A guide extension catheter assembly including a guide extension catheter and a support device. The guide extension catheter includes a shaft and a tubular member. The support device includes a push member and a shuttle member. The guide extension catheter assembly is configured to selectively provide a delivery state in which at least a portion of the shuttle member is disposed within the lumen, a leading end of the shuttle member is distal a distal end of the tubular member, and the shuttle member is directly, physically connected to the tubular member. In the delivery state, a longitudinal distal force applied to the push member is transferred to the tubular member as a longitudinal distal force via the shuttle member. The guide extension catheter assemblies of the present disclosure can promote a two stage guide extension catheter deployment.

An apparatus includes a body, a first shaft, an actuation assembly, and a dilation catheter. The first shaft includes a malleable distal portion. The actuation assembly includes a second shaft and an actuator. The second shaft is coaxially positioned about the first shaft. The actuator is operable to selectively bend the malleable distal portion of the first shaft. The dilation catheter is coaxially interposed between the first shaft and the second shaft. The dilation catheter includes an expandable dilator. The dilation catheter is operable to translate along the malleable distal portion of the first shaft.

An introducer includes a dilator received in a lumen defined by an introducer sheath and including a dilation end extending distally beyond a distal end of the introducer sheath. The introducer sheath includes a flat wire reinforcement having a hollow cylindrical shape sandwiched between an inner PTFE tube and an outer nylon tube. The outer nylon tube includes a distal segment that extends distally beyond the PTFE tube, which extends distally beyond the PTFE tube, which extends distally beyond the flat wire reinforcement. A withdrawal support wire has a distal end attached to a distal end turn of the flat wire reinforcement and extends in a proximal direction in parallel with a longitudinal axis between an outer surface of the nylon tube and an inner surface of the PTFE tube. The withdrawal support wire is configured to be in tension when the sheath is placed in tension to inhibit distal stretch separation breakage.

System for monitoring and regulating plant productivity comprising: a memory for storing instructions; a processor for executing the instructions to cause a method of monitoring and regulating plant productivity to be performed, the method comprising: receiving field data from monitoring sensors; computing, by the at least one processor executing a machine learning algorithm, a predicted value for a variable associated with the production environment condition of a crop field, the machine learning algorithm having been trained based on a training set comprising one or both of (a) the field data from the monitoring sensors, and (b) a generated feature derived from the field data; and determining, based on a threshold associated with the variable, that the predicted value for the variable indicates that an intervention in the crop field is to be initiated; and in response to the determining, causing a controllable device to vary the production environment condition.

A micropuncture kit for direct access of a surgically exposed vessel using direct visual guidance includes a micropuncture access needle having a proximal hub coupled to an elongate shaft defining an inner lumen and a visible depth indicator positioned on the elongate shaft a distance away from a distal tip of the elongate shaft. The kit includes an access guidewire sized to be received through the inner lumen of the micropuncture access needle and a microaccess cannula having an elongate body defining an inner lumen and a plurality of visible depth indicators formed on the elongate body. The guidewire includes a distal tip and at least one visible depth indicator positioned on the access guidewire a distance away from the distal tip of the guidewire. Each of the plurality of visible depth indicators identifies a distance from a distal tip of the cannula. Related systems, devices and methods are provided.

A modular dilation device is provided for inserting multiple dilators into a target patient tissue site. The modular dilation device includes a first dilator and a second dilator. The first dilator has a first dilator distal end and a first dilator inner lumen. The first dilator has a first dilator side wall opening. The first dilator distal end has a first dilator open tip. The first dilator has a first dilator open slit. The first dilator open slit extends between the first dilator side wall opening and the first dilator open tip. The second dilator has a second dilator distal end and a second dilator inner lumen. The second dilator distal end has a second dilator open tip. When the second dilator is joined to the first dilator, the second dilator open tip is adjacent to the first dilator side wall opening.

Various embodiments of a tube changer device and methods of use are described herein. A tube changer device to aid in placement or replacement of an endotracheal tube including tubular shaft having a hollow interior forming a main lumen extending from a proximal end to a distal end and a dilator portion at the distal end. The dilator portion having a tapered profile with an outer diameter that varies along a length measured from a junction point on the tubular shaft to a blunt tip. The main lumen extending through the dilator portion to the blunt tip. The tube changer device configured to be slidably received within the endotracheal tube. The tubular shaft can be flexible. The tube changer device can be used with or without a stylet for the placement or replacement of an endotracheal tube.

A medical instrument may include a tube, a sheath provided around and coaxial with the tube, and an inflatable balloon at a distal end of the sheath. The balloon may receive a fluid from a lumen of the sheath, and may have a central opening along a longitudinal axis thereof, and into which the tube extends, a proximal portion, a middle portion adjacent to and distal of the proximal portion, and a distal portion adjacent to and proximal of the middle portion. When the balloon is inflated with the fluid, a maximum diameter of the middle portion may be less than a maximum diameter of the proximal portion, and less than a maximum diameter of the distal portion. The medical instrument may also include an extraction member provided at a distal end of the tube, distal to the balloon, and movable axially relative to the balloon.

A kit including a sheath having a tubular body with proximal and distal ends, an axis extending between the ends and a wall defining a bore extending along the axis to the distal end of the body. A delivery tube having proximal and distal ends and a lumen is adapted for disposition within the bore of the sheath in sealing engagement with the sheath, the delivery tube being slideable distally relative to the sheath. An elongated cannula having proximal and distal ends and a lumen is adapted for disposition inside the lumen of the delivery tube and an elongated dilator is adapted to fit within the lumen of the cannula with a proximal portion of the dilator extending proximally beyond the proximal ends of the cannula and delivery tube and in sealing engagement with the delivery tube proximal to the cannula.

A medical insertion device includes an introducer assembly, a needle, and a housing. The introducer assembly includes a dilator coaxially disposed in a sheath, the dilator removably engaged to the sheath in an insertion configuration. The needle is coaxially disposed in the dilator, the needle having a distal tip and a proximal end coupled to a needle hub. The housing may be removably engaged to the dilator. The needle hub is movably disposed in the housing between a first locked position, in which the distal tip of the needle extends a first length from a distal end of the dilator, a second locked position, in which the distal tip of the needle extends a second length from the distal end of the dilator less than the first length, and a third locked position, in which the distal tip of the needle is within the dilator.