Surgery – Endoscope – Having endotrachael intuabation means on endoscope
Reexamination Certificate
2000-12-15
2003-10-07
Lazarus, Ira S. (Department: 3749)
Surgery
Endoscope
Having endotrachael intuabation means on endoscope
C600S116000, C600S130000, C600S128000, C600S139000, C600S143000, C600S153000, C600S160000, C600S178000
Reexamination Certificate
active
06629924
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates to an enhanced endotracheal tube used by physicians for intubating a patient whose air passage is obstructed or is unable to breathe on his own. The enhanced endotracheal tube utilizes a fiber optic bundle and reflectively coated bore to aid the physician in visualizing the trachea and inserting the tube.
Endotracheal tubes are used by health care providers to provide a positive air passageway for a patient. Typically, the endotracheal tube is used when a person is undergoing surgery to provide for the administration of anesthesia or when mechanical ventilation of the lungs is necessary. Another time when the endotracheal tube is needed is when a person is injured and has lost the ability to breathe on their own. In this case time is of the essence in reestablishing a positive air passageway. However, often in these cases, it is difficult to see clearly the laryngeal area due to blood or other body fluids in the area. It would therefore be desirable to provide an external light source to the laryngeal area and reflectively coat the bore of the endotracheal tube to aid the physician in visualizing the area and ensure the endotracheal tube is properly inserted into the trachea and not the esophagus.
As is well known to those of ordinary skill in the art, in the human anatomy, the epiglottis lays over the glottis opening to the larynx to prevent food entering the trachea during eating. This necessitates the epiglottis be displaced from the glottal opening to allow the endotracheal tube to be inserted into the trachea. In a typical intubation an instrument known as a laryngoscope is inserted through the patient's mouth and used to hold the patient's epiglottis open and allow insertion of the endotracheal tube as noted above. Two commonly used types of laryngoscopes are the “Miller blade” having a straight blade and a “Macintosh” blade having a slightly curved blade.
The usual procedure for intubation of the trachea using a laryngoscope of either type described above is to place the patient in a horizonal position on their back, tilt the head back and open the mouth as widely as possible. The blade of the laryngoscope is then inserted through the mouth into the throat and used to hold the tongue and epiglottis out of the way so the glottis is exposed. The larynx of the patient may then be seen through the mouth. The endotracheal tube is then inserted, either through the mouth or nose, along the blade of the laryngoscope and into the glottis and trachea.
The problems with such instruments and procedures include possible further complications and injury to the spine or neck of patient's having spinal or neck injuries, damage to the patient's teeth in using the rigid blade of the laryngoscope or difficulty in viewing the glottis if a patient has any malformation of the jaw or throat areas. Laryngoscopes with added light sources were tried, but this added increased size. Similarly, the user was still limited to visualize the larynx by the exposure of the anatomy with the laryngoscope.
Therefore, there exists a need for an endotracheal tube that has an integral light source along with a reflectively coated bore to aid the physician during insertion. It is the construction and method of use of such an endotracheal tube to which the present invention is directed.
2. Description of Related Art
U.S. Pat. No. 3,643,654 to H. R. Felbarg discloses a laryngoscope with an electric light and mirror.
A laryngoscope with a light and mirror that is anatomically curved to aid insertion is disclosed in U.S. Pat. No. 3,884,222 to G. P. Moore.
U.S. Pat. No. 4,086,919 to J. R. Bullard describes a laryngoscope utilizing fiber optic bundles to transmit light and images. A laryngoscope using fiber optic bundles in a similar manner is disclosed in U.S. Pat. No. 4,306,547 to J. R. Lowell and includes a channel for inserting an endotracheal tube.
Another laryngoscope using fiber optic bundles, disclosed in U.S. Pat. No. 4,384,570 to J. T. Roberts, includes a pivotable handle.
U.S. Pat. No. 5,873,818 to N. L. Rothfels describes a laryngoscope with an optical system to provide a wide angle field of view.
SUMMARY OF THE INVENTION
The enhanced endotracheal tube of the present invention includes a flexible tube formed of a suitably flexible plastic material. The tube has an outer surface and a bore therethrough defining a wall section therebetween. In its preferred embodiment, the bore's axis is offset from the axis of the outer surface so that the wall section has a variable thickness. In the region of the thicker wall section, three passages are formed in the wall section. The passages extend axially through the thicker wall section and substantially parallel to the bore.
One of the passages is adapted to receive a fiber optic bundle, one is adapted to receive a stylette, and the third acts as an air passage. The passages may be of round, oval or other suitable cross sections as required to serve their intended purpose. An inflatable cuff is positioned adjacent the inner end, i.e., the end inserted into the patient's trachea. The inner end of the air passage extends to a point adjacent the inflatable cuff and then exits radially outwardly through the wall section to form a passageway through which air can be blown into the inflatable cuff. The outer end of the air passage has a tube connected thereto as in prior endotracheal tubes to allow inflation of the inflatable cuff.
The passage containing the fiber optic bundle extends the length of the endotracheal tube. The outer end of the fiber optic bundle extends away from the endotracheal tube and is connected to an external light source. The bore of the endotracheal tube is coated with a reflective coating to improve light and image transmission through the endotracheal tube and thereby aid the physician in viewing the trachea through the endotracheal tube.
In another embodiment, the bore of the endotracheal tube includes an inner sleeve constructed of a material such as plastic or fiber optic glass that has a different refractive index than the material of the tube. This allows for reflection of light and transmission of images along the length of the bore and inner sleeve. An endotracheal tube for use with children without an inflatable cuff is also shown.
One object of the present invention is to provide an enhanced endotracheal tube that uses a fiber optic bundle to transmit light into the patient's trachea and thereby aid the physician inserting the endotracheal tube.
Another object of the present invention is to provide an enhanced endotracheal tube with a reflectively coated bore to increase light transmission and thereby increase visualization through the endotracheal tube.
Other objects and advantages of the present invention are pointed out in the claims annexed hereto and form a part of this disclosure. A full and complete understanding of the invention may be had by reference to the accompanying drawings and description of the preferred embodiments.
REFERENCES:
patent: 1945380 (1934-01-01), Russell
patent: 3643654 (1972-02-01), Felbarg
patent: 3884222 (1975-05-01), Moore
patent: 4086919 (1978-05-01), Bullard
patent: 4306547 (1981-12-01), Lowell
patent: 4384570 (1983-05-01), Roberts
patent: 4584998 (1986-04-01), McGrail
patent: 4655214 (1987-04-01), Linder
patent: 5067497 (1991-11-01), Greear et al.
patent: 5119811 (1992-06-01), Inglis et al.
patent: 5501652 (1996-03-01), Woods
patent: 5638812 (1997-06-01), Turner
patent: 5733242 (1998-03-01), Rayburn et al.
patent: 5840013 (1998-11-01), Lee et al.
patent: 5846183 (1998-12-01), Chilcoat
patent: 5873818 (1999-02-01), Rothfels
patent: 5941816 (1999-08-01), Barthel et al.
patent: 6113588 (2000-09-01), Duhaylongsod et al.
Duke Jackie Lee
Lazarus Ira S.
Nguyen Tu Cam
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