US 2912982 A
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Description (OCR text may contain errors)
Nov. 17, 1959 A. J. BARSKY ENDOTRACHEAL TUBE ADAPTER Filed June 4, 1958 INVENTOR United States Patent This invention relates to an improvement in endotracheal tube adapters used in connecting an endotracheal I tube to an anesthesia machine.
In many types of surgery it is not possible to use a nasal mask for administration of the anesthesia because the mask would cover and make inaccessible the portion of the mouth, nose, face, throat or other area to be operated upon. In such operations it is, therefore, the practice to introduce an endotracheal tube through the mouth and into the trachea or windpipe of the lung and to administer the anesthesia through this tube. In this manner the-patients face, mouth, nose and throat are not obstructed and may be operated upon.
In many types of surgery, however, the endotracheal tube and the adapter with which it is connected with the anesthesia machine will pull upon and distort the patients mouth and face, so that the surgeon in attempting to restore the mouth and face to the normal appearance during the operation must contend with and allow for these distortions, and it becomes very diflicult to restore the patients face to its exact appearance prior to the operation.
It is one of the objects of this invntion to provide an endotracheal tube adapter which will reduce distortion of the patients mouth and face to a minimum during an operation under anesthesia.
Another object of the invention is to provide an endotracheal tube adapter for connecting an endotracheal tube with an anesthesia machine which will permit a suction tube to be readily inserted through the endotracheal tube, for the purpose of withdrawing mucus, blood or other fluids from the lung cavity during the operation and which will permit ready reconnection of the lung cavity with the anesthesia machine after the said fluids have been withdrawn.
Various other objects and advantages of the invention will become apparent as this description proceeds.
Referring now to thedrawings which illustrate a preferred embodiment of the invention,
Fig. 1 is a sectional view illustrating an endotracheal tube inserted through the mouth, throat and pharynx and into the lung cavity, with my adapter connected to the endotracheal tube.
Fig. 2 is an enlarged view of the teeth and lips of the patient showing one end of my adapter projecting between the patients teeth.
Fig. 3 is a detailed view showing the suction tube opening in the adapter.
In the drawings the endotracheal tube 1, which is usually a soft rubber tube, is illustrated as passing through the mouth 2 and pharynx 3 and into the trachea or windpipe 4 of the patient. The adapter 5 constituting the present invention is a rigid tube, preferably metal, shaped somewhat like a question mark, which projects into the end 6 of the endotracheal tube 1, and at its other end is provided with a connection point 7 for connection with a tube 8 leading to the anesthesia machine. The connection joint 7 is ordinarily a ground telescoping slip ice joint connection by which the endotracheal tube adapter may be readily connected to and disconnected from the anesthesia machine by merely pulling the parts of ground connection apart or pushing them together.
As illustrated more clearly in Fig. 2 the upper end 5a of the adapter 5 projects into the end 6 of the endotracheal tube 1 far enough to extend beyond the patients teeth 9 so that in the event the patient should close his month during the operation he will not collapse or bite off the endotracheal tube.
A short distance from the end 5a the adapter 5 is provided with a flange 10 and with a screw threaded portion 11 adapted to receive a screw threaded collar 12 which normally is screwed tightly on the threaded portion 11 as illustrated in Fig. 1 when anesthesia is being administered. The threaded portion 11 and the screw threaded interior of the collar 12 may each be given a slight taper or frustro-conical, shape so that the further the collar 12 is screwed on to the threaded portion 11 the tighter the fit.
A hole 13 is provided through the screw threaded portion 11 leading to the interior of the adapter 5. As
illustrated in Figs. 2 and 3 the hole 13 passes diagonally through the wall of the screw threaded portion 11 and slopes in the direction of the end of the adapter 5 which is connected with the endotracheal tube 1. This slope facilitates the insertion of a suction tube 14 through the wall of the adapter 5 and through the endotracheal tube 1 into the windpipe or trachea for the purpose of with drawing mucus, blood or other fluids which may accumulate therein during the operation. The outer end of the tube 14 may be connected with a suction apparatus and the tube 14 is preferably formed of a flexible transparent plastic material such as polyethylene, so that the surgeon may observe through the transparent walls of the tube the nature and amount of the fluids being withdrawn and in this way judge whether there is excessive bleeding or other complications occurring.
The suction tube 14 may be inserted and withdrawn and fluids removed from the lung cavity several times during an operation, if desired, without materially interfering with the administration of the anesthesia or with the patients normal breathing during periods when the anesthesia is not being administered. To insert the suction tube 14 the collar 12 is unscrewed from the threaded portion 11 to expose the. hole 13 and the tube 14 is inserted through the hole 13. When the fluids have been removed the tube is withdrawn and the collar 12 again screwed on the portion 11 to seal the hole 13 and permit air tight communication between the endotracheal tube 1 and the'anesthesia machine.
The flange 10 prevents the collar 12 from moving beyond the upper end of the adapter 5 and the enlarged connection joint 7 prevents the collar 12 from sliding off the lower end of the adapter 5 so that the collar 12 can never be misplaced or lost. Other means for retaining the collar 12 permanently on the adapter 5 may be used, such as the flange 12a on the collar. The collar 12 is preferably made of the same metal as the adapter tube 5, such as steel, copper, aluminum or the like, however, the collar 12 may, if desired, be made of nylon or other synthetic materials and screw threaded on the inside as illustrated. While a screw threaded connection between the collar 12 and the portion 11 of the adapter is preferred, a telescoping slip joint connection may be used. The screw threaded connection, however, results in less movement of the adapter 5 when the hole 13 is being uncovered or closed and is, therefore, preferable.
The method of using the adapter is readily apparent from the description and drawings. During administration of the anesthesia and during normal breathing the adapter is used to connect the outer end of the endohole 13, the suction tube 14 is inserted and the fluids removed. After theusuction tube 14 is removed the collar 12' isagain screwed on :the portion 11 to close the hole 13 and administration of anesthesia or normal breathing through the anesthesia machine may be resumed. As the tube 14 is of much smaller diameter than the endotracheal tube 1 the patient may inhale and exhale air even while the tube 14 is being used. During an operation the anesthetist may hold the rigid tube in such position that there is no distortion of the patients mouth or lips. The tube 5 is of sutfcient length that the anesthetists hand holding the tube will not interferewith the surgeon in the operation.
It will be understood that different size endotracheal tubes and different size adapters are used with different size patients, and that other modifications and changes may be made from the specific embodiment illustrated without departing from the spirit of my invention or the scope of the following claims.
1. An endotracheal tube adapter for connecting an endotracheal tube with an anesthesia machine comprising a rigid curved tube, means on one end of said adapter tube for connection with an endotracheal tube, means on the other end of said adapter tube for connection with an anesthesia machine, said adapter having an opening through the wall thereof through which a suction tube may be passed, and means to cover and uncover said opening.
2. ,An endotracheal tube adapter for connecting an endotracheal tube with an anesthesia machine comprising a rigid curved tube, means on one end of said adapter tube for connection with an endotracheal tube, means .on the other end of said adapter for connection with an anesthesia machine, a threaded section on said adapter tube, said adapter tube having a hole through said thread- 4 ed section, an internally threaded collar adapted to screw on and off said threaded section to cover and uncover said hole and means to retain said threaded collar on said adapter tube.
3. An endotracheal tube adapter for connecting an endortracheal tube with an anesthesia machine comprising a rigid curved tube, means on one end of said adapter tube to extend into an endotracheal tube, a slip joint connection on the other end of said adapter tube for connection with an anesthesia machine, said adapter tube having an opening through the wall of the tube through which a suction tube may bepassed into the interior of the adapter tube and the endotracheal tube, means to cover and uncover said opening and means to movably retain said covering and uncovering means secured to said adapter tube.
4. An endotracheal tube adapter for connecting an endotracheal tube with an anesthesia machine comprising a rigid curved metal tube, means-on one end of said adapter tube to extend into an endotracheal tube, means on the other end of said adapter for'connection with an anesthesia machine, a threaded section on said adapter tube, said adapter tube having a hole through said threaded section into the interior of said adapter tube through which a suction tube may be inserted .into and removed from the adapter tube and the endotracheal tube, an internally threaded collar adapted to .screw on and rod said threaded section to cover and uncover said hole and means to retain said threaded collar on said adapter tube.
OTHER REFERENCES Hodges, R. J. et aL: The Lancet, Ian. 7, 1956 (page 26 required). (Copy in 128-351.)