RU2757523C2 - Device for the treatment of open pneumothorax - Google Patents

Abstract

FIELD: medical equipment.

SUBSTANCE: invention relates to medical equipment, namely to a device for the treatment of open pneumothorax. The device includes an occlusive bandage, the upper part of which is made of an airtight transparent membrane, and the lower part has an adhesive layer, a tee is fixed in its central through part, connected by means of a transition line with an audio signal valve. The bandage is made with a reinforced strip around its perimeter and with a fixing strap. The audible signal valve is designed to provide unidirectional air discharge into the environment, so that at the moment of air exit from the pleural cavity, an audible signal is issued, which can be used to diagnose the type of pneumothorax.

EFFECT: increase in the efficiency, reliability and ease of use of the device.

3 cl, 3 dwg

Description

Technology area

The invention relates to medicine and is intended for the diagnosis and treatment of open pneumothorax in wounded and injured with chest injuries.

The invention can be applied at the scene of an accident, catastrophe, in the field and in the provision of emergency medical care.

There are various methods and devices for the treatment of open pneumothorax: the use of tampons soaked in ointment or an individual dressing bag (PPI); closing the defect with an adhesive plaster; plastic film; Asherman's occlusive dressing; plaster for pneumothorax FOXSEAL; occlusive dressing HALO and others.

The disadvantages of these methods are the inability to carry out diagnostics, as well as their low efficiency in the treatment of open pneumothorax, the high probability of fatal complications when the lung or chest organs are injured, etc.

A device for the treatment of open pneumothorax is known (patent for a useful model of the Russian Federation No. 193225 dated 06.04.2019.).

The disadvantages of this device are its low reliability due to the possibility of overlapping the operation of the valve with convolutions of blood and fibrin, as well as fragments of destroyed tissues; violation of the patency of the lumen of the drainage system due to blockage of the valve by clothing or a warming blanket, which ultimately can lead to a fatal complication (respiratory and circulatory arrest); the inability to collect and store blood when internal bleeding occurs; visualization of valve operation due to clothing or a blanket, perform videothoracoscopy in order to diagnose trauma to internal organs and assess hemostasis; mechanical and hemostatic stopping of external bleeding, restore the patency of the wound channel; apply a bandage on either side of the chest (front, back, side) regardless of the position of the victim (wounded), etc.

Thus, there is a need to create a reliable device for use in providing first aid to an injured person with open pneumothorax.

The essence of the invention

The technical problem to be solved by the present invention is to develop an affordable reliable disposable device for the diagnosis and treatment of open pneumothorax at the scene of an accident, in ambulances and in extreme conditions, in particular, in the field.

The technical result of the invention is to improve the efficiency, reliability and usability of the device.

The technical result is achieved due to the fact that the proposed device for the diagnosis and treatment of open pneumothorax (Fig. 1) uses an occlusive dressing (12), the upper part of which is made of an airtight transparent membrane (2), and the lower part has an adhesive layer (1), in its central through part there is a tee (6) with a plug (5) connected by means of a transition line (8) to a sound signal valve (7), along the perimeter there is a reinforced strip (3) and a fixing strap (4).

The proposed device ensures the creation of reliable sealing of the pleural cavity due to four components: tight contact of the chest surface with the adhesive layer (1), a transparent airtight membrane (2), fixing the strap (4) and a reinforced strip (3), which congruently repeats the relief of the body surface and prevent the bandage from slipping and peeling off. The elastic fixing strap makes it possible to more tightly press the airtight bandage to the body of the victim (wounded), regardless of his chest circumference, as well as the phase of inhalation or exhalation. Mechanical tight pressing of the occlusive dressing due to the adhesive layer, reinforced strip and fixing strap in combination with hemostatic gauze (sponge) provide reliable stopping of external bleeding, which is completely excluded by analogs.

The horn valve (7) allows diagnostics and, at the same time, decompression in the pleural cavity, i.e. significantly reduces the likelihood of such a fatal complication as tension pneumothorax and the resulting cessation of breathing and blood circulation. By its sound signal, in the case of air flow from the pleural cavity, the presence or absence, as well as the type of pneumothorax, is diagnosed, it makes it possible to control the operation of the device at a distance and, in combination with auscultation, evaluate the expansion of the lung without using X-ray examination, which is completely excluded by analogs.

The transition line (8) allows the valve of the sound signal to be brought to the surface of clothing or a blanket, which makes it possible to cover the victim (wounded) and exclude hypothermia. The location of the valve on the surface of the victim also allows you to control (visually and by sound signal) his work. A transitional line with a valve assumes to apply an occlusive dressing on either side of the chest (front, back and side) without giving a special position to the victim (the valve can be brought to any level), which is completely excluded by analogs.

The use of a tee (6) significantly reduces the likelihood of closure of the valve lumen with convolutions of blood, fibrin and fragments of destroyed tissue. Removing the plug (5) from the tee makes it possible to perform video thoracoscopy for the victim (wounded) in order to diagnose trauma of internal organs and assess the stability of hemostasis. By means of a tee and pleural drainage, it is possible to restore the patency of the wound canal, which can be closed due to the displacement of the tissues of the chest wall and thereby level the occurrence of such a formidable complication as tension pneumothorax, which is completely excluded by analogs.

The use of a device with a storage tank (9) (Fig. 2) for the treatment of open pneumothorax in patients with chest injury, complicated by intrapleural bleeding makes it possible to minimize the valve failure with a sound signal, and also allows collection and storage of spilled autologous blood. The container with the hemo-preservative (11) makes it possible to dose it more accurately, depending on the amount of blood poured out of the pleural cavity. The adapter (10) together with the blood transfusion system is used for autohemotransfusion, which is completely excluded by analogs.

A device for the treatment of open pneumothorax of a firearm origin, which, as a rule, has an inlet and outlet, consists of two parts Fig. 1 and fig. 3. An additional device (Fig. 3) includes an occlusive dressing (12), the upper part of which is made of an airtight transparent membrane (2), and the lower part has an adhesive layer (1), a reinforced strip (3) and a fixing strap (4).

The inventive device for the treatment of open pneumothorax is used as follows.

Having found damage in the chest area, make a U-shaped dissection of clothing for adequate access to the wound. The exposed chest should be larger than the airtight dressing. If signs of open pneumothorax are detected, that is, the exhalation of air from the chest wound, the skin is cleaned of contamination with a napkin with an antiseptic, then an occlusive dressing (12) is applied with an adhesive layer (1) on the open wound of the chest wall, tightly fixing it, regardless of localization wounds and breathing phases so that the hole in the center of the dressing is over the wound defect. With the help of the fixing strap (4), the bandage is securely attached to the victim's chest, which excludes its displacement during the patient's movements and provided sealing of the wound during transportation. If the victim (wounded) has external bleeding, hemostatic gauze (sponge) is used, which is pressed to the wound by means of an occlusive dressing, fixing straps and a reinforced strip. All this taken together makes it possible to stop external bleeding in a victim (wounded) with a chest injury.

With an open pneumothorax, air from the pleural cavity through the tee (6), the transition line (8) enters the sound signal valve (7), which provides a unidirectional discharge of air into the environment. When the membrane vibrates at the moment of air release, sound vibrations occur. Thus, at the moment the air leaves the pleural cavity, the valve (7) emits a sound signal, which can be used to diagnose the type of pneumothorax (closed, open, valve or tense). The valve (7) also simultaneously decompresses the pleural cavity, i.e. eliminates the life-threatening condition of the victim (wounded), thereby fulfilling the main goal of providing first aid.

The type of pneumothorax is determined in accordance with the frequency and duration of the sound signal that occurs when air leaves the pleural cavity through the valve.

With an open pneumothorax without damage to the lung, the amount of air leaving the pleural cavity and the duration of the periodically arising sound signal gradually decrease.

In open pneumothorax with lung damage, the amount of air and the duration of the intermittent signal are usually constant.

With a tense pneumothorax, a continuous signal first appears, then an intermittent one of the same duration, but longer when the patient coughs and strains.

The use of the developed device makes it possible not only to diagnose the type of pneumothorax, but also to simultaneously carry out etiopathogenetic complete treatment.

The transition line (8) allows the sound signal valve (7) to be carried out and placed over clothing, thereby making it possible to insulate and avoid hypothermia of the victim (wounded) in winter. By the sound signal coming from the drainage system, it is possible to judge from a distance about the functioning of the proposed device, i.e. to assess the patency of the entire system and timely detect its exit from the working state, which allows timely leveling of the occurrence of fatal complications. All previously proposed devices for the treatment of open pneumothorax completely exclude monitoring of the drainage system.

The main principle of treatment of pneumothorax is earlier and complete expansion of the collapsed lung. In combination with the data of physical examination and the results of the characteristics of the sound signal, it is possible to judge with high accuracy the pace and nature of the expansion of the collapsed lung, even without x-ray examination.

In case of open pneumothorax complicated by intrapleural bleeding, a device (Fig. 2) is used, which additionally includes a storage tank (9) and a container with a blood preservative (11). Air and blood from the pleural cavity through the tee (6), the transition line (8) enter the storage tank (9). The blood poured out from the pleural cavity is dosed with the hemo-preservative from the container (11), and the air is further, respectively, into the sound signal valve (7), which ensures its unidirectional discharge.

Penetrating gunshot wounds of the chest, in which traumatic pneumothorax develops, as a rule, have two holes: inlet and outlet. In the provision of emergency medical care for this category of injured, two occlusive dressings are used: an occlusive dressing with a sound signal valve (Fig. 1) or a storage tank is applied to the entrance opening, if there is intrapleural bleeding (Fig. 2), an occlusive dressing without a valve is applied to the outlet opening (Fig. 3) in order to create a tightness in the pleural cavity, regardless of damage to the lung or other internal organs.

Thus, a simple highly effective device has been developed for the treatment of open pneumothorax, including those complicated by damage to the internal organs of the chest, as well as external and internal bleeding.

Claims (3)

1. A device for the treatment of open pneumothorax, including an occlusive dressing, the upper part of which is made of an airtight transparent membrane, and the lower part has an adhesive layer, a tee is fixed in its central through part, connected by means of a transition line to the sound signal valve, while the dressing is made with a reinforced a strip along its perimeter and with a fixing strap, while the sound signal valve is configured to provide a unidirectional discharge of air into the environment, so that at the moment air leaves the pleural cavity, a sound signal is emitted, which can be used to diagnose the type of pneumothorax. 2. The device according to claim 1, characterized in that a storage tank is connected to the tee fixed in the center of the occlusive dressing by means of a transition line, which has a sound signal valve and an adapter together with a blood transfusion system, made with the possibility of autohemotransfusion. 3. The device according to claim. 1, characterized in that it includes an additional occlusive dressing, including an adhesive layer, an air-tight transparent membrane, a reinforced strip and a fixing strap.

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