USRE20781E - Gas administering machine - Google Patents

Description

July 5, 1938. J. A. HEIDBRINK GAS ADMINISTERING MACHINE 3 Sheets-Sheet 1 Original Filed Aug. 23, 1935 July 5, 1938. J. A. HEIDBRINK GAS ADMINISTERING MACHINE Original Filed`Aug. 25, 1955 5 Sheets-Sheet 2 brink.

/f't'tor-neys Reissued July 5, 1938 UNITED STATES Re. 20,781Y

PAT ENT OFFICE.

GAS ADMINISTERING MACHINE Jay A. Heidbrink, Minneapolis, Minn., assignor to The 0hio Chemical and. Manufacturing Company, Cleveland, Ohio 11 Claims.

My invention relates to gas administering machines and has for its object to provide a machine for administering fluid for inhalation for producing varying states of anaesthesia, particularly that low form of anaesthesia known as analgesia, wherein the patient is conscious but the nerves are numbed and deadened to the sense of pain.

In many conditions of patients, such, for example, as that accompanying certain kinds of operations of dentists, or even in labor in child bearing, it is desirable to maintain the patient' in a state of analgesia wherein the patient is only partly anaesthetized.

It is a principal purpose of my invention to provide means to permit the patient himself to control the now and delivery of anaesthetizing iluid to himself, this control being customarily exercised in response to increased pain stimuli. The nature of the anaesthetizing fluid. and its volume will be determined in advance by the operator. The anaesthetizing fluid may be any gas or mixture of gases customarily employed to produce anaesthesia, as nitrous oxide, or nitrous oxide mixed with air or oxygen.

It is a further object of my invention so to construct the patient-operated means, after operation by the patient to deliver gas to him automatically, as to cut olf the delivery'of gas so the patient cannot of his own will and initiative maintain a constant'supply of gas, but'can only secure supplies of gas intermittently.

It is a further object of my invention to provide means such that, when'the patient operates the means which he supposes will cause delivery of gas to him, Whether it does or not, there will be an indication to him, in the form sho-wn and described, a sharp clicking noise, showing'that he has operated the gas delivering means.

It is a further object of my invention to provide means such that after the patient has operated the gas control valves to cause delivery of anaesthetizing fluid to him, the machinewillcontinue to deliver such fluid for definitely-timed periods under the control of the anaesthetist operator, at the endsof which periods supply of gas will be cut off.

It has` been found in manyA cases that more favorableresults are obtained bya constant ow of gas to the patient, determined by the trained anaesthetist. may be surges of pain stimuli which will make. the patient feel that he should have ay larger supply of anaesthetizing gas, and might have his nervous tension increased if he though he wasnt Yet, under'such conditions, therey (Cl. 12S-203) getting it. It is an object of my invention to provide means whereby the patient can operate the machine to admit and cu-t oiT flow of gas for analgesia together with means wherebyV the operator can render the patient controlled means inoperative to out olf flow although still capable of being operated by the patient, so thatv the patient While receiving a constant flow of the gas as determined by thel anaesthetist nevertheless believesy that he is oon-trolling the ow of gas with a highly valuable psychological eiect 0n the patient.

'I'he full objects and advantages of my inventionA will appear inconnection with the. detailed description thereof, and the novel features are particularly pointed outin the claims.

In the drawings, illustrating an application of my invention in one form,-

Fig. lis a front elevation Viewv of an anaesthetizing machine embodying my invention. Fig. 2 is a sectional view taken on line 2 2 of Fig. 4. Fig. 3 is a fragmentary elevation .view taken in the position of line 3 3 of Fig. 1. Fig. 4 is a part sectional elevation View taken in the plane of line 4--4 of Fig. 1. Fig. 5 is a part sectional elevation view taken on line 5-5 of Fig. 6. Fig. 6 lis a sectional elevation view taken on the line 6-6 of Fig. 5. Fig. 7 is a. sectional View taken on line 'l-l of Fig'. 5. Fig. 8 is an end View similar to a portion of what is shown in Fig. 6, with the Valve member in a different position.

As illustrated, a pedestal Il) supports head Il upon which is a plurality of gas cylinders l2, I3,` as nitrcus'oxide and oxygen or other gases which itis desired to deliver for anaesthetizing purposes. 'Ihe headcarries pressure reducers Hand' gauges l5 for each gas by means of which any gas may be delivered to a chamber I6, all in a well-known manner which it is unnecessary to` describe, it being suflicient to note that the separateV gases enter the chamber I6 through individual ports I1 and I8, as shown in Fig. 2, and leave the chamber through an extension member I!!k as clearlyshown in Fig. 4. Customarily a nipple- 20 connected with a rebreathing bag 2l anda breathing tube 22 has'been connected to the member I9. A valve- 23 operated by a handle 24` may be employedto vshoot a strong volume of one gas, as oxygen, through a special port- 25 as shown in Fig. 2, for resuscitation or other purposes.

The.` invention herein disclosed and claimed, and as shown, may be in the form of an attachment interposed in the breathing line represented by members l9 and 22, or it'may be formed directly upon the extension I9, eliminating the old breathing bag connector 20. This attachment comprises a cylindrical casing 26. On the inlet side this is provided with a nipple seat 21 into which projects a. valve head 28 having thereon a valve seat 28 as clearly shown in Figs. 4 and 5. The valve head 28 is an extension of a cylindrical member 29 which is secured to an interior tubular connector member 30, Figs. 4 and 5, by means of a screw or screws 3|. Member 30 embodies an outwardly extended annular flange 32, Fig. 4, which is embraced by a nut 33 threaded on the extension member, by which means the parts are maintained assembled in the breathing line.v

A guide member 34 provided with gas passages 35, Fig. 5, is threaded into the member 28 and has a central aperture which guides the valve stem 36, which valve stem has an inwardly projected part 31 which passes through a corresponding aperture in the wall of cylinder 26 Within valve seat 29 and is surrounded by gas holes 38. Upon the valve stem 36 is a valve disc 39 normally held in closing relation to valve seat 28 by a spring 40, as shown in Fig. 4. The opening of this valve is effected by thrusting theforwardly-extended portion 31 of the valve stem outwardly from within the chamber 4| formed in the cylindrical member 26. The cylinder 26 carries a nipple 42 adapted to be connected with the breathing tube 22 as shown in Fig. 4. Cylinder 26 also carries a second cylindrical extension 43 which is provided with a depending nipple 44 to which the rebreathing bag 2| is connected, as best shown in Fig. 4. The cylindrical extension member 43 is closed by a cap screw 45 which is provided with a centrally positioned guide socket 46 in which operates a valve stem 41. An extension 48 of valve stem 41 passes through a guide 49 formed in a partition 5|) which, except for apertures 5|, closes the interior of extension member 43 from the chamber 4| in the cylindrical member 26. A valve disc 52 on valve stem portions 41, 48 is caused by coil spring 53 normally to engage a valve seat 54 formed on the partition member 5B, the valve stem 48 projecting into the chamber 4I in cylinder 26. A bag shut-off 55 is adapted to throw the rebreathing bag 2| out of operation when that is desirable.

As the parts are shown in Fig. 4, the valve members 39 and 52 are held closed. That is the normal position of the parts, and when they are so positioned no gas can pass through into gas tube 22 to the patient or to waste out-of-doors. To operate the valves 39 and 52, I seat a piston 51 upon an internal ledge or support 56 toward the bottom of chamber 4| in cylinder 26. This piston carries` a plunger 58 of reduced diameter so as to leave an annular passageway 59 between it and the inner walls of the cylinder 26. At the upper end of the plunger po-rtion 58 there is formed an inwardly diminishing portion which provides a conical cam surface 60 in position to engage the ends of plunger portions 31 and 48 and move them from the position shown in Fig. 4 to the position shown in Fig. 5. That is from gasclosing position of Fig. 4 to the gas-open position of Fig. 5, which latter results from the plunger extensions 31 and 48 riding along the cam surface 60 to the cylindrical surface of plunger extension 58. It follows that whenever the piston 51 and its attached plunger portion 58 is raised in the chamber 4| within cylinder 26 the valves 39 and 52 are moved to open and permit gas to flow from the chamber I6 into chamber 4| and from there into rebreathng bag 2 I, when the same is not closed by cut-off valve 55, respectively.

The anaesthetist operator may control piston 51 and plunger 58 by means of cam member 6| positioned in the bottom of chamber 4| within cylinder 26 and fast on stem 62 which is operated by iinger lever 63, the parts beingheld in substantially gas-tight relation by means of spring 64. In the up-position of the finger lever 63, as shown in Fig. 5, cam member 6| has engaged the bottom of piston 51, lifting it to the position there shown wherein the valve stems 31 and 48 have ridden along the cam surface 69 to the outside of plunger cylinder 58. In this position the valve members 39 and 52 are rendered inoperative to close the valves, and gas passes through and to the rebreathing bag the same as if the attachnient herein described were not employed. When, however, the linger lever 63 is in the down-position of Figs. l, 4 and 6, valves 39 and 52 are held in their normal operative position and no gas can pass thro-ugh.

In the last-recited position, piston 51 may be operated to carry plunger 58 to open the valves by a blast of air injected below the plunger 51 by means of air bulb 65 connected by an extension tubing 66 on a nipple 61 carried by a valve casing 68. As shown in Fig. 4, Valve casing 68 is fast on a closure disc 69, which is held to close the lower end of chamber 4| within cylinder 26 by clamp nut 10. The nipple 61 has an aperture 1I which passes therethrough and into `the valve piece 68, being adapted to register with an indirect or Z-passageway 12 within a valve member 13. This Z-passageway in turn registers with a second passageway 14 in the valve casing 68, which passageway opens through the closure disc 69 below the piston 51, all as clearly shown in Fig. 6. When the parts are in this position the blast of air injected under piston 51 by the closing of bulb 55 in the hands (of the patient or other operator) will rapidly lift piston 51 and parts carried thereby until the projection 15 thereon strikes the top disc 16, which, by means of clamp nut 11 is held to close the top of chamber 4I within cylinder 26, the position of the parts at suchtime being shown in dotted lines in Fig. 5. The striking of extension 15 upon disc 16 will produce a sharp clapping or clicking sound audible to the patient even though he may be some distance from the machine. This constitutes an indication to the patient that he has operated the valve-opening mechanism to permit anaesthetizing gas to flow to him. The patient is correctly advised that the valves are opened, because when piston 51 and connected parts rise to the dotted-line position of Fig. 5, the valves in fact are opened. When this is done, with valve 13 in the position of Fig. 6, if the patient releases bulb 65, as he will be instructed to do, the weight of piston 51 and connected parts will quickly restore them to the operative position of Fig. 6, the air injected by the blast going back through the Various connections again into bulb 65.

Because, when the bulb is released and the piston 51 returned to normal position, the valves 39 and 52 close off both admission of fresh gas and entrance of the breathing line to the rebreathing bag, it is necessary for the patient to be provided with means of obtaining air for breathing. This is accomplished by means of an automatic inlet valve 11. This valve is always operative but the coil spring 11a against which the valve disk operates provides enough restriction so that when the valves 39 and 52 are open, the intake will be principally, if not entirely,

from the breathing line including the fresh gas supply and the re-breathing bag. Ordinarily the exhaling valve 11b will be keptr open and will remain open, it giving enough restriction to exhalation so that most or all of the exhaled gas will go to the re-breathing bag when that is open.

'I'he patient may, when the parts are in the position of Fig. 6, maintain his grip on the bulb 65 to keep it closed. If that is done, there will be a continuation of a supply to the patient of anaesthetic. Even when the anaesthetist has instructed the patient to release thev bulb so that he will receive only intermittent supplies of gas, pain stimuli may cause the patient not to follow instructions, but to continue to grip the bulb 65 with the intention of continuing to supply himself with anaesthetic. In either event, since there can be no escape of the air from below the piston 51 as long as the bulb 65 is held gripped, the piston could not descend and the patient would, in fact, continue to supply himself with anaesthetizing fluid. At times this might be ill advised and against the will and intent of the operatingl anaesthetist. Of course, if the cam member 6| has been lifted into the position of Fig. 5, so the valves are premanently held open, as intended by the anaesthetist, nothing will come from the patients efforts. With the arrangement as in Fig. 5, the patient from time to time will squeeze the bulb and hear the sharp click or clap of the projection 15 upon closure disk 15, and will believe he is controlling the ow of anaesthetizing gas to himself, or that he is obtaining a continuous flow by his own act. In many cases this belief has an extremely beneficial effect upon the patient, so when the operator himself maintains the valves open to permit continuous flow of anaesthetic as controlled by the operator, he will leave the valve 13 in the position of Fig. 6, and encourage the patient to operate the bulb 65 and encourage the patient to believe that he himself is controlling the administration of anaesthetic.

When, however, it is not desirable to have continuous flow of anaesthetic to the patient, and when it is desirable that the patient may not himself be able to secure continuous ow, though' he may think he is securing it, theV valve 13 is rotated to the position shown in Fig. 8. In this position a second passageway 18 in valve 13 leads directly to register with a passageway 19 in valve plug 58, which in turn leads throughA acasing in which is a check valve 8|. The casing 8|)A extends through the closure disc 69 and admits air` under piston 51 through openings 82 in the casn ing 89. At the same time a third aperture 83 in valve member 13 registers with an aperture 84 extending through valve piece 68y and closure 69 which opens Within the chamber 4| in cylinder 26. At its other end aperture 83v registers with an aperture 85 extendingl downwardly through an extension 86 of valve piece 68 into a chamber 81 therein. Chamber 81 is closed by extension nut 88 and hasa discharge therefrom through passageway 89. Centrally threaded inthe extension nut 88 is the stem 90 of a graduated needle valve 9| and the end of extension nut 88 is closed by a packing nut 92. Valve stem 90 has on the end thereof a knurled thumbnut 93 which is formed on its inside with a scale indicated at 94 in Fig. '1. O-n the stem is a pin 95 which is adapted to engage a stop pin, 96 fast on the nut 92. And when these parts are in engagement as shown in Figs. 6 and 7, the needle Valve is closed and a pointer 91 carried on the nut 9:2v will? pointon the scale to close. When the needle valve is in that position and the bulb 65 hasbeen operated to lift the piston 51'and connected p-arts to the dotted-line position of' Fig. 5, no air can escape from beneath the cylinder 51, with the result that the parts will be held in that position and the valves 39 and 52 will be kept openv to permit continuous flow of anaesthetizing gas to the breathing line. When the thumb nut 93V is revolved. to the left, as indicated by the arrow in Fig. '7, the needle valve will be opened varying degrees, indicated on the scale as progressively decreasing periods of time, which will permit air to. escape from below piston 51 so that it and the parts connected with it may descend. They will` dov this in periods of time inversely proportionate to the degree of openings, as indicated in Fig. '7. Thus, when the figure 60 is `at the pointer it will take sixty seconds for the piston to descend and the valves to close. When the pointer points to 30. itY will take thirty seconds. When it points to 15 it Will take fifteen` seconds. With this arrangement the operator* or anaesthetist can provide that after each time the patient closes the bulb 65 he will have gas flowed to him` for a definite period of time determined by the anaesthetist anywhere fromV one or two minutes down to` a few seconds.

The valve 13rmay conveniently be made conesh-aped, as clearly indicated in Fig. 6, and is held seated in a cone-shaped seat 98 by means of a screw 99. threaded intothe end of valve block 13, there being a. spring |00 between the screw head and a Washerplate |0| to hold the valve firmly seated at all times. Upon the end of the valve 13` is a knurled thumb. piece |02 upon which are scale lines |03, Fig. 3, indicating, on a pointer |04 on clamp nut 60,v whether the valve is set for single direct transmission back and forth below the piston 51, or for timed expulsion of the air below it,` and therefore, timed operation of the valves 3 9l and 52. An inlet check valve for bulb 65 is indicated at |05.

'I'he advantages of my invention will be apparent from the foregoing description thereof. 'I'he operating anaesthetist Controls, of course, the fluid for inhalation, and may control fully the volume going to the patient, even though the patient is led by the operation of the machine to think he is himself controlling the flow of gas which he is taking, with the psychological advantages which follow from that belief. The operator may, however, set the machine so the patient does himself control the flow of gas which he is getting, or he may so adjust the machine that the patient has control of the initial admission of gas to the patient, but the operating anaesthetist may determine how long the patient shall g-et a supply of anaesthetizing gas after each time he operates the delivery control mechanism. The arrangement is simple, not expensive to construct and in al high degree accurate and efficient.

I claim:

1. An anaesthetizingmachine comprising aconduit for conducting anaesthetizing gas to the patient, valve mechanism in said conduit for normally blocking the flowof gas therethrough, means operative by the patient to open said valve mechanism to permit flow of gas to the patient, means to indicate such operation to the patient, and means under the control of the anaesthetist to position said patient-operated means so as to hold the valve mechanism open while said means is still capable of conscious operation by the patient and while the said indicating means is still operative.

2. An anaesthetizing machine comprising a conduit for conducting anaesthetizing gas to the patient, a cylinder chamber in the conduit, valve mechanism associated with said chamber for normally blocking the iiow of gas therethrough, a piston in said chamber having means` thereon adapted to cooperate with said valve mechanism to open the same to permit flow of gas to the patient, and means controlled by the patient to effect operation of said piston.

3. An anaesthetizing machine comprising a conduit for conducting anaesthetizing gas to the patient, a cylinder chamber in the conduit, valve mechanism associated with said chamber for normally blocking the ilow of gas therethrough, a piston in said chamber having means thereon adapted to cooperate with said valve mechanism to open the same to permit flow of gas to the patient, means controlled by the patient to effect operation of said piston, and means operated by said piston to indicate to the patient that the piston has been operated.

4. An anaesthetizing machine comprising a conduit for conducting .anaesthetizing gas to the patient, a cylinder chamber in the conduit, valve mechanism associated with said chamber for normally blocking the flow of gas therethrough, a piston in said chamber having means thereon adapted to cooperate with said valve mechanism to open the same to permit flow of gas to the patient, means controlled by the patient to effect operation of said piston, and a striker on said piston engageable with the top of the cylinder chamber to make a distinctive sound when the piston is operated to indicate to the patient that the piston has been operated.

5. An anaesthetizing machine comprising a conduit for conducting anaesthetizing gas to the patient, a cylinder chamber in the conduit, valve mechanism associated with said chamber for normally blocking the flow oi gas therethrough, a piston in said chamber having means thereon adapted to cooperate with said valve mechanism to open the same to permit ilow of gas tc the patient, an air bulb adapted to be held in the hand of the operator, and an air conduit therefrom to below the piston whereby the patient may effect operation of said piston.

6. An anaesthetizing machine comprising a conduit for conducting anaesthetizing gas to the patient, a cylinder chamber in the conduit, valve mechanism associated with said chamber` for normally blocking the flow of gas therethrough, a piston in said chamber having means thereon adapted to cooperate with said valve mechanism to open the same to permit flow of gas to the patient, an air bulb adapted to be held in the hand of the operator, an air conduit therefrom to below the piston whereby the patient may effect operation of said piston, `and a valve across said last-named conduit for controlling low of air beneath the piston.

7. An anaesthetizing machine comprising a conduit for conducting anaesthetizing gas to the patient, a cylinder chamber in the conduit, valve mechanism associated with said chamber for normally blocking the flow of gas therethrough,

a piston in said chamber having means there-v on adapted to cooperate with said valve mechanism to open the same to permit iiow of gas to the patient, an air bulb adapted to` be held in the hand of the operator, an air conduit therefrom to below the piston whereby the patient may effect operation of said piston, and means under the control of the anaesthetizing operator to determine the length of time requisite for said air to exhaust from beneath the piston to permit the valve mechanism to close.

8. An anaesthetizing` machine comprising a conduit for conducting anaesthetizing gas te the patient, a cylinder chamber in the conduit, valve mechanism including a valve stem projecting into said chamber for normally blocking the flow of gas therethrough, a piston in said chamber having means thereon adapted to engage said valve stem to open the valve to permit flow of gas to thev patient, and means operated by the patient to force a blast of air under the piston to operate the same.

9. An anaesthetizing machine comprising a conduit for conducting anaesthetizing gas to the patient, a cylinder chamber in the conduit, valve mechanism including a valve stem projecting into said chamber for normally blocking the flow of gas therethrough, a piston in said chamber having means thereon adapted to engage said valve stem to open the valve to permit flow of gas to the patient, means operated by the patient to force a blast of air under the piston to operate the same, and means controlled by the anaesthetizing operator toI release said air from beneath the piston in predetermined periods of time for permitting the piston to return to a position such that the valve may go into normal gas blocking position.

l0. An anaesthetizing machine comprising a conduit for conducting anaesthetizing gas to the patient, a cylinder chamber in the conduit, a rebreathing bag connected with said cylinder chamber, valve mechanism associated with said chamber for normally blocking the iiow of gas through the chamber and tothe rebreathing bag, a piston in said chamber having means thereon adapted to cooperate with all said valve mechanism to open the same to permit ilow of gas to the rebreathing bag and to the patient, and means controlled by the patient to effect operation of said piston.

11. An anaesthetizing machine comprising a conduit for conducting anaesthetizing gas to the patient, a cylinder chamber in the conduit, a rebreathing bag connected with said cylinder chamber, a valve for admitting gas into the chamber and another valve for admitting gas to the rebreathing bag, each of said valves including a valve stem projecting into said chamber for normally blocking the ilow of gas thereinto and to the rebreathing bag, a piston in said chamber having means thereonadapted to engage said valve stems to open the valves to permit flow of gas to the rebreathing bag and to the patient, and means controlled by the patient to effect operation of said piston.

JAY A. HEIDBRINK. f

Images