WO2020055323A1

WO2020055323A1 - A plug having a deformable portion for indicating one or more throat pack

Info

Publication number: WO2020055323A1
Application number: PCT/SG2018/050468
Authority: WO
Inventors: Sellakkuddy SELVAGANESH; Vaikunthan RAJARATNAM; Chandra Mohan KUMAR; Kim Erl Veronica WONG; Jhoanna Napay CASTILLO; Zhide LOH
Original assignee: Alexandra Health Pte Ltd
Priority date: 2018-09-13
Filing date: 2018-09-13
Publication date: 2020-03-19

Abstract

A plug having a deformable portion for indicating one or more throat pack used in a surgical procedure and an attachment for attaching to an airway management device to maintain air pressure in an air inflatable part of the airway management device. The attachment of the plug is moveable between a first configuration to maintain air pressure in the air inflatable part and a second configuration to keep the air inflatable part of the airway management device deflated.

Description

A PLUG HAVING A DEFORMABLE PORTION FOR INDICATING ONE OR MORE THROAT PACK

FIELD OF INVENTION

The present invention relates to a plug having a deformable portion for indicating a number of throat pack used in a surgical procedure. For example, the plug may be a valve pressure depressurization tab of an airway management device.

BACKGROUND

Use of an endotracheal tube (ETT) or a supraglottic airway device (SAD) during surgical procedures in the throat and nose of a person usually necessitate the use of throat packs.

Typically, swabs are used as the throat packs, which are placed in a throat of a patient undergoing a surgical procedure requiring use of the ETT or SAD, to absorb any blood, bodily or external fluids or other materials that may seep into the back of the patient’s throat and enter into the oesophagus or lungs during surgery.

Throat packs are usually removed either after the surgical procedure while the patient is still in the operating theatre or sometimes when the patient is in a recovery room or an intensive care unit of a hospital. Leaving a throat pack behind by mistake or in situ is associated with a high risk of obstruction of the patients’ airway leading to fatality. There is therefore a need to ensure all throat packs are removed prior to removing the ETT or SAD.

The efficacy of current solutions largely depends on the discipline of the healthcare providers in adhering to the required throat pack removal procedures in an error-free manner. As a result, factors such as a fatigue induced memory lapse or a change in staff during an extended procedure could result in throat pack retention in a patient’s throat with potentially fatal consequences.

Efforts have been made to minimize the aforementioned possibility of human factor error by developing reminders that prevent subsequent procedures from happening until the throat pack is removed. However, the methods used to remind users to remove the throat packs are currently ad-hoc procedures depending on the practices and preferences of the healthcare providers. For instance, writing notes to serve as a reminder for throat pack removal such as writing on a swab count board, and sticking a sticker written or printed with a reminder for throat pack removal on equipment, the body of a staff involved in a surgical procedure, and the body of the patient.

SUMMARY

According to an example of the present disclosure, there is provided a plug as claimed in the independent claims. Some optional features are defined in the dependent claims.

BRIEF DESCRIPTION OF THE DRAWINGS

Examples of the present disclosure will be better understood and readily apparent to one skilled in the art from the following written description, by way of example only and in conjunction with the drawings, in which :

Figurel shows a perspective view of a conventional valve depressurization tab packaged with a tracheal intubation tube.

Figure 2 shows a front view of a conventional valve depressurization tab.

Figure 3 shows a perspective view of a plug according to an example of the present disclosure that is attached to an airway management device in one configuration.

Figure 4 shows an enlarged front view of the plug of Figure 3 in the one configuration.

Figure 5 shows a perspective view of the plug of Figure 3 that is attached to the airway management device in another configuration.

Figure 6 shows an enlarged front view of the plug of Figure 3 in another configuration.

Figure 7 shows a perspective view of the plug of Figure 3 with a deformable portion depressed and a clipping portion clipping a throat pack.

Figure 8 shows an enlarged front view of the plug of Figure 3 that features the clipping portion of the plug.

Figure 9 illustrates steps leading to removal of an airway management device from a patient after using the plug according to an example of the present disclosure. These figures are not drawn to scale and are intended merely for illustrative purposes.

DETAILED DESCRIPTION

In view of existing methods described in the background section that are used to remind users to remove swabs or throat packs used during a surgical procedure, an example of the present disclosure is configured to address a need for a solution that is more standardized and scalable by design. The surgical procedure can be a procedure in a throat or nose surgery for a person or a procedure to administer general anaesthetic.

The example of the present disclosure provides a plug having a deformable portion for indicating a number of throat pack used in a surgical procedure and an attachment for attaching to an airway management device to maintain air pressure in an air inflatable part of the airway management device. Specifically, the plug may be in a form of an improved valve pressure depressurization tab with a throat pack reminder feature. The airway management device may be an instrument such as an endotracheal tube (ETT), a tracheal intubation tube, or a supraglottic airway device that may be required in a surgical procedure. The improved valve pressure depressurization tab may be, by default, packaged with the airway management device such that the airway management device is always delivered with the improved valve pressure depressurization tab attached to the airway management device. However, in another example, it is not necessary that the throat pack reminder is packaged in such manner by default and the improved valve pressure depressurization tab may be provided as a separate item from the airway management device.

The plug provided by the present example is a solution that introduces a degree of errorproofing during the surgical procedure, thereby minimizing the possibility of throat pack retention in a patient’s throat. The solution is also standardized and scalable by design.

The throat pack refers to, for example, a swab, which may be an absorbent pad or piece of material used in surgery and medicine for cleaning wounds, applying medication, or taking specimens, or any other suitable item with ability to absorb any blood, bodily or external fluids, and/or other materials that may seep into the back of a person’s or patient’s throat and enter into the oesophagus or lungs during the surgical procedure.

Figures 1 and 2 show a conventional valve depressurization tab 101 attached to a tracheal intubation tube 100. The parts of the tracheal intubation tube 100 include a pilot balloon 103, a pilot balloon valve 104 (typically a spring loaded one way valve) and an inflatable cuff 102. The pilot balloon 103 comprises the pilot balloon valve 104 to restrict air flow to the pilot balloon 103 and the inflatable cuff 102. The pilot balloon 103 is connected to the inflatable cuff 102 through an air conduit 1 10. The pilot balloon 103 and the inflatable cuff 102 are typically deflated as shown in Figure 1 to have minimum or no air therein to reduce size of the tracheal intubation tube 100 for easier packaging and to prevent damage that may be caused to the pilot balloon 103 and the inflatable cuff 102 during the transportation or delivery of the tracheal intubation tube 100 if they are inflated. For example, if delivered as air cargo, the tracheal intubation tube 100 may face harsh air pressure and temperature conditions that may damage the pilot balloon 103 and the inflatable cuff 102 if they are inflated. The conventional valve depressurization tab 101 is used as a stopper to keep the inflatable cuff 102 and the pilot balloon 103 deflated during the transportation or delivery of the tracheal intubation tube 100 by activating the pilot balloon valve 104 to allow air in the inflatable cuff 102 and the pilot balloon 103 to escape through the activated pilot balloon valve 104.

The conventional valve depressurization tab 101 comprises a catch 1 1 1 in a form of a pair of opposing teeth to facilitate the attachment of the conventional valve depressurization tab 101 to a radial protrusion 1 12 of the tracheal intubation tube 100. Specifically, the conventional valve depressurization tab 101 has a projection 1 13 for inserting into an air inlet 1 14 leading to the pilot balloon valve 104. When inserted into the air inlet 1 14, the projection 1 13 activates the pilot balloon valve 104 so that any air in the inflatable cuff 102 and the pilot balloon 103 can escape through the pilot balloon valve 104 and remain deflated during the transportation or delivery of the tracheal intubation tube 100. Typically, the conventional valve depressurization tab 101 is thrown away when the tracheal intubation tube 100 needs to be used. There is no function or purpose for the conventional valve depressurization tab 101 other than to press on the pilot balloon valve 104 during the transportation or delivery of the tracheal intubation tube 100 to keep the inflatable cuff 102 and the pilot balloon 103 deflated.

Figure 3 shows an example of a plug 105 in a form of an improved valve depressurization tab attached to an airway management device 300. Figure 3 shows the plug 105 along with all the parts of the airway management device 300. Figure 4 shows an enlarged front view of the plug 105 attached to the airway management device 300 of Figure 3. The airway management device 300 in Figures 3 and 4 is similar to the tracheal intubation tube 100 of Figures 1 and 2. The reference numerals of common parts, namely the air inlet 1 14, radial protrusion 1 12, pilot balloon 103, the pilot balloon valve 104 and the inflatable cuff 102, in the tracheal intubation tube 100 and the airway management device 300 are reused in Figures 3 and 4.

With reference to Figures 3 and 4, the plug 105 has one or more deformable portions 107. In the present example, the plug 105 has a plurality of deformable portions 107, specifically, four deformable portions 107 that are each depressible to provide an indication of presence and use of one or more throat pack in a surgical procedure that requires the use of the airway management device 300. The throat pack reminder feature provided by the plug 105 may supplement existing throat pack retention reminder methods such as writing the reminder on a writing board, or writing or printing on a sticker to be pasted in a prominent spot.

In the present example, each deformable portion 107 is configured to be depressible to deform the deformable portion 107 and a numeral is indicated on each deformable portion 107. The numerals indicated on the four deformable portions 107 are numbers 1 to 4 respectively. In another example, the deformable portion may be perforable to form an aperture by pressing on the deformable portion. Such perforation may puncture a hole in the deformable portion. In yet another example, deformation of the deformable portion may be reversible by pressing the deformed portion back to a non-deformed configuration, for example, the non-deformed configuration of the deformable portion 107 as shown in Figures 3 and 4. Although a plurality of deformable portions 107 is described in the example of Figure 3, it should be appreciated that in another example, one deformable portion is also possible and this deformable portion may be printed with a numeral to indicate a number of throat pack used. A numeral herein refers to a figure, symbol, or group of figures or symbols denoting a number.

Similar to the conventional valve depressurization tab 101 of Figures 1 and 2, the plug 105 comprises an attachment 120 configured to act as a stopper to keep the inflatable cuff 102 and the pilot balloon 103 deflated during the transportation or delivery of the airway management device 300. Specifically, the plug 105 has a projection 121 for inserting into the air inlet 1 14 leading to the pilot balloon valve 104. When inserted into the air inlet 1 14, the projection 121 activates the pilot balloon valve 104 so that any air in the inflatable cuff 102 and the pilot balloon 103 can escape through the pilot balloon valve 104 and remain deflated during the transportation or delivery of the airway management device 300.

However, the attachment 120 of the plug 105 has an additional function not present in the conventional valve depressurization tab 101 . After the inflatable cuff 102 and the pilot balloon 103 are inflated during a surgical procedure, which is required during the use of the airway management device 300, the attachment 120 can be attached to the airway management device 300 again just to block access to the pilot balloon valve 104 but not to activate the pilot balloon valve 104 to allow air in the inflatable cuff 102 and the pilot balloon 103 to escape. In this manner, undesired deflation or further inflation of the inflatable cuff 102 and the pilot balloon 103 is prevented. With the plug 105 blocking the air inlet 1 14 leading to the pilot balloon valve 104, users are prevented from inserting a syringe at the air inlet 1 14 to inflate or deflate the inflatable cuff 102. In this manner, air pressure in the inflatable cuff 102 and the pilot balloon 103 can be maintained.

Hence, the plug 105 has two configurations, a first configuration to keep an air inflatable part, which is in the present example, the inflatable cuff 102 and/or the pilot balloon 103 of the airway management device 300, of the airway management device 300 deflated, and a second configuration to maintain air pressure in the air inflatable part. Specifically, the first configuration relates to the aforementioned stopper function to keep the inflatable cuff 102 and the pilot balloon 103 deflated and the second configuration relates to the aforementioned additional function not present in the conventional valve depressurization tab 101 . Figure 3 and 4 illustrate the plug 105 in the first configuration.

Furthermore, the plug 105 provides an advantage that the attachment 120 is moveable between the first configuration and the second configuration. The attachment 120 comprises a first catch 106a configured to engage a part of the airway management device 300 to prevent movement of the attachment 120 from the first configuration to the second configuration. Specifically, in the present example, the part of the airway management device 300 refers to the radial protrusion 1 12 of the airway management device 300 shown in Figures 3 and 4. In the present example, the radial protrusion has a substantially triangular cross-section with a vertex pointing away from the airway management device 300. In the present example, the first catch 106a comprises a recess 122 with a shape for accommodating a contour of the radial protrusion 1 12 and a pair of opposite facing teeth 123a to prevent movement of the attachment 120 from the first configuration to the second configuration. Each teeth 123a is substantially a right angled triangle and arranged to contact or abut the radial protrusion to prevent movement of the radial protrusion 1 12 pass the pair of opposite facing teeth 123a unless sufficient force is applied to overcome the pair of opposite facing teeth 123a.

Figures 5 and 6 illustrate the plug 105 of Figures 3 and 4 attached to the airway management device 300 in the second configuration. Figure 5 shows the plug 105 along with all the parts of the airway management device 300. Figure 6 shows an enlarged front view of the plug 105 attached to the airway management device 300 of Figure 5.

The attachment comprises a second catch 106b to catch the part of the airway management device 300 when the attachment 120 is moved into the second configuration. The attachment 120 is movable from the first configuration to the second configuration by pushing the part, which in the present example is the radial protrusion 1 12, of the airway management device 300 pass the first catch 106a until the part (112) of the airway management device engages the second catch 106b. Sufficient force has to be applied to push the part (1 12) of the airway management device pass the first catch 106a until the part (1 12) of the airway management device engages the second catch 106b. The reverse is also possible that is the attachment 120 may be movable from the second configuration to the first configuration by pushing (with sufficient force) the part (1 12) of the airway management device 300 pass the second catch 106b until the part (1 12) of the airway management device 300 engages the first catch 106a.

Specifically, in the present example, the second catch 106b is formed by two pairs of opposite facing teeth 123a and 123b, wherein one of the two pairs of opposite facing teeth is actually the pair of opposite facing teeth of the first catch 106a. For the attachment to move from the first configuration to the second configuration, the radial protrusion 1 12 of the airway management device 300 has to be pushed pass the pair of opposite facing teeth 123a of the first catch 106a until the radial protrusion 1 12 of the airway management device 300 engages and sits in between the two pairs of opposite facing teeth 123a and 123b of the second catch 106b to consider as engaged to the second catch 106b. The two pairs of opposite facing teeth 123a and 123b are arranged such that a pair of bases on opposite facing teeth are parallel to each other and a pair of vertexes on opposite facing teeth point to each other, which resemble jaws forming a seat, which is the second catch 106b, in between the teeth 123a and 123b for receiving and engaging the radial protrusion 1 12 of the airway management device 300 in the second configuration.

Figures 7 and 8 illustrate the plug 105 of Figures 5 and 6 attached to the airway management device 300 of Figure 3 in the second configuration. Figure 7 shows the plug 105 along with all the parts of the airway management device 300. Figure 8 shows an enlarged front view of the plug 105 attached to the airway management device 300. One of the four deformable portion 107 with a number 1 indicated on it is shown in Figures 7 and 8 to be depressed. Figures 7 and 8 further show the plug 105 having a clipping portion 108 for clipping a portion of one or more throat pack 109 that would be inserted into a throat during a surgical procedure. In the present example, the clipping portion 108 is a cut, for example, a U-shape cut shown in Figures 7 and 8. In another example, V-shape or other suitable shape is also possible as long as a clipping action can be achieved. In the present example, the material of the plug 105 is sufficiently flexible to be bent to open the cut for putting an end of a throat pack 109 through the cut. The material of the plug 105 is also sufficiently resilient to return to unbent state after opening the cut so that a portion of the throat pack 109 can be clipped to the plug 105. This would also serve as an optional supplementary measure users can utilise to further ensure the removal of throat-pack post-surgery.

Figure 9 illustrates steps of a throat pack removal process 900 from a patient after using a plug (for example, plug 105 described previously) of an example of the present disclosure in a surgical procedure to account for a number of throat pack or packs used in the surgical procedure. The plug introduces a degree of error-proofing in the throat pack removal process 900 by ensuring that medical staff accounts for all throat pack or packs to be removed prior to an extubation step i.e. removal of an airway management device (for example, 300 of Figure 3) from the patient, thereby minimizing the possibility of throat pack retention in the patient.

Specifically, after a surgical procedure, medical staff has to remove the airway management device, together with the throat pack or packs, from the patient. The medical staff has to proceed sequentially to remove the throat pack first at a step 901 . Following that, at a step 902, the medical staff has to account for all the throat pack or packs and ensure that the number of throat pack or packs that has been removed matches that the number of throat pack or packs that has been recorded as used on the plug. After all the throat pack or packs have been removed and accounted for, the medical staff then proceeds to a step 903 that is to remove the plug from the airway management device and deflate a cuff of the airway management device (for example, cuff 102 described previously). If not all the throat pack or packs have been accounted for, the medical staff will have to proceed to remove the missing throat pack or packs and step 901 is repeated. When all the throat packs are removed and the cuff has been deflated, the medical staff can then extubate and remove the airway management device from the patient at a step 904. Examples of the present disclosure may have the following features.

A plug having a deformable portion for indicating one or more throat pack used in a surgical procedure and an attachment for attaching to an airway management device to maintain air pressure in an air inflatable part of the airway management device.

The attachment may be moveable between a first configuration to maintain air pressure in the air inflatable part, and a second configuration to keep the air inflatable part of the airway management device deflated.

The attachment may comprise a first catch configured to engage a part of the airway management device to prevent movement of the attachment between the first configuration and the second configuration,

The attachment may comprise a second catch to catch the part of the airway management device when the attachment is moved into the second configuration.

The attachment may be movable from the first configuration to the second configuration by pushing the part of the airway management device pass the first catch until the part of the airway management device engages the second catch.

The attachment may be movable from the second configuration to the first configuration by pushing the part of the airway management device pass the second catch until the part of the airway management device engages the first catch.

The plug may comprise a clipping portion for clipping a portion of one of the one or more throat-pack.

The deformable portion may be perforate to form an aperture by pressing on the deformable portion.

The deformable portion may be depressible to deform the deformable portion.

Deformation of the deformable portion may be reversible by pressing the deformed portion back to a non-deformed configuration.

A numeral may be indicated on the deformable portion. For the avoidance of doubt, any feature of one aspect of the present invention may be utilised in any other aspect of the invention. It is noted that the examples given in the description below are intended to clarify the invention and are not intended to limit the invention to those examples per se.

While the invention has been particularly shown and described with reference to specific embodiments, it should be understood by those skilled in the art that various changes in form and details may be made therein without departing from the scope of the invention as defined in the appended claims. The scope of the invention is thus indicated by the appended claims and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced.

Claims

1 ) A plug having a deformable portion for Indicating one or more throat pack used in a surgical procedure and an attachment for attaching to an airway management device to maintain air pressure in an air inflatable part of the airway management device.

2) The plug of claim 1 , wherein the attachment is moveable between a first configuration to maintain air pressure In the air inflatable part, and a second configuration to keep the air inflatable part of the airway management device deflated.

3} The plug of claim 2, wherein the attachment comprises a first catch configured to engage a part of the airway management device to prevent movement of the attachment between the first configuration and the second configuration,

4) The plug of claim 3, wherein the attachment comprises a second catch to catch the part of the airway management device when the attachment is moved into the second configuration.

5} The plug of claim 4, wherein the attachment is movable from the first configuration to the second configuration by pushing the part of the airway management device pass the first catch until the part of the airway management device engages the second catch.

8} The plug of c!ai 3 or 4, wherein the attachment may be movable from the second configuration to the first configuration by pushing the part of the airway management device pass the second catch until the part of the airway management device engages the first catch.

7} The plug of any one of claims 1 to 6 wherein the plug comprises a clipping portion for clipping a portion of one of the one or more throat-pack.

8} The plug of any one of claims 1 to 7, wherein the deformable portion Is perforable to form an aperture by pressing on the deformable portion

9} The plug of any one of claims 1 to 8, wherein the deformable portion is depressible to deform the deformable portion. 10) The plug of any one of claims 1 to 9, wherein deformation of the deformable portion Is reversible by pressing the deformed portion back to a non-deformed configuration.

11 ) I he plug of any one of claims 1 to 10, wherein a numeral is indicated on the deformable portion.