MULTIPURPOSE AIRWAY DEVICE
20220280737 · 2022-09-08
Inventors
Cpc classification
A61B1/0055
HUMAN NECESSITIES
A61B1/32
HUMAN NECESSITIES
A61M16/0418
HUMAN NECESSITIES
A61M16/0463
HUMAN NECESSITIES
A61M16/0488
HUMAN NECESSITIES
A61M2205/0216
HUMAN NECESSITIES
A61B1/0057
HUMAN NECESSITIES
International classification
Abstract
An airway device facilitates the insertion of an ETT into a patient, the delivery of oxygenated air into a patient, an exchange of the pre-inserted ETT in an intubated patient, and an evaluation of the larynx and trachea in an intubated patient, The device comprises an overtube having a mask section attached to a distal portion of the overtube. An inflatable bladder affixed to the mask section includes a shape and surface configured to seamlessly contact the circumference of the elliptical construction of the laryngeal opening. Once the inflatable bladder is positioned adjacent the laryngeal opening enhanced sealing properties are created so that the axis of the airflow entering the device matches the axis of the trachea, allowing for the improved delivery of oxygenated air into the patient's lungs. The specific utilization of the bladder allows for the device to be constructed smaller than a typical airway device, which may more easily facilitate the insertion process. Additionally, the device may provide a seamless transition into endotracheal intubation when necessary.
Claims
1. An airway device, comprising: an overtube having a proximal end and a distal end; a mask section attached to the distal end of the overtube, the mask section including: a spine section comprising an esophageal obturator protruding from a distal end of the spine section; and an expandable body disposed on a proximal portion of the spine section, the expandable body including: an inlet portion disposed adjacent the overtube; an inflatable bladder anchored to the spine section a distance from the inlet portion; a sheath spanning along the spine from the inlet portion to the inflatable bladder; and a tunnel section disposed within the sheath and extending from the inlet portion to the inflatable bladder; and wherein the mask section is configured for radially retracting soft tissue away from the laryngeal opening to create an unobstructed path into the trachea of the patient and sealing engagement with a laryngeal opening of the patient. and wherein the esophageal obturator further comprises an inflatable esophageal obturator cuff affixed to a distal end of the esophageal obturator.
2. The device of claim 1, wherein the inlet portion and the spine section are constructed as a contiguous piece.
3. The device of claim 1, wherein the tunnel section and a sheath are affixed to the inlet portion proximally and to the inflatable bladder distally and forms an airtight seal between the inlet portion and the inflatable bladder.
4. The device of claim 1, wherein the spine section comprises a retroverted configuration configured to effectively engage the patient's hypopharynx/proximal esophagus.
5. The device of claim 4, further comprising securing engagement of the airway device via lodging of an esophageal obturator and an inflated inflatable esophageal obturator cuff of the spine section in a hypopharynx/proximal esophagus of the patient.
6. The device of claim 5, further comprising a plurality of inflating tubes, each of the inflating tubes configured to inflate a respective one of the inflatable bladder, the inflatable esophageal obturator cuff, and the sheath.
7. The device of claim 1, wherein the inflatable bladder comprises a torus-shaped expandable body.
8. The device of claim 1, wherein the inflatable bladder is positioned at a fixed, negative inclination angle in the range of 15 to 35 degrees orthogonal from the anchor point of inflatable bladder , the fixed angle configured to provide increased adaptability to aryepiglottic folds of the patient.
9. The device of claim 1, wherein a first portion of the inflatable bladder comprises substantially a portion of the body of the inflatable bladder anterior to its attachment to the spine and at least one of a circular cross-section and an elliptical cross-section and a second portion of the inflatable bladder comprises substantially a portion of the body of the inflatable bladder posterior to its attachment to the spine and a curvilinear cross-section.
10. A method for clearing soft tissue from a larynx and a hypopharynx of a patient, comprising: inserting an airway device into a throat of the patient, the airway device including: an overtube having a proximal end and a distal end; a mask section attached to the distal end of the overtube, the mask section including a spine section and an expandable body disposed on a proximal portion of the spine section, the expandable body including: an inlet portion disposed adjacent the overtube; and an inflatable bladder anchored to the spine section a distance from the inlet portion; a sheath spanning along the spine section from the inlet portion to the inflatable bladder; and a tunnel section disposed within the sheath and extending from the inlet portion to the inflatable bladder; inflating the inflatable bladder to form an airtight seal around a laryngeal opening of the patient, wherein the inflatable bladder is adapted to retract soft tissue adjacent the laryngeal opening of the patient to expose vocal cords and a trachea of the patient.
11. The method of claim 10, wherein the inflatable bladder is configured, when inflated, to generate a displacement force to radially displace soft tissue from a hypopharyngeal lumen toward a periphery of the hypopharyngeal lumen and clear the passage to the laryngeal opening and the trachea of the patient.
12. A method for intubating a patient, the method comprising: inserting an airway device into a throat of the patient, the airway device including: an overtube having a proximal end and a distal end; a mask section attached to the distal end of the overtube, the mask section including a spine section and an expandable body disposed on a proximal portion of the spine section, the expandable body including: an inlet portion disposed adjacent the overtube; and an inflatable bladder anchored to the spine section a distance from the inlet portion; a sheath spanning along the spine from the inlet portion to the inflatable bladder; and a tunnel section disposed within the sheath and extending from the inlet portion to the inflatable bladder; inflating the inflatable bladder to form an airtight seal around a laryngeal opening of the patient, wherein the inflatable bladder is adapted to retract soft tissue adjacent the laryngeal opening of the patient to expose vocal cords and a trachea of the patient; advancing an endoscope through the mask section of the airway device and into the trachea of the patient; advancing an ETT over the endoscope and into the trachea of the patient; retracting the overtube from the throat of the patient until the overtube is fully removed from the throat and mouth of the patient; and retracting the endoscope from the throat of the patient until the endoscope is fully removed from the throat and the mouth of the patient.
13. The method of claim 12, further comprising continuously providing ventilation to the patient starting at the inflating.
14. The method of claim 12, further comprising confirming the ETT is at least partially positioned within the trachea of the patient via the endoscope.
15. A mask section for an airway device, comprising: a spine section and an expandable body disposed on a proximal portion of the spine section, the expandable body including: an inlet portion disposed on a proximal end of the spine section and forming a contiguous structure with the spine section; an inflatable bladder anchored to the spine section a distance from the inlet portion; a sheath spanning along the spine section from the inlet portion to the inflatable bladder; and a tunnel section disposed within the sheath and extending from the inlet portion to the inflatable bladder; and wherein the bladder attachment is configured for sealing engagement with a laryngeal opening of a patient to create an unobstructed path into the trachea of the patient.
16. The mask section of claim 15, wherein the tunnel section is proximally affixed to the inlet portion and the inflatable bladder, further wherein the tunnel section forms an airtight seal between the inlet portion and the inflatable bladder.
17. A method for exchanging the endotracheal tube of an intubated patient, the method comprising: inserting an airway device, over a preexisting endotracheal tube, into a throat of the patient, the airway device including: an overtube having a proximal end and a distal end; a mask section disposed on the distal end of the overtube, the mask section including: a body having a proximal end and a distal end; an inflatable bladder anchored to the distal end of the body; and a sheath spanning from the body to the inflatable bladder; inflating the inflatable bladder to form an airtight seal around a laryngeal opening of the patient, wherein the inflatable bladder is adapted to retract soft tissue adjacent the laryngeal opening of the patient to expose vocal cords and a trachea of the patient; advancing an endoscope through the hood section of the airway device and into the trachea of the patient; removing the preexisting endotracheal tube; advancing a new endotracheal tube along the endoscope and into the trachea of the patient; retracting the overtube from the throat of the patient until the overtube is fully removed from the throat and mouth of the patient; and retracting the endoscope from the throat of the patient until the overtube is fully removed from the throat and mouth of the patient.
18. A method for examining the larynx and trachea of an intubated patient, the method comprising: inserting an airway device into a throat of the patient, the airway device including: an overtube having a proximal end and a distal end; a mask section disposed on the distal end of the overtube, the mask section including: a body having a proximal end and a distal end; an inflatable bladder anchored to the distal end of the body; and a sheath spanning from distal end of the body to the inflatable bladder; and a tunnel located within the sheath spanning from the distal end of the body to the inner surface of the inflatable bladder; inflating the inflatable bladder to form an airtight seal around a laryngeal opening of the patient, wherein the inflatable bladder is adapted to retract soft tissue adjacent the laryngeal opening of the patient to expose vocal cords and a trachea of the patient; inflating the esophageal cuff to secure the device in the patient and prevent gastric reflux; advancing an endoscope through the hood section of the airway device and into the trachea of the patient; deflating the esophageal cuff; retracting a preexisting endotracheal tube proximal to the larynx; examining and evaluating the larynx and trachea; and performing at least one of: advancing a new endotracheal tube and removing the preexisting endotracheal tube.
19. A method for collecting and evacuating oronasal secretion from a patient, comprising: inserting an airway device into a throat of the patient, the device including: an overtube having a proximal end and a distal end; a mask section disposed on the distal end of the overtube, the mask section including: a body having a proximal end and a distal end; an inflatable bladder anchored to the distal end of the body; and a sheath spanning from distal end of the body to the inflatable bladder; a tunnel located within the sheath spanning from the distal end of the body to the inner surface of the inflatable bladder; and a collection apparatus affixed to a posterior surface of each of the mask section and the inflating bladder; positioning the airway device adjacent a laryngeal opening of the patient; and positioning the collection apparatus in the patient's hypopharynx in an open configuration so that oronasal secretion is collected in the collection apparatus.
20. The method of claim 19, wherein the collection apparatus comprises a thin walled, semi-rigid plastic that spans an entire posterior wall of the inflating bladder.
21. The method of claim 19, wherein the collection apparatus is configured to flare out in the inferior to superior direction in regards to the sealed sides and inferior edge, and the open superior edge.
22. The method of claim 19, wherein the collection apparatus is hermetically sealed to the posterior surface and the inflating bladder via at least one of adhesives, chemicals, welding, and heat.
23. The method of claim 19, further comprising evacuating at least one of oronasal secretion and blood out of the collection apparatus via a suction catheter.
24. The method of claim 23, wherein the suction catheter is configured to be at least one of: preinstalled on an overtube wall and introduced along a pre-formed path of the device after insertion.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0045] The disclosed subject matter, objectives, and advantages thereof, will best be understood by reference to the following detailed description of an illustrative embodiment when read in conjunction with the accompanying drawings, wherein:
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DETAILED DESCRIPTION
[0090] Reference now should be made to the drawings, in which the same reference numbers are used throughout the different figures to designate the same components.
[0091] It will be understood that, although the terms first, second, third, etc. may be used herein to describe various elements, these elements should not be limited by these terms. These terms are only used to distinguish one element from another element. Thus, a first element discussed below could be termed a second element without departing from the teachings of the present disclosure.
[0092] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, the singular forms “a”, “an”, and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising” or “includes” and/or “including” when used in this specification, specify the presence of stated features, regions, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, regions, integers, steps, operations, elements, components, and/or groups thereof.
[0093]
[0094] In other embodiments, ventilator connector 101 may affix to intubation device 110 via means including, but not limited to threading, twist-lock engagement, O-ring attachment, magnetic attachment, form-fitting, and male-female engagement. When intubation device 110 is not in use, ventilator connector 101 may be removed for storage purposes. In other instances, ventilator connector 101 may be left on intubation device 110 and a lid 102 may be affixed to an end of intubation device 110 proximal the location of attachment of ventilator connector 101 (see
[0095] As shown in
[0096] In embodiments, ETT (endotracheal tube) 130 may be any other form of medical airway tube. Endotracheal tube (ETT) may also be referred to as an “airway tube” or an “intubation tube”.
[0097]
[0098] Overtube 120 may comprise an interior surface, an exterior surface, and an interior space that may house at least the ETT 130. Semirigid portion of overtube 120 may be designed to be semi-rigid/semi-flexible and may be made from a material in order to meet certain rigidity/flexibility requirements (such as, but not limited to, bending to efficiently fit within a patient's throat 214). In certain embodiments, overtube 120 may comprise polymer tubing such as, but not limited to polyvinyl chloride (PVC), silicone, and/or other thermoplastic materials. In embodiments, portions of the semirigid portion of overtube 120 may comprise a corrugated configuration in order to allow for additional flexibility.
[0099] Flexible tip 170 may be disposed within hood 210 and/or stem 145; both the flexible tip 170 and hood 210 may maintain rigidity and attachment to overtube 120 via stem 145. Stem 145 is a tubular portion of hood 210 that may overlap the semirigid portion of overtube 120, flexible tip 170, and stem 145 so that flexible tip 170 and additional material of hood 210 are secured between stem 145 and exterior surface of overtube 120. In certain embodiments, stem 145 may be removably affixable to overtube 120 using any of the aforementioned affixing means.
[0100] Flexible tip 170 may be fashioned to be more flexible than overtube 120 and may be freely contained within at least one of the stem 145 and hood 210. Flexible tip 170 may articulate 30 degrees or more in a vertical and/or horizontal direction within flexible tip 170 so that when device 110 is positioned adjacent a laryngeal opening 213 of a patient 105, flexible tip 170 may be manipulated to aim directly at the laryngeal opening 213 so that an ETT 130 (or other intubation tube) may be easily fed into the laryngeal opening 213 (and not into esophageal opening 215).
[0101] Monitor attachment section 155 may be affixed to an exterior surface of overtube 120 so that video monitor 140 may be maintained in a position viewable by an individual using device 110 when device 110 is positioned within the throat 214 of a patient 105. In certain embodiments, monitor attachment section 155 may be removably affixable so that the position of monitor attachment section 155 and video monitor 140 may be adjusted.
[0102] To insert the ETT 130 into device 110, the ETT 130 may be manually advanced through either the proximal opening (actuation module orifice 123) or distal opening 124 of hood 210 until the ETT 130 is positioned completely inside overtube 120. In embodiments, internal components of device 110 may hold ETT 130, at least temporarily, in place within device 110.
[0103] The plurality of control wires 172 affixed to the flexible tip 170 may be utilized to manipulate the position of the flexible tip 170. The plurality of control wires 172 may be connected to an actuation module 200 positioned at proximal end 122 of overtube 120. Each of the wires 172, in embodiments, may be surrounded by a flexible sheath 176 (see dotted line surrounding middle wire 172) that may be affixed to an interior surface of overtube 120 in order to keep wires 172 isolated from the ETT 130 or other components found within overtube 120. The flexible sheath 176 may also be constructed to flex with overtube 120 when overtube 120 is flexed within a patient 105. Flexible sheath 176 may be made of the same or a similar material as that of overtube 120. In other embodiments, each of the wires 172 may be positioned adjacent an exterior surface of overtube 120. The wires 172 may be surrounded by a flexible sheath 176 that may be affixed to an exterior surface of overtube 120 in order to keep wires 172 isolated from any interior components found within overtube 120. In embodiments, flexible sheath 176 may be affixed to overtube 120 via one or more attachment means such as, but not limited to, adhesive, heat bonding, solvent bonding, and ultrasonic welding.
[0104] It is noted that the wires 172 may embody a medium to low flexural rigidity in order for the wires 172 to bend with overtube 120 but may also embody a high compressive force in order for the wires 172 to be pushed forward in the flexible tip 170 so that flexible tip 170 may be moved in one or more directions. In certain embodiments, wires 172 may comprise an elastic material.
[0105]
[0106] In order to keep the discs 171 stationary (not sliding along wires 172) and spaced from one another, a malleable covering 175 may be disposed around the discs 171. The malleable covering 175 may be thin and may comprise a high flexural strength; covering 175 may comprise a polymeric material such as, but not limited to, polytetrafluoroethylene (PTFE), fluorinated ethylenepropylene (FEP), perfluoroalkoxy (PFA), ethylene tetrafluoroethylene (ETFE), polyether ether ketone (PEEK), polyvinyl chloride (PVC), and rubbers. In other embodiments, covering 175 may be corrugated in order to keep discs 171 from sliding along wires 172. In other embodiments, resilient devices, such as, but not limited to springs, may be positioned between and attached to adjacent discs 171 in order to keep discs stationary and allow for flexibility when in use.
[0107] Hood 210 may comprise a base 211, a hood body 212, an inferior projection acting as an esophageal seal (not depicted). Base 211 may comprise a solid semi-flexible structure and may be designed to sit against the posterior hypopharyngeal wall. Hood body 212 is affixed to base 211 and may provide the function of applying pressure to the soft tissue in the laryngeal vestibule and the hypopharynx of an individual so as to retract the soft tissue out of the line of vision of the device 110/a user of intubation device 110. Hood body 212 may be fashioned as a domeshaped expandable/inflatable structure affixed to the sides of base 211. In embodiments, hood body 212 may be half frustospherical or half frusto-conical in shape (roughly frustospherical or frusto-conical in shape in combination with base 211. The superior portion of the body 212 (adjacent overtube 120) may be contiguous or non-contiguous with the superior portion of body 212. The inferior portion, which faces the larynx when in use, is left open. In certain embodiments, hood body 212 may comprise an expandable/inflatable section having an inflating bladder made of soft plastics and/or fabrics. A deflated/collapsed hood body 212 may be inflated to a rigid/expanded state and may inflate outwardly away from base 211 to push out the soft tissue from the hypopharynx and laryngeal vestibule 213. Additionally, hood body 212 may be made taut and advanced anteriorly by a plurality of mechanisms including at least one of a hydraulic, pneumatic, and electromechanical system in order to apply pressure anteriorly to the hood body 212 to push out the soft tissue from the hypopharynx and laryngeal vestibule 213 (hood body 212 may act as a tent and may, in embodiments, include an expandable frame/element and/or expandable covering). The esophageal seal (not depicted) may be an inferior projection of hood body 212 and may comprise a solid, semi-flexible structure. It may serve to occlude the esophageal opening 215 when device 110 is positioned properly within a throat 214. In embodiments, esophageal seal may be any type or configuration of esophageal seal found in the art. Once device 110 is placed in the throat 214, deflated inflatable bladder of hood body 212 is inflated to a rigid state and inflates outwardly away from base 211 to push out the soft tissue from the hypopharynx and laryngeal vestibule 213. After the soft tissue is cleared out of the field of vision of a user of device 110, overtube 120 is advanced via a plurality of mechanisms including, but not limited to, an attachment means (tip director 169/alternative tip director 165) between the hood body 212 and flexible tip 170 of overtube 120 or base 211 and flexible tip 170. In embodiments, stem 145 and base 211 may be one contiguous part (made of the same material). It is noted that hood body 212 may be described as being in a retracted state when hood body 212 is not expanded and in an expanded state when hood body 212 is inflated/expanded to a rigid structure.
[0108] Via the tip director 169, the two processes of the soft tissue clearing and the overtube 120 positioning are effected simultaneously when hood body 212 is expanded.
[0109] When flexible tip 170 is positioned (by the inflating action of inflatable bladder/expansion of hood body 212) adjacent a laryngeal opening 213 of a patient 105, flexible tip 170 may be further maneuvered to precisely align overtube 120 with the laryngeal opening 213 of a patient 105 via manipulation of wires 172 using the mechanisms found in actuation module 200. Tip director 169 and its functionality may be discussed further in the following paragraphs.
[0110] Mechanisms in actuation module 200 may administer applied forces to one or more of the wires 172 so that wires 172 may be extended and/or retracted in flexible tip 170, which may adjust the position of flexible tip 170. In embodiments, the mechanisms may include one or more motors 250 (see
[0111] A camera 168 and a light source 167 may be positioned on the distal portion of flexible tip 170. These elements help an individual using device 110 to view the location of flexible tip 170 in relation to the laryngeal opening 213 of a patient 105 (when device 110 is inserted into a throat 214) so that the individual may manipulate the device 110 to an optimal positioning within throat 214 to allow flexible tip 170 to extend into laryngeal opening 213. Wiring of the light source 167 may extend through device 110 to a power source 257 (see
[0112] The wiring of camera 168 and light source 167, in embodiments, may be surrounded by a flexible sheath (similar to or the same as the flexible sheath 176 covering the wires 172) that may be affixed to either an interior surface of overtube 120 or an exterior surface of overtube 120 depending on whether the wiring is run along an interior surface or an exterior surface of overtube 120. This may allow the wiring to be isolated from other components of device 110. The flexible sheath of the wiring of camera 168 and light source 167 may be constructed to flex with overtube 120 when overtube 120 is flexed within a patient 105. Flexible sheath may be made of the same or a similar material as what overtube 120 is made of In embodiments, flexible sheath may be affixed to overtube 120 via one or more attachment means such as, but not limited to, adhesive, heat bonding, solvent bonding, and ultrasonic welding.
[0113] In other embodiments, flexible tip 170 may include a malleable covering 175 without discs 171. In this configuration, wires 172 may be affixed to a portion of covering 175 closest to distal opening 124 in order to allow for manipulation of flexible tip 170. It is noted that in this embodiment, malleable covering 175 may comprise a polymer that maintains its structural integrity without using discs 171.
[0114] In other embodiments, interior frame of flexible tip 170 may comprise a spring as opposed to discs 171. In this configuration, wires 172 may be affixed to a portion of the spring closest to distal opening 124 in order to allow for manipulation of flexible tip 170. It is noted that in this embodiment, the spring may provide a more stable interior frame/user experience due to the compressive force of the spring in combination with the extension and retraction of wires 172.
[0115] In other embodiments, actuation module 200, wires 172, flexible sheaths 176, and loops 173 may be absent from device 110. In this configuration of device 110, flexible tip 170 may include either discs 171 and a malleable covering 175 or may only include a malleable covering 175. With the absence of wires 172 and other components used by wires 172, flexible tip 170 may rely on tip director 169 or alternative tip director 169 to position flexible tip 170 adjacent a laryngeal opening 213.
[0116] In other embodiments, the setup and number of wires 172 may vary. For example, device 110 may comprise less than four wires 172 or more than four wires 172 positioned similarly or differently than the example described above.
[0117]
[0118] Second roller 191 may include a shaft 182 that juts out of a top side of second roller 191. The shaft 182 of second roller 191 may be affixed to a screw receiver 189 that juts outward towards the distal end 121 of overtube 120 (in relation to where second roller shaft 182 is affixed to screw receiver 189). In certain embodiments, a screw shaft 186 may be positioned within screw receiver 189 at one end and may be affixed to an interior wall of overtube 120 at a screw shaft base (not depicted) adjacent first roller 181. The screw shaft base may include a bearing in order to allow screw shaft 186 to rotate. This configuration may be constructed on either end of screw shaft 186. In embodiments (as depicted in
[0119] A second gear 197 may be affixed to a second chain 198 that extends into actuation module 200 which houses a gear 255 affixed to a motor 250 that turns second gear 197 and causes second chain 198 to move, thus rotating screw shaft 186 and causing screw receiver 189 and second roller 191 to move laterally towards first roller 181. This in turn forces both the first roller 181 and the second roller 191 to engage ETT 130 and securely feed ETT 130 through distal opening 124 of device 110 (ETT 130 moves due to the rotation of first roller 181). In this instance, ETT 130 is “automatically” fed through distal opening 124. In embodiments, first and second rollers 181,191 may be covered with a material with a high coefficient of friction and may be shaped to conform to the contour of ETT 130.
[0120] In other embodiments, a spring may be utilized in place of screw shaft 186. One end of a spring may affix to screw receiver 189, while the other end may affix to either the shaft 182 of first roller 181 or to the interior surface of overtube 120. When ETT 130 is positioned between first roller 181 and second roller 191, the spring may extend to allow second roller 191 to move laterally away from first roller 181 to provide a secure feeder mechanism 180 for ETT 130. In some instances, an inner support shaft may be positioned within the spring (and affixed to screw receiver 189 and either the shaft 182 of first roller 181 or the interior surface of overtube 120) in order to avoid lateral bending of the spring.
[0121] It is noted that the actuation of feeder mechanism 180 may be carried out either by hand, such as, but not limited to, using one or more hand cranks, or using a control unit 270 (see
[0122] In any of the aforementioned embodiments, a base 183 of second roller 191 may be disposed within a roller track 184 in order to keep the second roller 191 balanced and avoid shifting within overtube 120. Roller track 184, in embodiments, may comprise walls on each side of second roller base 183 that extend from one side of overtube 120 to the other in order to have second roller 191 avoid shifting problems and keep it moving along a path across the width of overtube 120.
[0123] In embodiments, one or more components of feeder mechanism 180 may be disposed outside of overtube 120. These components may be covered by an outer covering 201. For example, first and second gears 187,197 may be positioned outside of overtube 120; outer covering 201 may only cover these components. It is noted that outer covering 201 may be affixed to overtube 120 so that overtube, including outer covering 201, is airtight.
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[0126] It is noted that one skilled in the art can conceive of and create the components for affixing trigger mechanism 280 to clamp 282 so that when trigger mechanism 280 is actuated, clamp 282 securely clamps onto ETT 130.
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[0128] As shown in
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[0130] As shown in
[0131] Positioning of the flexible tip 170 may occur once the expansion of hood body 212 is separately carried out to clear the soft tissue from the hypopharyngeal and laryngeal vestibule. Additionally, flexible tip 170 may be pulled farther (along with overtube 120) by alternative tip director 165 in response to locking mechanism 190 being unlocked/in an unlocked position or state an in response to the expansion of hood body 212.
[0132] In embodiments, locking mechanism 190 may be controlled via user input entered into control unit 270. User input for unlocking locking mechanism 190 may include the use of screens, buttons, switches, controls etc. Control unit 270 may receive the user input as gestures such as, but not limited to touch screen gestures and button/switch/control actuating. In other embodiments, locking mechanism 190 may comprise multiple configurations besides the protrusion-groove mechanism that may be easily conceived of by one skilled in the art. Other configurations may include, but are not limited to male-female engagement mechanisms, twist-lock mechanisms, threaded bearing mechanisms, and magnetic mechanisms. It is noted that in the case where locking mechanism 190 is controlled by user input, locking mechanism 190 may be unlocked prior to hood body 212 being expanded since the unlocking is not dependent on the expansion of hood body 212 in this case.
[0133] In embodiments, hood body 212 may be affixed to the free edge of hood base 211 (side walls of hood base 211) via one or more attachment means such as, but not limited to, adhesive, heat bonding, solvent bonding, and ultrasonic welding.
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[0136] When hood body 212 is expanded, flexible tip 170 may be automatically pulled anteriorly and inferiorly via tip director 169/alternative tip director 165 and may position flexible tip 170 (and ETT 130 positioned within flexible tip 170) at the laryngeal opening 213 of patient 105 and increases the likelihood of successful insertion of ETT 130 into the laryngeal opening 213 (see
[0137] Camera 168 and light source 167 may be utilized to see if the ETT 130 is in a position to be fed into the laryngeal opening 213. If the ETT 130 is not optimally positioned, actuation module 200 may be utilized to adjust the lengths of wires 172 to move flexible tip 170, and thus ETT 130, into an optimal position to be fed into laryngeal opening 213.
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[0139] In order to close the circuit, first and second protrusions 350,355 of handle 220 are inserted into first and second passages 360,365. Once inserted, handle 220 is turned counterclockwise 45 to 100 degrees until first and second protrusions 350,355 contact first and second conductive receivers 330,335, as shown in
[0140] In embodiments, the spring-loaded mechanism of first and second protrusions 350,355 may be controlled using trigger mechanism 280. It is noted that one skilled in the art can conceive of and create the components for using trigger mechanism 280 as an actuator for the spring-loaded mechanism of first and second protrusions 350,355. In other embodiments, trigger mechanism 280 may be used as a switch for the circuit of device 110. It is noted that one skilled in the art can conceive of and create the components for using trigger mechanism 280 as a switch for the circuit of device 110.
[0141] When handle 220 comprises actuation module 200 and/or power source 257, it is noted that handle 220 (and any components it contains) may be kept in a medical setting as a standard piece of equipment, while the rest of device 110 may be disposable (as a single-use product or a product that is only used a few times). In this embodiment, handle 220 may also include control unit 270.
[0142]
[0143] In embodiments, method 1100 may include securing 1120 ETT 130 within the overtube 120 via a feeder mechanism 180 positioned within overtube 120 after the positioning 1110. The securing 1120 may further include laterally displacing 1130 a first roller 181 of the feeder mechanism 180 towards a second roller 191 of feeder mechanism 180 so that ETT 130 is secured within overtube 120.
[0144] In embodiments, method 1100 may comprise providing air to an end of the overtube 120 adjacent the laryngeal opening 213 via a ventilator The providing of air may be performed after the positioning 1150 of flexible tip 170 and may be performed if hood body 212 is inflatable (includes an inflatable bladder).
[0145] In other embodiments of method 1100, the unlocking 1160 may be dependent upon the expanding 1170 if a locking mechanism 190 not controlled by user input is utilized. In this case, locking mechanism 190 unlocks 1160 when tip director 169 is pulled due to the expanding 1170; expanding 1170 may therefore occur before the unlocking 1160.
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[0147] It is noted that certain elements are not drawn to scale and it would be obvious to one skilled in the art how to amend the elements to be properly scaled in relation to other elements.
[0148] It is noted that the utilization of handle 220 adds increased stability to the removal process of removing device 110 from a patient's throat 214.
[0149] In any of the aforementioned embodiments, any wiring or wires 172 may be embedded within the thickness/wall of overtube 120 instead of being covered by flexible sheath 176.
[0150] In any of the aforementioned embodiments, gears 187,197,255 may not include cogs and may comprise a pulley structure. In other embodiments, the pully structure may include cogs in the grooved portion of the pulley structure. Additionally, in other embodiments, chains 188,198 may instead comprise a wire-like structure. In other embodiments, the wirelike structure may include protrusions (similar to cogs) that may fit properly into any cogs on gears 187,197,255 and/or pulley structure.
[0151] For the purposes of this disclosure, the terms “hood 210” and “hood portion 210” may be synonymous. For the purposes of this disclosure, the terms “ETT 130” and “endotracheal tube 130” may be synonymous. For the purposes of this disclosure, the terms “wire 172” and “control wire 172” may be synonymous. For the purposes of this disclosure, the terms “malleable covering 175” and “covering 175” may be synonymous. For the purposes of this disclosure, the terms “inflatable bladder” and “bladder” may be synonymous. For the purposes of this disclosure, the terms “laryngeal opening 213” and “laryngeal vestibule 213” may be synonymous.
[0152]
[0153] A mask section 415 attached to the distal end 414 of overtube 405 includes a spine section 417 having a proximal end 422 and a distal end 424 and an expandable body 420 disposed on a proximal portion of spine section 117. Expandable body 420 includes an inlet portion 426 disposed adjacent overtube 405 and an inflatable bladder 430 disposed about spine section 417 a distance from inlet portion 426. Spine section 417 passes through a second (lower) portion 432 of inflatable bladder 430 via spine orifice 418. Spine section 417 alternatively may pass anteriorly or posteriorly to the inflatable bladder 430. Inflatable bladder 430 additionally includes a shape and surface configured to seamlessly contact the circumference of the elliptical construction of the laryngeal opening 510 when mask section 415 is inserted into a patient's throat 530.
[0154] A sheath 425 of expandable body 420 spans along the spine section 417 from the inlet portion 426 to the inflatable bladder 430 to create a sealed environment between the inlet portion 426, inflatable bladder 430, and spine section 417. A tunnel section 427 disposed within sheath 425 extends from (and is proximally affixed to) inlet portion 426 to the inner surface of the inflatable bladder 430 to create a sealed (airtight) connection between the inlet portion 426 and the inflatable bladder 430 within the sheath 425. Mask section 415, when utilized within a patient's throat 530, is configured for sealing engagement with a laryngeal opening 510 of the patient 402 to create an unobstructed path into the trachea 520 of the patient 402. Additionally, the distal end 424 of spine section 417 includes an esophageal obturator 435 that protrudes from the distal end 424 of spine section 417 and includes a retroverted configuration configured to engage the hypopharynx/proximal esophagus and mitigate the device 400 from dislodging when the mask section 415 is positioned adjacent laryngeal opening 510 of the patient 402. Once lodged in the hypopharynx/proximal esophagus of patient 402, an inflated inflatable esophageal obturator cuff 440 affixed to a distal end 436 of the esophageal obturator 435 is configured to securely lodge the esophageal obturator 435 in hypopharynx/proximal esophagus of the patient 402.
[0155] It is noted that, as shown, three areas/components of device 400 are inflatable, allowing device 400 to efficiently and effectively function within a patient's throat 530. These areas/components include the volume of space within sheath 425 (excluding the inner volume of tunnel section 427), inflatable bladder 430, and inflatable esophageal obturator cuff 440. In order for these components to be inflated, a plurality of inflating tubes 437,438,439 extending along the length of overtube 405 (and portions of mask section 415) may provide air to each of the components. As shown, inflating tubes 437,438,439 may be positioned on an outer surface of device 400 but in other embodiments, inflating tubes 437,438,439 may be positioned within walls of device 400 or within an inner volume of device 400. It is further noted that the inner volume of tunnel section 427 may allow for gases to pass through, but may not specifically configured to receive an inflating tube for inflation purposes.
[0156] As designed, device 400 may precisely approximate the ellipsoid shape of laryngeal inlet 510 to produce occlusion using inflatable bladder 430 resting on top of laryngeal inlet 510. The anatomy-dictated design (also see
[0157]
[0158] As shown in
[0159] Additionally, the distal end 424 of spine section 417 includes an esophageal obturator 435 that protrudes from the distal end 424 of spine section 417 and includes an inflatable esophageal obturator cuff 440 affixed to a distal end 436 of esophageal obturator 135. When inflated, inflatable esophageal obturator cuff 440 may be configured to securely lodge esophageal obturator 435 in an esophagus 550 of patient 402. Once lodged in the esophagus 550, esophageal obturator 435 and an inflated inflatable esophageal obturator cuff 440 may provide a secure engagement of the airway device 400 within the patient's throat 415 when positioned in a hypopharynx/proximal esophagus of the patient 402. It is noted that a proximal portion of mask section 415 may rest against the body (as opposed to the free superior edge) of the epiglottis of patient 402 where the AE (aryepiglottic) folds connect with the epiglottis. In this location, the epiglottis firmly attaches to the thyroid cartilage, thus, a secure seal can be achieved when mask section 415 is in sealed engagement with laryngeal opening 510 of patient 402.
[0160] As further shown in
[0161]
[0162] In embodiments, the body of inflatable bladder 430 may not include spine orifice 418 and may instead include a contiguous outer surface similar to the rest of the body of inflatable bladder 430 (a full body around the circumference of inflatable bladder 430). This configuration of inflatable bladder 430 may be configured to be positioned on top of or below spine section 417. In this case, spine section 417 may include a divot (on a top or bottom surface of spine section 417) configured to comfortably receive inflatable bladder 430.
[0163]
[0164] An anchor point 434 is shown adjacent the apex of the curvature of spine section 117 and includes an indented configuration for effective attachment of inflatable bladder 130. A mid-portion of spine section 117 (
[0165]
[0166] Once inflatable bladder 430 is inflated and positioned adjacent laryngeal opening 510, enhanced sealing properties may be created so that the axis of airflow entering device 400 matches the axis of the trachea 520, allowing for improved delivery of oxygenated air into the patient's 402 lungs. Furthermore, inflatable bladder 430 may be stabilized 1330 adjacent the laryngeal opening 510 of the patient 402 via lodging of an esophageal obturator 435 and an inflated inflatable esophageal obturator cuff 440 of spine section 417 in the esophagus 550 (hypopharynx/proximal esophagus) of patient 402. The lodging of an esophageal obturator 435 and an inflated inflatable esophageal obturator cuff 440 of spine section 417 may additionally secure engagement of the airway device 400. Once the inflatable bladder is stabilized 1330, an endoscope 445 may then be advanced 1340 (
[0167] Overtube 405/airway device 400 may then be retracted 1370 (
[0168] It is noted that in embodiments, endoscope 445 may be detached from visualization device 475 so that components such as, but not limited to airway device 400 and ETT 410, may be slid in and out of patient 402 around/along the length of endoscope 445 (so that the components may be effectively added or removed).
[0169]
[0170]
[0171]
[0172]
[0173]
[0174]
[0175]
[0176] In embodiments, the suction catheter may be configured to be at least one of: preinstalled on a wall of an overtube 405 and introduced along a pre-formed path of the airway device 400 after the inserting 1820.
[0177]
[0178] In embodiments, inflatable bladder 430 and esophageal obturator cuff 440 may each comprise at least one of the following materials: polyethylene teraphthalate (PET/PETP), low-density polyethylene (LDPE), polyvinyl chloride (PVC), silicone, neoprene, polyisoprene, and polyurethane (PU). In further embodiments, at least one of inflatable bladder 430 and esophageal obturator cuff 440 may be formed via blow molding.
[0179] In embodiments, esophageal obturator cuff 440 may be positioned over a distal end of one of a plurality of inflating tubes 437,438,439 (each affixed to an air supply) located at the distal end 436 of the esophageal obturator 435 so that esophageal obturator cuff 440 may be inflated. In further embodiments, esophageal obturator cuff 440 may be hermetically sealed via means including, but not limited to, adhesives, chemicals, welding, and heat.
[0180] In embodiments, one or more of the plurality of inflating tubes 437,438,439 may be integrated with the body of inflatable bladder 430. In further embodiments, at least one of the plurality of inflating tubes 437,438,439 may be integrated with expandable body 420.
[0181] In embodiments, the inflatable bladder 430 and the esophageal obturator cuff 440 may each comprise a wall thickness ranging between 5 micrometers and 100 micrometers and a safe pressure level range ranging from 0.1 PSI to 2 PSI.
[0182] In embodiments, inflatable bladder 430 may be affixed to a mid-portion of the spine section 417 with a longitudinal axis of the inflatable bladder 430 parallel with a transverse axis of the patient 402 and a “tire plane” rotated between 1 degree and 45 degrees.
[0183] In embodiments, inflatable bladder 430 may be affixed to spine section 417 via at least one of adhesives, chemicals, welding, and heat.
[0184] In embodiments, inflatable bladder 430 may be constructed as at least one of: abutting at least one of an anterior surface and a posterior surface of spine section 417, centering within a body of spine section 417 with anterior and posterior portions of the spine encircling inflatable bladder 430, and encircling spine section 417 so that spine section 417 runs through inflatable bladder 430.
[0185] In embodiments, sheath 425 may comprise a plurality of thin sheets of material each of a similar material and each sheet of material ranging in thickness from 5 micrometers to 500 micrometers. The plurality of thin sheets may be formed into a tubular structure and may be hermetically attached, by means of at least one of adhesives, chemicals, welding, and heat, to the inlet portion 426 superiorly, the inflatable bladder 430 inferiorly, and the spine section 417 posteriorly.
[0186] In embodiments, each of the spine section 417 and the overtube 405 may comprise a semirigid material. In embodiments, each of the spine section 417 and the overtube 405 may comprise a material selected from the group consisting of: polyethylene teraphthalate (PET/PETP), low-density polyethylene (LDPE), polyvinyl chloride (PVC), silicone, neoprene, polyisoprene, and polyurethane (PU). In further embodiments, each of the spine section 417 and the overtube 405 may comprise a Shore A hardness ranging between 20 and 90 on the Shore A hardness scale.
[0187] In embodiments, the inlet portion 426 and the spine section 417 may be constructed as a contiguous piece. This contiguous construction may, in embodiments, may be formed via injection molding. In further embodiments, inlet portion 426 may be configured to fit over and affix to the distal end 414 (or tip) of overtube 405 by means including at least one of adhesives, chemicals, welding, and heat.
[0188] It is noted that in embodiments, esophageal obturator 135 may be integral with spine section 117.
[0189] It is noted that in embodiments, any of the applicable steps of retracting 1370,1560,1650 airway device 400 out of the patient 402 without dislodging the ETT 410 may be carried out in a plurality of ways. One way to remove airway device 400 includes utilizing an endotracheal tube holder/ETT holder to assist in the removal.
[0190] In embodiments, various attachment and fitting techniques and equipment (male-female engagement, fastening means, magnets, welding, adhesives, bonding, etc.) may be utilized in any of the disclosed embodiments in order for components of the embodiments to properly attach themselves to and/or efficiently position themselves with one another and so that the airway device 400 can efficiently and/or properly function. As an example, the mask section 415 of airway device 400 may include inflatable bladder 430 that may be heat bonded to the body 420 of mask section 415, as opposed to an inflatable bladder 130 affixed to body 420 via fasteners.
[0191] For the purposes of this disclosure, the terms “laryngeal inlet” and “laryngeal opening” may be synonymous.
[0192] For the purposes of this disclosure, the terms “hood body” and “mask section” may be synonymous.
[0193] For the purposes of this disclosure, the terms “endotracheal tube” and “ETT” may be synonymous. In certain embodiments, an “ETT” may be a device for intubating a patient or individual other than an endotracheal tube.
[0194] For the purposes of this disclosure, the terms “obturator” and “obdurator” may be synonymous.
[0195] For the purposes of this disclosure, the terms “bladder”, “inflating bladder”, and “inflatable bladder” may be synonymous. It is further noted that each of the terms “bladder”, “inflating bladder”, and “inflatable bladder” may be used to refer to any disclosed embodiment of a bladder found in airway device 400 and/or intubation device 110.
[0196] For the purposes of this disclosure, the term “medially affixed” may refer to an element of the disclosure being connected to at least one other object at or around its midpoint or middle point.
[0197] For the purposes of this disclosure, the term “retroverted”, in relation to spine section 417, may refer to the convex nature of the spine section 417 wherein the spine section along its entire length assumes a gentle curve with the convexity facing in the anterior direction.
[0198] For the purposes of this disclosure, the position and configuration of the inflating bladder/inflatable bladder may be described using the terminology and the coordinate system as defined in the Standard Automotive Engineering (SAE) J670.
[0199] A plurality of additional features and feature refinements are applicable to specific embodiments. These additional features and feature refinements may be used individually or in any combination. It is noted that each of the following features discussed may be, but are not necessary to be, used with any other feature or combination of features of any of the embodiments presented herein.
[0200] Unless otherwise defined, all technical and scientific terms used herein have the same meanings as are commonly understood by one of ordinary skill in the art to which this disclosure belongs. Although methods similar or equivalent to those described herein can be used in the practice or testing of the present disclosure, suitable methods are described herein.
[0201] All publications, patent applications, patents, and other references mentioned herein are incorporated by reference in their entirety. In case of conflict, the patent specification, including definitions, will prevail. In addition, the materials, methods, and examples are illustrative only and not intended to be limiting.
[0202] It will be appreciated by persons skilled in the art that the present disclosure is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present disclosure is defined by the appended claims and includes both combinations and sub-combinations of the various features described hereinabove as well as variations and modifications thereof, which would occur to persons skilled in the art upon reading the foregoing description.