US 2376971 A
Description (OCR text may contain errors)
. Maly 29, 1945. MwkLEw v. 2,376,911
SONANT RESPIRATION INDATOR Filed March 18', 194s IN V EN TOR.
Patented May 29, `1945 f t 2,379,971'v j UNITED STATES PATENT OFFICE y* v K 2,376,971 Y o soNAN'r RESPIRATION INDICATOR MorrsW.` Kleit, Teaneck, N. .L Application March 1s, 1943, senin No. 419,670
f 7 Claims.
This invention relates to indicatorsfor the respiration of patients who are under the influence of general anaesthetics, 'and has particular reference to such indicators applicable to patients breathing through the nose.
The problem to which this invention is addressed is well illustrated bythe technique of dentists in the administration of nitrous oxide. The latter is inhaled by the patient through the nose, while his mouth is open so that the dentist may perform whatever dental work may be necessary. It is Well known that patients react differently, sometimes in the most unexpected ways, to the Frequently the patients pulse and respiration becomes rather weak, and sometimes stop altogether;` hence the patient may beregarded f as in continuous danger. There is usually no history of the patients action under the influence of gas, and if there were, the patients reaction y may be different. While the dentist is busy'work ing in the mouth and using both hands in manipulating various instruments, he is unable to take the patients pulse. Nor have the majority7 of dentists assistants or nurses to observe the patient.- Yet a delay of a minute in changing the ratio of oxygen to nitrous oxide, or in completely shutting off the anaestheticmay result in a serious condition or even death of the patient.
One object of the invention, therefore, is to provide an improved device, including a sonant Another object of the invention is `to furnishimproved means such that the .indicator shall sound only upon exhalation and be cut ofl on inhalation to prevent aspiration of air which would affect the carefully adjusted gas to oxygen ratio in degrees which may vary as the strength of the Another object of the invention is to provide an improved device whereby the sonant indicator does not prevent the making of various adjustments, for instance at the exhalation nose piece, so that the device may be readily set tothe needs of the individual patient.
In general, the invention has the vfurther object of providing va sonant respiration indicator so arranged and constructed in an improved manner as to be responsive to the relatively slight exhalatlon pressure of an unconscious patient whose mouth is held open, the indicator being simple,l
compact, durable, highly reliable in usefand. light in Weight.
Other objects and advantages of the invention will become apparent as the` specification .pro-
'With'the aforesaid objects in viewythe invention consists in the novel combinations and arrangements of` parts hereinafter described in their preferred embodiments, pointed out in the subjoined` claims, fand illustrated on the annexed l drawing, wherein like'parts are designated by thev same reference characters throughout the several patient of whom a fragmentary view is given in dotted lines.
Fig. 2 is an enlarged to the invention Vwith pa'rtslin section and parts in elevation.
Fig. 3 is an enlarged top plan view of thesounding member in detached position.
Fig. 4 is a view in elevation thereof.
Fig. y5 is a central, sectional view, with parts in elevation showing the,` combined valve means,
ofthenosepiece, accord- 1 and sounding member ing to the invention.`
The advantages ofthe invention ashere out-l lined lare best realized when all'of its features and instrumentalities are combined in one kandthe same structure, but, useful devicesmay be produced embodying lessthan the whole,
It Will be obvious to" those skilled in the art-to'` which` this invention appertains, that the same` may be incorporated in several different constructions. The accompanying drawing, therefore, is submitted `merely as showing the preferred emplification ofthe invention.
Referringm detail mihedrawing, m denotes a device embodying the invention andillustrating l a typicaly use thereof. The same may include any desiredsource H of a suitable anaesthetic, comprising a tank of `nitrous `oxide VI2` and a tank of oxygen '|73. The outlets of these tanks may -be controlledl as by pressure reducing and regulating tting or mixing chamber I'Lwhence extends a viewjof a device according i single flexible tube is. The latter may le'adiinte a branch fitting I9,' lfrom which extend flexible tubes 2li-that connect into a nose piece device 2l.
proportions ofnitrous oxidel 'and oxygen may be adjusted lat valves I5, and that these gases are continuouslyi'mixed; together onfliheglr wayyto thevlo nose pieceewithL-"lthe pressure lof lthel'finiture coni;- trolled and indicated. In general, when once the proportions and' pressure of ,the mixture hai/ef'k so that any gas which Ahas not been absorbed by the patient may again be used.
It is a'natural physiologic action for a person to be capable of breathingthrough the nose While his mouth is open. When gas is rst adminisn mentir beore `theedentis'tbeginstoyvitorkonteeth.
.Il'isl'cottoneservesl to prevent articles from ac# cidentally falling into the patients throatand reduces any tendency` to breathe through the f f been adjusted'the'y need not be changed, except, v,nicgulth, ifit does, not whollyvpreventit. If the as .may be requredby avchange n"`the'cordition* 15'*cottonshouldislip into the throat it may cut 01T 'of the patient indicated by the respration,..,las=f ,they breathing; through the HOSEy but this WOllld y be instantly indicated by the sounding device.
Thfeibestlresutssare obtained by 'embodying in thegdeviceilla valve means for .automatically cutting vvoi` the sounding device during inhala` hereinafterdescribed. It Willbeappre'ciated that y l the ystructure thus far described"-is'conventionalfv 'and'merely illustrative.v
1 beiottffthenose-'as ind" nessof 'this ope v This openingl'i' im.theetubestleadingetogthemose ieoatthisprels.- f
The sonant respiration indicator 2| 20 cludeaenoseepieceZ @made of@fanyfiexibl mate# I f l 2 5y of soft rubber to aid in formingja gastigrlitiv in 'detteu linee: "opposite: cenet *portee ta aie-#- ing inhalation, Vso asinbft totundljialttlieratio'" ofja outi'npsztjiriciies .t v y v i* aeratiier eharpgedees sejasrelcong stitute-wnat'is' knewin' pneumaticsasa tiiiiiedee j A orincfe.v Accordingly innesta iiigniicoeneint'-lofl' friction and a lowvjcoeibien of "discharge-,- Whereserve ."as,'aA soundingftdevice. The action. (of the-,5l
t ing the end Wall '32 inwhich..tlieorice-isiformedf sureudropping; almost-to i zero duringinhalationf. soethattheetendency; fonanyy flow lthrough the.,.
30 elementsfua mayfbie threadedl'y dnterconnectedu l thefp'orts 445;. ,and/that i there fis,- @r Substantialcdise tance betweenl the orifice aliandthe portsmlie y tion: Thus a air-ris'.- avoided.:A mighfti beiainhaledlandaiectrsthe delicate balancerotithezsgasi; andoxygfen' mixture,` especiallgcwlienethe .patients breathing becomesjprogr'essivelyiWeakeri In Eig.: "'ntrned-Hfyl 5 is-shown a device 2'1az.:lcorniirrisinfgiaisourrdirrgev member 2 aux which is:Iv generally@ likeetnat'. a4tn28,
afzcylindrical .'casi-ngsjidhavingiirritlreclowenparti thereof-ia; slidablef cylindrical@ lelementi. 35e Thee atxf36v. 'I heP loa/erp"partv ofi 'elementziivirnay.;I be.: thickened Lto .f provider an: circular seatfi orgias disci.; valve s31,*fwhicnfcornrnunicatess with .-a; clampinga ninblez orzotherizinlet; Amelicalifexpansion coilsV `35S spring 38 lf-bea'rsgonfthe topv` wallsofiaeiement i3 Mandi:
on theffdisoevalfveito fhGIdztheeIatteri downronuits seat. Ae-pin 4f! extends ,axially thronghrthe Wallf- 4-andithroirgilrlthe -topifwafllimofg th'e velementi 34e, bei-ngv upwardly Vrurgedzrby am expansionA coil :v ,Msprirrgr43flextendinge'aroundflthe pirrsandbeanng.;
omthe Nva-ll 40e-ridurre; collar ,Mfoii Itlxetpnrwhiclr: collarY restsi on; [the :Wall 4,2 r, vlorrcornzn'nmicatiun :f with ithezvalvesitheewails1140i;andhmaygeach;reef
455! The'` memberiz wimaybe-removablsosleeve dion. the.;
casingielement 34-with1fa snuggirtep. Y l c Imoperatio the casingif element isenre d; beings secured; toi: the arrose-f. piece: 24e byu the; clam'pingf;
nipple 38:1. rBy.turningitlsieffcasirrg :elementdl d; the
therpin #Al toward4 the :valve 35i itorliimsit the vopen.-A ing miovementpf thef-latteri A :'ITheavalve; is nor.- i mallyfclosed vibyvtheespringe391whiichf isfgse"weaksA i. as to permit the valve to orten-:irl:responsertoi(exaA i 1 50" halation'q. pressuregf, im whichvcaseethe valve-fris guidednbwthe sideewalliof.-thercasingaelement-? Thefsprllgi 43- Lise-stronger; `thanxtluaitat 39, jand.;` if.: thiefv operatori desi-rese h'eemainlrnanualliyfgpress;; l M. f Y ,l i downionntheuw rr 'o'e byvthe'fate v0f Aflow 1S reduced.. l Thlsonstrutln- 6o. pmjan'd eausepie Due :to: frictional, contactf'b'etweenetle 'sounding member'. ZBwaAudl the casingfM ytheelatter 'mayybev turnedpbyijturning .the membgertz s c, -It -wi beenotedethamtheefsoun ingpricenisi 651 :nach sr-naller. thanitheqareafof ftneeports .174 tion of Such spacing is importantfbeeauser-if too: close, theaturbulence causediatethe;portsdeaffectsethe .i
- ni-l.- 1 Du-ring,exlfialaticm` the slig-htfpressuretin:the-t. A
- tubes mavfbeecounteractedimpart'ibyethe-@Xhalaef y tion pressure, Y soifthat; onlysa negligiblezq rltitir" j `ofz'gas:may/trescapefiintoithe'atmosphere., l someofitne :exhale/tion mayyreturnatoithe:baeuzziV75*indicationlissesQntiviaSnW/arsmMelumewtha eral :thaflysaaineeshouldibe` about; one-hair ofi am asf/.6,971
control. of` the v.'valve, whereby' a Weak exhalation.v is capableoffoperating.the sounding device'. f
the volume of respiration, thus giving-the dentist'- a Warning signalWhen itbecomes `very weak.-
The invention thus relieves the dentistof the loss of timein attempting to check the patient from time totime, and reduces the nervous strain due to the.'uncertaintyofthepatients condition.
from moment to'moment, and issimple, convenient and reliable in-use. l l y It is interesting to note that my device is adapted' to indicate 'the volume, frequency anddepthvof respiration, with the mouthopen 'or` structive .to the earof 'the skilled anaesthetistv with reference tol the.A rst, second, thirdV andlv fourth stages of anaesthesia.- `The device :produces a whistling sound by the exhalation pressure acting against the edge of the opening 3|. So sensitive is my device to .those skilled in its use that the presence of an anatomical obstruction, such as a deviated septum, a tumor, or adenoids will be indicated, so that the action of the anaesthetist may be governed accordingly. Pressure on the nerves causing interference With respiration will be indicated or suggested. Accidental loosening of the nose piece, or shifting of a cotton Wad in the back of the mouth to partially obstruct the respiratory tract, as where the dentist presses down on the tongue, will readily show up'.
3; A sonant respiration indicator Afora dental patient breathing gaseous yanaesthetic through the i nose including` a' nose piece having` a casing; a l sounding Adevicefconnected vtofthe casing,l atube i connectedzwith the nose pieceandk providing with the latter a passage of relatively large' area` for communicating only exhalation ypressure 4to'.y the Y sounding device,thelatter. having a sonantoriice of substantially smaller area,'the orice'fhavinga thin .sounding edge, rand'thecasing having a relatively largevolume with the sounding orifice being rsufficiently spacedfromthe nose. piece t`v prevent turbulence of gases therein from prevent-v ing operation of the sounding orifice, `whereby the soundingdevice is `responsive'to the Weak exhalation of the-unconscious patient. ff
4. `A sonant respiration indicator lincludinga nose piece 'having `meansior embracing the nose and having an inlet portion, a tube connected to the nose piece at the inlet portion, means for controlling the supply of a gaseous anaesthetic thereto to be inhaled by the Wearer, the nose piece Where gas is used for analgesia to dull the pain of the conscious patient, the tendency to breathing through the mouth may be overcome by instructing the patient to listen to the sounding device to thus make sure that he is breathing through the nose.
1. A sonant' respiration indicator whereby a dentist can continuously check the condition of a patient who is under the inuence of a gaseous anaesthetic, including a member arranged and constructed to embrace the nostril portion of a patient who is breathing through the nose, said member being adapted to communicate with a means for adjustably supplying oxygen and an anaesthetic gas to the member to be inhaled by the patient, said member having an exhalation outlet, and a sounding device external of the member and being connected thereto in communication with the exhalation outlet, the sounding device having an outlet so substantially small that the exhalation gases are capable of producing a sound Whose volume varies vwith the breathing of the conscious and unconscious patient, said means being so adjusted as to be incapable of causing operation of the sounding device during inhalation,
2'. A- sonant respiration indicator whereby a dentist is given timely Warning of the condition of a patient under the influence of nitrous oxide, including a nose piece having a casing adapted to snugly embrace only the nose of the patient, the casing having an inlet opening, a tube connected to the casing at said inlet for supplying gaseous anaesthetic thereto, said casing having an outlet opening and a sounding device connected to the casing at said outlet, a closure valve for the outlet openable in response to exhalation pressure the sounding device having a sound orifice substantially smaller in area than sai-d tube and said openings, and being normally in continuous commimication with said outlet subject to the having an outlet portion, a valve means carried by the nosepiece that automatically closes the outlet to prevent flow of gases into the casing through the outlet upon inhalation and permits free flow of gases from the outletupon exhalation, and a sounding device having a casing connected to said nose piece to communicate with the valve means, the sounding device having a thin edge orice, the latter being suiiciently small'to render rthe sounding device operative by an exhalation through the nose and the casing being of sullcient size with the orifice being at a sufficient distance from the valve means to prevent turbulence of gases caused by the latter from affecting the operation of the sounding device. i y y 5. A sonant respiration indicator including means forsupplying 'toga patient a, mixture of oxygen and anaethetic gas, at an adjusted pressure, including means communicating solely with the nose while the mouth of the patient is open, valve means responsive .to gaseous pressure for f communicating lwith the nose to permit exhalation into the atmosphere at an adjusted pressure and to automatically cut off communication with the atmosphere during inhalation, and a sounding device communicating With the valve means for the discharge of the exhalation into the atmosphere, the sounding device being normally continuously operative upon each exhalation and being constructed to be so sufficiently sensitive to be responsive to relatively weak exhalations of the unconscious patient with vthe volume of soundl varying to thus indicate kthe condition of the patient under the influence of said anaesthetic.
6. A sonant respiration indicator including a nose piece arranged and constructed to t solely over the nose of the patient, `said nose piece having a first port adapted to continuously communicate with a source of gaseous anaesthetic. and a second port communicating with the atmosphere, the nose piece having a chamber for the nostrils having direct, unrestricted continuous communication with the rst port, and with the second port during exhalation, a valve means for the second port normally closing ythe same during inhalation and being responsive to exhalation pressure to open the second port, a sounding device and:havinggangoutletpgrtongatubexxnnectediv: f the noser piecek atathee-outletxportiomgmeamsfonf controllings the 1 suppiy 'fof a a gaseousf: anaethetic; `15 theretostoube,'iuhaleimygfthe fpatienthefnosez: