US 2269823 A
Description (OCR text may contain errors)
Jam 13, 1942. .1.- KREl-sELMAN 2,269,823
INS UFFIQAT ION APPARATU S Filed Nov. 24, 1959 I.- ggf e@ Patented Jan. 13, 1942 UNITED stares PATENT oFFlcE INSUFFLATIUN APPARATUS Joseph Kreiselman, Washington, D. C.
Application November 24, 1939, Serial No'. 306,016
(Cl. 12S- 184) 3 Claims.
This invention relates to insufliation apparatus and particularly to apparatus of this general type which is designed and intended to be used in the introduction of gases directly into the lungs of patients, for instance to supply oxygen directly into the lungs of newly born infants to prevent asphyxiation or to relieve asphyxia. The apparatus is of general utility, however, and may be used with great advantage not only in introducing oxygen into the lungs of infants but in introducing oxygen or other gases into the lungs of adults to effect resuscitation or to anesthetize. The invention is likewise highly useful when employed as a means for inating or distending atelectatic lungs of infants or adults and also for a patient with necessary oxygen during the time that an operation is being performed upon the patients tongue or throat, the device having the capacity not only to ensure unimpeded movement of oxygen or anesthetic gases into the lungs, and to permit proper exhalation, but also to act as a seal preventing drainage of blood downwardly into the lungs or the escape of matter therefrom.
In Patent 1,848,232, granted March 8, 1932, there is disclosed and claimed a resuscitation and artificial respiration apparatus which has been demonstrated to be eminently practical and valuable in actual use, and in Patent 1,848,234, also granted March 8, 1932, there is disclosed and claimed a face mask and the parts immediately associated therewith which are brought into. contact with the patient, together with the valve for controlling inflow and outflow of gases. Included in the elements forming the combination covered by this last mentioned patent is a flexible tubular member or airway which is designed and intended to be inserted into the mouth of the patient, to pass beyond the oral tissues of the patient and hold them apart so as to permit the free passage of gas to and from the lungs of the patient. The airway shown in the patent referred to comprises a flexible tube, preferably of rubber and of uniform diameter from end to end. The apparatus shown and described in the patent in question, including the airway, has been employed with great success for numberless cases of asphyxia, and for other purposes, but I have now discovered that, to perform certain desired functions and under certain conditions, it is highly desirable to employ what may be designated a tracheal catheter, in order to accomplish the objects heretofore set forth. The improved catheter is likewise a iiexible tubular member through which gases of any kind `or description may be passed, but instead of being uniform in cross-section throughout its length, it is of varying section, having a main portion and tip of different diameter, the diameter of the tip being substantially less than the diameter of the remainder of the tube.
The tip and main portion of the tube are connected by a section of ygradually increasing diameter, that is, by a section which is of conical shape, and this conical or substantially conical section functions as a seal when the apparatus is actually in use, seating in the larynx and'preventing passage of gas or fluid either into or out of the trachea or windpipe while so positioned, except through the tube. Hence it is desirable that the diameter of the tip be substantially less than the diameter of the windpipe of the patient with whom the apparatus is to be used and the diameter of the remainder or main portion of the tubular catheter be of larger diameter than that of the patients windpipe. When this is the case, the tip of reduced section may be readily introduced into the windpipe and the larynx sealed by the conical section, with Athe ,beneficial results desired. Naturally, as the patients vary in age and size, it will be necessary to have flexible tubular catheters which vary in diameter, both as to the tip and `to the main portion, but this is no substantial disadvantage inasmuch as it is easily possible to have a plurality of .such tubes for use with the resuscitation apparatus so that one of the desired size may be readily selected.
One form of the invention has been selected for disclosure by way of example and this form is illustrated in the accompanying drawing in which:
Figure 1 is an illustration in side elevation, partially broken away, of a catheter embodying the invention, and a gas control valve with which it may be conveniently associated, the end portion of the airway being shown as inserted into the mouth and trachea of an infant;
Figure 2 is an enlarged sectional viewv of the end of the catheter, showing the relative sizes of the tip and main portion of the airway and clearly indicating the conical section intermediate these two portions;
The catheter sh'own in the drawing, which is generally indicated by the numeral l0, is a ilexible tubular member which is preferably Afabri-v tip portion I2 having a diameter which is considerably smaller than that of the portion II. Likewise, by preference, the wall of the main portion II is thicker th'an the wall of the tip portion I2 so that the tip may be flexed more easily than the main portion. It may be said that the catheter described may be handled most effectively when the main portion II is stiily exible and the tip portion I2 somewhat more flexible. As so constructed it may be readily positioned in the mouth and windpipe of the patient in the manner indicated in Figure 1. In this figure th'e tip I2 is shown to have been wholly inserted into the trachea of the patient, the adjacent end of the larger portion II of the airway is shown to lie between the palate I4 and the tongue I5, and the intermediate conical portion intermediate the tip I2 and main portion I I, which conical portion is indicated at I6, is shown to be seated in sealing relationship to the mouth of the windpipe, or larynx, the windpipe or trachea being indicated at I'I. VThis conical seating portion of the catheter will in the usual case bear against and hold aside the epiglottis I8 and in general may be said to comprise a sealing member which will prevent the movement of gas or liquid either into or out of the trachea or windpipe except insofar as such gas or fluid may pass through th'e catheter itself.
The `employment of a catheter of the character` described ensures prompt and effective lung inflation, when lung inflation is desired, since gases issuing from the discharge Vport in the end of the tip I2 cannot escape by passing upwardly around the tube, in the manner heretofore experienced, but must necessarily pass into the lungs. In the event that anesthesia is desired, gases of various kinds may be transmitted in lieu of in/gen to the lungs of the patient with the tube positioned as shown in the drawing, there being no chance that these gases may escape without reaching the patients lungs. Likewise, as previously stated, the conical section I6 of the catheter constitutes a seal against the passage of liquids either into or out of the windpipe. It is very often desired to prevent blood from flowing into the trachea or wndpipe during an operation upon the oral tissues, particularly during an operation involving removal of the tongue. With the tube shown and described and positioned in the manner indicated in the drawing, an extensive operation of this nature may be performed without the slightest danger of leakage of blood into the lungs while at the same time the patient may be supplied either with oxygen or anesthesia gases as may be desired.
The catheter I0 may be made as long as desired but should not be too long or the patient will not be able to exhale properly. Conveniently it may be supplied with oxygen or other gas by means of an apparatus such as illus trated and described in Patent No. 1,848,232, previously referred to, the gas being supplied under the close control of an operator and in such manner that a safe maximum pressure cannot possibly be exceeded. In the drawing a valve for controlling ow of gas from a source of supply to the tube IU, and escape of gas from the same to the atmosphere, is indicated generally at V. The details of construction of this valve need not be described at length since they are fully disclosed in Patent 1,848,234. In lieu of the valve illustrated any equivalent may be made use of, as the novel catheter may be connected to various suitable sources of gas supply, as found convenient. In the present instance the valve V is provided with a cylindrical extension 20 and the airway I0 is provided with a coupling member or adapter 2I, having a cylindrical flange 2|' which is adapted to make a close sliding fit with th'e cylindrical outer surface of the extension 20 of the valve. With a construction such as this, the improved catheter may be readily attached to or detached from the valve and it is convenient to have the parts readily detachable inasmuch as any one of a number of tubes of different sizes may be employed in association with a single valve and gas supply mechanism.
It will be clear to one skilled in the art that, while the improved catheter is primarily intended to be used for introducing gas into the lungs, it may be employed as a means for removing liquids from the lungs. For the purpose of removing liquids the catheter is connected to a suction apparatus of suitable type, so that any fluid in the trachea will be drawn into the tube through the port in the end of the tip I2.
Having thus described the invention, what is claimed as new and desired to be secured by Letters Patent is:
1. Insuiilation apparatus comprising a flexible tubular member having main and tip portions connected by an intermediate portion, the diameter of the tip portion being such as to render the tip easily insertable into the trachea, the length thereof not exceeding the length of the trachea, and the end of the tip having an opening through which gas may be nsuftlated or exhaled, th'e main portion of said member being of larger diameter and of greater length than the tip, and `the intermediate portion being substantially frusto-conical and adapted to be seated in and to seal the mouth of the windpipe or larynx against the escape of insuflated gases between the larynx and tubular member and entry of foreign matter into the trachea, and to limit the extent of introduction of the tip portion into the trachea.
2. The combination set forth in claim 1 in which the main portion of the tubular member is stifily exible and the tip is readily flexible, to facilitate introduction into the trachea and to prevent injury thereto after introduction.
3. Insuiflation apparatus comprising a flexible tubular member having main and tip portions connected by an intermediate portion, the diameter of the tip portion being such as `to render the tip easily insertable into the trachea, the length thereof not exceeding the length of the trachea, and th'e end of the tip having an opening through which gas may be insufilated or exhaled, the main portion of said member being of larger diameter than the tip and being of sufficient length to extend from the larynx to oxygen supply means located without 'the mouth of a patient, and the intermediate portion being substantially frusto-oonical and adapted to be seated in and to seal the mouth of the windpipe or larynx against the escape of insufilated gases between the larynx and tubular member and entry of foreign matter into the trachea. and to limit the extent of introduction of the `tip portion into the trachea.