized in that the end connecting element is made to connect to a source of liquid or gas.

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