Methods and devices to facilitate positioning of a catheter into a vessel. Devices include axially concentric assemblies of a piercing needle and a dilator that guides an outer catheter into a vessel, such as a blood vessel. The assemblies described herein can include retraction mechanisms and/or lock mechanisms to control needle positioning during catheterization processes as well as improved valves that prevent leakage of fluid from the proximal end of the devices. The devices and method include the use of novel valves to prevent undesired leakage of fluids through the proximal end of the catheter.

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 dilator that includes a shaft and a spirally-arranged protruding portion. The shaft includes a tapered section, a distal end section, and a body section. The spirally-arranged protruding portion includes spirally-arranged protruding sections provided on outer peripheral surfaces of each of the tapered section, the distal end section, and the body section, and gaps between adjacent spirally-arranged protruding sections along an axial direction of the shaft. At least one of a height t of the spirally-arranged protruding portion at a first location gradually decreases toward a distal end side and a height of the spirally-arranged protruding portion at a second location gradually decreases toward a proximal end side.

A guidewire and catheter are disclosed which are configured together so that it is not possible to advance the guidewire into the patient where it may be undesirably retained in the patient. The improved safety is achieved by protrusions on each of the guidewire and catheter which coordinate with one another. Novel methods of catheterization are also disclosed.

In one aspect, a playback device includes a command-keyword engine having a local natural language unit (NLU). The playback device detects, via the command-keyword engine, a first command keyword in voice input of sound detected by one or more microphones of the playback device. The playback device determines whether the sound input data includes a keyword from a first predetermined library of keywords via a local natural language unit (NLU). The playback device transmits the input sound data to a second playback device over a local area network, the second playback device employing a second local NLU with a second predetermined library of keywords. The playback device receives a response from the second playback device and performs an action based on an intent determined by at least one of the first NLU or the second NLU according to the keywords in the voice input.

The shaft of a dilator has a tapered part whose outer diameter at a distal end is smaller than at a proximal end, and either a distal end part and a proximal end part, or a proximal end part without a distal end part. If only the proximal end part is provided, the pitch of neighboring sections of a spirally-arranged protruding portion on the tapered part is larger than that on the proximal end part. If both the proximal end part and the distal end part are provided, the pitch of neighboring sections of the spirally-arranged protruding portion on the tapered part is larger than those on the distal end part or the proximal end part.

A dilator includes a shaft in a hollow shape whose distal end has a smaller outer diameter than the proximal end, and a connector on the proximal end of the shaft. A spirally-arranged protruding portion on an outer peripheral face of the shaft has gaps between neighboring sections along an axis of the shaft. The shaft has a first location and a second location located closer to the distal end than the first location and having an outer diameter smaller than at the first location. The spirally-arranged protruding portion has, with respect to the axis, an angle of inclination that is larger at the second location than at the first location.

A steerable guide sheath system adapted for delivery into a patient's vasculature. The pull wire which is used to tension the deflectable portion of the sheath is wrapped or twisted around the axis of the sheath.

The present invention relates to a device for inserting a tracheostomy tube, comprising a guide element and a dilator, wherein the guide element has a shield, wherein, according to the invention, the guide element has a first securing means and the dilator has a corresponding second securing means, whereby the guide element can be detachably connected by positive locking to the dilator in a position in which a distal end of the dilator is engaged with an inner surface of the shield when the latter is in the first state.

Disclosed is an arterial access sheath for introducing an interventional device into an artery. The arterial access sheath includes an elongated body sized and shaped to be transcervically introduced into a common carotid artery at an access location in the neck and an internal lumen in the elongated body having a proximal opening in a proximal region of the elongated body and a distal opening in a distal region of the elongated body. The internal lumen provides a passageway for introducing an interventional device into the common carotid artery when the elongated body is positioned in the common carotid artery. The elongated body has a proximal section and a distalmost section that is more flexible than the proximal section. A ratio of an entire length of the distalmost section to an overall length of the sheath body is one tenth to one half the overall length of the sheath body.