US 2638096 A
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Description (OCR text may contain errors)
May 12, 1953 E. A. wALDHAUs 2,638,096
""'APPARATUS FOR ORAL ANESTHESIA Filed Nov. 8, 1949 num-g ATTORNEY Patented May 12, 1953 UNITED STATES PATENT OFFICE 2,638,096 APPARATUS Fon oRAL ANEsTHEsIA l s Edith A. Waldhaus, Birmingham, Ala.. l Application` November 8, 1949, Serial No. 126,176
This invention relates to the art of administering anesthesia through a patients mouth and throat Where this is made necessary by circumstances which prevent nasal administration.
An object of the` invention is to simplify. ex-
pedite and make safer the technique of intubation of an intratracheal catheter by alici-ding prompt and reliable evidence of whether the inner invisible end of the catheter tube has been inserted properly in the trachea of the patient, since it can easily happen that the catheter will improperly enter the esophagus.
A contributory object of the present improvements is to provide a device that will sound a clearly audible signal, giving positive evidence of even feeble breathing through the catheter, and to make such signal device applicable to the outer end of the catheter in a manner not to interfere with the patients breathing.
A related objective is to arrange such signal device to be instantly detachable from the outer end of the catheter tube and replaced by conduit means for supplying gaseous anesthetic Without danger of any nerve irritating disturbance of the inserted end of the tube while it re mains in the patients throat.
These and associatedobjects of the` invention will become apparent in fuller detail as the description proceeds, the following specification having reference to the accompanying drawing disclosing a successfu1 embodiment of the invention in which drawing! Fig. 1 is a view showing intubation of a tracheal catheter with an audible signal devicetemporarily applied thereto for the purpose of the invention.
Fig. 2 shows in practicalactual size the trachea catheter of Fig. 1 with myV improved signal device removably in place thereon. f
Fig. 3 is a fragmentary'plan view of the subject of Fig. 2.
Fig. 4 is an enlarged view of the signal device detached from the catheter tube shown partially in section on a central vertical plane.
Fig. 5 is an enlarged sectional view of the sound causing structure removed from the signal device of Fig. 4.
Fig. 6 shows a modified construction of the signal device adapting it to a catheter having a bare tubular end.
Fig. 7 shows the catheter terminal of Figs. 1 and 2 connected to a source of gaseous anesthetic after temporary test use and removal of the signal-giving device.
In Fig. l conventional surgical anesthesia ap- 6 Claims. (Cl. 12S-348) paratus is represented by upright pressuretanks or cylinders I2, I 4 containing any of variousanesthetic gases such as ethylene, nitrous oxide, ,carbon oxide, oxygen, ether, cyclopropane with helum, etc. The cylinders` I2 and I4 may be supported by a floor stand I5 which may be of the cabinet type presenting a shelf I6 carrying the hook Il on which is hung, so as to be instantly available for use, a T.shaped adaptor I8 branching into conduit connection with corrugated flexible respiration tubings I9, 20. These communicate with the usual bag, absorber, and other conventional parts of the apparatusI including control valves serving to condition and proportion the delivery of gas mixtures to the ,lungs of the patient. i The open end 2I of T-shaped adaptor I8 may have a slip fit on a metallic connector 22 which may be xedly lodged in the outer end of the trachea catheter tube 23 to form the outer terminal thereof. The tube is usually ofsemi-soft rubber molded to somewhat torio-like curvature for conformity with the throat passage of a prone patient. In Fig.- 6, however, the walls ofthe catheter tube 23 at its outer end are merely flared outward conically to form the tubeterminal, no connector such as 22 being present. When a connector such as 22 is present. it may conveniently consist of a knurled flange 26 somewhat larger lindiameter than the catheter tube integral with a `nipple 2l xedly lodged in the end of the tube and also integral with anoutwardly projecting open `ended barrel 28 exposed to receive the T-adaptor I'8 with a slide iitA therebetween. I T-adaptor I8 `incorporates aswivel jointat2ll.` f y 5 -According'to the present improvements, when connectiony isv broken between adaptorv I- and connector 22,' the latter remains embedded in the catheter tube 23 and its exposed barrel 28 is therefore always ready to receive my improved audible signal-giving device 3l which thereby forms a partial closure for the tube terminal and thus throttles the outer end of the catheter to a certain extent when temporarily-and removably applied thereto as shown in Fig. 1. If the catheter is properly placed in the trachea, this fact will be evidenced at once by a whistle-like sound generated at orifices 32 and 33 of the signal device, these orices being large enough to pass a now of air into and out of the catheter tube sumcient to sustain normal breathing of the patient combined with a tubular catheter having an inside diameter of or thereabouts if the hole or holes are round and, say .111" to .134 in diameter. Successfully loud sound is produced if both holes are close to 1/8 in diameter. However. I have found that the sound-producing ability becomes impaired if the holes are made as large as .175" in diameter. Hence it is necessary that these holes lie Within some range of sizes sufficiently smaller than the air passageway through the catheter tube to considerably throttle the open end of the latter. The extent of throttling must not interfere with safe breathing of.' the patient but must be suiiicient to speed up and..
vibrate to an audible frequency the flow of air into or out of the tube induced by the respira tion of the patient. In this sense the soundv producing unit, shown detached in Fig. 5; constitutes a partial closure for the outer endjvof the Y catheter.
. Coni/enientlyl may construct the sound. unit c'fliig. 5 as; asonant insert of three sheet-metal parts comprising a drawn metal cup-shaped reso- .n'ance chamber 35, a cap 36 covering and crimped over'the larger top end of chamber 35 containing the hole 3,2, and a baille disc 3l upset to produce 'the central hole 33 therein -bordered by rim prongs which protrude through an opening in the small end of the drawn metal cup 35 and are eyeletted over into interlocking relation tothe cup. The external annular flange lportion .Tl of ,thedisc is of size to be lrictionally lodged in an opening 38 in the head 39 of the signal device 3l with a' press fit. This thimble-like signal device further includes a rigid shell 40 having an open mounting end and having at its opposite end a transverse h ead wall containing the aforesaid resonance chamber, `and a knurled flange :il
affording-'the maximum girth of shell mi by 'stream passing through holes 32 and 33 in either direction and makes the Whistling sound 'loud enough to be audible .in case of the most shallow breathing.
"In Fig. 6 the 'cylindrical mounting barrel 40 'of 'a 'modified signal device 3|' is replaced by a lconically tapered barrel Ml' which is capable of fitting and being lodged removably in the bare "rubber end of catheter tubes of different Ysizes represented 'by the end portion 23 -of a catheter ftube flared .by stretching it Vonto the barrel 40.
The appended claims are directed to and intended to cover all variations and equivalents of the size, shape and arrangement of parts herein chosen to illustrate the principles of the invention that fairly come within the broadest interpretation of the definitive terms used in the claims.
1. Apparatus for testing momentarily without disturbing the patient the properl intubation of an oral catheter inserted into the trachea, comprising in combination with an intra-tracheal catheter having a tubular terminal at its outer end, a test appliance comprising a perforate Whistle affording unit mounted on said terminal and' removably fitting said terminal in a manner to be joined quickly therewith and separated vtherefrom without disturbing the inserted portion of the catheter While it occupies the patients throat, said Whistle affording unit comprising a partial closure for saidterminal containing a vent giving the catheter restricted communicaf tion with ambient air and forming the sole source of respiratory gas available to the patient through said catheter, said vent being of size, shape and arrangement to vibrate into clearly audible sound waves weak streams of air impelled gently through said Avent by feeble breathing of the patient.
2. Test apparatus` as defined in claim 1, in which the said Whistle affording unit includes walls confining a space forming a resonance chamber and containing `substantially co-aXial holes, one of said holes opening to the said catheter and thevother of said holes openingto ambient air.
3. Test apparatus 'as defined in claim 2, in which at least one of the said holes is substantially round and less than .175" in diameter. A
e. lest apparatus as defined in 'claim 2. in which yeach of the said holes is substantially round and less than .175" in diameter. f 5. Test apparatus as dened in claim 2, in which each of the said holes Ahas a diameter of between .118" and .143".
6. Test apparatus as defined in claim 2, in which the said resonance chamber comprises a tapering cup-shaped barrel closed at its larger 'end by a transversely extending cap, said cap and the smaller end of said cup-shaped barrel respectively constituting the said Walls.
EDrrH A. WALDHAUS.
References cited in .the fue of tnis'patent UNITED 's'rrrrss PATENTS Swindle Dec. 7 '1943