Surgery – Respiratory method or device – Respiratory gas supply means enters mouth or tracheotomy...
Reexamination Certificate
1999-08-05
2001-10-09
Weiss, John G. (Department: 3761)
Surgery
Respiratory method or device
Respiratory gas supply means enters mouth or tracheotomy...
C128S207180, C128S207140, C128S204120, C128S202270
Reexamination Certificate
active
06298850
ABSTRACT:
FIELD OF THE INVENTION
This invention relates in general to nasal cannulas, and more particularly to a securing a nasal cannula at a desired position on a patient and an improved nosepiece.
BACKGROUND
Nasal cannulas are well known in the art, and are characterized by U.S. Pat. No. 4,106,505 to Salter et al. Cannulas are frequently used to alleviate respiratory distress due to many types of respiratory medical conditions by supplying an oxygen enriched air stream to a patient. Often wearing the cannula on a 24 hour a day basis is a medical necessity. The use of a nasal cannula allows the patient freedom of movement and activity, while being unobtrusive as compared to the larger and bulkier facemasks.
A nasal cannula comprises essentially a nasal assembly, or nosepiece, with a hollow main body having two directed orifices near or in a patient nostrils. The gas is supplied to the main body that acts as a distributing manifold. Typically, the orifices are placed at the end of nasal extension tubes extending upwardly from a main body portion and in communication with the main body. Commonly two gas supply tubes are attached to the cannula nosepiece, that is held in place by extending the gas supply tubes from the patient's nasal area behind the patient's ears. The flexible tubes are bent downward behind the ears to run generally along the jaw area, and are held in place by an adjustable slip loop or a cinch tightened below the chin to hold the nosepiece in place. Oxygen or other gas flows through the tube to the two orifices, and the gas is mixed with the air stream of the patient air intake.
While being one of the most convenient methods known to date for supplying a patient with a gas enriched environment, nasal cannulas suffer a major drawback: the positioning of the tubes around the ears for support is uncomfortable and is prone to falling off the patient's face. Additionally, it causes the patient chaffing and pain. Patients regularly find that body movement, especially during sleep, causes the cannula to dislocate, depriving the patient of the needed oxygen enrichment. Accidental removal of the cannula often causes severe discomfort to the patient and in certain cases may even be life threatening.
U.S. Pat. Nos. 5,636,630 to Miller et al., 4,836,200 to Clark, and 4,422,456 to Tiep, all attempt to solve this problem. Miller et al. discloses running the tubes behind the patient head and utilizing a coupling portion contacting the back of the head, with the gas conduits passing in criss-cross manner behind the head. This arrangement suffers from several disadvantages, major amongst them is the location of both oxygen tubes behind the patient's head where they may be blocked if the head is resting thereupon. Additionally, placement of tubes behind the head is often uncomfortable to the patient.
The Clark patent utilizes a pressure-fastening strap adapted to go over the top of a user's head, onto which the flexible tubes are attached. Clark also discloses and teaches away from a strap wrapped completely around the head, with separate attachment means for the flexible tubes. Clark's preferred implementation is less desirable since the strap may slide over the head of the user and is liable to entangle with the patient's hair.
Tiep's patent discloses means for supporting the cannula in place by an elastic band that is adjustably connected to two holders each located on one of the conduits or flexible tubes. Each of the holders includes a band fitting around the conduit and in frictional engagement with it, and a tab attached to the band so as to extend generally along the conduit. An elastic band extending behind the patient's head is secured to the tab by being threaded through openings within the tab. Two problems arise from the Tiep patent: First, a structure according to Tiep requires threading adjustment of the elastic band. This is time consuming, and when done on a patient head also runs the risk of entanglement in the patient's hair. This problem is especially significant to nurses in a hospital where time is often of the essence. Additionally, an elastic band, being flat in cross section, runs the risk of entanglement in the patient's hair.
In use, typically the nosepiece of a cannula is placed against the nasal septum, and tension is applied against it to secure the nosepiece in place. The tension exerted against the septum causes sever discomfort to some patients, especially during respiratory or medical conditions such as allergies and cold. Soft and flexible materials are commonly used in the construction of nasal cannulas, but the pressure on the soft tissue surrounding the nasal septum stems from the tension necessary to hold the nasal cannula in place.
It is clear therefore that a need exists for a device to secure a nasal to a patient's head in a light, inexpensive, and effective manner, and doing so in a manner that will be unobtrusive to the patient. Additionally, a better solution is needed for providing user comfort in the nasal septum area as described above. The current invention discloses such a device and method for its use.
SUMMARY
It is therefore an objective of the current invention to provide means for securing a gas supply cannula to a patient wearing it so as to insure continuous and uninterrupted supply of oxygen as needed, thus avoiding the discomfort stemming from having to place gas supply tubing behind the patient's ears, or a tight cinch under the patient's neck.
The current invention is based on the discovery that using a flexible elastic cord
40
of generally round cross section and having a relatively small diameter, preferably no larger than one or two millimeters, is uniquely suitable for securing the cannula with only minor inconvenience to the patient. It was found that the use of such round, small diameter elastic cord in combination with other aspects of the current invention, solves the problem of user comfort and hair entanglement, all while ensuring a secure method of affixing the nasal cannula in place. It is also an object of this invention to provide for easy, fast, and single-handed adjustment of the cannula in place to permit easy adjustment for different head dimensions. To that end, a cord coupler
30
and
35
is also disclosed herein. The cord coupler is in slidable engagement with the flexible gas supply tubes
20
and
25
supplying oxygen to the cannula nosepiece
10
. The elastic cord
40
is attached to the cord couplers
30
and
35
, that in turn couples the cord to the gas supply tubes
20
and
25
. In the preferred implementation, two cord couplers are utilized, made of flexible tubing with an inner diameter slightly larger than the outer diameter of the gas supply tubes. The cord is attached to the cord couplers in any convenient manner. The simplest form of a cord coupler comprises a loop formed in the cord around the gas supply tube and tied or otherwise bonded against it in a slidable engagement.
In use, the first end of the cord is coupled to one of the two gas supply tubes, and the second end of the cord is coupled to the other gas supply tube. At least one end is coupled by means of a cord coupler as described above. By placing the nosepiece next to a patient's nostrils, and by placing the elastic cord behind the patient's head so it rests against the back portion of the head, the nasal cannula is secured in place. The gas supply flexible tubes are extended towards the patient's ears. At least one of the cord couplers is slidably adjusted forward towards the nosepiece in order to achieve a comfortable fit of the cannula while securing it in place. Thus the cord couplers support the flexible gas supply tubes and the tubes rest on opposite sides of the patient's face, and may be bent downwardly behind the cord couplers and thus avoid the patient's ears altogether. The gas supply tubes generally run down along the jaw area to a meeting point under the patient's neck, but without requiring a cinch to hold them ti
Saltamar Innovations
Srivastava V.
Weiss John G.
Wertsberger Shalom
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