Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
• • 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. ventilators; Tracheal tubes
  • A61M16/04—Tracheal tubes
  • A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
• • 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. ventilators; Tracheal tubes
  • A61M16/04—Tracheal tubes
• • 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
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/02—General characteristics of the apparatus characterised by a particular materials
  • A61M2205/0216—Materials providing elastic properties, e.g. for facilitating deformation and avoid breaking

Definitions

• This disclosure relates to endotracheal intubation devices, and more particularly to an endotracheal intubation device that can be easily and quickly prepared for reuse.
• Endotracheal intubation devices having a manipulated (e.g., curvable) distal end that facilitates guiding of an endotracheal tube into a trachea of a patient are known. It is also known to employ a flexible sheath over the distal portion of the device, which can be discarded at the end of an intubation process and replaced with a new sheath before the device is used again. This arrangement reduces or eliminates the need for sterilization and/or disinfection of the instrument between procedures.
• a manipulated (e.g., curvable) distal end that facilitates guiding of an endotracheal tube into a trachea of a patient are known. It is also known to employ a flexible sheath over the distal portion of the device, which can be discarded at the end of an intubation process and replaced with a new sheath before the device is used again. This arrangement reduces or eliminates the need for sterilization and/or disinfection of the instrument between procedures.
• a sheath for an endotracheal intubation device in accordance with this disclosure includes an elongate flexible portion defining a longitudinally extending conduit for receiving an elongate articulated arm having a distal curvable end opposite a proximal end coupled to a handle, and an open channel defined adjacent the conduit by a pair of lips that extend from a wall of the conduit to form a C-shaped profile for releasably retaining an intubation tube.
• the sheath also includes a rigid portion extending from a distal end of the flexible portion.
• a plurality of resilient clips are disposed in spaced apart relationship along the length of the open channel to enhance retention of an intubation tube in the channel.
• a gap is defined along a section of one of the lips, such as at the distal end of the flexible portion to pinch a tube in the channel and enhance retention while the distal end of the articulated arm is curved.
• Figure 1 is a perspective view of a sheath for an endotracheal intubation device in accordance with th s disclosure.
• Figure 2 is a cross-sectional view of the sheath as viewed along lines II-II of
• Figure 3 is a cross-sectional view of the sheath as viewed along lines III-III of
• Figure 4A is a side view of an endotracheal intubation device which is usable with the sheath.
• Figure 4B is a side view of the endotracheal intubation device of Figure 4A with the sheath of Figure 1 disposed over the articulated arm of the device, and the lever in a compressed position causing the articulated arm to bend to a relatively curved configuration.
• Figure 4C is a side view of the endotracheal intubation device of Figure 4B with the lever in a released position causing the articulated arm to relax to a relatively straight (non- curved) configuration.
• Figure 5 is a perspective view showing detail of the articulated members of the articulated arm of the endotracheal intubation device.
• Figure 6 is a perspective view of the endotracheal intubation device shown in
• Figure 4 A illustrating the video display of the device.
• Figure 7 is a cross-sectional view of the sheath as viewed along lines VII- VII of
• Figure 1 is a perspective view of the distal end of the sheath showing a transparent window for a camera.
• Figure 9 is a perspective view of an endotracheal intubation device having an intubation tube pinched between an edge of the rigid section of the sheath and lip of the open channel when the articulated arm of the device is curved.
• Sheath 10 for an articulable endotracheal intubation device is illustrated in Figure 1.
• Sheath 10 includes a relatively flexible portion 12 constituting the majority of the length of the sheath and a relatively rigid portion 14 at the distal end of the sheath. Together, and individually, the flexible and rigid portions define a longitudinally extending conduit 20 that is sized and shaped to receive a jointed or articulated arm of an intubation device having a distal curvable end that is opposite an end configured to be attached to a handle.
• sheath disclosed herein are described as “single-use, disposable sheaths," it is understood that this language is more descriptive of the practical and intended use of the sheaths than the structure of the sheaths.
• the term “single-use” is intended to mean that the sheaths are made of inexpensive materials that can be easily and economically molded into a finished component that can be economically discarded after a single intubation procedure.
• the relatively flexible portion 12 of the sheath 10 is softer and more flexible than the relatively rigid portion 14 of the sheath.
• the flexible portion 12 can be made of a flexible rubber, such as a silicone rubber, and can have a Shore A hardness below 70, below 60, or below 50.
• a suitable Shore A hardness for the flexible portion 12 of sheath 10 can be from about 10 to about 70, from about 20 to 60, or from about 30 to about 50.
• the relatively rigid portion 14 of the sheath 10 is harder and less flexible than the relatively flexible portion 12 of the sheath.
• the relatively rigid portion 14 can be made of a relatively rigid thermoplastic material, such as a polycarbonate, polystyrene, nylon, or an acrylic polymer (e.g., polymethylmethacrylate), and can have a Shore D hardness of at least 60, at least 70, or at least 80.
• a hardness for the relatively rigid portion 12 of sheath 10 can be from about 60 Shore D to about 150 Rockwell R, about 70 Shore D to about 150 Rockwell R, or about 80 Shore D to about 150 Rockwell R.
• conduit 20 has a square cross-sectional shape or profile as shown in Figure 2 of the illustrated embodiment. However, other cross-sectional shapes can be used. Conduit 20 is generally defined by a first wall 24, an opposite second wall 26, and opposing walls 28 and 30 that extend between walls 24 and 26 to define a closed structure that prevents body fluids from entering when the sheath is disposed over the articulated arm of an intubation device during an intubation procedure.
• the distal end of conduit 20, which is located in the trachea of a patient during an intubation procedure can include a clear optical window 32 that sealingly closes the distal end of the tube, preventing body fluids from entering conduit 20, while allowing an image of the position of the device in the trachea of a patient to be viewed during the intubation procedure, such as via a camera or imaging device located at the distal end of the articulated arm of the intubation device adjacent the window 32.
• An open retaining channel 33 is defined adjacent conduit 20 by a pair of retaining lips 34, 36 that extend perpendicularly away from opposite ends of wall 26 and curve toward each other to form a C-shaped profile for retaimng an intubation tube during an intubation procedure.
• the channel opening 33 is sized to accommodate an intubation tube having a predetermined outer diameter, with the ends 38, 40 of retaining lips 34, 36 being spaced apart by a distance (or gap) that is less than the outer diameter of the intubation tube when the lips 34, 36 are in a relaxed state (i.e., a state in which the lips 34, 36 are not flexed or distorted, but instead are in the natural conformation or configuration when there are not any applied forces).
• a plurality of resilient C-shaped clips 40 may be employed along the length of the retention channel.
• the C-shaped clips can be spaced apart to provide sections between the clips 40 into which an intubation tube can be more easily inserted and from which an intubation tube can be easily released once the tube has been satisfactorily positioned in the trachea.
• the clips 40 can be fully or partially embedded (see Figure 7) in the flexible rubber material from which the portion 12 of sheath 10 is formed.
• clips 40 can be adhesively bonded to lips 34, 36 and/or wall 26, or mechanically attached to lips 34, 36, such as with tabs projecting from the clips and engaging slots through lips 34, 36.
• Clips 40 can be made of a deformable material that can be resilient or non-resilient. Clips 40 can exhibit less flexibility than lips 34, 36. Examples of suitable materials for clips 40 include metals (e.g., steel, stainless steel, aluminum, nickel, nickel alloys, etc.) or thermoplastic elastomers.
• the relatively rigid portion 14 of sheath 10 has a first section 37 immediately adjacent a distal end of flexible portion 12 of the sheath, which has a cross-sectional shape that is substantially the same as illustrated in Figure 2.
• a tongue elevator 42 Projecting integrally in a generally distal direction from an upper wall 12A of rigid portion 14 is a tongue elevator 42 that can be used during endotracheal intubation to lift the epiglottis of the patient as the endotracheal tube is being inserted into the trachea of the patient.
• a cut-out section or gap 46 in lip 34 defined at a distal end of the flexible portion 12 of sheath 10 is a cut-out section or gap 46 in lip 34.
• a cross-sectional profile of the distal section of flexible portion 12 is shown in Figure 3. In this cut-out section, lip 34 is non-existent.
• the gap 46 generally extends over only a small fraction of the total length of the flexible portion 12 (e.g., less than 25%, less than 20%, less than 15% or less than 10%).
• FIGS. 4 A and 4B Shown in Figures 4 A and 4B are side views of an intubation device 50 having a handle portion 52 including grips 54 and 56, and a lever 58 pivotably connected to handle portion 52 at pivot pin 60.
• a detachable module 61 includes an actuator housing 62 containing an actuator assembly operatively connecting lever 58 with a spring loaded member 64 ( Figure 5) reciprocatably movable relative to the longitudinal direction of jointed arm 66.
• the jointed arm 66 includes two joints or articulations 70,
• linkage 74 hinged at one end to the main portion 76 of arm 66 and hinged at the other end to terminal member 78, which is sized and shaped to conform with and substantially fill the internal volume defined by the first section 37 of rigid portion 14, such that the distal end of flexible portion 12 of sheath 10 bends in conformance with rotational movement of linkage 74 and terminal member 78 around hinges 70 and 72, respectively, when spring loaded member 64 is actuated.
• Additional linkages, similar to linkage 74 may be used if desired to provide more articulations and greater ability to curve arm 66.
• the distal end of main portion 76 of arm 66 includes two pulleys 80, 81 arranged side-by-side and each rotatable around an axle 82
• Linkage 74 also includes two pulleys 82, 83 arranged side-by-side and each rotatable around an axle 84.
• a first control wire 86 is fixed to member 64, wrapped around pulley 80, then wrapped around pulley 82, and joined to terminal member 78.
• a second control wire 88 is fixed to member 64, wrapped around pulley 81, then wrapped around pulley 83, and joined to terminal member 78.
• Guides 90 and 91 can be provided to control movement and position of wires 86 and 88 during actuation of arm 66 and bending of sheath 10 when sheath 10 is positioned over arm 66.
• the use of pulleys 80, 81, 82 and 83 reduces friction between the control wires and the linkage or linkages during bending of the distal end of arm 66 as compared to an arrangement in which the control wire or wires merely pass through guide openings in the linkage(s).
• the pulleys also provide a mechanical advantage and smoother operation without sacrificing sensitivity (i.e., the ability to accurately control bending of the distal end of arm 66 by manipulation of lever 58).
• a single set of pulleys (one on linkage 74 and another on terminal member 78) can be used with a single control wire if desired. However, the use of two control wires and two sets of pulleys provides a more balanced and smoother application of force to the articulated members of arm 66.
• device 52 can include a video display device 92 having a video display screen 93 which can be connected to a camera 95 positioned on the distal end of terminal member 78 to allow a medical professional to see inside the throat and trachea of a patient during an endotracheal intubation procedure.
• a video display device 92 having a video display screen 93 which can be connected to a camera 95 positioned on the distal end of terminal member 78 to allow a medical professional to see inside the throat and trachea of a patient during an endotracheal intubation procedure.
• lever 8 can be directly attachable to a reciprocating member 200 to which control wires 86 and 88 are attached so that when lever 58 is pressed toward grip 6, reciprocating member 200 is pulled proximally along with attached wires 86 and 88 causing the articulated members 74 and 78 to curve the distal end of arm 66 as shown in Figure 4B.
• a sheath 10 is positioned over arm 66 as shown in
• an endotracheal tube 110 is positioned in open channel 33 as shown in Figure 9.
• the distal end of the device is inserted into the mouth of a patient, with the curvable distal end of the device in the straighter (less curved), relaxed position.
• Lever 58 can be operated during insertion as needed to curve the distal end of arm 66 and flexible sheath 10 to allow the device to be safely advanced through the throat of the patient to the trachea.
• a surface of tube 110 engages an edge 112 of relatively rigid portion 14 of sheath 10, which is exposed by gap 46.
• An opposing surface of tube 110 also engages an interior surface of lip 36.
• gap 46 allows strong tube retention when arm 66 is flexed or articulated causing tube 110 to be pinched and Fixed at the edges 120, 122 of gap 46, and facilitates removal of the tube from the device when arm 66 is straight or relaxed.

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• Health & Medical Sciences (AREA)
• Pulmonology (AREA)
• Life Sciences & Earth Sciences (AREA)
• Engineering & Computer Science (AREA)
• Veterinary Medicine (AREA)
• Public Health (AREA)
• General Health & Medical Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• Heart & Thoracic Surgery (AREA)
• Biomedical Technology (AREA)
• Otolaryngology (AREA)
• Emergency Medicine (AREA)
• Hematology (AREA)
• Anesthesiology (AREA)
• Surgery (AREA)
• Physics & Mathematics (AREA)
• Pathology (AREA)
• Optics & Photonics (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Biophysics (AREA)
• Medical Informatics (AREA)
• Radiology & Medical Imaging (AREA)
• Molecular Biology (AREA)
• Physiology (AREA)
• Endoscopes (AREA)
• External Artificial Organs (AREA)
• Quick-Acting Or Multi-Walled Pipe Joints (AREA)
• Media Introduction/Drainage Providing Device (AREA)
• Surgical Instruments (AREA)

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• 2014
  • 2014-09-30 BR BR112016007593A patent/BR112016007593A2/pt not_active Application Discontinuation
  • 2014-09-30 MX MX2016004419A patent/MX2016004419A/es unknown
  • 2014-09-30 US US14/501,294 patent/US9883791B2/en not_active Expired - Fee Related
  • 2014-09-30 AU AU2014332324A patent/AU2014332324A1/en not_active Abandoned
  • 2014-09-30 JP JP2016520023A patent/JP6497785B2/ja not_active Expired - Fee Related
  • 2014-09-30 CA CA2925327A patent/CA2925327A1/en not_active Abandoned
  • 2014-09-30 KR KR1020167010562A patent/KR20160070085A/ko not_active Withdrawn
  • 2014-09-30 CN CN201480055198.1A patent/CN105899251B/zh not_active Expired - Fee Related
  • 2014-09-30 EP EP14852083.6A patent/EP3055014B1/en active Active
  • 2014-09-30 WO PCT/US2014/058249 patent/WO2015053983A1/en not_active Ceased

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