US 3175557 A
Description (OCR text may contain errors)
March 30, 1965 D. o. HAMMOND 3,175,557
TRACK- EAL CANNULA Filed May 17, 1963 'VOCAL CORD -TRACHEA DANIEL O. HAMMOND BY J M M ATTORNEY United States Patent 3,175,557 TRACHEAL CANNULA Daniel 0. Hammond, 5901 N. Bayshore Drive, Miami, Fla. Filed May 17, 1963, Ser. No. 281,132 8 Claims. (Cl. 128-351) This invention relates to a cannula for aspirating the upper portion of the respiratory tract of newly born infants, particularly with a view to removing mucus and resuscitating a newly born baby in the delivery room.
When a newly born infant is delivered and is found to have diiliculty in breathing due to a congestion in the respiratory tract, prior to the present invention it has been customary in the delivery room to use long thin catheters approximately 10 to 12 inches in length, having a relatively small bore, to suck out mucus from the infants upper respiratory system. The catheters used are usually rather firm and have very limited flexibility. In addition they are extremely difiicult to clean once they have been used, especially after any portion of the mucus has hardened in the bore of the catheter.
One object of this invention is to provide a means for intubating the upper respiratory tract and for permitting the passage of large volumes of fluids, gases and liquids, rapidly and safely into or out of the respiratory tract.
Another object of the invention is to provide a disposable plastic cannula for intubating the upper respiratory tract of infants.
Still another object is to provide a cannula having means to permit the administration of oxygen through the cannula if the need for same arises.
A further object is to provide a cannula for intubating the upper respiratory tract of infants which has a built-in safety feature for automatically limiting the amount of pressure applied to the respiratory system during resuscitation of infants.
These and other objects are achieved in accordance with the present invention which will be more fully understood from the description which follows, taken in connection with the accompanying drawings, in which:
FIGURE 1 is a more or less diagrammatic representation of the invention as assembled and positioned in treating an infant;
FIGURE 2 is an enlarged side view of a portion of the device, partly in section, looking toward plane 2-2 of FIGURE 3;
FIGURE 3 is a top view of the device of FIG. 2; and
FIGURE 4 is a view taken on plane 4-4 of FIG- URE 2.
As best shown in FIGURE 2, the cannula comprises three main components, namely, a mucus trap 30 between a first lumen 19, and a second lumen 40. The first of these components is a tube 10 adapted to be inserted through the infants mouth and thence into the upper respiratory tract. Tube 10 consists of a tip portion 12 approximately 4 centimeters or 1.6 inches long, this length being approximately 80% of the average length of the trachea in normal new born infants. The average length of the trachea of normal new born infants in about centimeters. In premature deliveries, the infant is somewhat smaller and the usual length of the trachea is approximately 4.2 or 4.3 centimeters. The tip section 12 extends to a shoulder 14 and is preferably about 4 mm, or a No. 12 French in external diameter. Sinpe the entire tube is a thin walled tube, having walls of about 0.5 in thickness, the bore is then about 3 mm. internal diameter,
At shoulder 14 the tube 10 enlarges to approximately twice the diameter of the diameter of the tip section. Shoulder 14 is designed so that when it has been inserted 4 3,175,557 lcfi Patented Mar. 30, 1965 to the desired extent, shoulder 14 will rest against the trachea in the region of the vocal cords, as is the practice when using the Cole tube, presently commercially available for intubation of the upper respiratory tract of young children for administration of an anesthetic.
Shoulder 14 represents a tamponade which enables the vocal cords to be effectively obstructed by the tube in order to facilitate aspiration of the lower portion of the trachea. In addition, this shoulder makes it substantially impossible to penetrate the trachea to such an extent that the trachea could be ruptured by the extreme end of the tube 1.0. In other words, shoulder 14 acts as a safeguard to prevent too deep a penetration of the trachea.
At 16 in FIGURE 2 there is an elbow section in the tube 10 in order that the tube conform more closely to the normal structures that are present in the infant at the time of intubation. Elbow 16 is located near the midpoint of tube 10, so as to comprise a smoothly curved portion connecting relatively straight sections 18 and 20 to one another, sections 18 and 20, and elbow 16 defining the main section of tube 10. Branching from straight section 20 is a short side arm 22. Preferably, side arm 22 extends for about 1 cm. in an outward direction and has an internal diameter of about 4 mm. Side arm 22 is covered at its outermost end with a thin membrane 25 which can be readily ruptured with the point of a scissors or other sharp pointed instrument.
Tube 16 terminates in a bent converging section 26 which is tightly fitted into the lower wall 28 of a receptacle 36 which serves as a mucus trap. As seen in the drawings, section 26 extends upwardly and terminates in a sidewardly open tip 32. Although a specific trap construction is shown herein, it will be appreciated that other forms of traps can be utilized, such traps being generally well known.
Tube 49 is of a diameter which is substantially the same as that of tube 10 and includes two straight portions 42 and 46 joined by a short curved section 44. Portion 42 may terminate at the wall of trap 30 or it may be provided with an extension 34 extending upwardly from its open tip 36 through the upper wall 38 of the vessel 30, in the same manner as extension 26. Section 46 preferably terminates in a flattened or somewhat fishtail shape tip 48 which forms a mouthpiece so that suction can be easily applied from the mouth of the person aspirating the mucus from the infant.
It is believed that the method of using the device will be evident from the above, but in order that the same be clearly understood, the following description is appended. First a laryngoscope 50 is inserted through the mouth of the newly delivered infant, to expose the opening to the trachea. Then the tip end 12 of the device of the present invention is inserted into the mouth and passed on down past the epiglottis into the trachea. Shoulder 14 of the device arrests any further insertion of the tip once the shoulder comes into contact with the trachea in the area of the vocal cords. Suction is then applied to tip 43 and mucus present in the respiratory tract is passed up along and through tube 1% and into trap 39.
During resuscitation, it is necessary to introduce air into the respiratory system. Too aggressive insufiilation could very easily cause rupture of the lung. The membrane 25 acts as a safety device in that it is so constructed as to rupture when the pressure thereon exceeds a predetermined pressure such as, for example, about 14 mm. of mercury. Therefore, when the air pressure exceeds 14 mm. of mercury, the membrane 25 automatically ruptures to release the pressure. If it is found necessary or desirable to administer oxygen to the infant, membrane 25 is punctured and a hose connected to a tank of oxygen is slipped over side arm 22. It will be noted that this is accomplished without withdrawing the cannula, and
If aspiration is to continue, the opening in the side arm 7 22 can be closed by finger. pressure. Referring again to bend 16 in tubeld, this bend assists in inserting the cannula into the thorax, and also allows easy visualization of the vocal cords past the shoulder 14. Without the bend, the shoulder 14 frequently would obstruct vision of the narrower tip 12. f
In the described embodiment, the tube ltlhas a side arm 22. It is apparent that a cannula according to the present invention can be 'rn'adewithout the side arm (not shown) with the resultant elimination of the safety fea ture and the means for introducing oxygen during resuscitation. However,'according to the preferred and most advantageous structure, the side arm is included.
FIGURES 2 and 3, although enlarged as compared to FIGURE 1, show the cannula of the present invention substantially to scale. In the illustrated embodiment, the height of the trap 30, Le, the distance between walls 28 and 38 is about 3 cm., the vertical distance from Wall 38 to the upper extremity of tip 48 is about 6 cm. and the vertical distance from wall 28 to shoulder 14 is about 8% cm. The side arm 22 extends about 1 cm. from tube 10. v
In the illustrated embodiment, the tube 10 is shown as being formed of two generally straight sections 18 and 20 joined by a curved or elbow portion 16. The tube 10 can also be fashioned to form a continuous curve (not shown), although the upper portion 20 can be straight with the lower portion 18 defining a continuous curve with elbow 16 (not shown). Ina-ll of these variations, tube 10 can be described as an angled tube. esirably, the angle defined by the tube is about 140.
.Tube 10 can be made of any desirable plastic, and because of the thinness of the walls thereof, the tube is some- What flexible, thereby minimizing the danger of breakage in the infant and also the danger of injuring the infant. The trap and the tube can be made of any desirable materials such as glass or plastic, but is most preferably made of plastic so that the cannula can be made as a unitary plastic article-which need be used only once, and is, therefore, disposable.
Itwill be apparent that/the aspirating device is susceptible of considerable modification without departing front the inventive concept and hence having described what is regarded as .a preferred embodiment of my invent-ion in accordance withthe patent statutes, his not intended that it be limited except as required by the appended claims.
I claim: I
1. A cannula for aspirating the upper portion of the respiratory tract of an infant comprising a first tube adapted to be inserted into the trachea, a'second tube, and a mucus trap interconnecting said tubes, one of said tubes having a tubular side arm joined thereto for introducing fluid'into the cannula, said side arm being closed by a rupturable membrane. r p
2. A cannula for aspirating the upper portion of the respiratory tract of an infant comprising a first tube r r i Y fluid into the cannula, said first tube comprising a main. section and a tip portion of lesser diameter secured thereto, said main section merging into said tip portion so that said main section and tip portion form a continuous tubev having a continuous bore, the intersection of said main. section and said tip portion defining a shoulder for limit-- ing insertion of said cannula into the trachea, the end of .said main section remote from said tip portion being se-- cured to said mucus trap. V
3. A cannula according to claim'2, wherein said main :section is angled.
4. A cannula according to claim 3,. whereby said side;
arm is connected to said main section of said first tube.
5. A cannula according to claim 4, wherein said side;
arm is closed by a rupturable membrane.
6. A cannula according to claim 1 wherein said membrane is constructed so as to rupture when the pressure thereon exceeds a predetermined pressure.
7. A cannula according to claim 1, Whereinsaid tubes and trap are integral with each other and are made of plastic to provide a disposable cannula.
i 8. A disposable cannula for aspirating the upper por- 'tion of a respiratory tract of an infant, comprising a first angled tube adapted to be inserted into the trachea, a second tube, and a mucus .trap interconnecting said tubes, said first tube comprising a main section and a tip portion of lesser diameter secured thereto, said main section merging into said tip portion so that said main section and tip portion form a continuous tube having a continu ous bore. the intersection. of. said main section and said tip portion defining a shoulder for limiting insertion of References Cited by theExaminer hUNITED STATES PATENTS 2,575,513 11/51 Fox 128---277 3,017,880 1/62 Brook 12829 3,050,062 8/62 Ulmer 128-276 3,060,927 10/62. Gattone 12829 3,066,672 12/62 Crosby et a1. 128-276 OTHER REFERENCES I.A.M.A., Resuscitation of the Asphyxiated Newborn Infant, 'vol. 152, No. 3, pp. 216221, May 16, 1953.
J.A.M.A. Method and Machine for Resuscitator of the Newborn, vol. 152, No". 14, pp. 1333-1335, Aug. 1, 1953. i
The Lancet, A Mucus Extractor for Babies p. 701, Oct. 6, 1 962.
RICHARD A. GAUDET, Primary Examiner.