US 2931358 A
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Description (OCR text may contain errors)
April 5, 1960 D. s. SHERIDAN 2,931,358
NASAL. CANNULAE Fild July so, 1958 2 Sheets-Sheet 1 INVENTOR.
DAVID S. SHERIDAN BY @014 7 W ATTORNEYS April 5, 1960 Filed July 30, 1958 D. s. SHERIDAN 2,931,358
NASAL CANNULAE 2 Sheets-Sheet 2 INVENTOR.
DAVID S. SHERIDAN ATTORNEYS United States Patent NASAL CANNULAE David S. Sheridan, Argyle, N.Y.
Application July 30, 1958, Serial No. 752,050
Claims. (Cl. 128-206) This invention relates to nasal cannulae for use in the nasal administering of fluids, such as oxygen, into the nasal passage of a patient. More particularly, the invention is concerned with nasal cannulae which are formed entirely of sections of extruded flexible tubing.
Field of invention In various medical and surgical procedures, it is neces sary to administer gases through the nasal passages of a patient. This can be accomplished in a number of ways. For example, a mask adapted to cover the face or nose of the patient may be applied to the patient and the gas administered by means of the mask. Apparatus of this type is illustrated and described in various patents and publications, e.g., see U.S. Patent 1,896,716.
Another method of administering gas and fluids to a patient by way of the nasal passages is to use a catheter which is inserted into one of the nostrils and passed into the pharynx and the esophagus.
Face masks can be used satisfactorily where special or inflammable gases are to be administered, or where the administration procedure is to take only a short period of time. However, they are unsatisfactory where the gas administration is to extend for an indefinite period of time, e.g., the administration of oxygen to a bed ridden patient. In such situations, it has been customary to employ catheters as described above.
The use of catheters for the administration of oxygen or other fluids to a patient through the nasal passages is invariably associated with a great deal of patient discomfort, if the patient is not unconscious or is not under heavy sedation. With a view to elimination of patient discomfort under such situations, there have been developed and used in recent years so-called nasal cannulae which in substance are flexible gas conducting tubes provided with openings or tubular extensions so arranged as to direct a flow of gas from the tube into the nasal passages of the patient. Illustrations and descriptions of such devices may, for example, be found in U.S. Patents 2,499,650, 2,693,800 and 2,735,432.
(3) The provision of nasal cannulae in which there is a pair of narine tubes adapted to extend back into the nasal passages of the patient which may be quickly and easily adjusted in length without having to cut the tubes because this invariably leaves a sharp edge on the end of the tube which can irritate the nasal passages of the patient.
(4) The provision of nasal cannulae which are so constructed that the narine pieces do not tilt outwardly when the cannula is positioned on the head of a patient, but which stay comfortably towards the back or center of the nostril passages, thus providing for improved patient comfort.
(5) The provision of nasal cannulae of such design that they can be made at high rates of speed and with a minimum of manual assembly operations, so that the cannulae may be produced at very low cost.
(6) The provision of new forms of nasal cannulae which may be worn in various ways by a patient, all of which will permit oxygen or other gases to be administered to the patient without any substantial irritation of the patients nostrils and without any great discomfort to the patient.
General description These objects are accomplished according to the preseut invention by constructing a nasal cannula to comprise a face contacting bridge member, a pair of adjustable length gas delivery nares-insertable tubular mem bers slidably carried in holes which extend through the bridge member, means for inhibiting sliding or other movement of the tubular members in the holes when the cannula is in use on a patient, separate tubular extensions on each of the tubular members, these extensions being long enough to pass from the bridge member to the back of the head of the patient, and connector means on the inlet ends of said extensions for connecting these ends to a single gas conveying tube. Preferably, the bridge member consists of a short arcuate section of extruded flexible tubing and the means for holding the tubular members stationary constitutes additional holes in the bridge member near the end thereof, through which the tubular member extensions pass. Furthermore, in the preferred forms of the new cannula, the naresinsertable tubular members and the tubular extensions thereon constitute integral sections of tubing.
The drawings The more complete understanding of the new forms of nasal cannulae provided by this invention may be obtained by reference to the accompanying drawings, in which:
Figure 1 is a side elevational view of one of the new nasal cannulae fitted upon a patients head.
Fig. 2 is a plan view, partly broken away, of one of the new nasal cannulae shown in Fig. 1.
Fig. 3 is an enlarged fragmentary exploded view of the connector means used to join the pair of narine tubes of the cannulae to a single gas delivery tube.
Fig. 4 is an enlarged fragmentary side view, partly in section, of one form of connection which may be used to join the pair of narine tubes of the cannulae to a single gas delivery tube.
Fig. 5 is an enlarged fragmentary elevational view, partly in section, showing a modified form of connec tion between the pair of narine tubes and the single gas delivery tube.
Fig. 6 is a fragmentary plan view of a modified form of bridge member used to hold the pair of narine tubes of the cannulae in a nares-insertable position.
Fig. 7 is an enlarged fragmentary end view of yet another modified form of bridge member for the new nasal cannulae.
Detailed description Referring in detail to the drawings, the nasal cannula 2 basically comprises a pair of narine tubes 4, means 6 for holding the outlet ends 8 of the narine tubes in tnares-insertable position, connector means 10 and a gas Q conveying tube 12. outwardly tapering section 14 on its inlet end which The gas conveying tube 12 has an enables this tube to hie-easily connected to a ribbed, maleend connector of a gas supply source.
In the form of the new nasalc'annula shown in Fig. 2,
- the narine tube' holding means 6 comprises a sectionof flexible tubing about 2 to inches in length, which has :a 'p'air of holes 18 slightly larger in opening than l the outside diameter of the narine tubes 4, spaced apart about /2 to inches, i.e., about an average internaris ldistance; extending through the flexible tubing 16 adjacent the'center thereof. There is also a second pair of similar size holes 20, located adjacent to the first pair of The fiexible tube 16 is provided with yet another pair of holes 22, one of the holes of this pair being located near the end 24, and the other hole of the pair being locatednear the other end 26 of the flexible tube 16. Furthermore, the pair of holes 22 are formed in the flexible tube 16 so that their longitudinal axis'runs perpene di'cular to the axis of the holes 18 and 2t]. 7
' As shown in Fig. 2, one of the narine tubes 4 is slidably inserted through oneof the pair of holes 18, "and the second narmine tube 4 is similarly inserted through the other pair of holes 18, with the outlet ends 8 of each of the narine tubes extending about /2 'to 1' inch beyond the tubing 16, forming a pair of adjustable I length gas-delivery nasal members 28.
The narine tubes 4 are provided'with extensions 30 so that the distance from the outlet ends 8 to' the inlet' "ends -32yare-at least about-a foot long for each of the separate tubes, i.e., long enough to permit. the tubes to extend around from the front to the back of the head pfia patient, as shown in Fig. 1. Extensions 30 on the narinetubes 4 could, of course, be separately formed sections of tubes cemented ,or otherwise joined to the 'nasal members 28, but, preferably as shown in Fig. 2, the narine tubes are formed of integral extruded sections of flexible tubing which extend without seams or' joints from the outlet ends 8 to the inlet ends 32.
As shown in Fig. 2, the section 34 of each narine tube which extends beyond the tubing 16 on the side opposite to the nasal members 28, bends around, in an arcuate section, so that each narine tube then extends through the most adjacent end positioned hole 22. The ,narine tubes .have suflicient resistance toward bending so that the relatively sharp backward bending of the tubes between the holes 18 and 22 create substantial frictional engagement between the outside walls of the tubes and the holes in the tubing 16. Consequently, the end holes 22 in the tubing 16 serve as means for retaining the narine tubes in a fixed position on the bridge member 6 and tolock the nasal members 28 at a set length.
' The bridge member 6 of the new nasals cannula may assume other forms than that shown in Fig.2. For example, as illustrated in Fig. 6, this bridge member may be formed from a section of flexible tubing 38 with a central portion 40 that has beenflattened, such as being pressed with a heated platen. This flattened section 49 causes'the tubing 38'to be less rigid towards its center a and enables the outside ends 42 and 44 of the tubing to bend back and forth more easily than where there is no flattened portion in the tube, such as with the bridge member 6 shown in Fig. 2. Consequently, a bridge member such as shown in Fig. 6 provided with a flat central section 40 can be used where it is desired to permit the bridge member to conform very easily and lay as flat as possibleagainst the face of a patient.
A further modification of the bridge member of Fig. 6 as compared with thatshown in Fig- Si e P QVision of a plurality of pairs of .holes '46 and 48 .in .the ends 42 and 44 of the tubing 38. As can be seen, the
pair of holes 46 have their longitudinal axis running perpendicular to the axis of the pair of holes 48. Such an arrangement enables the bending of the tubing in the arcuate sections 34 to be changed somewhat relative to the axis of extension of the nasal members 28, so that the'greatest degree of patient comfort can be obtained, particularly if the nasal cannula is to be installed upon the head of the patient with the narine tubes running back over the ears of the patient and around in front of the neck, rather than around to the back of the head as will be explained somewhat more fully hereinafter.
Still another form of bridge member'6 for the new nasal cannulae is shown in Fig. 7. This form of bridge member comprises a strip of flat plastic material 50 which is bent as shown in Fig. 7 to form'a U-shaped channel member 52. In other words, the channel member 52 formed of a flat plastic 50 can be used to replace the flexible tubing 16 or 38 of the forms of bridge members shown in Figs. 2 or 6. Of course, the various modified arrangements of holes and the like shown in Figs. 2 and 6 for the bridge members can be incorporated in the modified form of bridge member shown in Fig. 7.
The new nasal cannulae of this invention can be formed entirely of sections of extruded flexible tubing. This applies not only to the narine: tubes 4, bridge member 6, and gas connector tube 12, but'also to the connector means 10. The way in which this is accomplished is illustrated in Figs. 3 to 5.
Connector means 10 comprises a short section 54 of double channel tubing and one of the inlet ends 32 of the narine tubes is inserted into one of the channels of this section'54, while the other inlet end 32 of the other narine tube is inserted into the other channel of the section 54. This is diagrammatically shown in the exploded View of Fig. 3; in which the inlet ends 32 of the narine tubes, are shown just before being inserted into the section .54 of double channel tubing.
It is possible with modern plastic extrusion apparatus to maintain very close tolerances to dimensions of tubing.
' Hence, it is possible to form the lumen of the channels 32 of the narine tubes and the'exposed surfaces of the channels 56 in the double channel tubing section 54.
.This makes possible assembly of the connector 10 without use of cement. On the other hand, cement may be used to fix the ends 32 within the channels 56, if desired.
Figs. 4 and 5 illustrate two diflerent methods for uniting the combined tubing ends and double channel section to a single gas conveying tube 12. In Fig. 4, the upstream end 58 of the tubing section 54 abuts the outlet end 60 of the tubing 12, and this butting arrangement is encased in a short section of slightly larger diameter tubing 62. Here again, the various dimensions of the tubing sections 12, 54 and 62 can be controlled so that a fluid-tight, substantially permanent positioning of the tubing sections can be obtained without the use ofcement, particularly where tubing of the plasticized vinyl type, which possesses a certain, very'slight degree of surface tackiness, is employed in the formation of various tubing sections. On the other hand, if it is desired to form an absolutely permanent, immovable arrangement .between the tubing sections, cement or adhesive may be utilized between the outside walls of the tubing end 54 .and the inside-walls of the tubing section 62. Obviously,
into the tubing 12 by slightly expanding the outlet end of the tube 12. Since most of the forms of the flexible tubing which are used in the formation of these nasal cannulae possess a certain degree of inherent resiliency, this outward expansion of the outlet end of the tube 12 can be readily accomplished. Usually, there will be sufficient frictional engagement between the tubes 12 and 54 to create a fluid-tight connection therebetween with out the use of cement, but, here again, cement or adhesive may be employed to insure a permanent positioning of the tubing section 54 within the gas conveying tube 12.
Description of use The new nasal cannulae of this invention are not only simple and inexpensive to manufacture, but are also remarkably easy to use. Furthermore, in contrast to the prior known devices of this type, it is possible to adjust the length of the nasal pieces 28 by simple movement thereof, in contrast to a need to cut the nasal pieces of ,fixed length provided on prior known nasal cannulae.
Thus, in order to obtain an adjustment in length of the nasal pieces 28, they are simply moved in one direction or another through the holes 18 or the other holes in the bridge member 46, to which they are carried. This sliding of the tubes within the holes can be accomplished by the application of a small amount of pressure so that the length of the nasal pieces 28 can be adjusted without injuring the smooth outlet ends 8 of the pieces, or without adversely bending the tubes. n the other hand, there is suflicient frictional engagement between the tubes in the holes so that the nasal pieces 28, once their length is adjusted, will not move relative to the bridge member 6 while the nasal cannula is in use on a patient. This adjustable length feature is very useful and extremely simple, and, yet, no prior available nasal cannulae have included this desirable feature.
One method of positioning the nasal cannula on the head of a patient is shown in Fig. 1. In this method, extensions 30 of the narine tubes 4 extend across the side of the face over the ears and to the back of the head. A small ring 64 of gum rubber or plastic is slidably fitted around the pair of narine tubes, and this can be moved up on the tubing extensions 30 to hold the cannula rather tightly onto the head of the patient. There is enough frictional engagement between the retaining ring 64 and the tube extensions 30 so that it will remain on the tubes at whatever position it is placed.
The new nasal cannulae may also be positioned on the patient so that the tubing extensions 30 pass over the ears of the patient, around the ears, and then down under the chin. This method of application may be used in those cases where a patient remains permanently on his back, and it would be uncomfortable for the tubes to remain for long periods of time around the back of the patients head.
Conclusions New forms of nasal cannulae which are both easy and inexpensive to manufacture and simple to use have been described in the foregoing specification. These new products are so designed that they can be formed entirely of extruded sections of flexible tubing. Since such tubing can be formed at high rates of speed using standard extrusion equipment, it can be made from many readily available materials such as rubber, vinyl plastic such as vinyl chloride, vinyl acetate copolymers, plasticized vinyl chloride, polyethylene or other suitable flexible compositions. Hence, it is possible to produce the new forms of nasal cannulae at relatively less cost than related products which incorporate molded sections of plastic or the like made either by injection molding or dipping methods, or which include special assembled tubular sections which require time-consuming manual assembly to manufacture. Furthermore, these new cannulae eliminate the need for special ear pieces, similar to the temple pieces on eye glasses, which are used in some forms of prior known nasal cannulae to hold the nasal piece assembly in position on the patient. It would be possible to form the nasal cannulae of this invention with such ear pieces, which for example, might be fastened to the ends 24 and 26 of the bridge member 6, but such an arrangement is not recommended, because this necessarily results in an increased cost of the product, due to requirement for additional special elements and additional assembly steps.
The foregoing specification includes a detailed description of the invention and of the manner of making and using the same, along with a description of a complete embodiment of the new structures, and an explanation of the mode of operation and the best mode contemplated by the inventor for carrying out the invention, the scope of which is defined by the following claims.
1. A nasal cannula comprising a pair of narine tubes, means for holding the outlet ends of said tubes in a naresinsertable position comprising a longitudinally elongated bridge member, a plurality of spaced apart holes slightly larger in opening than the outside diameter of said narine tubes extending through said bridge member, said holes being located toward the center of said bridge member, one of said narine tubes being slidably inserted through one of said holes and the other narine tube being similarly inserted through a second of said holes, endwise means on said bridge member for holding a section of one of said narine tubes to said bridge member with an arcuate portion in said tube extending between said endwise means and the respective tube inserted hole outwardly of said bridge member, comparable means on said bridge member for similarly holding the second of said tubes and connector means connecting together the inlet ends of said narine tubes whereby said tubes may be operatively joined to a single gas conveying tube.
2. A cannula as claimed in claim 1 wherein said bridge member is a section of flexible tubing.
3. A cannula as claimed in claim 1 wherein said endwise means are holes slightly larger in opening than the outside diameter of said narine tubes.
4. A cannula as claimed in claim 1 wherein said bridge member is a longitudinally folded strip of flexible plastic material.
5. A cannula as claimed in claim 1 wherein said connector means comprises a short section of double-channel tubing, the inlet end of one of said narine tubes being inserted into one of the channels of said tubing and the inlet end of the other narine tube being inserted into the other channel of said tubing.
6. A cannula as claimed in claim 5 wherein the inlet end of said section of double-channel tubing abuts the outlet end of a gas conveying tube and there is a short section of single channel tubing tightly enclosing the resulting butt joint and extending a short distance on either side of said joint forming a fluid-tight connection between said double-channel tubing and said conveying tube.
7. A nasal cannula comprising a pair of narine tubes each at least about a foot in length, means for holding the outlet ends of said tubes in a nares-insertable position comprising a section of flexible tubing about two to five inches in length, a first pair of holes slightly larger in opening than the outside diameter of said narine tubes spaced apart an average internaris distance extending through said flexible tubing adjacent the center thereof, a second pair of similar size holes extending through said tubing, one of said second pair holes being located near one end of said tubing and the other second pair hole being located near the other end of said tubing, one of said narine tubes being slidably inserted through one of each of said first and second pair holes and the second of said narine tubes being similarly inserted through the other of each of said first and second pair holes with the outlet end of each narine tube extending between about one-half to one inch beyond said tubing forming a pair of adjustable length gas-delivery nasal members, the sechole of said second pair, and connector means on the inlet end of said narine tubes for connecting said tubes to a single 'gas'conveying tube.
8. A nasal cannula comprising a pair of marine, tubes each at least about a foot in length, means for holding theoutlet ends of said tubes in a nares-insertable position comprising a section of flexible tubing about two to five inches in length, a first pair of holes slightly larger in opening than the outside diameter of said narine tubes Spaced apart an average internaris distance extending through said flexible tubing adjacent the center thereof, a second pair of similar size holes extending through said tubing, one of said; secondupair holes being located near one end of said tubing and the other second pair hole being located near the otherend of said tubing, one of said narine tubes being slidably inserted through one of each of said first and second pair holes and the second of said narine tubes being similarly inserted through the other of each of said first and second pair holes with the outlet end of "each narine tube extending between about one-half to one inch beyond said tubing forming a pair of adjustable length gas-delivery nasal members, the sec- 25 tion of each narine tube which extends beyond the opposite side of said tubing being bent backward with the v narin'e tube thence extending through the most adjacent hole of said second pair, a short section of double-channel tubing fixed upon the inlet ends of said narine tubes with the inlet end of said tubes being inserted into the outlet tubes for connecting said in addition to said first and second pairs' of holes, said additional holes permitting the internaris distance of said nasal members to be adjustedto meet individual patient requirements.
10. A nasal cannula formed entirely of sections of extruded flexible tubing comprising a short arcuate section of tubing, a pair of narine tubes, each of .said narine tubes slidably extending twice through said'tubingsection forming arcuate portions thereof on oneside of said tubing section, and a pair of adjustable length gas-delivery nasal members on the opposite side of the tubing section and connector means on the inlet ends of said narine tubes toatsingle gas conveying tube.
References Cited in the file of this patent UNITED STATES PATENTS v 1,129,583 Miller Feb. 23, 1915 2,245,969 Francisco June 17, 1 941 2,590,006 Gordon Mar. 18, 1952 FOREIGN PATENTS 618,570 Great Britain Feb. 23, 1949