US 3182663 A
Description (OCR text may contain errors)
May 11, 1965 L. ABELSON cmcowmmowom NEEDLE 2 Sheets-Sheet 1 Filed March 8, 19a;
UPPER JAW Low ER TONGUE JAW EPIGLOTTIS CRICOTHYROTOMY THYROID 4 CARTILAGE ESOPHAGUS TRACHEA INVENTOR. Louis Abglson BY M ATTORNEYS a 11, 1965 L. ABELSQN 3,182,663
CRICOTHYROTOMY NEEDLE Filed March 8. 1961 2 Sheets-Sheet 2 INVENTOR. Louis Abelson ATTORNEYS United States Patent 3,182,663 CRICOTHYROTOMY NEEDLE Louis Abelson, 585 McLean Ave., Yonkers, N.Y.
Filed Mar. 8, 1961, Ser. No. 94,287 2 Claims. (Cl. 128305) This invention relates to a cricothyrotomy needle.
Among the objects of the invention is to provide a cricothyrotomy needle of simple construction so that it can be easily carried in a doctors pocket or case or is readily fitted into emergency kits but which, nevertheless, is effective so that, in emergency situations, no additional apparatus is required to utilize the device in acute obstruction of the larynx. i
The objects of the invention are attained by providing a curved tube fitted with a stilette having a handle at one end, shaft that fits within the tube which is pointed at the opposite end and of such a length that the point is adapted to extend beyond that end of the tube which is to extend inside the trachea when the handle is against the outer end thereof. The tube is provided with means adapted to show when the tissue above the cricoid has been penetrated and with a flange which is adapted to rest on the neck of the patient when the needle is in place. The flange is provided with means adapted to indicate the direction the curved end of tube takes when within the trachea.
The outer end of the tube is provided with lock fitting which can be attached to a tubing. The tubing is provided with an adapter adapted to fit any of the oxygen or anesthesia machines so that if such machines are available they may be used for inflating the lungs. The lungs may also be artificially inflated by blowing directly through the adapter if a machine is not readily available.
In the drawing,
FIG. 1 is a cross sectional view of the assembled needle of the invention.
FIG. 2 is an exploded view of the cricothyrotomy needle together with the tracheotomy tubing.
FIG. 3 is an end view of the tube of the needle with the stilette removed.
FIG. 4 is a view in cross section illustrating the position of the tube in a patient.
FIG. 5 is a detail view of the adapter means at the end of the adapter tubing.
As indicated in the exploded view of FIG. 2, the device of the invention comprises the stilette 10, the curved tube 22 and preferably the adapter tubing 30. The stilette comprises a curved needle-like prong 11 which is sharply pointed at one end 12 and comprises an enlarged handle or knob 13. Adjacent to thearea where prong 11 joins the handle 13, the prong 11 includes an enlarged portion 14 adapted to provide a fairly tight fit in the tube connection 26. The intermediate shaft portion of the stilette 10 is of smaller diameter than the internal diameter of curved tube 22 except that in the region 15 just back of the point 12 the shaft is enlarged to provide for a tight fit against the rim 21 of the tube so that the stilette fits in the tube to provide a structure which is substantially unitary in appearance and operation until the stilette is removed from the tube. If desired, the rim 21 may project inwardly somewhat and is beveled inwardly.
The hollow-needle part 20 comprises a curved tube 22 with an internal passage which is slightly greater in diameterthan the diameter of the intermediate portion of the shaft 11 of stilette 10. As stated above, the end rim 21 of tube 20 is beveled and, if desired, swaged inwardly toward the stilette end 15. Approximately P /2" from the rim 21 is a ring marking 23 about the tube 20. This ring marking 23 is not deeply cut into the tube but must be clearly identifiable thereon. Approximately 2" along ice the curved linear path back from the rim 21 of tube 20, a disk-like flange 24 is positioned. The flange 24 is fixed on the tube 20 in any desirable way and is approximately at right angles to the axis of the tube 22 at the point where it is attached to said tube. At least one radial portion of the disk 24 contains a characteristic mark such as the notch 25 shown in FIG. 3. The mark 25 can be a notch as shown, or any other shape of notch or a marking on that side of disk 24 which faces the handle 13 may be provided. The unique function of the ring 23, the disk 24 and the mark 25 will be described below in connection with the use of the device. Preferably, however, the notch 25 appears on the disk 24 at a point which is exactly opposite the projection of tube rim 21 (see FIG. 3). The diameter of the passage of the tubular element may be varied from about 1.5-4 mm., or more, for example. A very satisfactory radius of curvature for the stilette and tubular shaft is around 2". The curved portion covers approximately a quadrant of a circle from the rim 21 to the flange 24.
Back of the disk 24, the needle part 20 is provided with a portion 26 adapted to receive a conventional tubing adapter for connecting to an anesthesia machine, for example. A vent 37 is provided in the side of adapter 31 to regulate the amount of oxygen forced into the lungs of the patient.
As shown in FIG. 2, the conventional adapter 31 fits onto portion 26. Connected to the adapter is a tube 32 and a second adapter 33. The second adapter which is not a conventional one is shown in detail in FIG. 3. This adapter 33 includes relatively small tube portion 34 at one end, which fits onto tube 32, and a second, similar tube portion 35 at the open end. Between the two smaller tube portions 34 and 35 is the enlarged hollow frustoconical portion 36 which converges toward the tube portion 35. As shown in FIG. 5, the smaller tube end 35 is adapted to fit onto a tube 40 of the size ordinarily found with anesthesia machines used by dentists whereas the frustoconical portion of the adapter 33 is adapted to fit tightly with the tubing 41 of larger anesthesia machines.
The needle 20 with the stilette 10 in place, as shown in FIG. 1 may be carried in a small case in the pocket or kit of a doctor or first aid administrator. If a patient is in danger of asphyxiating due to some acute obstruction of the larynx, the doctor palpates the thyroid cartilage (Adams apple) between the second finger and the thumb, the first finger then locates the interval between the thyroid and cricoid cartilages. The needle with the stilette is place in inserted in this interval for a depth up to the marker 23 /2 inch) whereupon the stilette is removed. The needle is then forced inwardly with the notch 25 of disk 24 upwardly towards the chin of the patient (as shown in FIG. 4). When the disk 24 rests against the skin of the patients neck and the notch 25 upwardly, the disk may be taped to the neck. If the insertion of the needle itself does notstimulate respiration (as it very often does), oxygen may be artificially supplied through the adapter 26, fitting 31, tube 32, etc. Oxygen may be supplied from an anesthesia machine by means of adapter 33 (FIG. 5) or by blowing into adapter 33.
The marking 23 permits the physician to inject the needle the correct distance before removing the stilette 10. The removal of the stilette 10 just as soon as the necessary portion of the flesh is punctured prevents any injury to the trachea. The disk 24 and the notch thereon provide an indicator for preventing any dislocation of the tube or any necessity of probing with the tube 20 or its rim 21 after it has been introduced into the trachea.
The features and principles underlying the invention de- '3 scribed above in connection with specific examplifications will suggest to those skilled in the art many other modifications thereof. It is accordingly desired that the appended claims shall not be limited to any specific feature or details thereof.
1. In a cricothyrotomy needle a curved tubular part adapted to extend into the trachea of a patient and a unitary stilette part removably inserted in said tubular part said stilette part comprising a main shaft portion with an arcuate axis approximately equal in length to a quadrant of a circle having a radius of curvature of approximately 2 inches, said shaft having an enlarged integral forward end terminating in a sharp point and handle means at the opposite end,
said tubular part coaxially surrounding the shaft of said stilette,
the axis of said tubular part having a curvature substantially identical with that of said stilette part and a length such that the point of the stilette projects from the forward end of the tubular part with the handle of the stilette resting against the second end thereof,
the forward end of said tubular part comprising an inwardly bevelled rim having an internal diameter which tightly fits said enlarged forward end of the shaft of the stilette,
said tubular part comprising permanent slightly indented marking means extending around the same approximately /2 inch from said rim,
flange means surrounding the tubular part in a plane substantially at right angles to the axis of the tubular part, said plane intersecting the axis of said tubular part at a point distance from said rim by a length approximately equal to the length of said quadrant, notch means on said flange means to indicate the position of said tubular part in the trachea of a patient. 2. The cricothyrotomy needle as claimed in claim 1 wherein the second end of the tubular part comprises coupling means for an oxygen supplying device.
References Cited by the Examiner UNITED STATES PATENTS 300,285 6/84 Russell 128-305 1,740,174 12/29 I-Ievern 128347 1,902,418 3/33 Pilgrim 128-350 2,873,742 2/59 Shelden 128351 2,889,089 6/59 Herrick 285260 2,922,420 1/ Cheng 128-221 3,030,953 4/62 Koehn 128214 FOREIGN PATENTS 529,404 11/40 Great Britain.
OTHER REFERENCES American Cystoscope Maker-s Inc., Catalogue title Catheters, Drains, Bougies and Accessories, copyright 1938.
RICHARD A. GAUDET, Primary Examiner.
JORDAN FRANKLIN, Examiner.