WO2011051896A2

WO2011051896A2 - Patient moisturisation and protection

Info

Publication number: WO2011051896A2
Application number: PCT/IB2010/054868
Authority: WO
Inventors: Thomas Dominic Ford
Original assignee: Thomas Dominic Ford
Priority date: 2009-10-27
Filing date: 2010-10-27
Publication date: 2011-05-05
Also published as: ZA201203417B; WO2011051896A3

Abstract

The invention provides for a device (10) for reducing dehydration of a patient, to a kit for reducing dehydration, to methods of reducing dehydration and to a device and method for delivering a medicament to a patient with a gas via tubes (76, 38). The device (10) also provides a measure of protection to a patient's teeth and lip. The device (10) includes channels (20, 22) for receiving the patient's upper lip and a front portion of the patient's upper jaw and also includes a palate portion (18), the palate portion (18) having a moisturisable material (28). One of the methods includes positioning the palate portion (18) adjacent the palate (106) and positioning, adjacent the palate portion (18), one or more outlets (78) of a gas tube (38). The other method includes moisturising the gas prior to introducing it into the patient's nostrils and/or mouth via tubes (76, 38).

Description

PATIENT MOISTURISATION AND PROTECTION

This invention relates to the patient moisturisation and protection and the delivery of a medicament to a patient. More particularly, the invention relates to the reduction of patient dehydration, more particularly to a device for reducing dehydration of a patient, to a kit for reducing dehydration of a patient and to methods of reducing dehydration of a patient to whom gas is to be administered and also relates to a device and method for delivering a medicament to a patient. Certain embodiments of the invention also provide a measure of protection to a patient's teeth and lower lip.

During or after surgical procedures, exposure to intra-oral tubes and airways, open mouth breathing, oxygen or other anaesthetic gas inflow, hot theatre lights, warm ambient temperatures, anti-secretion medicines and intra- operative and post-operative analgesics can result in naso-oro-pharyngeal dehydration and thus discomfort of the patient. This invention aims to ameliorate oral and/or naso and/or pharyngeal dehydration, at least to some extent. Certain embodiments of the invention can also provide a measure of protection to a patient's teeth and lower lip, in particular during intubation, as is described below.

According to a first aspect of the invention there is provided a device for reducing dehydration of a patient, which device includes a body which defines one or more channels for receiving the patient's upper lip and a front portion of the patient's upper jaw, and which body includes a palate portion which is shaped and dimensioned for positioning adjacent the patient's palate, the palate portion having a moisturisable material for providing moisture to the patient's oral cavity. The body may be of a plastics material. The body may be manufactured in various sizes, for example small, medium and large, for different sizes of oral cavities. The body is preferably somewhat flexible but nonetheless having a degree of rigidity. The moisturisable material may be in the form of an absorbent pad. The moisturisable material may be of sponge material or of absorbent cloth, for example a dense fabric of tightly woven natural fibres. The plastics material of the body may be fixed to or fused with the cloth, thereby to secure the cloth to the body and to avoid detachment from the body of any piece of the cloth which could enter the patient's upper respiratory tract. In one embodiment of the invention, the palate portion of the body defines a receptacle and the palate portion has two moisturisable materials, one of the moisturisable materials being the material of the body and the other moisturisable material being an absorbent pad which is located within the receptacle. The body may be of a hydrophilic plastics material. The palate portion may define a plurality of openings for allowing moisture to pass through the palate portion onto the patient's tongue. The openings may be in the form of slots. The palate portion may comprise a plurality of elongate strips and slots. In use, a patient may facilitate release of moisture onto the tongue by pressing the tongue against the palate portion, thereby to squeeze out moisture from the moisturisable material. The palate portion is preferably flexible, thereby to facilitate the squeezing out of moisture from the moisturisable material. It will be appreciated that the moisture thus released may be spread around the oral cavity by means of the patient's tongue.

The body may include an upper part and a lower part, the upper part including the palate portion and defining an outer channel for receiving the patient's upper lip and an inner channel for receiving the front portion of the patient's upper jaw, and the lower part defining an outer channel for receiving the patient's lower lip and an inner channel for receiving a front portion of the patient's lower jaw. The upper part may be hingedly attached to the lower part. It will be appreciated that an advantage of the attachment of the upper part to the lower part being hinged is that it can allow the opening and closing of the patient's mouth and thus facilitate the insertion of an endotracheal tube or airway. Thus, the body of the device may be inserted into the patient's oral cavity pre-operatively and, immediately post-surgery before extubation, an anaesthetist can suction out any secretions that may threaten the oropharynx. Likewise, an airway, for example post-operatively after extubation, can be passed between the upper and the lower parts. The upper and lower parts may be separable from each other. Optionally, where dryness is not too severe, the upper part only may be used.

The or each channel may have a wall, and the device may include, located on the wall of the or each channel, moisturisable material for providing moisture. Instead or in addition, the body may be of a moisturisable material, for example a hydrophilic plastics material, as indicated above.

The device may include a gas-delivery apparatus for delivering gas to the patient, the gas-delivery apparatus being connectable to a supply of the gas, for example it may be connectable to a conduit which is in fluid flow communication with an outlet of a gas cylinder or a hospital wall gas outlet. The gas-delivery apparatus may include a tube for conducting the gas, the tube having a wall which defines a plurality of apertures, thereby to allow air outside of the tube to be drawn into the tube via the Venturi effect, so as to dilute the gas in the tube with air from outside of the tube. It will be appreciated that if the gas is substantially pure oxygen or includes oxygen with an elevated partial pressure, the dilution of such gas with air from outside of the tube can reduce the possibility of oxygen toxicity being induced in the patient. The gas-delivery apparatus may include a tube having an end which includes a connector for connecting the tube to a conduit that is in fluid flow communication with the gas supply.

The device may include a moisturising unit for moisturising the gas prior to its entrance into the nostrils. The gas-delivery apparatus may include cannulae for positioning in the patient's nostrils to deliver the gas to the nostrils, the moisturising unit including a moisturising chamber and moisturisable material located within the chamber, the moisturising chamber being in fluid flow communication with the cannulae. The moisturising unit may include a plurality of outlets and the cannulae may be connected or connectable to the outlets. The moisturising unit may include a housing, which may be located in front of the channel for receiving the upper lip. The interior of the moisturising chamber may be in fluid flow communication with the exterior of the moisturising unit, thereby to enable water to flow into the moisturising chamber when the moisturising unit is dipped in water. For example, the moisturising chamber may have a wall which defines a plurality of apertures, the interior of the chamber being in fluid flow communication with the exterior of the device via the apertures. Instead or in addition, the housing may define the moisturising chamber and the housing may be open at both of its ends. The device may include a filter operable to filter the gas to remove excess moisture therefrom after it has been moisturised in the moisturising chamber. The moisturising unit may include a plurality of such filters, for example a coarse filter and a fine filter. Instead or in addition, the gas-delivery apparatus may include a tube for conducting the gas, the tube having at least one outlet which, in use, is located adjacent the palate portion of the body of the device. The tube may include a plurality of outlets in the form of apertures defined by a wall of the tube. In one embodiment of the invention, the apertures are located on an upper side of an end of the tube, the tube being located beneath and adjacent the palate portion. In an alternative embodiment of the invention, the end of the tube is located adjacent and above the palate portion, and the wall of the tube defines apertures which are located on a lower side of the tube. It will be appreciated that the gas from the one or more outlets will be moistened when it flows through the moistened material of the palate portion. The upper and lower parts of the body may be hingedly connected to each other by means of pins located at both ends of the body. Instead, the upper and lower parts may be hingedly connected to each other by means of a pair of pins respectively located at both ends of the body, and the opposite end of the body may have two apertures which are in register with each other, one of the apertures being defined by the upper part and the other being defined by the lower part, a tube for conducting the gas, in use, being threaded through the apertures.

The device may include a hand grip for gripping the device. The hand grip may conveniently be located at the front of the device.

The device is preferably for use for one patient only, it being disposed of after the patient has finished using it, thereby to avoid cross- contamination from one oral milieu to another.

The device is preferably manufactured at an accredited facility where an appropriate standard of cleanliness for medical devices is maintained but the device need not be sterilized since it will be appreciated that the intra-oral milieu of a healthy individual is always contaminated with multiple micro-organisms.

According to second aspect of the invention there is provided a kit for reducing dehydration of a patient, the kit including: a device which includes a body which defines one or more channels for receiving the patient's upper lip and a front portion of the patient's upper jaw and which body includes a palate portion which is shaped and dimensioned for positioning adjacent the patient's palate, the palate portion having a moisturisable material for providing moisture to the patient's oral cavity; and a gas-delivery apparatus for delivering gas to the patient, the apparatus being connectable to a supply of the gas and to the device.

The kit may include a container for containing water. It is envisaged that, in use, the patient or a care provider will from time to time dip the moisturisable material into the water in the container to moisten the material and then re-insert it into the patient's oral cavity.

The device, the gas-delivery apparatus and the container may be located within a common packaging. The common packaging may be of a plastics material.

The body may be of a plastics material. The body may be manufactured in various sizes, for example small, medium and large, for different sizes of oral cavities. The body is preferably somewhat flexible but nonetheless having a degree of rigidity. The moisturisable material may be in the form of an absorbent pad. The moisturisable material may be of sponge material or of absorbent cloth, for example a dense fabric of tightly woven natural fibres. The plastics material of the body may be fixed to or fused with the cloth, thereby to secure the cloth to the body and to avoid detachment from the body of any piece of the cloth which could enter the patient's upper respiratory tract. In one embodiment of the invention, the palate portion of the body defines a receptacle and the palate portion has two moisturisable materials, one of the moisturisable materials being the material of the body and the other moisturisable material being an absorbent pad which is located within the receptacle. For example the body may be of a hydrophilic plastics material.

The kit may include a moisturising unit for moisturising the gas and may include cannulae for positioning in the patient's nostrils to deliver the gas to the nostrils, the moisturising unit including a moisturising chamber for receiving moisturisable material in the chamber, the cannulae being connected or connectable to the moisturising unit.

Instead or in addition, the gas-delivery apparatus may include a tube for conducting the gas, the tube having at least one outlet which, in use, is located adjacent the palate portion of the body of the device. The tube may include a plurality of outlets in the form of apertures defined by a wall of the tube. In one embodiment of the invention, the apertures are located on an upper side of an end of the tube, the tube being located beneath and adjacent the palate portion. In an alternative embodiment of the invention, the end of the tube is located adjacent and above the palate portion, and the wall of the tube defines apertures which are located on a lower side of the tube. The palate portion may define a plurality of openings for allowing moisture to pass through the palate portion onto the patient's tongue. The openings may be in the form of slots. The palate portion may comprise a plurality of elongate strips and slots. The palate portion is preferably flexible, thereby to facilitate the squeezing out of moisture from the absorbent material.

The body may include an upper part and a lower part, the upper part including the palate portion and defining an outer channel for receiving the patient's upper lip and an inner channel for receiving the front portion of the patient's upper jaw, and the lower part defining an outer channel for receiving the patient's lower lip and an inner channel for receiving a front portion of the patient's lower jaw. The upper part may be hingedly attached to the lower part. The upper and lower parts may be separable from each other. The or each channel may have a wall, and the device may include, located on the wall of the or each channel, moisturisable material for providing moisture. Instead or in addition, the body may be of a moisturisable material, for example a hydrophilic plastics material, as indicated above. The gas-delivery apparatus may be connectable to a supply of the gas, for example it may be connectable to a conduit which is in fluid flow communication with an outlet of a gas cylinder or a hospital wall gas outlet. The gas-delivery apparatus may include a tube for conducting the gas, the tube having a wall which defines a plurality of apertures. The gas-delivery apparatus may include a tube having an end which includes a connector for connecting the tube to a conduit in fluid flow communication with the gas supply.

The upper and lower parts of the body may be hingedly attached to each other by means of a pair of pins respectively located at both ends of the body. Instead, the upper and lower parts may be hingedly connected to each other by means of a pin located at one of the ends of the body, and the opposite end of the body may have two apertures which are in register with each other, one of the apertures being defined by the upper part and the other being defined by the lower part, a tube for conducting the gas, in use, being threaded through the apertures.

The device is preferably for use for one patient only, it being disposed of after the patient has finished using it.

According to a third aspect of the invention there is provided a method of reducing dehydration of a patient to whom gas is to be administered, which method includes positioning a palate portion of a body of a device adjacent the patient's palate and positioning, adjacent the palate portion, an outlet of a tube for conducting the gas, the palate portion having moisturisable material which has been moisturised. The method may include the prior step of moisturising the material.

The tube may include a plurality of outlets. The outlets may be in the form of apertures defined by a wall of the tube. In one embodiment of the invention, the apertures are located on an upper side of an end of the tube that is located beneath and adjacent the palate portion. In an alternative embodiment of the invention, the end of the tube is located adjacent and above the palate portion and the wall of the tube defines apertures which are located on a lower side of the tube.

The gas may be substantially pure oxygen or may include oxygen at an elevated partial pressure. The gas may be diluted with air prior to introducing it into the patient's body.

The material may be moisturised in water which is of a temperature which has been selected to meet the patient's needs or preferences. For example the water may be slightly warmed or lukewarm. The device may be as hereinbefore described in relation to the first aspect of the invention.

According to a fourth aspect of the invention there is provided a method of reducing dehydration of a patient to whom a gas is to be administered, which method includes moisturising the gas prior to introducing it into the patient's body, the moisturised gas being introduced into the patient's nostrils or the patient's mouth or both the mouth and the nostrils via one or more tubes. The gas may be moisturised by being passed through a moisturising unit which includes a moisturising chamber which contains moisturisable material which has been moisturised. The moisturising chamber may be in fluid flow communication with an exterior of the moisturising unit, and the moisturisable material may be moisturised by dipping the moisturising unit in water prior to introducing the gas into the patient's body, thereby to allow the moisturisable material to be moisturised by water flowing into the chamber. In one embodiment of the invention, the moisturising unit includes a housing which defines the moisturising chamber, and the housing is open at both of its ends, thereby to allow the material to be moisturised by water flowing through the ends. Instead or in addition, a wall of the moisturising chamber may define a plurality of apertures, thereby to allow the material to be moisturised by water flowing through the apertures. The method may include, prior to introducing the gas into the patient's body, filtering the gas after it has been moisturised to remove excess moisture therefrom. The gas may be substantially pure oxygen or may include oxygen at an elevated partial pressure. The gas may be diluted with air prior to introducing it into the patient's body. The introduction of the gas into the patient's nostrils may be via two cannulae of a device, the cannulae being inserted into the patient's nostrils, which device may be as hereinbefore described in relation to the first aspect of the invention. According to a fifth aspect of the invention there is provided a device for delivering a medicament to a patient, which device includes:

a unit which includes a chamber which includes a material for capturing the medicament, the material being located in the chamber;

a gas-delivery apparatus for delivering gas to the chamber, the apparatus being connectable to a supply of gas and to the unit where the medicament is admixed with the gas; and

one or more tubes for positioning in the patient's nostrils or the patient's mouth or both the mouth and the nostrils and for carrying the gas and the medicament thereto, the tubes being in fluid communication with the chamber.

The material within the chamber may be an absorbent material which absorbs the medicament, thereby capturing the medicament. According to a sixth aspect of the invention there is provided a method of delivering a medicament to a patient, which method includes:

capturing the medicament with a material which is located in a chamber which is connectable to a supply of gas; and

passing gas through the chamber, where the medicament is admixed with the gas, and through one or more tubes which are in fluid communication with the chamber and which are positioned in the patient's nostrils or the patient's mouth or both the mouth and the nostrils, thereby to deliver the gas and the medicament thereto. The material within the chamber may be an absorbent material which absorbs the medicament, thereby capturing the medicament.

The invention will now be described by way of an illustrative, non-limiting example with reference to the accompanying schematic drawings in which:

Figure 1 is a diagrammatic side view of a device for reducing dehydration of a patient in accordance with the first aspect of the invention;

Figure 2 is a diagrammatic cross-sectional front view of the moisturising unit of Figure 1 , viewed in the direction of line ll-ll of Figure 3;

Figure 3 is a diagrammatic cross-sectional side view of a moisturising unit of Figure 1 , viewed in the direction of line Ill-Ill of Figure 2;

Figure 4 is a diagrammatic front view of the device of Figure 1 ;

Figure 5 is a diagrammatic three-dimensional view of an upper part of the body of the device of Figure 1 ;

Figure 6 is a diagrammatic top plan view of a portion of the oxygen- delivery apparatus of Figure 1 ; and

Figure 7 is a diagrammatic cross-sectional side view of the device of Figure 1 , in use.

Referring to Figures 1 to 7, a device for reducing dehydration of a patient in accordance with the first aspect of the invention is designated generally by reference numeral 10. The device 10 includes a body 12. The body 12 is of a plastics material which is somewhat flexible but which nonetheless has a degree of rigidity. The body 12 includes an upper part 14 and a lower part 16. The upper part 14 includes a palate portion 18 and defines an outer channel 20 for receiving the patient's upper lip 21 a (Figure 7) and, behind the channel 20, an inner channel 22 for receiving a front portion of the patient's upper jaw 21 b (Figure 7). The lower part 16 defines an outer channel 24 for receiving the patient's lower lip 25a (Figure 7) and, behind the channel 24, an inner channel 26 for receiving a front portion of the patient's lower jaw 25b (Figure 7). The upper part 14 is hingedly attached to the lower part 16, as is described more fully below. The body 12 is of a hydrophilic plastics material (i.e. it attracts water) and is somewhat porous. The palate portion 18 includes an enclosed receptacle 27 which holds a moisturisable absorbent pad 28 located in a cavity 29 defined by the receptacle 27. The palate portion 18 defines a plurality of openings in the form of slots 30 (Figure 5) on the roof 31 a and the floor 31 b of the receptacle 27. The receptacle 27 is dimensioned and shaped for positioning adjacent a patient's palate, the receptacle in plan view being generally oval in outline.

The device 12 includes a gas-delivery apparatus 32 for delivering gas to the patient. In this example the patient is provided with substantially pure oxygen or instead, or in addition, a medicament. The apparatus 32 includes a tube which, in use, carries oxygen to be delivered to the patient's nose and mouth, as is more fully described below. An end 40 of the tube 34 includes a connector 42 for connecting the tube 34 to a tube (not shown) connected to an oxygen cylinder or an oxygen wall outlet (not shown). The apparatus 32 includes a nasal moisturising unit 43 for moisturising the oxygen prior to its entrance into the patient's nostrils. The moisturising unit 43 has a housing 44 defined by the upper part 14 of the body 12. A portion 45 of a wall 46 of the channel 20 provides a rear wall of the housing 44. The housing 44 further includes a front wall 47, a roof 48, a floor 49 and two end walls 50. The moisturising unit 43 is connected to an end 51 (Figure 2) of the tube 34. The housing 44 defines a chamber 52 (Figures 2 and 3) which, in use, contains moisture, in particular, the chamber 52 includes an absorbent material 53 (Figure 3) which, in use, is moisturised, thus moisturising the oxygen as it flows through the chamber 52. The housing 44 is open at both of its ends since the end walls 50 do not close off the ends entirely. A wall 54 of the tube 34, defines a plurality of outlets being 56, the portion being received by a socket 57.

The moisturising unit 43 includes an adjustment knob 58 for selectively opening and closing the outlets 56 by rotating the socket 57, thereby to allow for the adjustment of the rate of oxygen flow through the moisturising unit 43. More particularly, the adjustment knob 58 is attached to the socket 57, which defines openings 59, the oxygen being permitted to flow into the moisturising chamber 52 when the socket 57 is rotated into a position where the openings 59 are in register with the outlets 56, the outlets 56 being closed off when the socket 57 is rotated to a position where the openings 59 are not in register with the outlets 56. The apparatus 32 includes cannulae 76, which are attached to outlets 77 of the moisturising unit 43.

A branch tube 38 leads off the portion of the tube 34 which is located within the moisturising unit 43. The tube 38 is semi-circular in outline in cross-sectional view. An end of the branch tube 38 is located beneath and adjacent the palate portion 18 and includes a plurality of outlets, in the form of apertures 78 defined by a wall of the tube 38, but is otherwise closed, the apertures 78 being located on the upper side of the tube 38. In an alternative embodiment of the invention (not shown), the end of the tube 38 is adjacent and above the palate portion 18 and the apertures 78 are located on the lower side of the tube 38.

On either side of the body 12, the upper part 14 and lower part 16 are hingedly attached to each other by means of pins 92, which extend through a pair of registering apertures 94.

The wall of the oxygen-delivery tube 34 defines a plurality of longitudinally spaced apertures 100, the apertures 100 being located along the length of a portion of the tube 34 which extends from where the tube 34 is connected to the connector 42 up to and including the portion of the tube 34 located within the moisturising unit 43, the apertures 100 on the portion in the unit 43 providing the outlets 56 referred to above. The adjusting knob 58 defines an axial passage which extends through the knob 58, thereby allowing oxygen and air in the tube 34 to flow out through the knob 58 via an open end of the tube 34.

The device 10 includes a hand grip 104 for gripping the device 10, the hand grip 104 being attached to the wall 47.

Prior to insertion of the device 10, the body 12, together with the material 28 and the material 53, are dipped into a container (not shown) of water, and are moistened or moisturised. The cannulae 76 are inserted into the patient's nostrils and the body 12 is inserted into the patient's oral cavity such that the palate portion 18 is proximate the patient's palate 106 (Figure 7). The channel 20 receives the patient's upper lip 21 a and the channel 22 receives the front portion of the patient's upper jaw 21 b (Figure 7). The channel 24 receives the patient's lower lip 25a and the channel 26 receives the front portion of the patient's lower jaw 25b (Figure 7). Thus, the moistened body 12 and the moistened material 28 moistens the patient's palate 106, gums and lips 21 a, 25a. The tube 34 is connected, via the connector 42, to a tube (not shown) connected to an oxygen cylinder or a fixed oxygen outlet (not shown) of a hospital. The rate of flow of oxygen to the nostrils is adjusted by rotating the knob 58 or by adjusting the rate of flow of oxygen at a fixed oxygen outlet (not shown) of a hospital. The gas to the nostrils is moistened by the moisture in the material 53 located in the moisturising chamber 52 and the gas to the mouth is moistened by the moisture in the material 28 on the palate portion 18. From time to time, a patient can facilitate release of moisture onto the tongue by pressing the tongue against the flexible palate portion 18, thereby to squeeze out moisture from the material 28, the moisture passing through the slots 30 and being spread around the oral cavity by means of the patient's tongue 108. From time to time, when the body 12 and/or the material 28 and/or the material 53 becomes dry, the patient or a care provider dips the body 12 into the water in the container (not shown) to moisten the body 12, the material 28 and the material 53 and re-inserts the body 12 into position in the patient's oral cavity (Figure 7). The device 10 can last for a few days and is disposed of when the patient no longer needs it, thereby to avoid cross-contamination from one oral milieu to another.

By means of the invention, as illustrated and described, patient dehydration can be reduced. Further advantages of the invention include the reduction of the possibility of damage being caused to the patient's teeth and lower lip 25a during intubation and the facilitation of direct vision of the patient's trachea, as explained below.

At intubation performed at operations done under general anaesthetic, which includes insertion of a tube into the trachea, the anaesthetist makes use of a laryngoscope. The laryngoscope is placed on the patient's tongue, slid down into the oropharynx and is then levered upwards to pull open the mouth and force the patient's head backwards so that the larynx and epiglottis can be visualised and the breathing tube slipped down into the trachea. This gives the anaesthetist control over the patient's breathing. The anaethetist can then administer gases which keep the patient asleep as well as oxygen, essential for life, and nitrous oxide, a carrier gas, throughout the duration of the anaesthetic. The laryngoscope is of metal and includes a thin blade and a projecting ridge which extends along the length of the laryngoscope and which houses an optic fibre that provides light to shine into the depth of the throat. There is a danger of the teeth of the upper jaw 21 b or lower jaw 25b being chipped, broken or dislodged when the laryngoscope is inserted. This danger is exacerbated by the fact that patients undergoing larger surgical procedures are often elderly and therefore more likely to have weaker teeth, fillings, crowns and other dental problems. If the amount of relaxation of the patient's muscles, especially those of the jaw, is not adequate and quick access and control of the airway is needed, then the mouth is more forceably levered open with the laryngoscope. It will be appreciated that if the device 10 is used, a force applied by the laryngoscope can be distributed along the lengths of the channels 22, 26 so that all the force is not applied to one tooth only, thus providing a measure of protection to the teeth. With regard to protection of the patient's lips, often at intubation, when the laryngoscope is pushed into the patient's mouth, because in use the blade of the laryngoscope curves concavely towards the teeth of the lower jaw 25b, with extension of the patient's neck, the lower lip 25a of the patient is pulled over the teeth of the lower jaw 25b and pressed between the steel blade of the laryngoscope and the incisor teeth of the patient's lower jaw 25b. This can result in swelling of the lip 25a and may even result in a tooth cutting the lip, particularly in an emergency situation where intubation to obtain immediate airway control is performed by a paramedic, who is not qualified to inject muscle relaxants. Because the lower lip 25a is received within the channel 24 and the teeth of the lower jaw 25b are received within channel 26, the lip 25a is thus separated from the teeth and, since the walls of the channels 24, 26 have a degree of rigidity, the lip 25a receives a measure of protection from the teeth during intubation. A further advantage is that the hinged connection of the upper and lower parts 14, 16 are arranged to be relatively stiff so that the upper part 14 and the lower part 16 tend to maintain their relative positioning with respective to each other. This is advantageous as this can assist to keep the patient's lower jaw 21 b from falling backwards towards the patient's laryngopharynx. This can be useful to facilitate direct vision of the patient's trachea, thus enabling a health practitioner to ensure that the endotracheal tube is inserted into the trachea and not the oesophagus, and thus avoid oxygen being blown into the patient's stomach and anoxia. Instead of water, the device 10 can be used to deliver a medicament to a patient. Thus the device 10 is also an embodiment of a device for delivering a medicament to a patient in accordance with the fifth aspect of the invention, and the device 10 implements a method of delivering a medicament in accordance with the sixth aspect of the invention. The medicament can be included in the chamber 52 which holds the material 53, the material 53 being soaked with the medicament. The medicament may be that used for asthma sufferers or other numerous conditions causing a severe shortness of breath due to constriction of the smaller airways. Thus, in for example an acute asthma incident a medicament can be placed in the chamber 52 of the unit 43 and, with the use of air and dilute oxygen blowing through tube 34, the chamber 52 and out of the chamber 52 through the tubes or cannulae 76 and the tube 38, droplets of medicament are administered through the mouth and/or nose and breathed into the lungs, thereby to cause a dilation or opening of the air cells and allowing a reversal of the loss of breath suffered by the asthma or any other suitable dyspnoeic patient. The medicament can easily be squirted onto the chamber 52 via the ends of the unit 43 and thus, with the flow of air and dilute oxygen, would be easily administered to the patient.

Claims

1 . A device for reducing dehydration of a patient, which device includes a body which defines one or more channels for receiving the patient's upper lip and a front portion of the patient's upper jaw, and which body includes a palate portion which is shaped and dimensioned for positioning adjacent the patient's palate, the palate portion having a moisturisable material for providing moisture to the patient's oral cavity.

2. A device as claimed in Claim 1 , in which the palate portion of the body defines a receptacle and in which the palate portion has two moisturisable materials, one of the moisturisable materials being the material of the body and the other moisturisable material being an absorbent pad which is located within the receptacle.

3. A device as claimed in Claim 1 or Claim 2, in which the body is of a hydrophilic plastics material.

4. A device as claimed in any of the preceding claims, in which the palate portion defines a plurality of openings for allowing moisture to pass through the palate portion onto the patient's tongue.

5. A device as claimed any of the preceding claims, in which the body includes an upper part and a lower part, the upper part including the palate portion and defining an outer channel for receiving the patient's upper lip and an inner channel for receiving the front portion of the patient's upper jaw, and the lower part defining an outer channel for receiving the patient's lower lip and an inner channel for receiving a front portion of the patient's lower jaw, the upper part being hingedly attached to the lower part.

6. A device as claimed in any of the preceding claims, which includes a gas-delivery apparatus for delivering gas to the patient, the gas- delivery apparatus being connectable to a supply of the gas.

7. A device as claimed in Claim 6, in which the gas-delivery apparatus includes cannulae for positioning in the patient's nostrils to deliver the gas to the nostrils and a moisturising unit for moisturising the gas prior to its entrance into the nostrils, the moisturising unit including a moisturising chamber and moisturisable material located within the chamber, the moisturising chamber being in fluid flow communication with the cannulae.

8. A device as claimed in Claim 7, in which the chamber is in fluid flow communication with the exterior of the moisturising unit.

9. A device as claimed in any of Claims 6 to 8, in which the gas- delivery apparatus includes a tube for conducting the gas, the tube having a wall which defines a plurality of apertures.

10. A device as claimed in any of Claims 6 to 8, in which the gas- delivery apparatus includes a tube for conducting the gas, the tube having at least one outlet which, in use, is located adjacent the palate portion of the body of the device.

1 1 . A kit for reducing dehydration of a patient, the kit including:

a device as claimed in any of Claims 1 to 5; and

a gas-delivery apparatus for delivering gas to the patient, the apparatus being connectable to a supply of the gas and to the device.

12. A kit as claimed in Claim 1 1 , which includes a moisturising unit for moisturising the gas and cannulae for positioning in the patient's nostrils to deliver the gas to the nostrils, the moisturising unit including a moisturising chamber for receiving moisturisable material in the chamber, the cannulae being connected or connectable to the moisturising unit.

13. A kit as claimed in Claim 1 1 or Claim 12, in which the gas- delivery apparatus includes a tube for conducting the gas, the tube having at least one outlet which, in use, is located adjacent the palate portion of the body of the device.

14. A method of reducing dehydration of a patient to whom gas is to be administered, which method includes positioning a palate portion of a body of a device adjacent the patient's palate and positioning, adjacent the palate portion, an outlet of a tube for conducting the gas, the palate portion having moisturisable material which has been moisturised.

15. A method of reducing dehydration of a patient to whom a gas is to be administered, which method includes moisturising the gas prior to introducing it into the patient's body, the moisturised gas being introduced into the patient's nostrils or the patient's mouth or both the mouth and the nostrils via one or more tubes.

16. A method as claimed in Claim 15, in which the gas is moisturised by being passed through a moisturising unit which includes a moisturising chamber which contains moisturisable material which has been moisturised.

17. A method as claimed in Claim 16, in which the moisturising chamber is in fluid flow communication with an exterior of the moisturising unit, and the moisturisable material is moisturised by dipping the moisturising unit in water prior to introducing the gas into the patient's body, thereby to allow the moisturisable material to be moisturised by water flowing into the chamber.

18. A method as claimed in any of Claims 15 to 17, in which the gas is diluted with air prior to introducing it into the patient's body.

19. A device for delivering a medicament to a patient, which device includes:

a unit which includes a chamber which includes a material for capturing the medicament, the material being located in the chamber; a gas-delivery apparatus for delivering gas to the chamber, the apparatus being connectable to a supply of gas and to the unit where the medicament is admixed with the gas; and

20. A method of delivering a medicament to a patient, which method includes:

passing gas through the chamber, where the medicament is admixed with the gas, and through one or more tubes which are in fluid communication with the chamber and which are positioned in the patient's nostrils or the patient's mouth or both the mouth and the nostrils, thereby to deliver the gas and the medicament thereto.