US 3441020 A
Abstract available in
Claims available in
Description (OCR text may contain errors)
April 29, 1969 E. c. WORTZ ET'AL 3,
CONTINUOUS FLOW INHALATOR MASK WITH OBTURATOR MEANS sheet ors Filed May 2, 1966 (fa 420 C. #46272 /V 5. 4455/1/ INVENTORS.
April 29, 1969' c W TZ ET Al. 3,441,020
CONTINUOUS FLOW INHALATOR MASK WITH OBTURATOR MEANS Filed May 2, i966 April 29, 1969 c, wo Tz ET AL 3,441,02
CONTINUOUS FLOW INHALATOR MASK WITH OBTURATOR MEANS Filed May 2. 1966 Sheet of s fi Q I 50 INVENTORS.
flwi 11m United States Patent O 3,441,020 CONTINUOUS FLOW INHALATOR MASK WITH OBTURATOR MEANS Edward C. Wortz, Northridge, and Leiv B. Aasen, Palos Verdes Peninsula, Calif, assignors to The Garrett Corporation, Los Angeles, Calif., a corporation of California Filed May 2, 1966, Ser. No. 546,692 Int. Cl. A62! 7/00; A61m 17/00, /00 US. Cl. 128-1453 5 Claims ABSTRACT OF THE DISCLOSURE A closed circuit anethesia apparatus has a mixing plenum to insert anesthetic gas into the circuit, and has a mask with gas inlet and outlet passageways. The mask outlet passageway has an obturator for hand manipulatable restriction of the gas flow in the circuit to increase gas pressure in the mask at desired intervals in the breathing cycle.
This invention relates in general to breathing devices for living organisms, and particularly relates to those devices comprised of a mask to be utilized in connection with apparatus, and a method of employing the apparatus in anesthesia procedures.
In anesthesia masks of the prior art there has usually been provided a nipple or fitting for the attachment thereto of a flexible hose which conveys the breathing or anesthesia gas to the mask for administration to the patient. The mask is usually disposed over the mouth and nose of the patient who thereupon is forced to inhale the gas being administered. The mask or the hose is usually provided with a check valve which is forced open when the patient exhales to exhaust the exhalation gaseous and microorganism products.
It is to be noted that in normal breathing without such a mask, the exhalation products are forcibly expired away from the nose and mouth, to be replaced by fresh air for the inhalation. Such is not the case with masks of the prior art since there is a space between the nose and the exhaust check valve, which is confined by the walls of the mask, and possibly a short length of the hose. This space constitutes a dead space containing exhalation products which will be re-inhaled by the patient with the next intake of breath. This space may comprise upwardly of /2 to 1 liter, and since a resting patient will inhale about 4 to 5 liters per minute it is seen that the rebreathing, or pendulum breathing, as it has come to be known, of exhalation products is a matter of some concern.
It is a general object of the present invention to provide a mask and apparatus of such structure and function that the exhalation products are ducted away from the mask and continuously replaced by fresh breathing gas, such that pendulum breathing is reduced to an infinitesimal minimum. To that end, the present invention contemplates a mask provided with an inlet duct for admitting inhalation gas continuously thereto, and an exhaust duct for the continuous egress of the exhalation products as well as that portion of the inhalation gas not taken up by the organism during the continuous flow thereof.
It is a particular object to provide a mask as aforesaid with edge and medial portions, and with means disposed ice around the edge portion defining a passageway communicating with one of the ducts and a further passageway defined by the medial portion which communicates with the other of the ducts, the edge portion means being provided with a plurality of inwardly directed orifices.
In a preferred arrangement the inlet duct communicates through the passageway disposed adjacent the edge portion and the exhaust duct communicates with the passageway through the medial portion. This is particularly eflicacious in that it has not been generally recognized that the nose and lips cause the existence of dead space pockets in the mask where exhalation products tend to collect. Hence the inhalation gas through the orifice adjacent the edge portion sweeps over the facial features and provides assurance that no exhalation products Will stagnate therein to be rebreathed.
Further, in the preferred mask the configuration is of probosciform having an exhaust duct provided with an obturator by way of a manipulatable restriction for a purpose to be described in detail hereinafter. Preferably, the mask of this invention is constructed of a semi-rigid light material, for example, a plastic, which retains its general configuration when pressed by hand over the nose and mouth of the patient. The medial portion may be of fairly thick section, say 3 to 5 mm., which tapers off to a convoluted or inwardly curled edge portion having a section of say 0.5 mm. The inwardly curled edge portion will have some flexibility which permits it to adapt to the variations of the bony structure of the face over which the mask is disposed, thus sealing olf communication from the interior of the mask to the exterior except through the ducts.
It is a further object of the invention to provide apparatus for use in connection with the mask, the apparatus being arranged for the continuous supply of inhalation gas, the pressure of which may vary from a normal breathing pressure of say 0.5 inch of water, when there is little or no restriction to the flow, upwardly or about 10 inches of water when the aforesaid obturator in the exhaust duct from the mask is deliberately manipulated. A particular feature of the invention is the arrangement of the mask and apparatus in a substantially closed cycle system with provision for (a) extracting unwanted exhalation products from the exhaust gas, and (b) injecting a makeup supply of fresh inhalation gas. With such a system there is no requirement for check valves, inflatable gas reservoir bags, reciprocating pumps, or other complicated mechanical devices.
-A feature of the apparatus of the invention is a small air-turbine-driven fan in the closed gas loop, whereby the pressure of the gas continuously pumped thereby may be increased in the mask by manipulation of the aforesaid obturator in the exhaust duct of the mask. Thus, if a patient should stop breathing during a surgical procedure, the anesthetist could switch the makeup supply gas from anesthetic gas to an oxygen supply bottle by manipulation of valves with one hand and then institute pressurized breathing by manipulation of the obturator with the other hand to restore normal breathing.
It is, therefore, a general object of the invention to provide a new method of anesthesia technique for use in emergency procedures in the operating room.
With the advancement of the foregoing discussion on general and particular aspects of the invention, and consideration of other and further objects which are or will become apparent, reference is made to the following description set forth in connection with the drawings, in which:
FIG. 1 is a fragmentary and schematic illustration of an operating room procedure, showing the invention in use;
FIG. 2 is a perspective view, partly schematic and with part broken away, showing the apparatus of the invention;
FIG. 3 is a view taken on line 3-3 of FIG. 2, showing a cross section of the air turbine and fan used for continuous circulation;
FIG. 4 is a head-on illustration of the novel breathing mask in use;
FIG. 5 is a side view illustrating the use of the mask, portions of which are shown in section;
FIG. 6 is a fragmentary view of a portion of the mask shown in FIG. 5 with the obturator being manipulated;
FIG. 7 is a fragmentary cross section view of a portion of the mask, taken on the line 7--7 of FIG. 4; and
FIG. 8 is a fragmentary cross section view of another portion of the mask, taken on the line 8-8 of FIG. 4.
Referring to the drawings, by way of illustration only, and not with intent to limit the mask and apparatus of the invention to anesthesia procedures, there is illustrated in FIG. 1 a portion of an operating theater with an anesthetist 10 in attendance to a surgical patient 12 disposed on an operating table 14. The subject of the attention of the anesthetist is the breathing apparatus 16 being employed in connection with the patient. Apparatus 16 comprises a cabinet 18 having a communication with a mask 20 by way of a hose assembly 22.
Cabinet 18, as schematically illustrated in FIG. 2, contains a plurality of gas bottles 24 communicating by way of conduits 26 with the mixing and dispensing chamber of a first plenum 28, only one of the conduits being shown complete, for the sake of clarity, with a pressure regulating valve 30, a pressure gage 32, a flow regulating valve 34 and a flow meter 36. It will be understood that each of the conduits 26 is likewise complete, the disposition of valves, gages and meters for all the conduits being suitably arrayed on a sloping panel in the cabinet 18, as shown in FIG. 1, so as to be immediately at hand for the convenience of observation and manipulation as required by the anesthetist in the performance of his service. The bottles 24 may contain a variety of breathing gases as required by the anesthetist. One of the bottles may have oxygen and the others may contain cyclopropane, for example.
It will be observed that since all the bottles communicate with the plenum 28 by way of the pressure regulating and flow valves and the flow meters, the anesthetist is enabled to manipulate the valves for any desired flow of gases into the chamber of the plenum and subsequent mixture therein.
Communicating with an outlet port (not shown) of plenum 28 is the intake side of a pump 40. As shown in somewhat more detail in FIG. 3, the pump 40 is preferably of the type employing an air driven turbine 42 which is supplied with compressed air from any convenient source (not shown) through the turbine inlet fitting 44, the air thereafter exhausting to atmosphere through the exhaust fitting 46. The turbine drives a fan 48 which provides positive movement of breathing gas from the plenum 28 through a Y-shaped hose adapter 50 to the mask 20 by way of a pair of hoses 52 which form a portion of the aforesaid hose assembly 22. Fan and turbine arrangements of the type shown are well known in the art and require no exhaustive explanation by way of tedious detail.
The hose pair 52 communicates with the interior of the mask 20, as does a larger exhaust gas hose 54 at one end thereof, the other end being received by a nipple fitting (not shown) at the inlet to a first chamber 56 of the second plenum 58.
The plenum 58 provides a second chamber 60 divided by a partition wall 62 from the first chamber 56, the chambers communicating by way of a port 64 in the partition 62. Plenum 58 also provides a third chamber 66 communicating with the second chamber 60 through a port 68 in a dividing partition wall 70. The plenum 58 is provided with a fiuid tight cover 72 which is removable for the placement of filter and/or coalescent elements within the chambers 56, 60 and 66. Thus, the chambers 56 and 66 are available to receive elements which will remove water and carbon dioxide from the breathing gas entering the plenum 58 from the hose 54.
The arrangement of parts as above noted is for the case of disposition of the cabinet 18 to the right side of the patient and anesthetist. Disposition of the cabinet to the left side under circumstances necessitating the same are provided for by way of means to connect the hose assembly 22 to the opposite ends of the adapter 50 and plenum 58. It will be observed that the adapter 50 has outlet fittings 51 and 53, to either of which the hose pair 52 may be connected. When the hOSe pair 52 is connected to the fitting 51, as shown, the outlet nipples of the fitting 53 are suitably capped, and vice versa.
Similarly, the plenum 58 has nipple fittings at each end thereof, providing communication for the hose 54 with either the first chamber 56 or the third chamber 66. As described above, the hose 54 is connected to a nipple fitting (not shown) while the nipple fitting communicating with the chamber 66 is provided with a cap 67 to prevent loss of breathing fluid therethrough. When the hose assembly is to be disposed on the right side of the cabinet, the cap 67 is removed from the nipple fitting and secured to the nipple fitting which communicates with chamber 56, after which the hose 54 may be attached to the nipple fitting which communicates with chamber 66.
Breathing gas flowing from the hose 54 first enters the chamber 56, or chamber 66, as the case may be, for the removal of the water and water vapor in the gas, after which the gas fiows through the port 64 into the chamber 60 for the removal of carbon dioxide, the gas thereafter flowing through a short conduit 74 into the plenum 28 where the purified gas mixes with a fresh supply of breathing gas from the bottles 24 and is thereafter recirculated to the mask 20 through the hoses 52 by the pumps '50. The filter elements in chambers 56 and 60 may also be effective for removing microorganisms and traces of toxic gases.
The aforesaid closed circuit for the breathing gas, comprising the plenum 28, pump 50, hoses 52, mask 20, hose 54, plenum 58 is a preferred arrangement since it provides for conservation of the breathing gas furnished by the bottles 24 as makeup to the plenum 28. With this arrangement, no expired breathing gas is wasted by venting it to atmosphere as is the case with prior practice. Furthermore, it should be noted that some of the expired breathing gases employed in anesthesia procedures form lightly explosive mixtures with air, hence constitute a fearful hazard when vented to the ambient air unless adequate provisions are made for ventilation of the operation theater.
The structure of the mask 20 forms an important feature of this invention. To this end it is configured generally in probosciform having a medial portion merging with an edge portion 82, as best seen in FIGS. 4 and 5. As seen in FIG. 7, the edge portion thins out in section and is convoluted or curled inwardly to partially enclose a passageway-defining tube 84 which is continuous around said edge portion 82. A pair of nipples 86 depend outwardly from the edge portion and provide communication between the passageway in the tube 84 and the hoses 52 attached to the nipples 86. The gas admitted from the hoses 52 to the passageway in the tube 84 exits through a plurality of uniformly distributed orifices 88 which direct gas across the immediate facial areas of the patient upon whom the mask is disposed.
The medial portion '80 merges gradually into a substantially circular terminal portion 90 over which the end of the hose 54 is disposed. Intermediate the terminal 90 and the edge portion 82 is an obturator 92, preferably comprised of a thin resilient membrane of generally circular configuration having an outer edge portion 94 cemented or otherwise bonded to the interior of the mask 20 and a raised button-like portion 96 at its center arranged to be disposed in a hole 98 in the terminal portion 90 of the mask. As illustrated in FIG. 6, the obturator is adapted to the application of finger pressure to restrict the passage of gas in the terminal portion 90, as will be pointed out hereinafter.
The hose 54 and the pair of hoses 52 are preferably sheathed in a tubular sleeve 100 to constitute the assembly 22.
For convenience in securing the mask 20* over the nose and mouth of the patient, the mask is provided with a pair of raised buttons 102 secured thereto and adapted to receive the ends 4 of the head strap assembly 106, the ends 104 being slotted in the known manner to be slipped quickly on or ofi the buttons 102, as better seen in FIG. 8.
As was mentioned hereinbefore, the mask 20 is preferably fabricated from a semi-rigid plastic material, such as polyethylene, which has sufficient rigidity in the thicker sections to maintain its configuration, yet is sufficiently resilient in the thin section of the edge portion as to enable the mask edge to conform to facial irregularities adjacent the patients nose and mouth over which the mask is disposed. In furtherance of this feature of the invention, the terminal part :108 of the edge portion 82 (FIG. 7) extends preferably for some distance past the tube 84, forming therewith a cantilevered resilient terminal edge which provides an excellent seal with patients face to prevent communication between the interior and exterior of the mask other than through the hoses 52 and 54.
It will be particularly observed in FIGS. 5 and 7 that the disposition of the tube '84 within the convolution in the edge portion 82 of the mask 20 provides for fully sweeping the irregular facial surfaces within the mask by the breathing gas emerging from the passageway within the tube through the orifices 88. Consequently, no dead pockets of stale expired gas can accumulate adjacent the nose and mouth. This is decidedly advantageous in assuming that the patient does not re-breathe carbon dioxide, trace toxic gases, and microorganisms previously exhaled.
What we claim is:
1. A mask for disposition over a breathing orifice of a living organism, comprising:
(a) a mask body having a medial portion and having an edge portion with a peripheral edge conforming substantially to the anatomical portion of said living organism over which said mask is to be disposed;
(b) means defining a first passageway for the admission of inhalation fluid to said mask;
(c) means defining a second passageway for the exhaust of exhalation products from said mask,
one of said passageways communicating through said medial portion of said mask body,
the other of said passageways communicating through a plurality of inwardly directed orifices disposed around said edge portion of said mask body in such fashion that fluid passing through said orifices washes across adjacent areas of the anatomical portion of the living organism so as to prevent the formation of pockets of stagnant exhalation products within said mask; and
(d) obturator means on said second passageway means and arranged for manipulatable restriction thereof by hand to effect a pressure increase in said mask.
2. A mask for disposition over the breathing orifices of a living body, comprising:
(a) a mask body having an edge portion with a peripheral edge conforming substantially to the anatomical portion of the living body over which said mask is to be disposed, and having a medial portion defined by said edge portion;
(b) means defining a first passageway for the admission of inhalation fluid to said mask,
said first passageway communicating with the interior of said mask through a plurality of inwardly directed orifices distributed around said edge portion of said mask body in such fashion that fluid passing through said orifices washes across adjacent areas of the anatomical portion of the living body between said mask edge portion and the breathing orifices of the living body so as to prevent the formation of pockets of stagnant exhalation fiuid within said mask;
(c) means defiining a second passageway for the exhaust of exhalation products from said mask,
said second passageway communicating with the interior of said mask through said medial portion of said mask body, and
(d) obturator means on said second passage means and arranged for manipulatable restriction thereof by hand to effect a pressure increase in said mask.
3. An anesthesia mask for disposition over the nose and mouth of a person, comprising:
(a) a semi-rigid body including.
a body portion of generally proboscidiform configuration defining a chamber open at one end, and
an edge portion at the open end of said chamber configured substantially to the physical characteristics of facial anatomy adjacent the nose and mouth of a person;
(b) wall means defining a substantially continuous first passageway immediately adjacent and therealong said edge portion,
said wall means further defining a plurality of smaller passageways communicating between said first passageway and said chamber within said body;
(c) first conduit means communicating with said first passageway;
((1) second conduit means communicating through said body portion with said chamber,
one of said conduit means being adapted to be coupled to a source of breathing fluid to be supplied to the person over whose nose and mouth said mask is disposed; and
(e) obturator means on the other of said conduit means and arranged for manipulatable restriction of the passageway therein by hand to effect a pressure increase in said mask.
t Breathing fluid apparatus for a living organism comprising:
(a) mask means for disposition over a breathing orifice of the organism,
said mask means being provided with inlet means for the admission of inhalation fluid and outlet means for the egress of exhalation products;
(b) a source of inhalation fluid coupled to said inlet means; and
(c) obturator means associated with said outlet means and arranged for manipulatable restriction thereof by hand to effect a pressure increase in said mask means.
5. Anesthesia apparatus comprising:
(a) an anesthesia mask for applying an anesthetic fluid to a person,
said mask being provided with inlet means for the admission of inhalation fluid and outlet means for the egress of exhalation products;
(b) a source of anesthetic fluid coupled to said inlet means; and
(c) obturator means associated with said outlet means and arranged for manipulatable restriction thereof by hand to effect a breathing pressure increase in said mask when said mask is disposed over the face of the person being anesthesized.
References Cited UNITED STATES PATENTS Loredo 128-188 Szekely et a1 128-194 Peterson 128-141 Glasser 128-194 Quilter et a1. 128-1423 Bird et a1. 128-188 XR Silverman 128-145.6 Emerson 128-1456 10 RICHARD A. GAUDET, Primary Examiner.
K. L. HOWELL, Assistant Examiner.
U.S. C1. X.R.