經濟部中央標準局I工消費合作杜印装 4439 3 7 五、發明説明(1 ) 本發明係有關一種進行人體氣管之插管定位方法及其 裝置’特別是指一種能輕易地判斷出氣管内插管姑· 定位於人體氣管而非誤置於食道之定位方法,且應用於本 發明方法之裝置,其不僅方便攜帶應用於外出急救及容易 擺置於醫療現場,且其設備成本低廉,但卻更^有醫療安 全之實用價値’為一種突破現今進行人體氣管之插管操作 的新發明。 在手術房進行外科手術時,必需對病患實施全身麻醉 ’而實施全身麻醉必須進行氣管内插管的插置動作,將内 插管定位於病患之氣管内,藉著内插管另端所銜接的呼吸 輔助器,提供病患維持生命所必需的氧氣。由於人體氣管 開口係緊鄰食道開口,加諸於視線不佳觀察不易,每每發 生操作者誤將内插管插置於食道内,若未能及時發現,不 僅會導致病患缺氧、心跳停止、神經系統受損,甚至於導 致病患死亡,進而產生許多醫療糾紛。有鑑於將内插管誤 插置於食道内所產生影響生命的嚴重問題及後遣症,於一 般手術房内均設置有二氧化碳分析儀,利用二氧化碳分析 儀監測病患肺部所呼出之二氧化碳濃度,作為判斷内插管 是否被正確地插置於氣管内,然此種二氧化碳分析儀之設 置費用相當高昂,除了手術房以外,並不普遍應用於一般 急診室、重症病房及外出急救等範圍。在一般急診室、重 症病房及外出急救所採用幫助病患呼吸的方法,其均是先 行將内插管插置於患者之氣管内,復利用手動壓擠式供氣 球銜接内插管,持續壓擠供氣球以提供病患之呼吸,在病 患已不能自主呼吸且情沉緊急的狀態下,操作人員若稍有 不愼,即可能造成無以彌補的遺憾。更何況被施救的患者 在未施予麻醉的情況下,内插管在插入人體喉嚨内部時, 喉部神經系統會因接觸物體而將氣管開口封閉,更加鉅操 本紙張尺度適用中國國家標率(CNS ) A4規格(210X297公釐) 3I. Consumer Cooperation with Central Standards Bureau, Ministry of Economic Affairs, Du Printing 4439 3 7 V. Description of the Invention (1) The present invention relates to a method and device for intubation positioning of the human trachea, particularly a method that can easily determine the endotracheal insertion. Guangu · A positioning method that is positioned on the human trachea instead of being placed in the esophagus and is applied to the method of the present invention, which is not only convenient to carry out and used in first aid and easy to place in a medical site, and its equipment cost is low, but Moreover, it has a practical value for medical safety. It is a new invention that breaks through the intubation operation of human trachea. When performing a surgical operation in the operating room, the patient must be subjected to general anesthesia, and to perform general anesthesia, an endotracheal intubation must be performed. The endotracheal tube is positioned in the patient's trachea and the other end The connected breathing aid provides oxygen necessary for patients to maintain their lives. Because the human tracheal opening is close to the esophagus opening, it is not easy to observe with poor eyesight. When the operator inserts the intubation tube into the esophagus by mistake, if it is not found in time, it will not only lead to hypoxia, cardiac arrest, Nervous system damage, and even death of patients, has led to many medical disputes. In view of the serious life-threatening problems and posterior problems caused by the intubation of the intubation tube in the esophagus, a carbon dioxide analyzer is installed in the general operating room. The carbon dioxide analyzer is used to monitor the carbon dioxide concentration exhaled by the patient's lungs. As a judgment to determine whether the intubation tube is correctly inserted into the trachea, the installation cost of this carbon dioxide analyzer is quite high. Except for the operating room, it is not widely used in general emergency rooms, intensive care units, and out-of-care first aid. In general emergency rooms, intensive wards, and out-of-care facilities, the methods used to help patients breathe are to first insert the intubation tube into the patient's trachea, and then use a manual squeeze-type balloon to connect the intubation tube and continue to press. Squeeze the balloon to provide the patient's breath. In the state where the patient can no longer breathe on his own and the situation is urgent, if the operator is slightly uncomfortable, it may cause regret that is beyond repair. What's more, when the rescued patient is not anesthetized, when the intubation tube is inserted into the human throat, the larynx nervous system will close the opening of the trachea due to contact with the object. Rate (CNS) A4 specification (210X297 mm) 3
44393 7 A7 B7 經濟部中央標準局貝工消費合作社印製 五、發明説明(2 ) 作人員插管的因難度及危險性。本發明之發明人係為具有 多年醫療臨床經驗之醫療從業人員,有感於現今進行氣管 插s的操作方法及早純使用一内插管而無法迅即監測是否 正確定位的實務缺失,及作為監測的二氧化碳分析儀並無 法被普及應用於外出急救、急診單位、病房等限制下,乃 予於研發,歷經多次努力,終於發展出一種可克服氣管插 管時所潛伏危險性之新方法及其使用裝置,緣是; 其本發明之主要目的,其係提供一種進行人體氣管之插 管定位方法,該方法係利用一在前端設有信號產生源之探 樺先行套進内插管内,於被施行氣管插管之病患的頸部喉 結外表皮膚貼黏一感測器,該感測器可將拾取的訊號輸入 厂在内部設有電路控制系統之控制箱,且由控制箱上之燈 號顯示及蜂鳴聲指示出内插管已被正確定位於氣管開口内 者0 ' 本發明之另一主要目的,其係提一種進行人體氣管之 插f定位的監測裝置,該裝置包括有探棒、發射元件、感 測器、控制箱,該探棒於前端設有可產生信號源之發射元 件:感測器則可拾取信號,藉由控制箱内設電路控制系統 執行,並於内插管被正確插置於氣管内時,顯示出燈號及 蜂鳴聲。 ' 有關本發明方法及裝置,可佐以圖式詳為説明如后。 圖式部份 第一圖:係本發明方法將探棒穿套於内插管。 第二圖:係本發明方法於病患喉結外表部黏貼感測器 Ο 第三圖:係本發明方法插管完成定位之示意圖。 第四圖:係本發明裝置之構成示意圖。〜 請 先 閲 之 注 意 事 項 再 裝 頁 訂 本紙張尺度適用中國國家標準(CNS ) A4規格(210X2P7公釐) 83, 3. 10,000 (3)感測器 (42)蜂鳴器 (6)内插管 (9)内插管 44393 7 、發明説明( 第五圖:係本發明控制箱内所設電路控制系統之方塊 圖0 第六圖:係應用於人體氣管插管之内插管構造示意圖 〇 第七圖:係習知方法將内插管插置於人體氣管開口内 之示意圖。 圖號部份 (】)探棒 (2 )發射元件 (4)控制箱 (41)指示燈 (43)指針指示器(5)電路控制系統 (7)氣管 (8)食遒 (C)連接器 (A )二氧化碳分析儀 (B)手動壓擠式供氣球 請先參考第六及七圖,第六圖所示即為現今普遍被應 用於人體氣管在插管時所使用之内插管(9),該内插管(9) 被定位於病患氣管(7)開口内時,内插管(9)另端則可聯結 一連接器(C) ’如第七圖所示,而連接器(〇即是可套接 於呼吸輔助儀器,亦即是二氧化碳分析儀(A),或是手動壓 擠式供氣球(B),藉此可幫助病患維持呼吸。 請參考第一至三圖,本發明方法係利用一設有可產生 信號之發射元件(2)的探棒⑴先行穿套於内插管⑹之管内, 於病患喉嚨外部之喉結處貼黏定位一可拾取信號之感測器 (3),復將已穿套探棒(1)之内插管(6)置進病患喉嚨内部,藉 著此種方法,能輕易地判斷出内插管(6)與目標位置之距離 而正確無誤地將内插管⑹定位於氣管⑺通道内。當然,於 定位完成後,必須取出被穿套於内插管(6)處之探棒(1),後 續動作則如同第七圖所示,同樣地將内插管(6)另端銜接具 有連接器(C)之呼吸輔助儀器或手動壓擠式供氣球,幫助病 裝— (請先閲讀背面之注>1^項再填寫本頁) 訂—-------線------- 本紙張尺及適用中國囷家標準(CNS ) A4規格(210><297公釐) 83. 3.10,000 A7 B7 4439 3 7 五、發明説明(4 ) 患呼吸並獲取氧氣。 、本發明方法之主要特徵,其一係在插置於病患喉嚨内 部炙内插管處,附設有一可發射信號之發射元件(2),而於 巧外喉嘴1外表部則定位一可接收信號之接收元件,即感測 器(3),以此種方法應用於人體氣管之插管操作上,可掌控 内插管行進之正確性及定位。 復請參考第四圖,本發明方法所使用之裝置,其係含括 有一探棒(1)、發射元件(2)、感測器(3)及控制箱⑷,該探棒 H為一可撓性且具適當長度之棒體,於探棒(1)前端設有— 信號產生源之發射元件(2),該發射元件(2)係為磁性元件,44393 7 A7 B7 Printed by the Shellfish Consumer Cooperative of the Central Standards Bureau of the Ministry of Economic Affairs 5. Description of the invention (2) Due to the difficulty and danger of intubation of workers. The inventor of the present invention is a medical practitioner with many years of medical clinical experience, and feels that the current method of performing tracheal intubation and the early use of an intubation can not immediately monitor the correct positioning of the practice, and as a monitoring The carbon dioxide analyzer cannot be universally used under the restrictions of going out to first aid, emergency units, wards, etc., but was researched and developed, after many efforts, finally developed a new method and its use that can overcome the latent danger of tracheal intubation. The main purpose of the present invention is to provide a method for intubation positioning of the human trachea. The method uses a birch probe which is provided with a signal generating source at the front end to be inserted into the intubation tube. A sensor is attached to the external skin of the neck and laryngeal knots of patients undergoing tracheal intubation. The sensor can input the picked-up signal into a control box with a circuit control system inside the factory, and the light on the control box Display and beep indicate that the intubation tube has been correctly positioned in the tracheal opening. 0 ′ Another main object of the present invention is to provide a human body A monitoring device for positioning the tube, which includes a probe, a transmitting element, a sensor, and a control box. The probe is provided with a transmitting element that can generate a signal source at the front end: the sensor can pick up the signal and borrow It is executed by the circuit control system in the control box, and when the intubation tube is correctly inserted into the trachea, it displays a light and a beep. '' The method and device of the present invention can be described in detail with drawings as follows. Schematic part The first figure: the method of the present invention penetrates a probe into an intubation tube. The second figure: the method of the present invention sticks the sensor on the outer part of the patient's laryngeal nodule. The third figure: the schematic diagram of the method of the present invention to complete the positioning of the intubation. The fourth figure is a schematic diagram of the device of the present invention. ~ Please read the precautions before loading the book. The paper size applies the Chinese National Standard (CNS) A4 specification (210X2P7 mm) 83, 3. 10,000 (3) Sensor (42) Buzzer (6) Interpolation Tube (9) Intubation tube 44393 7. Description of the invention (fifth figure: a block diagram of a circuit control system provided in the control box of the present invention 0 sixth figure: a schematic diagram of an intubation structure applied to human tracheal intubation) Fig. 7: It is a schematic diagram of inserting an intubation tube into a tracheal opening of a human body by a conventional method. Fig. Part ()) probe (2) transmitting element (4) control box (41) indicator light (43) pointer Indicator (5) Circuit control system (7) Trachea (8) Food scoop (C) Connector (A) Carbon dioxide analyzer (B) Manually squeezed balloon supply Please refer to Figures 6 and 7 first, Figure 6 shows Shown is the inner cannula (9) which is commonly used in human trachea when intubating. The inner cannula (9) is positioned in the opening of the patient's trachea (7). The other end can be connected to a connector (C) 'as shown in the seventh figure, and the connector (0 is a socket that can be connected to a respiratory assistance device, that is, carbon dioxide The analyzer (A), or the hand-pressed balloon (B), can help patients maintain breathing. Please refer to the first to third figures. The method of the present invention uses a transmitting element (which can generate a signal) ( 2) The probe 穿 is first put through the tube of the intubation tube ⑴, and a sensor (3) that can pick up the signal is stuck on the throat joint outside the patient's throat, and the probe (1) is put through the sleeve The intubation tube (6) is placed inside the patient's throat. With this method, the distance between the intubation tube (6) and the target position can be easily determined and the intubation tube ⑹ can be accurately positioned in the trachea channel. Inside. Of course, after the positioning is completed, the probe (1) that is put on the insertion tube (6) must be removed. The subsequent action is the same as shown in the seventh figure, and the end of the insertion tube (6) is the same. Connect a breathing aid with a connector (C) or a hand-pressed balloon to help the patient— (Please read the note on the back > 1 ^ before filling this page) Order —------- line ------- This paper ruler and the applicable Chinese standard (CNS) A4 specification (210 > < 297 mm) 83. 3.10,000 A7 B7 4439 3 7 V. Description of the invention (4) Gain Oxygen. The main feature of the method of the present invention is that one is inserted in the internal cannula of the patient's throat, and is provided with a transmitting element (2) capable of transmitting signals, and is positioned on the outer surface of the mouthpiece 1 A receiving element that can receive signals, that is, the sensor (3), is applied to the intubation operation of the human trachea in this way, and can control the correctness and positioning of the intubation travel. Please refer to the fourth figure, this The device used in the method of the invention comprises a probe (1), a transmitting element (2), a sensor (3) and a control box 该, the probe H is a flexible rod with a suitable length Body, at the front end of the probe (1) is provided a transmitting element (2) of a signal generating source, the transmitting element (2) is a magnetic element,
當然,探棒(1)及發射元件(2)外圍可包裹一安全膜(於圖示 中未予示出)’避免發射元件(2)掉落;感測器則具有拾 取發射元件(2)所產生之信號的功能,該感測器(3)可為霍爾 1C ’衲述感測器(3)拾取之信號經由控制箱⑷内設之電路控 制系統(5)執行,可由控制箱(4)所設之指示燈(41)及蜂鳴器 (42)顯示正確定位之訊號。前述電路控制系統(5)係可如第 五圖所示,從感測器(3)拾取的訊號變化非常微弱(約 IOf course, a safety film (not shown in the figure) can be wrapped around the probe (1) and the emitting element (2) to prevent the emitting element (2) from falling; the sensor has a pickup emitting element (2) The function of the generated signal, the sensor (3) can be the Hall 1C's sensor (3), the signal picked up by the circuit control system (5) built in the control box, can be performed by the control box ( 4) The set indicator light (41) and buzzer (42) show the signal of correct positioning. The aforementioned circuit control system (5) can be shown in the fifth figure, and the signal picked up from the sensor (3) changes very slightly (about I
〇_5〜l.Omv),首先經過雜訊濾波器濾除不需要之雜訊,經由I:. 比較器與參考訊號相比較後,由運算放大器放大,即可將 | 訊號輸出並由指示燈(41)、降鳴器(42)、指針指示器(43)顚 I 示。由於一般正常人從喉頭前方到氣管後方距離大约為… 25mm左右,當内插管尖端接近感測器時,指針指示器⑷) 即開始顯示内插管(6)前端與感測器(3)間之距離,若内插管 ⑹前端已到達氣管⑺開口内,指示燈(41)及蜂鳴器(42)即產 生作用’若指示燈(41)及蜂鳴器(42)均無作用,則表示内插| 管(6)不在氣管(7)範圍内,讓操作人員甚容易判斷出内插管 是否誤插於食道(S)内。整個控制箱(4)之佔用空間甚小,不 僅易於攜帶外出,亦甚容易擺置於操作現場,況且該控制、 纸乐元变速用中國國家標準(CNS )以規格(210X297公釐)^ (請先聞讀背面之注意事項再填寫本X ) --裝------,σ! .il, — ,---,__〇_5 ~ l.Omv), first filter out unwanted noise through noise filter, compare it with the reference signal through I :. comparator, and then amplify it with op amp, then output | The lights (41), the buzzer (42), and the pointer indicator (43) are displayed. Because the distance from the front of the throat to the back of the trachea is about 25mm, when the tip of the intubation tube is close to the sensor, the pointer pointer ⑷) starts to display the front end of the intubation tube (6) and the sensor (3). If the front end of the intubation tube has reached the opening of the trachea, the indicator light (41) and the buzzer (42) will work. 'If both the indicator light (41) and the buzzer (42) have no effect, It means that the insertion tube | (6) is not within the range of the trachea (7), allowing the operator to easily determine whether the insertion tube has been inserted into the esophagus (S) by mistake. The entire control box (4) takes up very little space, which is not only easy to carry out, but also easy to place on the operating site. Moreover, the control and the paper national variable speed use the Chinese National Standard (CNS) to the specifications (210X297 mm) ^ ( Please read the notes on the back before filling in this X) --install ------, σ! .Il, —, ---, __
^43937 A7 _B7_ 五、發明説明(5 ) 箱使用可重覆充電的長效性蓄電池,正常的情況下,可連 績使用100次以上,並可接收外部電源(+ 12V)的輔助及 充電,可讓控制箱隨處使用。 本發明裝置中之發射元件(2)雖係為磁性元件,唯其實 施仍可利用可發射電子信號或光訊號之發射器,而感測器 則是可接收電子信號或光訊號之接收器。 統觀前論,本發明利用具有發射元件(2)之探棒(1)穿套 於内插管⑹内,於病患喉結外表部則貼黏可接收發射訊號 之感測器(3),此種方法不同於現今所採用單純以内插管(6) 插置於病患氣管之使用方式,習知插管操作後,必需仰賴 二氧化碳分析儀監測,然二氧化碳分析儀之設置費用高昂 ,並不能普及於一般急診室、病房及外出急救之使用,然 本發明裝置頗方便配置於一般醫療現場,乃至於被攜帶外 出急救,藉著感測器監測發射元件之訊號,讓搡作人員能 輕易並正確地將内插管插置於被醫療者之氣管内,不會產 生誤插於食道而影響或危及患者生命之虞,為一種具有醫 療安全價値之插管方法及裝置。 {請先聞讀背面之注意事項再填寫本頁)^ 43937 A7 _B7_ V. Description of the invention (5) The box uses a long-lasting rechargeable battery that can be repeatedly charged. Under normal circumstances, it can be used more than 100 times in a row, and can receive external power (+ 12V) for assistance and charging. Let the control box be used everywhere. Although the transmitting element (2) in the device of the present invention is a magnetic element, in practice, a transmitter capable of transmitting an electronic signal or an optical signal can be used, and a sensor is a receiver capable of receiving an electronic signal or an optical signal. To sum up, the present invention uses a probe (1) with a transmitting element (2) to be sleeved in an intubation canal, and a sensor (3) that can receive a transmitting signal is attached to the outer part of the patient's throat. This method is different from the current use of simple intubation (6) in the patient's trachea. After intubation, it is necessary to rely on the monitoring of the carbon dioxide analyzer. However, the installation cost of the carbon dioxide analyzer is expensive and cannot It is widely used in general emergency rooms, wards and out-of-the-box first aid, but the device of the present invention is quite convenient to be deployed in general medical scenes, and even carried out for first-aid. The sensor monitors the signal of the transmitting element, so that operators can easily and easily Correctly inserting the intubation tube into the trachea of the person being treated does not cause the risk of inadvertently inserting the esophagus and affecting or endangering the patient's life. It is a method and device for intubation with medical safety value. (Please read the notes on the back before filling in this page)
本紙張尺度適用中國國家標準(CNS ) Μ規格(2I0X29V>釐) 83. 3.10,000This paper size applies Chinese National Standard (CNS) M specifications (2I0X29V > centimeter) 83. 3.10,000