US20170173291A1 - Ventilation mask - Google Patents
Ventilation mask Download PDFInfo
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- US20170173291A1 US20170173291A1 US15/127,758 US201515127758A US2017173291A1 US 20170173291 A1 US20170173291 A1 US 20170173291A1 US 201515127758 A US201515127758 A US 201515127758A US 2017173291 A1 US2017173291 A1 US 2017173291A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/06—Respiratory or anaesthetic masks
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/082—Evaluation by breath analysis, e.g. determination of the chemical composition of exhaled breath
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- A61B5/097—Devices for facilitating collection of breath or for directing breath into or through measuring devices
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- A61M2230/43—Composition of exhalation
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Definitions
- the present invention relates to improvements in anesthesia masks and ventilation masks.
- a ventilation mask is used to provide oxygen to the patient either during emergency and/or elective airway management, which includes but is not limited to; before a patient is anesthetized for surgery, while the patient is anesthetized, if the patient is sedated during the surgery or procedure, while the patient is recovering from anesthesia, after the patient has recovered from anesthesia, or during any event where a patient requires supplemental oxygen.
- one of the drawbacks of mask ventilation is that it requires constant contact between the provider's hands and the patient's face to hold the mask in place and keep the patient in the sniffing position in order to ensure that oxygen and anesthetic gases do not leak out into the air and that the patient's airway remains patent. If the provider does not maintain the patient in the sniffing position, a dangerous complication known as upper airway obstruction may occur. The reason the provider needs to perform continuous mask holding and maneuvering is the human anatomy and physiology.
- the present invention in another aspect relates to cardiopulmonary resuscitation (CPR) masks.
- CPR cardiopulmonary resuscitation
- Cardiopulmonary resuscitation commonly known as CPR is an emergency procedure performed in an effort to manually preserve intact brain function until further measures may be taken to restore spontaneous blood circulation and breathing in a person (hereinafter the “subject” or “victim”) who is in cardiac arrest.
- CPR also is indicated in those who are unresponsive with no breathing such as in the case of a drowning victim or victim of electrical shock, or abnormal breathing, for example agonol respiration.
- CPR involves chest compressions at least two inches deep and at a rate of at least 100 per minute in an effort to create artificial circulation by manually pumping blood through the heart and thus the body.
- the rescuer also may provide breaths by either exhaling directly into the subject's mouth, or through a CPR mask into the subject's mouth and/or nose (collectively “mouth-to-mouth resuscitation”), or using a device that pushes air into the subject's lungs through the subject's mouth and/or nose.
- the process of externally providing ventilation is termed “artificial respiration”.
- Current recommendations place emphasis on high-quality chest compressions over artificial respiration; however, when coupled with high-quality chest compressions, artificial respiration provides potentially the greatest benefit to the patient.
- CPR masks are held in place by hand, by the CPR provider, or may be retained in position by straps that extend behind the head of the subject or victim. While CPR masks may assist in ventilation of a subject or victim who is not breathing, when a rescuer provides mouth-to-mouth and/or nose-to-mouth resuscitation, the air provided contains a significant amount of CO 2 which is lethal. As will be discussed below, the present invention in another aspect addresses the aforesaid and other disadvantages of the prior art.
- a nasal ventilation/anesthesia mask comprising one or more offset gas openings to allow the provider to have a clear view of the mouth and airway during direct laryngoscopy and intubation, which consists of a ventilation port to supply oxygen and other gases during anesthesia via Non-Invasive Positive Pressure Ventilation (NIPPV) and which is connected to an anesthesia circuit which can measure end-tidal CO 2 from the nose, an oral opening port under the nose for scavenging anesthesia gases and end-tidal CO 2 that are expelled orally from the patient; a gas scavenging/end-tidal CO 2 port connected to a channel inside the mask that is isolated from the nasal cavity, and an oxygen port for supplying post op oxygen.
- NIPPV Non-Invasive Positive Pressure Ventilation
- Completing the mask are a plurality of tabs or eyelets, preferably three, or four, for strapping the mask to the patient's head or for tying the mask down to the operating table, e.g., in accordance with the teachings of our co-pending PCT application PCT/U.S.14/44934 and on co-pending PCT application PCT/U.S.15/34277.
- a nasal ventilation mask having an O 2 port for introducing oxygen into the mask, a ventilation port and a gas monitoring attachment integral to or attached to the ventilation port.
- the gas monitoring port includes a luer lock.
- a nasal ventilation mask having an exterior opening under a nose region in the mask, over the patient's lip region, that allow gases expelled orally to be scavenged and ported to a scavenger device, said mask optionally further including a Scavenger line for diverting a portion of the expelled gas to be monitored for end-tidal CO 2 , and, wherein a connector preferably is provided at point where the end-tidal CO 2 monitoring line intercepts the Scavenger line, effectively diverting the gas flow, resulting in a positive pressure relative to the end-tidal CO 2 line whereby to permit gasses to be sampled from the scavenger line.
- the mask may further comprise an anesthesiologist controlled 2-way, 3 port valve permitting an anesthesiologist to switch between separately monitoring nasal and oral expulsions of end-tidal CO 2 or monitoring them simultaneously when the valve is open to both, wherein, when the Oral end-tidal CO 2 monitoring port is chosen, the end-tidal CO 2 monitoring line preferably also serves to scavenge other ventilation gasses during anesthesia.
- the present invention also provides a nasal ventilation mask having tabs or eyelets for attaching the mask anteriorly with the mask anchor, or posteriorly with a traditional anesthesia mask strap, said mask further optionally characterized by one or both of the following features:
- the mask is usable as an oxygen transport mask or as a Ventilation mask providing O 2 and anesthesia gases and for monitoring end-tidal CO 2 simultaneously;
- the present invention also provides an anesthesia mask having a built in scavenger system for collecting anesthetic gases that leak out around the mouth and/or nose.
- the present invention provides a chin strap for application to the submental space, attached to a nasal mask, for applying pressure to force a wearer's tongue against the soft palate and induce an obstruction of the retro-glossal space, whereby to reduce or prevent leakage of gases out of the patient's mouth and allow the patient to breath out of the nose, wherein the chin strap also has the ability to release pressure, if needed, during exhalation to prevent an expiratory obstruction.
- the present invention provides an improved CPR mask for mouth-to-mouth and/or nose-to-mouth resuscitation and includes a CO 2 absorber that eliminates re-breathing of rescuer or provider exhaled CO 2 by the victim. More particularly, the present disclosure provides a CPR mask which includes a CO 2 filter or absorber built into the mask or mask inlet for absorbing CO 2 being exhaled by the rescuer or provider.
- a CPR mask for mouth-to-mouth and/or nose-to-mouth resuscitation comprising a body shaped to cover the nose and/or mouth of a victim, said mask including a CO 2 absorber for eliminating at least in part rescuer exhaled CO 2 delivered to the victim.
- the CO 2 absorber is coated on an inside surface of the mask.
- the mask includes a ventilation tube, wherein the CO 2 absorber is located in the ventilation tube.
- the mask includes one-way valve and/or straps for holding the mask to the head of the victim.
- the mask includes a compliant periphery to conform to the face of a victim.
- the periphery may include a soft, compliant air bladder, or resiliently deformable foam cushion.
- the mask includes a biological filter incorporated into the inside of the mask, or incorporated into the ventilation tube.
- the mask further includes a compliant periphery to conform to the face of a wearer, wherein the periphery preferably includes a soft, compliant air bladder or a resiliently deformable foam cushion;
- FIGS. 1 a and 1 b are front view and top views of a nasal ventilation mask in accordance with the first embodiment of the present invention
- FIG. 2 is an inside view of the FIG. 1 a ventilation mask
- FIGS. 3 a and 3 b are plan views showing the ventilation mask in accordance with the present invention on a patient's head;
- FIGS. 4 a and 4 b are views similar to FIGS. 3 a and 3 b showing a chin strap attached to the mask;
- FIGS. 5 a and 5 b show an alternative configuration of the nasal mask with an end-tidal CO 2 monitor in accordance with the present invention
- FIG. 6 is a side elevational view of an alternative configuration of nasal mask ventilation system in accordance with the present invention.
- FIG. 7 is a plan view of an alternative embodiment of nasal ventilation mask with a CO 2 monitor in accordance with the present invention.
- FIG. 8 is a plan view of yet another alternative configuration of nasal mask with a CO 2 monitor in accordance with the present invention.
- FIG. 9 is a view, in partial cross-section of a CPR mask in accordance with the first embodiment of the present invention.
- FIG. 10 is a side elevational view of a second embodiment of a CPR mask in accordance with the present invention.
- FIGS. 1 a and 1 b A nasal ventilation mask 10 in accordance with a first embodiment of the present invention is illustrated in FIGS. 1 a and 1 b .
- the first is the ventilation port 12 that supplies O 2 and other gasses either during anesthesia or for NIPPV in critically ill patients and allows for any end-tidal CO 2 that is expelled nasally to be retrieved from the patient.
- the second is an Oral opening 14 under the nose but isolated from the nasal cavity created by the mask over the patient's nose. The purpose of opening 14 is for scavenging anesthesia gases and end-tidal CO 2 that are expelled orally from the patient.
- the third opening is the Gas Scavenging/end-tidal CO 2 port 16 that is connected to the opening by a channel 18 inside the mask (see FIG. 2 ) that is isolated from the nasal cavity.
- the Gases, including any expelled end-tidal CO 2 leave the mask through port 16 and are guided by a tube 20 to a gas scavenging filter and end-tidal CO 2 monitor 32 (see FIG. 3 ) that samples gas from the gas scavenging line.
- the fourth opening is an O 2 port 22 that is capped off during anesthesia, but may be connected to an O 2 source (not shown) either pre-operation, intra-operation, or post-operation.
- O 2 When O 2 is supplied, the Ventilation tube is detached from the ventilation port 12 so that end-tidal CO 2 and be expelled nasally.
- a gas hood 24 located under the nose around the oral opening 14 extends beyond the mask as shown. It is optionally included in order to extend the influence of the Oral Opening 14 in the mask in order to contain a greater percentage of the expelled gases from the patient.
- the mask also includes three eyelets or tabs 60 , 62 , 64 , or four eyelets or tabs 66 68 , 70 , 72 ( FIG. 7 ) for attaching a chin strap or head strap, as described below, or for attaching straps to the operating table in accordance with the teachings of our co-pending application PCT/U.S.14/44934 or our co-pending PCT application PCT/U.S.15/34277.
- FIG. 2 An interior view of the nasal ventilation mask 10 of the present invention is illustrated in FIG. 2 .
- the ventilation port 12 and O 2 port 22 are connected to the nasal cavity 26 .
- Orally expelled gases travel from the Oral opening 14 on the outside of the mask through Gas Channel 18 and out the Gas Scavenger & end-tidal CO 2 monitoring port 16 on to the Scavenger device and end-tidal CO 2 monitor.
- the Gas channel 18 separates the Nasal cavity 26 created by the ventilation mask over the nose and the Oral regions of the patient.
- O 2 or O 2 and anesthesia gasses and are being supplied to the patient travel to the nasal cavity 26 through a ventilation circuit 28 attached to the ventilation port 12 , and a cap shown in phantom at 30 , seals the O 2 port.
- the cap 30 can be removed from the O 2 port 22 and an O 2 line attached to the port, supplying O 2 to the patient.
- the ventilation circuit 28 is removed from the ventilation port 12 and the nasal cavity 26 is open to the atmosphere where end-tidal CO 2 can be expelled nasally.
- FIGS. 3 a and 3 b The gas circuit for both the Nasal Mask Ventilation/end-tidal CO 2 monitor Oral Gas Scavenger/end-tidal CO 2 monitoring lines are illustrated in FIGS. 3 a and 3 b .
- FIG. 3 a shows nasal gas flow from the Nasal cavity 26 connected to the Ventilation Circuit 28 and to the end-tidal CO 2 monitoring equipment 32 .
- FIG. 3 b shows the orally expelled gasses entering the Oral opening and flowing through the Gas Scavenger line to a recovery device 34 and the associated line that is connected to the scavenger line and flows to the end-tidal CO 2 monitoring equipment.
- the opening to the scavenger line should be positioned approximately 90° to the scavenger gas flow in order for the local pressure to be higher than it would be if the opening were perpendicular to the gas flow. If it were perpendicular, a negative pressure would prevent the end-tidal CO 2 monitoring line from being able to sample the flow due to the negative pressure gradient.
- a chin strap 36 also can be applied to the submental space, attached to the nasal mask 10 , and apply a pressure to force the tongue against the soft palate and induce an obstruction of the retro-glossal space, which will help prevent any leak of gases out of the patient's mouth and allow the patient to breath out of the nose.
- the chin strap 36 also has the ability to release pressure, if needed, during exhalation to prevent an expiratory obstruction and allow end-tidal CO2 and other gases to be released out the mouth.
- FIGS. 5 a and 5 b the gas circuit for both the Nasal Mask Ventilation and end-tidal CO 2 monitoring are illustrated in FIGS. 5 a and 5 b .
- the figure shows a 2-Way, 3 Port valve 40 that connects the Nasal circuit to the end-tidal CO 2 monitoring equipment.
- the anesthesiologist decides which region, the nasal, oral region, or both simultaneously, should be monitored for end-tidal CO 2 .
- FIG. 6 A side view of the alternate configuration for the nasal mask ventilation and monitoring end-tidal CO 2 expulsion from the oral airway is illustrated in FIG. 6 . Note the 2-Way, 3 Port valve 40 has been turned in the direction of the mouth for sampling end-tidal CO 2 .
- the nasal ventilation mask also allows only one combined anterior-posterior head strap to be attached, where the posterior head strap can attach to the mask alone, or can attach to the mask and then to a surface, which will prevent movement of the patient's head and/or neck.
- the posterior head strap can attach to the mask alone, or can attach to the mask and then to a surface, which will prevent movement of the patient's head and/or neck.
- FIG. 7 illustrates yet another embodiment of the invention, in which a patient is being provided oxygen via an O 2 line connected to the O 2 port on the ventilation mask.
- the exhaled gasses are exhausted to the atmosphere via the ventilation port 12 as illustrated in FIG. 7 .
- a “T-Shaped” gas monitoring attachment 50 that slides onto the mask ventilation port 12 .
- the main body of the attachment 50 which is tubular in shape allows exhaled gasses to be exhausted to the atmosphere.
- To the side of the attachment is a tubular opening 52 , nominally at a 90° angle off to the side.
- the end of this opening 52 can have a luer lock or any other kind of securing connection. Exhaled gas from the main flow can be sampled through this opening if a gas monitoring line 54 connected to a gas monitor is attached to the gas monitoring line interface.
- the gas monitoring line interface is an integral element of the mask ventilation port 12 .
- O 2 flows into the O 2 port via a supply line and the exhaust gases are passed to the atmosphere via the ventilation port 12 .
- the side of the ventilation port 12 is a tubular opening 56 , nominally at 90° angle off to the side. The end of this opening can have a luer lock or any other kind of securing connection. Exhaled gas from the main flow can be sampled through this opening if a gas monitoring line connected to a gas monitor is attached to the gas monitoring line surface.
- FIG. 9 there is shown a first embodiment of a CPR mask in accordance with another aspect of our invention, designated 110 , to affect rescue breathing, mouth-to-mouth resuscitation or any other CPR procedure requiring emergency breathing assistance.
- Mask 110 is shaped to cover the nose and/or mouth of a victim, and includes a soft and compliant periphery 112 to conform to the face of a victim upon application of moderate force to obtain a tight-fitting mask seal.
- the periphery 112 of the mask includes a soft, compliant air bladder 114 or resiliently deformable foam cushion or the like.
- Ventilation tube 116 is attached to an integral inlet port 118 protruding from the mask through which air may be supplied by the rescuer by exhaling into the tube.
- Ventilation tube 116 or inlet port 118 typically includes a one-way valve 120 that permits air to enter the mask through tube 116 .
- Ventilation tube 116 and its associated valve 120 may be formed integrally with the port 118 , or may be a replaceable, disposable element or package. ( FIG. 10 ).
- the inside surface 122 of mask 110 is coated in part by a CO 2 absorbing material such as activated carbon or a zeolite. Also, certain minerals such as serpentinite advantageously may be employed. Typically, these materials are sorted to optimal size and encased in a filter material 124 bound to the inside surface 122 of the mask 110 . Alternatively, the inside surface 122 of the mask 110 may he coated with a CO 2 absorbing polymer such as polyethylenimine containing fumed silica or the like as reported in Scientific American, Jan. 6, 2012, page 33.
- a CO 2 absorbing material such as activated carbon or a zeolite.
- certain minerals such as serpentinite advantageously may be employed. Typically, these materials are sorted to optimal size and encased in a filter material 124 bound to the inside surface 122 of the mask 110 .
- the inside surface 122 of the mask 110 may he coated with a CO 2 absorbing polymer such as polyethylenimine containing fumed silica or
- a CO 2 filter 126 containing CO 2 absorbing material may be incorporated into ventilation tube 116 .
- the rescuer places the CPR mask 110 over the nose and/or mouth of a victim to initiate emergency ventilation of the victim.
- the rescuer applies moderate force to obtain a substantially air-tight seal against the victim's face, and ventilation is then supplied by the rescuer by exhaling into the ventilation tube 116 .
- the exhaust from the rescuer contains CO 2 , most of the CO 2 will be removed by the CO 2 filter material.
- Mask 110 may be formed in different sizes, for example, adult size, youth size and child size, to accommodate different size faces.
- a feature and advantage of the CPR mask of the present invention is that significantly reduces the amount of CO 2 administered to the victim. Also, the mask helps to protect both victim and rescuer in an emergency situation by preventing transfer of disease.
- a biological filter shown in phantom at 130 in FIG. 10
- the mask may include straps 132 for strapping the mask to the victim's head, thus freeing the rescuer from having to press the mask against the victim's face. Still other changes are possible.
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- 2015-08-07 WO PCT/US2015/044341 patent/WO2016028522A1/en active Application Filing
- 2015-08-07 EP EP15833101.7A patent/EP3183023B1/de active Active
- 2015-08-07 KR KR1020177007457A patent/KR20170046699A/ko unknown
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US11298046B2 (en) * | 2017-04-07 | 2022-04-12 | Owlstone Medical Limited | Breath sampling device and method |
US20200101250A1 (en) * | 2017-05-22 | 2020-04-02 | Fisher & Paykel Healthcare Limited | Respiratory user interface |
US11826509B2 (en) * | 2017-05-22 | 2023-11-28 | Fisher & Paykel Healthcare Limited | Respiratory user interface |
US11813399B2 (en) | 2019-11-28 | 2023-11-14 | Liauna Kelly | Continuous positive airway pressure (CPAP) apparatus and system |
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