US2063043A - Respiration method and apparatus - Google Patents

Description

Dec. 8, 1936. E, i, MGKESSON 2,063,043

RESPIRATION METHOD AND APPARATUS Filed Nov 6, 1933 4 Sheets-Sheet l Dec. 8, 1936. MCKESSON 2,063,043

RESPIRATION METHOD AND APPARATUS Filed Nov. 6, 1935 4 Sheets-Sheet 2 w fl A Dec. 8, 1936. E. I. McKESSON RESPIRATION METHOD AND APPARATUS 4 Sheets-Sheet 3 IlII'lIIlIIIIIll/l/ Filed Nov. 6, 1955 Dec. 8, 1936. E, MOKESSON 2,063,043

RESPIRATION NETHOD AND APPARATUS Filed Nov. 6, 1935 4 Sheets-Sheet 4 Patented Dec. 8, 1936 PATENT OFFICE RESPIRATION METHOD AND APPARATUS Elmer I. McKesson, Toledo, Ohio, assignor to Martha F. McKesson, Toledo, Ohio Application November 6, 1933, Serial-No. 696,868

10 Claims.

This invention relates to flowing of a gas to and from a patient.

This invention has utility when incorporated for resuscitation and respiration.

Referring to the drawings:

Fig. 1 is a front view of a unit housing, as a container, opened to disclose the apparatus therein as a portable resuscitator, parts being broken away;

Fig. 2 is a side view of the unit of Fig. 1 in a closed position and on a reduced scale;

Fig. 3 is a front view of the unit housing of Fig. 2;

Fig. 4 is a fragmentary plan view looking down from the line IV-IV, Fig. 1;

Fig. 5 is a section on the line VV, Fig. 4;

Fig. 6 is a section on the lineVI-VI, Fig. 4;

Fig. 7 is a section on the line VII--VII, Fig. 5;

Fig. 8 is a fragmentary plan view looking down from the line VIII-VIII, Fig. 1;

Fig. 9 is a section on the line IXIX, Fig. 8; Fig. 10 is a section on the line X-X, Fig. 8; Fig. 11 is a section on the line Xl-XI, Fig. 8; Fig. 12 is a section on the line X[IX[I, Fig. 10; Fig. 13 is a section on the line XIIIX[II, Fig. 8;

Fig. 14 is a section Fig. 8;

Fig. 15 is a fragmentary plan view looking 30 down from the line XVXV, Fig. 1;

Fig. 16 is a section on the line XVI-XVI, Fig. 15;

Fig. 17 is a view on the line XVIIXVII, Fig. 15;

35 Fig. 18 is a detail view of the mask;

Fig. 19 is a view on the line XIX-EX, Fig.

18; and

Fig. 20 is a section on the line XX Q Fig. 19.

In carrying out the invention of this disclosure 40 which has utility as a lifesaving equipment for those subjected to asphyxiation or other emergency difficulties, as drowning, gas exposure or otherwise, importance resides in having the device as a readily portable compact unit. To this end there is provided a housing or cabinet having bottom I (Figs. 1, 2, 3), back 2 upwardly extending to have at its top portion hinge 3 mounting hood 4. Fromthe bottom I there rises short front section 5, and side section 6 which has hinge connection 1 to front section 8 bridging between lower front portion 5 and the hood 4. This front section 8 may swing about to have hasp connection 9 with side I 0 opposite to the side 6. This side 10 may have handle H as a carrying means for the device as a suitcase, In

on the line XIVX[V,,

the instances wherein it may be convenientto have two persons carry the unit, handle I 2 on the hood 4 is provided and handle l3 on the short bottom section 5 is provided. It is thus seen the device may be readily housed in a portable unit. 5 On the base I are legs [4 (Fig. 9) mounting cylindrical shell I5. This shell I5 is assembled by .bolts IS with disk l1. Between the disk I! and the cylindrical shell I5, there is assembled, by these bolts l6, annularly corrugated member I 8 l0 sustaining movable disk l9 opposing the disk I! and providing a bellows, herein serving as a pump. Centrally of this disk I9 is connection 20 with piston rod extension 2| extending through cylinder head 22 fixed with the disk l1. l5 'I'his'piston rod extension 2| is assembled at piston 23 with piston rod 24 extending through piston head 25. This piston rod 24 has adjustably mounted thereon collar 26 having connections provided by means of tension springs 21 with 20 arms 28 as a lever fixed at opposite ends to rockable valve member 29 (Figs. 13, 14:) in housing 30. This rockable valve 29 has medial bar portion 3| as its control valve for a plurality of ports.

Adjacent the back 2 (Figs. 1, 8) and spaced from the disk I! may be pressure gas supply tanks, cylinders or bottles'32 in seats 33 cushioned by pads 34. Each bottle 32 has top fitting 35 with valve 36. Yoke 31 may determine seat-- ing of fitting port 38 at check valve fitting 39 (Figs. 4, 6) so that as the valve 36 is opened, pressure from the tank 32 may unseat the valve in the fitting 39 and the pressure gas may flow by duct 40 to gage 4| mounted by bracket 42 on the back 2, there to disclose a reserve tank pres sure as supplied to fitting 43 assembled by the yoke 31 with the back'2. This fitting 43 is a reducing valve which may be operated by adjusting screw 44 in regulating pressure of delivery as to be disclosed by gage 45 mounted on the fitting 43. This delivery of pressure may be past (Figs. 6, 7 T-fitting' 46 to needle valve 41 adjustable in regulating the volume of flow to duct 48 extending to fitting 49 at the valve housing 30 in shell 50 between the bottles 32 and on the disk l1. This shell thus serves to house not only cylinder 5| about the piston 23 but the valve housing 30 and intermittent pressure gas supply, say of oxygen, by way of the duct 48 and fitting 49 into the housing 30. At the position 50 shown in Fig. 13, gas would enter port 52 and be directed by the valve portion 31' to flow by port 53, duct 54, for flow through port 55 in the oylinder head 25 above the piston 23 (Fig. 9).

Simultaneously. within the cylinder 5| below 55.

the piston 23, there is port 56 in communication by duct 51 with port 58 in the housing 30 to be directed by the valve member 3| for flow by way of port 58 and duct 60 to port SI in the disk I1 as a delivery of exhaust from the motor piston and cylinder device into the bellows for the bellows chamber 62. This delivery of the exhaust from below the piston 23 into the bellows chamber is at the inspiration action of the bellows for the descent of the piston 23 and enlarges the chamber 62 to a greater extent than the delivery of exhaust gas thereto.

As the piston rod 24 descends, the adjustable collar 26 passing the axis line for the valve member 29 is effective through the springs 21 to snap this valve device into its reverse position which is shown in dotted lines in Fig. 13, for thus communicating the pressure supply to the lower side of the piston 23 and the exhaust from the upper side of the piston 23 to fiow into the bellows as this piston and cylinder device is now to operate the bellows as a pump for expiratory action from the chamber 62 in thus efiecting a push instead of a pull,'this push being not only of the exhaust from the piston andcylinder motor device as above the piston 23, but of the previous charge of exhaust from below the piston 23 as now flowing from the chamber 62. The operations of this piston and cylinder device as a reciprocating motor for effecting pulsatory operation of the bellows is thus automatically effected, for as the piston 24 rises, it will reset the valve member 29 into the initial position. It is to be understood that, as will be hereinafter described in detail,

the pumping action of the bellows is coordinated properly with the forced inhalation and exhalation of the patient, duct 69 from said chamber 62 leading to the breathing mask for such coordination, between the delivery to chamber 62 and the exhaust therefrom via the duct 69.

From an arm 28 there is extension arm 63 opposite to the connection of the spring 21. From this arm 63 there extends upward stem 64 through removable lid 65 for the housing.50. There is thus provided a handle which may be operated manually in determining a speed of desired operation greater or less than that which may be automatically effected in the pressure operation of the gas. Variation in the speed of the fluid motor accomplished by changing the position of the valve member 29 via handle rod 84. It is thus seen that while the greater the pressure the greater thespeed of operation, one may 'by this manual control obtain an independent operation speed for the pulsatory effect in bringing about artificial respiration of a patient. Additionally, through this cover 65 is opening 66 for cup 61 as a lubricant source for the valve 29.

Rising from the disk I'1 adjacent the shell is boss 88 (Figs. v9, This boss 68 has therein chamber 89 from which extends duct 10 as a delivery tube, herein shown as extending to cross fitting 1I (Fig. 18) on which is mounted mask 12. As this boss 88 is suction relief valve device 13 which includes disk 14 on stem normally held seated by compression helical spring 18. Adjustment of nut 11 surrounding the spring 16 may vary the compression of this spring and-thus the suction at which the disk is unseated for intake of air. Manual disturbance of this valve may be had by pressing on head 18 of the stem 15, thus effecting unseating of the disk 14. This is a safeguard against exposing the patient to excessive exhalation or exhausting of the lungs. Additionally, there is relief device 19 at this boss 68 against accumulation of too great an inhalation pressure. This device 19 involves a disk 80 loosely mounted on arm 8I, normally urged by torsion spring 82 (Figs. 11, 12) about stem 83 to hold said disk 80 in seating position. The torsion action of this stem may be varied by adjusting knurled disk 84 as frictionally held by spring disk 85.

.Fitting H is provided with an adjustable relief valve against accumulation of pressure, which relief valve 86 is similar to relief valve device 19 at the boss 68. This device 86 is fixed on stem 81 having handle 88 and stops 89, 90. Fixed with the fitting H is additional stop 9|. Accordingly, in rotating this handle 180, port 92 in the barrel 81 may register with the duct 10 or cut off the duct 10 and register with duct 93. At all times, whether the communication of this ported plug 81 be with the duct 10 or with the duct 93, the plug has its open lower end 94 in communication with the mask 12. This mask 12 may be assembled by device 95 in position at the nose or nose and mouth of a patient (Fig. 1)

As the patient responds to the mechanical or externally applied pulsations to have muscular reresponse in respiration, the operator may merely shift the handle 88 from connection with the duct 10 for communication with the duct 93. In

this latter event the source of supply may have been given previous attention, for from the T- fitting 46 there is flexible duct 96 (Figs. 1, 5, 7, 15) to valve 91. If this valve 91 were open before the operation of the handle 88, the'mechanism, in its entirety, would function automatically in response to the inhalations and exhalations of the patient. This is accomplished, for this valve 91 is in communication with housing 98 having therein passage 99 to port I00. This port I00 is closed by flexible disk IOI (Fig. 16). This position of the flexible disk IOI is transmitted by plunger I02 as acted upon by short arm I03 of lever having fulcrum I04, and long arm I05 having offset I06 extending through opening I01 in shell I08. This offset I08 engages seat I09 centrally of flexible diaphragm IIO as opposed by diaphragm II I, housed by shell II2 opposing the shell I08. This sheet metal metallic shell I08, H2, serves as positive limiting. means for the pressure distention of the rubber bag IIO, Ill. Furthermore, it is a factor in contributing to the life of the bag.

There is thus a disk-shaped bag having opposing diaphragm walls IIO, III. This bag is generally housed by the shell sections I 08, I I2. Both the shell and the bag are mounted with the fitting 98 and the bag is in communication through duct I I3 with chamber I I4 adjacent the diaphragm IOI independent of the port I00. Accordingly, as the bag collapses to allow the pressure from the duct 99 to unseat the'diaphragm IOI from the port I00, flow of pressure gas may occur into the chamber H4 and into the bag, thus to have gas volume in the bag effective to reseat this valve and cut off the supply as the pressure and volume are built up in the bag.

The bag H0, III, is thus a reduced pressure.

as it becomes exhausted and. replaced with another tank, but that in the interim, the tank as assembled in the cabinet may be first cutin for its pressure supply to the reducing valve device 43, at which there may occur the first stage of pressure reduction.

As herein disclosed, there may be a second stage of pressure reduction in the device from the housing 98 during the automatic or muscular respiration; while for mechanical respiration, there is the stage pressure reduction at the piston and cylinder device, and then in the pump or bellows as a second stage of expansion for pulling the pressure gas in volume down to, say in the range of 40 millimeters of mercury and thus in a range not of hazard for a patient. These pressure devices at the bellows or at the device of the diaphragm structure from the fitting 98 thus control the gas pressure in a patients lung range without hazard therefrom.

Located on the inside of the housing 8 is clip I20 which may mount wrench I2I for operating the valve 36. Fitting or bracket I22 on the inside of the back 2 (Fig. 1) may engage the cross fitting II at closed position of the structure when the mask 12 is removed therefrom and placed upon one of the brackets I23 of the housing side 8. There are shown two of these brackets I23, so that there may be a supply of masks of different sizes. Tongue guards I 24, I25, are detachably mounted on the housing 8 at fitting I26 for removal and use, as in oral operations. Cross clips I21 assemble the ducts I0, 93, in their extent from the housing or cabinet to the mask.

In emergency operation hereunder, those upon call may grasp the housing and carry it as a suitcase or as a steamer trunk, and rush to the place where the emergency has arisen. The device, whether retained by a medical group, hospital, or fire or police department, should beat all times equipped with the gas for resuscitation, as oxygen tanks 32. Upon arrival at the place for use, the patient should be given the normal first aid care and in lieu of other respiration methods, there may be at once application of the mask, and with the handle 88 in position for gas supply by the duct III, the needle valve 41 may be opened for starting the motor with the mechanism connected up to one of the tanks or bottles 32. As suggested, there may be manual intervention n'ot only for the relief valve of pressure applied but for the inhalation pressure.

The manual operation of the relief valves is by adjusting the exhaust relief, while the intake relief is by pressing on the fitting head 18. For the pulsation control apart from the automatic operation, manipulation may be had of the handle 64. However, in getting the equipment set up, adjustment of the needle valve 41 for a desired volume may effect an automatic pulsation rate in resuscitation operation. Exhaust occurs from the piston and cylinder device motor 23, 5| into the bellows chamber 62. At inspiration action, this bellows chamber 62 not only takes exhaust from the cylinder 5I lower side, but brings about an inspiration action through the duct 10 for evacuating the lungs of the patient to atleast some extent. This pull on the patient, as suggested, may be definitely controlled by pressing upon the head 18 of the intake relief. At the reverse operation of the reciprocating motor or piston and cylinder device, the bellows evac'uates not only a portion of the inspiration from the patient but the exhaust as previously from the piston and cylinder device. The reverse operation of the motor in delivering gas to the patient corresponds to the inspiration by the patient.

There is thus economy in the use of the motor exhaust gases for supplying inhalation gas to the patient. As the pressure builds up, the relief valves avoid any excess of pressure supply-to the patient. Economy of oxygen supply may be determined by adjusting this inspiration for allowing air to enter at the valve'13. This adjustment at the valve I3 may occur not only during this pneumatically efiected pulsation as external of the patient but during the muscular respiration as normal, for as the patient begins to use his muscles for normal breathing or approaching breathing, this motor operation may be transferred to that which will respond directly to the patient by shifting the handle 88 to cut out the supply from the duct I0 and cut in the supply from the duct 93. This automatically discontinues the operation of the piston and cylinder device, and automatically starts the operation of the device at the fitting 98. The operation of the device at the fitting 98 is directly responsive in volume and rate to the muscular action of the patient in respiration. It is to be noted that in the cutting over of the device from automatic operation as controlled by the pneumatic motor to the operation controlled by the patient, there may still be motor operation with the motor running very slowly in the instance that the motor is not actually out out.

What is claimed and is desired to secure by Letters Patent is:

1. A portable unit housing comprising therein a bellows providing a pump having a suction stroke and a succeeding reverse pressure stroke, a double-acting piston and cylinder device thereon providing a motor directly connected for operating said bellows, a snap valve for the device operable by the device for controlling fluid fiow of gas from the device to the bellows at each stroke of the bellows, a fluid source, pressure controlled mechanism between the source and valve, a delivery duct from the bellows, and a mask terminus for the delivery duct.

2. A portable unit housing comprising therein a bellows providing a pump having a suction stroke and a succeeding reverse pressure stroke, a double-acting piston and cylinder device thereon providing a motor directly connected for operating said bellows, a snap valve for the device operable by the device for controlling fluid flow of gas from the device to the bellows at each stroke of the bellows, a fluid source, pressure controlled mechanism between the source and valve, a delivery duct from the bellows, a mask terminus for the delivery duct, an additional delivery duct from the housing to the mask, and a pulsating pressure-controlling valve mechanism between said additional delivery ductand the fluid supply.

3. A portable unit housing comprising therein a bellows providing a pump having a suction stroke and a succeeding reverse pressure stroke, a double-acting piston and cylinder device thereon providing a motor directly connected for op-' tween said additional delivery duct and the fluid supply, and valve mechanism controlling fluid flow for the mask as a continuation from the first mentioned delivery duct and from the other delivery duct.

4. A reciprocating doub1e-actingmotor, a single-acting pump, direct-connected to the motor,

said pump having a suction stroke and. a pres sure stroke as a respiration cycle, pressure fluid supply, and valve mechanism for the motor and pump, said mechanism connecting said supply first to one side and then to the opposite side of the motor, said mechanism having connections adapted for communication with the respiratory organs of a patient and having passages for conducting motor exhaust to the pump on pump intake and to the pump on pump discharge strokes.

5. A pressure source of gas supply, and a respiration gas administering machine therefrom comprising valve mechanism including a distensible chamber having opposing diaphragms forming side walls therefor, one of said diaphragms having fixed therewith a central reinforcement providing a seat, a housing limiting the distension of the chamber and having a port in register with said diaphragm seat, a control valve embodying a lever, a rod therefrom protruding through said port to engage the diaphragm reinforcement at said'seat, and an additional diaphragm with which said rod coacts remote from said seat. a

6. Respiration apparatus involving ,a doubleacting piston and cylinder motor device, a motive fluid supply, control connections therefor to the cylinder successively exposing the opposite sides of the piston to motive fluid pressure, a bellows pump having a suction stroke for promoting exhalation and a reverse stroke for promoting in-f halation, and mechanism directly connecting the pump in series both mechanically and pneumatically with the device for operation in synchronism, and a valve tripped by the operation of said device to controL fluid flow for the device and pump in delivering the exhaust from said device to the pump at each stroke of the pump. 7. Respiration apparatus embodying a bellows and a motor, said bellows including apair of opposing members, and an endless connecting flexible fluted member therebetween, said motor including a cylinder, a piston, and a rod therefrom extending to one of the pair of bellows members effective to extend the flexible member in one direction of rod movement and collapse the flexible member in the other direction of rod movement in causing the bellows to operate as a pump, and connections for gas flow from the motor to thebellows at each direction of rod motor, duct means from the motor to the pump,

there being connecting members transmitting motor reciprocation to the pump, said duct means being directly connected through said pump with said delivery means, and control means efiecting different motor connection to said duct means at difierent directions of motor reciprocation.

9. A piston, a cylinder having a. head, a rod from the piston through the head, a member opposing, the head to which member the rod is connected, distensible means about the rod between the head and member forming therewith a bellows as operable by the rod, passage means from the cylinder to the bellows, a rocker valve directly connecting through said passage means from said cylinder to one side of the piston and then to the other side of the piston, and a gas pressure supply connected, in the respective positions of said valve, for actuating said piston and cylinder as a motor.

10. A reciprocating pneumatic motor, a pump direct-connected toand for operation by the motor, said pump having port means providing an intake and an outlet, valve mechanism, and apressure fluid supply for the motor controlled by the valve mechanism, said mechanism including control means actuable from said motor for-said valve mechanism to connect said supply first to one side and then to the opposite side of the motor, there being connections from said pump adapted for communication with the respiratory organs of a patient and effective for ELMER I. MCKESSON.

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