US 3754554 A
An endotracheal tube having a protrusion with small orifice at its forward end. An introducer or guide rod extends through the orifice to guide the tube between the vocal cords. The rod has a stop to limit its protrusion from the tube. A handle is provided on the rod to operate it.
Claims available in
Description (OCR text may contain errors)
United States Patent [191 Felbarg Aug. 28, 1973  ENDOTRACHEAL TUBE MEANS 2,541,402 2/1951 Caine 128/351 3,511,243 5/1970 Toy 128/351 x  12 Kmgsley 3,175,557 3/1965 Hammond 128/351 Huntmgton, NY. 11 3,196,876 7/1965 M1116: 128/343  Filed: Feb. 22, 1972  Appi. No.: 227,734
 US. Cl. 128/351, 128/341 7  Int. Cl A61m 25/00  Field of Search 128/10, 11, 341,
 References Cited UNITED STATES PATENTS 2,458,305 1/1949 Sandemi, 128/348 Primary Examiner-Dalton L. Truluck Attorney-James P. Malone 2 Claims, 8 Drawing Figures ENDOTRACIIEAL TUBE MEANS This invention relates to endotracheal tube means and more particularly to a novel version for cases in which the regular tubes are difficult to insert between the vocal cords.
Endotracheal tubes are generally introduced through the nose or mouth beyond the vocal cords and into the larynx and trachea. For this purpose a laryngoscope is used.
Quite often this is readily accomplished by using an ordinary endotracheal tube. In some cases, because of the patient having a small mouth, protrudent teeth,
large tongue, etc., the operation may not be so easy and become difficult or impossible.
One of the difficulties in inserting the tube is that the tube is of such caliber that blocks up all the available visual field or lumen of the laryngoscope instrument and the leading end of the tube cannot be seen nor the opening between the vocal cords. The operation ends up being ablind or almost blind intubation of the trachea. Tubes that are transparent, made up of clear plastic, do not solve the problem.
The present invention provides means to be able to see the narrow opening between the vocal cords without interference from the endotracheal tube, comprising a introducer made up of a teflon rod or other suitable material..Teflon is desirable because it has adequate stiffnessand yet will bend easily should it encounter resistance to advance, does not stick to rubber or plastic requiring little lubrication for removal. It can also be bent to a desirable curvature according to the needs of the particular case.
The introducer is inserted'inside the endotracheal tube and it is adjusted to extend forwardly beyond the distal end of the endotracheal tube several inches so that it can be seen easily in the laryngoscope field.
Even if only part of the opening between the cords are seen it is readily easier to insert the introducer rather than the much more larger endotracheal tube.
The introducer serves as a guide and the endotracheal tube will follow easily once the introducer is advanced between the vocal cords.
Accordingly, a principal object of the invention is to provide new and improved guide means for inserting an endotracheal tube.
Another object of the invention is to provide new and improved guide means for inserting an endoctracheal tube having a teflon introducer extending through the tube and protruding from the distal portion of the tube.
Another object of the invention is to provide new and improved guide means for use in an endotracheal tube comprising an introducer, said introducer being adapted to be inserted through said tube and protrude from the distal end of said tube to permit visual guiding of said tube when said tube is inserted between the vocal cords and advanced into the trachea.
These and other objects of the invention will be apparent from the following specification and drawings of which:
FIG.- I is a side view of an endotracheal tube.
FIG. IA is an end view of FIG. 1.
FIG. 2 is a side view of the guide means.
FIG. 3 is a side view of the endotracheal tube with the guide means inserted.
FIGS. 4 7 are diagrams illustrating the operation of the invention.
Referring to thefigures, FIG. I there is shown an en dotracheal tube 1 which comprises a tubular member of rubber, plastic or latex with a continuous spiral of nylon embedded-in the wall. I
Referring to the distal end of tube 1, it has a large opening I" obtusely cut in bevel which provides for the.
which could be blue colored. for easy detection in the laryngoscope field over the generally pink background of the-pharynx. The teflon rod 4 is mounted in a rubber sleeve 5, which at the upper end the introducer is ended in a handle 6.
The sleeve 5, on rod 4, increases the caliber of the teflon rod and by bearing against the orifice 3 limits the amount of protrusion of rod 4 beyond the tip of the endotracheal tube.
Handle 6, is at the end of the same rubber sleeve 5, for easy gripping and quick removal of the introducer from inside the endotracheal tube. This is illustrated in FIG. 3 which shows the complete assembly.
The teflon rod 4, passes through the hole 3, in the protrusion 2 and the handle 6 is shown before the fit ting la at the upper or proximal end of the tube 1. The introducer goes through orifice 3 somewhat tightly and a small amount of a wetting agent such as diluted zephiran chloride secures enough lubrication for removal.
In practice, referring to FIG. 4, the assembly. as shown in FIG. 3 is inserted through the laryngoscope'8. First the opening between the vocal cords 10 is located, and due to its small size the end 4' of the introducer can be seen in the same visual field. This greatly facilitates the introduction of the assembly between the cords under direct vision.
The operator, whose eye is 5 in the diagram, holds the laryngoscope 8 with his left hand. The tube 1 assembly can be seen just about to enter between the vocal cords 10. As can be seen, the opening is very small and the natural tendency for the tube if not visually guided will be to fall into the esophogus 9 which is a larger cavity where the larynx 7 is located. The rest of the drawing shows the trachea l2 and the lungs 13, -13. This invention is not intended for blind intubation. If the vocal cords cannot be seen a regular tube would be better for blind attempts.
As the tube 1 assembly is advanced, FIG. 5, into the trachea, the introducer 4, works as a guide. Once the tube is properly located, the introducer is withdrawn completely from the tube 1, as shown in FIG. 6, and the supply tube 14 for the anesthetic may be connected to the fitting la, FIG. 7.
If this introducer is used with any of the presently available endotracheal tubes the vocal cords will prevent the advance of the endotracheal tube 1 as none of them have a distal end adapted to thread and hold an introducer through and beyond the distal end.
It can be seen that tube 1 and introducer 4 form a unit and they adapt to each other especially at the distal end.
Once the introducer is beyond the vocal cords, by advancingfthe assembly, tube 1 will gain its way in by riding over the cords by virtue of a very smooth transition of the two components. The conelike shape of the dis- 3 tal end of the tube allows for continuity of the two components.
1. A modified endotracheal tube having a tip; said tube having two orifices in its tip, said tip having a large beveled orifice for the gas passage duringventilation and a small orifice located next to and forwardly of said large orifice at the tip of a cone-like shaped protrusion, an introducer plastic rod removably received within said tube bore so that said rod distal end may extend several inches'from the end of said endot'rach'eal tube, said small orific'e being designed to thread and support s'aid introducer snuggly, said small orifice having such dimensions as to allow easy threading yet support said introducer.
2. Apparatus as in claim 1 having a rubber sleeve mounted on the plastic rod, said sleeve extending dis tally up to the cone like shaped distal end of the endotracheal tube working as a stop to limit the protrusion of the introducer beyond the endotracheal tube and also causing the endotracheal tube to follow the introducer when said introducer is pushed forward into the trachea beyond the vocal cords, said sleeve extending proximally up to the end of the plastic rod working as a handle, said handle being made with the purpose of providing an easy grip for the removal of said introducer.
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