US RE20226 E
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Description (OCR text may contain errors)
Jan. 5, 1937. P:- DRINKER El AL Re. 20,226
RESPIRATION APPARATUS Original Filed July as, 1929 2 Sheets-Sheet 1 v anventozo Philip Drinker Louis Agassiz Shaw Jan. 5, 1937. P. DRINKER ET AL Re. 20,226
usruwnou APPARATUS Orluaal Filer; July 23, 1929 2 Sheets-Shut- 2 Y Swueutoza Drinker 1 Louis dgaasiz Shaw'- Philzp Reissned- 1.... s, 1937' vvnezo'gzei UNITED STATES PATENT OFFICE 1 a i am aasrmsnou msas'ms Philip Drinker and Louis Asa-ls Shaw,
Ma... meane- Warren E. Collins, Warren E. Collins, In, and
Walter G. Chick, all of Boston. m; W
E. Collins. Jr, executor of said Warren-E. (Jol- Original No. use:
80, dated Serial No. 380,271, Jilly 23, 1929.
December 1. 1931, Application for rel-use June 1, 1936, Serial No. 82,941
11 Claims. (01. lea-so) treated without subjecting his body to strain, and I which will simulate natural breathing in the patient, both as to the periods of exhalation and inhalation andas to the quantity of air drawn 10 into the lungs of the patient, thus resulting in artificial breathing which will be regular and rhythmic.
It is a-further object of the invention to provide an apparatus of this character in which the pa- 5 tient will be at his ease during-.the treatment and in which he can breathe naturally, if so in-. clined, orin which he may be assisted to any desired extent by the apparatus.
It is a further object to provide an apparatus go of .this character in which the patient can talk.
eat and sleep without discomfort and without discontinuing the treatments.
Anotherobiect of the invention is to provide an apparatus from which the patient's body may 5 be quickly withdrawn and returned without having to shift one portion of the patients body relative to another portion and without material loss of time.
These and other objects will appear more fully. so from the following description when considered in connection with the drawings, in which:
Fig. l is a side elevation'al view of one form which our apparatus may assume.
Fig. 2 is a front elevational view thereof.
as Fig. Sis aslightlyenlargedplan view'of one' fortlgrof prasure producing apparatus and alterna a Fig. 4 is a detailed view approximately on the line H of Fig.3 showing the-reduction gears 40 employedfcvaryingtbeperiodofthcpressure Fig. 5 is a detailed viewof one of the valves.
l'igJisasectionalviewonthslineHoi' as Fig. 5.
Fig.7isadetailedviewontheline'1-I Fig. 1 showingthe'valve mechanism of the alternator.
Referring to the details of the drawings. there I so is provided a relatively strong, air-tight casing ll of any preferred shape which is constructed ofsuillcient length. height and breadth to accommodate the body of a large man or woman. 'lhe casing i0 is supported upon any suitable stand- I aid, as indicated for example at II. whereby the casing is placed at a convenient height for use. One wall .of the casing, preferably the front wall ll, is removable to provide access to the interior thereof. The front wall has an additional support II facilitating the movement of the wall ll toward or away from the casing iii. The casing I and the wall II are made sufliciently rigid that they will not flex or bend under the pressures used inside the respirator.
' A body support II, shown as a mattress, and 10 its supporting frame, is mounted for movement into or out of the casing ll. Rollers i9 and a cooperating track 2| onthe floor of the casing serve to support the body rest ll within the casing and to permit the withdrawal of the body supp fromthe casing when desired. The body support i8 and a head rest 28 are attached to the endwall It and when withdrawn are supported by the support I, so that the entire .bed ll, head rest It and movable wall it, may be moved'toward and away from the casing with the patient resting thereon, to expose the body of the patient.
. without having to shift or move the body or head of, the patient relative to the bed or head rest.
The end wall I is provided with an opening a 12' large enough to receive the patient's head which receives a flexible sealing member 2| formed of relativeiy'strong, flexible rubber; The sealing member 24 has a central opening adapted to fit snugly around the neck of the patient. The a head of the patient may be through the opening I2 due to the resiliency of the material of the sealing member 24. The member 24 is removably attached within the opening 21 and is sealed at its outside edge against the admission 3' of outside air by means of the securing bolts shown or other equivalent means. Several different sizes of collars or sealing members 24 may be provided and the one best suited to the size of the patient selected. 40
The head of the patient is allowed to rest upon a support It positioned just outside of the opening 22' and adjustable vertically to accommodate the particular patient being treated. Any suitable adjustment means may be used for the support ins. Athermometeril indicates atalltimesthe temperatin-ewithinthecasing.
is normally maintained at substantially room temperature-by the air-flowto and from the easingasdescribedbelow. Themaybe the air througha suitable cooling medium.
The degree of pressin'e or partial'vacuum withinthecasingisindicated at alltimesby means of an open manometer ll, one leg of which is connectedtothecasing llbymeansofatubular conductor it; the other le being exposed to the outside air. The manometer is provided with a suitable chart to indicate the degree of suction or pressure then present. The'manometer It thus serves as an indicator of the pressure conditions within the casing. The manometer also serves as a pressure or suction relief valve in that any excessive pressure or suction blows or draws the fluid. out of the open manometer and thus relieves the excessive pressure or suction condition within-the casing.
,The mechanism for providing alternate suction and pressure conditions within the casing It may be constructed in various manners. In
' the present embodiment, we have shown a preferred construction wherein a plurality of centrifugal air compressors 30 and 30 are connected in series relation to the suction tube II and pressure'tube 42. This construction is preferred in that it provides a substantial air flow and sufficient pressure for the proper operation of the apparatus at all times. The tubes 40 and 41 are formed with vents 43 and 44 which are normally closed. but which permit either the suction or pressure portion of the apparatus to be rendered ineffective. The rotary closures 4! may bereadily adjusted to open or close the tubes 4. or I with respect to the outside air. The tubes 4. and I! pass through the ,valve mechanism orofthetubesllandllsoastocauseoneoi'these tubes to communicate with the tubular member II and the other member to be exposed to the outside air through the cut-away portion ll. 0n rotation of the valve member' I! about a half circle the other .tube (4! or Al) will'then be placed in communication with the tubular member l2 and the opposed member ill or 42) placed in commtmication with the outside air.
Rotation of the valve shaft N is accomplished by meansof atimingmotorllandasetofreduction gearing indicated generally at 00. This gearing includes three stage or sets of gears which have been found suillcient for our purposes. The gears ii, 02 and is are mounted rigidlyon ashiftable shaft it having asquared portion to cause the same to be rotatedwith the gear I driven from the motor II. The driven shaft ll carries three cooperating gears ll, 81
and is which may be enmeshedwith any of the shiftable gearsli. II or -II respectively. when tbegearsli andllareinmesh,theshaftl4is driven at a relatively slow This provides theminimum number of aliernatio-ofpremire upto six or'eisht years of age. When the dren gearsflandl'lareenmeshedtheshaftllis rota ted more rapidly providing alternations in pressure chance at a relatively higher rate ffromlltoflpressurechangesper minute. adjustment is used for the treatment of very small children, for example, premature and still-born While the pressure and suction pumps ll and 3! provide greater degrees of pressure and partial :vacuum than required for the normal use of the apparatus, their effect may be varied to any extent by means of the adjustment valve III. This valve is manually adjustable to permit only a suiiicient amount of air to pass the same to increase or decrease the pressure within the casing tothe extent desired. It will be evident that if the valve 1| is adjusted to provide a relatively small opening permitting the passage of air therethrough, the pressure or partial vacuum condition within the casing II will reach a much lower extent than where the'valve II is wide open and the entire force of the compressors is directly admitted into the interior of the casing.
' The usual degree of vacuum or pressure required for producing artificial breathing in the average patient is about 5 to 15 centimeters of water. although Il centimeters of water or more may be required to cause the subject to fall into rhythm with the pump.
Suitable switches indicated generally at I! supply electric current to the timing motor I! and to the motors of the compressors 81 and II.
In the operation of the above apparatus, the clamps II are, unfastened and the end wall It and body support II are moved outwardly from the casing ll into position to receive the body of .the patient. The head of the patient is passed the casing and theclamps tightened to seal the wall H-against the casing II. The body of the patient. is thus entirely within and subjected to the pressure conditions within the casing, yet the head of the patient is exposed for observation or treatment and the patient is entireLv at ease. The shalt i4 is shifted to cause the proper gears to enmesh'as described above for the patient then being treated. The switch 12 is then actuated to start the timing motor and compressors. The valve ll is adjusted while observing the manometer 34 to provide the proper extent of the pressure variations within the casing. Thereafter the patient isobserv'ed and if a higher temperature is necessary within the casing, the light 32 is lightedand the temperature correspondingly increased. The body of the patient may be observed withln the casing through the opening 28. The patient may be given food or medicine,
and can sleep or talk without interrupting the treatment.
Ifaccesstofliepatient'sbodyisdmiredatany 1g time during'treatment, the-entire body on the bedltmaybequicklywithdrawniromtherespirator by releasing the clamps II and sliding the bed ll,rigidwall l4 andheadrest Ilas aunit away from the casing ll, without disturbing the position oi. the patient's body or head resting onthebedllandheadrestfl. Onslidingthe body back into the casing, an air-tight seal is quickly made between the wall I and a'rubber gasket fitted in the end wall or the casing II.
If at any time it appears that the patient is breathing normally and of his ownpower, the valve Ill may be entirely closed and the apparatus used as a plethysmograph. Any natural breathing of the patient may thus be observed in the manometer without disturbing the patient or the apparatus in any other manner. If it appears that the patient is not breathing naturally, the
' valve may be opened again and the artificial respiration resumed.
It will be evident that many variations may be made in the apparatus within the principles of the invention asstated above. the shape and size oithecasingmaybevaried andanydesiredf mechanism used to efiect the pressure changes therein without departing (mm the spirit or our invention or the scope of the accompanying claims.
Having thus described our invention, what we claim as new and Patent is:
I. In an appartus for producing artificial respiration, a casing constructed to receive the major portion oi the body or a patient, a bed which is siidable into and out-oi said casing, said casing having a rigid removable 'wall section connected to said bed and slidable therewith and including an opening through which the head of the patient may be passed, a head rest supported on said removable wall sectionwand movable therewith, a sealing member positioned in said opening and formed with a restricted opening adapted to fit tions or pressure within said casing.
2. In an apparatus for producing artificial respiration a portable hollow casing having an open end, a portable carriage carrying a bed adapted to receive the body of a patient and to slide in and out 01 said casing, a rigid closure for the open end oi said casing connected to said carriage and mov-.
I able therewith having an opening through which the patient's head projects, a head rest connected to said closure for supporting the patient's head and means to'provide a seal between the neck oi the patient and said opening, means to seal said closure to the open end of said casing, and means .to induce periodic variations oi pressure within saidv casing.
3. In an apparatus for producing artificial respiration, a hollow casing having an open end, a' portable carriage adapted to receive the body oi a'patient and to slide within said casing, a rigid closure tor the open end oi said casing connected to said carriage and movable therewith, means to seal said casing with the head of the patient external or said casing, means connected to the closure and movable therewith to support the head of the patient, clampmeans to permit unsealing of the casing and removal of the patlent's body on the portable carriage, and means to periodically'vary the pressure within said casing from a negative pressure to atmospheric presnirewhenthecasingissealedandtoreguiate desire to. secure by Lettersthe rate of said variations-to correspond to the normal rate oi breathing.
' 4. In an apparatus for producing artificial respiration a hollow casing having a rigid removable wall section with an opening for the head of the patient, a portable carriage to receive the body 01. a patient, means to slide said carriage into and out of said casing, means to seal said casing with the head of said patient projecting .through said opening in the removable wall section, a pump, a distributor valve between said pump and said casing to periodically vary the pressure within said casing and means to control the maximum and minimum amounts oi said pressure variation.
5. An apparatus for producing artificial res-v piration comprising a hollow casing having a in said casing, means to control the maximum and minimum amounts of said pressure variation, -a manometer connected to said casing to indicate the'variations of pressure within said casing, and an inspection plate whereby the patient removable wall section with an opening for the may be observed during the pressure variations.
6 A respirator apparatus for artificially producing respiration comprising a hollow casing having an open end, a patient receiving carriage slidable intoand out of said casing, a rigid closure connected to said carriage and adapted to seal against the open end of said casing, said closure having a central aperture through which the pa'tient's head may be projected and a collar to closely encompass the neck of the patient and a head rest connected to said closure and movable therewith to support the head of the patient outside the casing, said carriage adapted to receive the body oi a patient and to he slid into said casing with the head of said patient extending outside of said casing and supported on said head rest, whereby the carriage closure and head rest may be moved'as a unit to permit the patient's body to be inserted into the casing and removed therefrom without disturbing the position of the body on the carriage and head rest, said collar having-an open end. a patient receiving carriage, and a rigid closure connected to said carriage and movable therewith and adapted to seal said casing, said closure having a central aperture through which the patients head may be projected and a rubber collar to closely encompass the neck oi the patient, said carriage adapted to support the body oi the patient and to he slid into .said casingwith the head of said patient extending outside 01' said casing, said collar acting as 'a pressure seal whereby the body of said patient within said casing may be at a pressure difi'erent from the pressure upon the head of said patient, means to vary the pressure within artificially producing respiration comprising a hollow casing I said casing from a below atmospheric pressure to atmospheric pressure or above, meansto control the temperature within said casing including a warming means, cooling means and means to ventilate the casing, said casing having whereby said internal conditions may be known.
8. In an apparatus for producing respiration, a hollow casing for the body 01 a patient, a bodysupport slid'able to and 1mm the interior of said casing, said casinghav- .ing a rigid removable wall section connected to and slidable with. said bodysupport, through which the head of the patient is adaptedto pro- 'iect, a head rest connected to said removable wall section and movable therewith to support the head of the patient outside said casing. means for forming an air-tight seal'around-the neck of the patient and means for forming an air-tight seal between the removable wallsection and the with' saidvremovabie with section to support the head of the patient, said body support, wall section and head rest. being connected together to move as a unit, means to support one end of said movable unit when withdrawn-from the casing while the other end is supported in the casing and means for producing alternate variations oi pressure within said casing.
10. In an. apparatus for producing artificial respiration, a hollow casingior receiving the body a '11, In an, apparatus for p oi apatient, 1.1mm slidabie mm and'out' ,oi'said casing. said casing havin airfie r movablewallsectionconnectedtosaidbodysupport *and slidable therewith and includinga flexible .rubber sheet with an openingior'the patient's neck, saidsheet being arranged to form an airtight seal around the neck of the patient while permitting movement of 'thehead. and neck. means for clamping the outer edges of said rubber sheet to form an airtight seal'withthe wall of the casing, means to form an independent sal between said removable wall section and the easing, a head rest connected to said removable .wall section outside or said casing and means 101' producing alternate variations oi pressure within said casing.
respiration a hollow casing for receiving the body pi a patient, means to support said casing, a body support slidable into and out 01 said casing, said casing having a rigid removable wall section connected to said body support and slidabie therewith and including a flexible elastic rubber sheet with an opening for the patient's neck, said sheet being suiiiciently elasticto permit insertion of the head through the opening and being adapted in contracted condition to form an airtight seal around the patients neck, means for clamping the outer edges of said rubber sheet to form an airtight seal with the wall of the casing, a
head rest outside of the casing and connected to said removable wall section, supporting means connected to one end of said .body support to support the same when withdrawn'i'rom said casring and means to support the other end of said body support in said casing and means for pro'- ducing alternate variations of pressure within said casing when the casing is closed.
PHILIP DRINKER. LOUIS A.