US 3713448 A
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Description (OCR text may contain errors)
United States Patent 1 1 Arrott 51 Jan.30,1973
[541 ENDOTRACHEAL TUBE HOLDER  Inventor: Janice J. Arrott, 7625 Mountain Road, N.E., Albuquerque, N. Mex. 87110  Filed: Feb. 16, 1971  Appl. No.1 115,438
 US. Cl ..128/351, 128/208, 128/D1G. 26  Int. Cl. ..A6lm 25/02  Field of Search..128/l33, 206, 208, 348, 349 R,
128/350 R, 351, DIG. 26, 146.7; 24/5,8l HS  References Cited UNITED STATES PATENTS 3,161,199 12/1964 Shaw ..128/348 2,820,457 1/1958 Phillips... ..128/351 2,908,269 10/1959 Cheng ..128/351 X 2,168,705 8/1939 Francisco et al. ..128/206 2,159,947 5/1939 Gansel ..128/349 3,013,556 12/1961 Galleher ..128/146.7 1,949,863 3/1934 Hay ..128/127 Primary Examiner-Dalton L. Truluck Att0rneyClarence A. OBrien and Harvey B. Jacobson  ABSTRACT An endotracheal tube holder adapted to supportively balance, suspend, harness, and reliably hold the tube in given position in the trachea and mouth of a patient. A prescribed length of adhesive tape has a median portion wrapped around and adhesively attached to a predetermined portion of the tube. The free end portions of the tape are tautened lengthwise across the patients left and right cheeks, respectively, and are adjustably and detachably fastened to clamps. These clamps are oriented with like loops, more particularly, a pair of ear encircling adapters. These adapters are made from plastic tubing and are applied to the ears of the patient prior to intubation, if desired. The rearward curvate end portion of each adapter is lodged and seated in the deepest groove behind the cartilage directly above the earlobe and adhesively held in place. The adapter proper encircles the ear, resides flatwise against the patients cheek and locates a complemental clamp in the place and position desired. Accordingly, the clamped and harnessed tape functions to properly suspend and prevent displacement of the tube.
8 Claims, 8 Drawing Figures Endolrachae/ Tube PATENTEDJAN 30 ms SHLU I l]? 2 Janice J. Arm/l I.\' VENTOR.
I PATENTEDJAI 30 I973 Fig.7
SHEEI 2 BF 2 Endolrachae/ Tube Janice J. Arrafl l.\'l EXTOR ENDOTRACI'IEAL TUBE HOLDER This invention relates to hospital appliances and surgical devices and has to do with a device which is expressly designed and susceptible of practical and unhampered use when the user is called upon to locate and reliably hold an endotracheal tube in the trachea and mouth of a patient with respiratory problems, and which also functions to stabilize the tube in the trachea and mouth of patients undergoing general endotracheal anesthesia (a common anesthetic technique).
Persons who are conversant with the use and handling of endotracheal tubes are aware that it is the prevailing practice to employ ribbon-type adhesive tape which, in most cases provides counter traction to undue pull on the tube. Unfortunately, such tapes, which are frequently made wet from uncontrolled saliva, lose retentive properties and are perilously detached. The herein disclosed tube harnessing and retaining appliance can be conveniently applied, prior to intubation, if desired. To the ends herein desired loop-type adapters are applied and reliably attached to the patients ears and are equipped with readily accessible clamps which reside against the patients cheeks and are in position to permit the free ends of the tape to be adjustably and releasably anchored and held in set positions, with the result that the tube can be stabilized and maintained in its intended locale.
For background information and as indicative, generally stated, of the prior art pertaining to insertable and removable endotracheal tubes, reference can be made to the tube holder shown in the patent to Peter A. Cheng U.S. Pat. No. 2,908,269 which embodies, unlike the present invention, a plurality of relatively movable component parts to compensate for different sizes of endotracheal tubes.
In carrying out the principles of the instant concept, tape anchoring ear encircling plastic adapters are provided and are such in construction and adaptability that they permit unhampered access to most of the patients head, face and neck and are applicable and usable with time saving expediency. Its presence on the patient allows surgery to be done on most areas, except behind the ears and is feasible for use in the operating room. Not only does it give free access for surgeons to operate on all parts of the head (except the ears) and neck (front and back); it provides the counterbalance for holding the tube secure in the many positions patients are placed in when undergoing various types of surgery, for example, prone, sitting and lateral. Then, too, the disclosed adaptation is simple and practical in construction, is susceptible of mass production, can be made of economical and disposable materials, can be acceptably used in conjunction with commonly used bite blocks and in all other ways serves its intended purposes with efficiency and reliability.
Briefly, and construing the over-all concept in a combination sense the associatively cooperable components have to do with an endotracheal tube of a conventional type, and a length of commonly used ribbonlike adhesive tape which, as shown, has a median portion not only properly wrapped around but adhesively and retentively attached to a predetermined portion of the tube and has like free end portions which are adapted to be uniformly stretched lengthwise across the left and right cheeks of the patient. A pair of like as well as companion adapters are utilized and designed and expressly adapted to be properly oriented with and temporarily attached and attached to and supported by the patients ears. These adapters have means by way of which the free end portions of the tapes can be cooperatively attached thereto and thus harnessed and suspended and held in a given tube stabilizing position. For best results each adapter comprises a horizontal elongated plastic tube loop of a size and shape that it encompasses and is hung over the associated ear and resides flatwise, when in use, against the coacting cheek of the patient and in which position the clamp on the forward end assumes an ideal position to facilitate lining up and attaching the free end of the adhesive tape thereto.
These together with other objects and advantages which will become subsequently apparent reside in the details of construction and operation as more fully hereinafter described and claimed, reference being had to the accompanying drawings forming a part hereof, wherein like numerals refer to like parts throughout, and in which:
FIG. 1 is a view in front elevation showing the tube, the centrally attached adhesive tape, both the free end portions of the tape and the left and right tape anchoring and harnessing adapters.
FIG. 2 is a view in side elevation showing one side of the head and face of the patient and likewise showing the adapter, clamp and an end portion of the adhesive tape with the median portion of the tape attached to an in-use endotracheal tube.
FIG. 3 is a section on the line -33 of FIG. 2.
FIG. 4 is a view on an enlarged scale and appearing in perspective and showing the over-all tube holder and how the component parts are constructed, cooperatively related and used.
FIG. 5 is a section of fragmentary type and suitably presented and taken on the plane of the vertical section line 5-5 of FIG. 4 looking in the direction of the arrows.
FIG. 6 is a view at right angles to FIG. 5 and taken on the plane of the section line 6-6 of FIG. 5.
FIG. 7 is a horizontal detail section on the line 7-7 of FIG. 5.
FIG. 8 is an enlarged detail view with parts in section and elevation taken on the plane of the line 88 of FIG. 4.
The manner in which the endotracheal tube 10 is inserted and used in brought out, satisfactorily it is believed, in FIGS. 1 and 2 wherein it will be noted that a portion 12 of the tube is inserted into the trachea of the patient. A portion 14 of the tube is centered and inserted between the lips into the patients mouth. In carrying out the principles of the present invention it has been found desirable to provide the portion exteriorly of the mouth on diametrically opposite sides with strips or bands of adhesive material as at 16 to facilitate attaching the tape. The tape is of the usual ribbon-like flexible form and is denoted generally stated by the numeral 18. In practice, the adhesive coated side (not detailed) of the tape is wrapped around the tube as at 20 (FIGS. 1, 2 and 4). Each end portion is denoted at 22 and the terminal thereof is denoted at 24. It is obviously the significant purpose of the invention to stabilize and maintain the tape so that it will retain the tube 10 against undesirable displacement from its intended in-use position.
The aforementioned elongated loop-type ear encircling adapters (which are identical in construction at the left and right) are properly devised and used to anchor and harness the tape ends 24. Each adapter is denoted by the numeral 26. Considering the over-all adapter it is of elongated loop form and of requisite size and shape to not only embrace the ear but to reside substantially flatwise against the adjacent cheek of the patient. Broadly the adapter has a rearward end portion which is attached to the ear (FIG. 3) and a forward end portion which carries tape fastening means, for example, a specially constructed clamp as at 28 (FIG. 4). More specifically, the principal component part of the adapter is approximately C-shaped in side elevation and embodies a bight portion 30 and a pair of upper and lower longitudinally bowed legs 32 which have turned in laterally directed free end portions 34. The bight portion and legs are made of frequently plastic tubing the hollow portion of which contains a suitable length of malleable wire 36. The wire is manually bendable to assume and maintain a given shape. It will be noted that the respective forward end portions of the wire terminate short of the (FIGS. end portions 34 (see FIG. As also brought out in FIG. 5 in particular, a stiff metal spreader or rod 39 serves to adjoin the end portions 34. This rod has a median portion 38 and upper and lower end portions 40 which are fitted telescopingly into the lateral end portions 34 in a manner to bridge the gap between the same whereby to thus complete the encircling loop and to accommodate the pivotally attached tape anchoring clamp 42.
With further reference to the bight portion 30 of the loop-type adapters it may well be mentioned that the adapters can be and frequently are applied prior to intubation, if desired which means that if it is desirable to place the bight portion of the loop or adapter around each ear. It is advisable to hold the ear forward and to place the adhesive coating or media 31 (FIGS. 3 and 4) in the deepest groove behind the cartilage directly above the earlobe. This procedure functions to locate the over-all adapter and serves to poise the clamp 42 in a ready-to-use position. The clamp can be made of noncorrodible material and comprises a first or inner jaw 44 the forward edge of which is provided with a laterally directed flange 46 (FIG. 7) which has a serrated edge 48 thus providing tape engaging teeth. The other vertical edge of the jaw is provided with a suitably curved clamp mounting member. This is to say the edge 50 (FIG. 7) has a pivoted knuckle or sleeve 52 which is properly split and is retentively bent around the portion 38 of the aforementioned rod 39 (FIG. 5). The exterior jaw is denoted at 54 and has its upper end joined by a bendable hinging web 56 to the upper end of the jaw 44. The lower end is provided with a lateral lip flange 58 which can be pressed toward the lower edge of the jaw 40 and has embossed detents 60 which serve to hold it in a set position, as illustrated in phantom lines in FIG. 6. It is also within the purview of the invention to provide a film of adhesive media (not detailed) on i the interior of the jaw 44 so as to allow the adhesive to hold the over all device to the cheek until the tape holding the endotracheal tube in place is pressed into position between the closable jaws 44 and 46 of the aforementioned clamp 42. It can be added too that it is within the purview of the concept to provide the cheek contacting surface of the jaw 44 with pad means (not shown) which can be impregnated with adhesive media. The purpose is to temporarily set the clamp after the adapter has been positioned and to thus maintain the jaws open and to facilitate placing the portions 22 and 24 of the adhesive tape in correct position and relationship.
Experience has shown that the spreader rod 39 is a significant and important part not only in mounting the clamp means 42 but also in stabilizing the terminal ends 34 of the plastic tubing and to make sure that the two ends are kept spread apart to avoid accidental displacement of the' adapter from the ear. Further, the adherence of the adhesive coated bight portion 30 is important in maintaining the adapter so that the part 30 is situated in the deepest groove behind the cartilage which lies just above the level of the earlobe. Experience has shown that if the adapter is not correctly located it would be possible for it to pull off the ear and thus interfere with proper anchorage, stabilization and maintenance of the tube 10.
The tape-end positioning tautening and anchoring adapters equalize, suspend and anchor the terminal left and right free end portions of the adhesively attached tube centering and retaining tape. Conjointly the component parts contribute a proportionate share to stabilizing the tube and securing and maintaining the same in a given locale, thus serving not only the needs of the patient but purposes of the nurses, doctors and all personnel who are called upon to achieve the end result desired.
In most instances an endotracheal tube must be passed with direct vision of the vocal chords with the lighted instrument and this aspect of the problem has been kept in mind in working out and perfecting the instant appliance. Further, the appliance is such in construction that the tube can be removed while the adapters and clamps thereon remain in place. It follows that the disclosed invention well serves the purposes for which it has been devised.
The foregoing is considered as illustrative only of the principles of the invention. Further, since numerous modifications and changes will readily occur to those skilled in the art, it is not desired to limit the invention to the exact construction and operation shown and described, and accordingly all suitable modifications and equivalents may be resorted to, falling within the scope of the invention.
What is claimed as new is as follows:
1. In combination, an endotracheal tube having exterior adhesive coated surfaces, a length of flexible adhesive tape having a median portion securely wrapped around and adhesively and retentively attached to a prescribed portion of said tube and having like free end portions which are adapted to be uniformly and tautly stretched lengthwise across the left and right cheeks of the patient, a pair of companion adapters which are designed and adapted to completely encompass the patients left and right ears, said adapters having jaw means by way of which the free end portions of said tapes are detachably and adjustably attached to said adapters and thus harnessed and held in given tube positioning, suspending and stabilizing positions, each adapter comprising a horizontally elongated loop of a size and shape that it not only encompasses but is supportively hung over the associated ear and resides flatwise against the coacting check of the patient, said loop having an arcuately curved rearward end which is conformable to and is adapted to be lodged and seated in the deepest groove of the ear and behind the cartilage which lies just above the earlobe, said rearward end being coated with adhesive media which assists in seating and function to retain the loop and the complemental adapter in its given position.
2. The combination defined in and according to claim 1, and wherein each jaw means is mounted on and is carried by a forward end portion of the associated adapter and comprises a clamp.
3. The combination defined in and according to claim 1, and wherein each jaw means is carried by a forward end portion of the associated adapter and comprises a clamp, said jaw means comprising a pair of openable and closable jaws between which a free end portion of the cooperable tape can be passed and between which said end portion can be retentively but removably and adjustably clenched and held.
4. The combination defined in and according to claim 3, and wherein there are inner and outer jaws having upper ends hingedly joined by a malleable bend, said inner jaw having a flat face to reside firmly in a given position on the associated cheek, said jaw having a lateral outstanding serrated flange providing a toothed tape securing lip, said outer jaw having a portion which is manually bendable toward and from and is clampingly cooperable with said toothed lip.
5. An ear supported adapter for use as a component part of an endotracheal tube holder comprising: a length of plastic tubing containing and encasing a corresponding length of malleable wire having like end portions terminating short of the respective free forward ends of said tubing, said wire-encased tubing being bent upon itself intermediate its ends into elongated C-shaped form and providing longitudinally bowed upper and lower legs joined at their rearward ends by a curvate bight portion and having free forward ends which are turned in toward each other and aligned but are spaced apart, a rigid spreader rod positioned between said forward ends, bridging said space and having end portions telescoping retentively into said free forward ends and cooperating therewith and with said legs and defining an endless loop which is designed and adapted to (l) wholly encompass and (2) hang over a selected ear whereby the loop can assume a flatwise position against the patients cheek, and a tapeend accommodating and anchoring clamp pivotally mounted on and carried by a median portion of said spreader rod.
6. The adapter defined in and according to claim 5, and wherein said clamp comprises a pair of openable and closable jaws between which a free end portion of the cooperable tape can be passed and between which said end portion can be retentively but removably clenched and held, whereby the over-all tape functions to not only locate the wrapped portion of the tube but serves to prevent displacement by equalizing and stabilizing the tubes position in the patients trachea and mouth.
7. The combination defined in and according to claim 6, and wherein there are inner and outer jaws having upper ends hingedly joined by a malleable bend,
said inner jaw having a flat face to reside firmly in a given position on the associated cheek, said aw having a lateral outstanding serrated flange providing a toothed tape securing lip, said outer jaw having portion which is manually bendable toward and from and is clampingly cooperable with said toothed lip.
8. The adapter defined in and according to claim 6, and wherein said bight portion is coated with adhesive media and is expressly designed and conformingly adapted to be insertably and removably seated in the deepest groove in the patients ear just above the lobe of said ear.