Thin wall endotracheal tube

An ultra-thin wire reinforced endotracheal tube which includes a novel sealing design adapted to fit in a complementary manner in a subject’s larynx. The endotracheal tube includes a laryngeal mask airway section which has a cross sectional shape and size that are complementary to a subject’s glottis. Preferably, the laryngeal section has an oval or egg-shaped cross section.

   Endotracheal tubes are widely used in anesthesia and critical care medicine. In use, tracheostomy tube  provide access to the upper airways for controlled, assisted ventilation or spontaneous unassisted ventilation with positive end expiratory pressure.
   One of the drawbacks of inserting an endotracheal tube into an upper airway of a patient results in the reduction of the lumen of the airway. One cause by which the lumen is reduced is the inability to use the largest possible endotracheal tube for a given patient without subjecting the patient to increased risks. Generally, it is not advisable to insert the largest possible suction catheter in a patient since such an attempt will entail many trials and errors which may take additional time which should be avoided especially in critical care or emergency situations.
   In addition, the wall thickness of an endotracheal tube needs to be such to provide sufficient strength so as to be safely handled by the using physician or technician during insertion and to maintain the tube stable after insertion. At present, adult feeding tubes range between 7 to 9 millimeters in internal diameter with a total wall thickness ranging between 1.4 and 1.5 millimeters. For newborn endotracheal tubes, the decrease in lumen internal diameter as a result of the required wall thickness amounts to approximately 0.5 millimeters or more.
   Any decrease in the lumen due to wall thickness of an endotracheal tube has a profound effect on the airway resistance, since the resistance to air flow is inversely proportional to the fourth power of the radius.
   As a result of the deficiencies in prior art endotracheal tubes, a need has developed to provide an endotracheal tube having reduced airway resistance so as to facilitate establishment of artificial airways other than those using mechanical ventilators.

endotracheal tube  laryngeal mask airway   tracheostomy tube

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Laser resistant endotracheal tube

A catheter such as an endotracheal tube is rendered resistant to laser beam impaction by coating the cuff and/or the tube with a laser-reflective compound which is preferably comprised of one to three parts of powdered aluminum to one part silicone rubber solution. The laser-reflective compound may be permanently bonded to the cuff and/or the tube by first dipping the cuff and/or the tube in a bath of the compound to form a smooth outer coating on the cuff and/or the tube and then baking the cuff and/or the tube to cure the coating.

During certain medical procedures and especially during surgery, it may be necessary to admit or remove fluids (either liquids or gases) from the patient and a catheter is often employed carrying such fluids. For example during surgery of thethroat, a mixture of oxygen（oxygen mask）and anesthesia usually must be carried into the lungs and a special type of catheter, known as an endotracheal tube, is employed for this purpose.
   Although present day silicone rubber, latex rubber and polyvinyl chloride tracheostomy tube have proven safe and reliable, use of silicone rubber, latex rubber and polyvinyl chloride endotracheal tubes often presents a serious risk of hazard ifused during laser surgery unless the tube is protected against inadvertent laser impaction. In the past, endotracheal tubes used during laser surgery have been protected against inadvertent laser impaction by wrapping the tube with a self-adhering metal foil whichthus serves to reflect the laser beam should the laser inadvertently impact the endotracheal tube. However, several disadvantages are believed to be associated with this method of protecting the endotracheal tube. Firstly, a certain amount ofpreparation time is consumed in wrapping a standard endotracheal tube with relfective foil.
   In contrast to the feeding tubes of the prior art, the present invention concerns an improved laser-resistant endotracheal tube which is not subject to the above enumerated disadvantages.
   It is an object of the present laryngeal mask airway  to provide an improved laser-resistant endotracheal tube;
   It is yet another object of the present invention to provide an improved laser-resistant endotracheal tube having a smooth exterior surface to facilitate endotracheal tube intubation;
   It is yet another object of the present invention to provide an improved laser-resistant endotracheal tube which requires no special preparation for use during laser surgery.

endotracheal tube  oxygen mask  feeding tubes  laryngeal mask airway

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Self –inflating endotracheal tube

Endotracheal tube with cuffs that self-inflate during inspiration and remain inflated during expiration. Shown are distal openings on the outside of the tube into the cuff volume. Also shown is a tube having an opening through its wall into the cuff volume, and a flutter valve to restrict the flow of air. The cuffs shown are substantially larger than the trachea and are of thin film material.

The present laryngeal mask airway relates generally to medical and surgical equipment and is more particularly concerned with the provision of means for maintaining normal breathing of of the patient during surgical operations and the like.

A primary object of the instant oxygen mask is the provision of a novel and improved endotracheal tube.

An important object of the instant tracheostomy tube

 is the provision of an endotracheal tube having a self-inflating cuff.

Another object of this invention is the provision of an endotracheal tube having a self-inflating cuff that automatically inflates during inspiration through the tube and which remains inflated during expiration therethrough.

Another object is the provision of an endotracheal tube having a self-inflating cuff that makes a good seal with the wall of the trachea but which nevertheless minimizes the likelihood of trauma at the area of the trachea wall where the seal is made.

A further object of the instant invention is the provision of a self-inflating endotracheal tube having novel and improved structural means for automatically causing inflation of the inflatable cuff during inspiration of the patient and for maintaining the cuff inflated during expiration.

Another object is the provision of an endotracheal tube of the character described that is relatively simple and inexpensive to manufacture and which therefore may be disposable after use.

Other object, features and advantages of the invention will become apparent as the description thereof proceeds when considered in connection with the accompanying illustrative drawings.

As will be seen, all forms of the present Endotracheal tube provide for automatic inflation of the cuff during the inspiratory phase of the respiration cycle, and at the same time, the cuff is maintained sufficiently inflated during expiration to retain an effective seal. The simplicity of construction of the various forms of the instant invention hereinbefore described make it feasible for the tubes to be disposable after each use.

Endotracheal tube laryngeal mask airway  tracheostomy tube

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Four Major advantage of endotracheal tube

Environment

Endotracheal tube should be abolished, the patient physiological monitoring, in appropriate emergency equipment and trained health care providers of airway management skills, the environment is immediately available
Objectives

Airway control when the endotracheal tube to be identified as no longer necessary to continue treatment for the patient, the management should be abolished. Determination of the subjective or objective underlying cause pulmonary and / or gas exchange capacity is improved by the former extubation conditions. In general, this need to have enough patience: the central inspiratory drive, respiratory muscle strength, strength cough clear secretions, laryngeal mask airway function, nutritional status, as well as the role of sedative and neuromuscular blocking release.

•   Occasionally, surgical mask obstruction of the artificial airway due to mucus or mechanical deformation mandates immediate removal of the artificial airway.

•   Patients in whom an explicit declaration of the futility of further medical care is documented may have the endotracheal tube removed despite failure to meet the above indications .

Contraindications

There are no absolute contraindications to extubation; however, to maintain acceptable gas exchange after extubation some patients may require one or more of the following: noninvasive ventilation, continuous positive airway pressure, high inspired oxygen mask fraction, or reintubation. Airway protective reflexes may be depressed immediately following and for some time after extubation

Limitations of Methodology

Extubation predicted results and the poor. However, the literature on the subject is a limited number of measures to verify the target accurately forecast the results of individual patient’s extubation.

endotracheal tube  oxygen mask   laryngeal mask airway    surgical mask

Endotracheal tube cleaning apparatus

A cleaning apparatus to be used with an endotracheal tube and including an elongate tubular member that extends into the endotracheal tube. A cleaning assembly is provided at a distal end of the elongate tubular member and is radially expandable to engage the interior wall of the endotracheal tube for cleaning thereof by an irregular configuration on an exterior surface that achieves an effective cleaning engagement, as well as a fluid impervious bladder portion to provide an effective seal that prevents fluid seepage during cleaning withdrawl. A ventilator coupling is further provided and is connected to the endotracheal tube, a first inlet port of the ventilator coupling being coupled to a ventilator assembly to supply air to a patient, and a second inlet port of the ventilator coupling being structured to receive the elongate tubular member there through into the feeding tubes.

CLAIM OF PRIORITY

The present oxygen mask is a Continuation-In-Part application of previously filed, now pending application having Ser. No. 10/384,130 filed on Mar. 7, 2003 which is a Continuation-In-Part application of previously filed, now pending application having Ser. No. 09/995,342 filed on Nov. 27, 2001 and which matured into U.S. Pat. No. 6,679,262 on Nov. 27, 2001, which is a Divisional patent application of a Continuation-In-Part patent application Ser. No. 09/608,026 which was filed on Jun. 30, 2000 and which matured into U.S. Pat. No. 6,494,208 on Dec.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to an endotracheal tube cleaning apparatus to be used to effectively and efficiently clean the flow through passage of an endotracheal tube, including the effective removal of even solid buildup on the interior wall surface of the tracheostomy tube safely, effectively, and in a self contained sterile assembly that does not have to be removed from the patient, does not significantly restrict airflow to the patient, and may be used to administer needed medication. 2. Description of the Related Art

Many patients in a hospital, and in particular, patients in an Intensive Care Unit (“ICU”) must be fitted with endotracheal tubes to facilitate their respiration. Specifically, an endotracheal tube is an elongate, semi-rigid lumen which is inserted into a patient’s nose or throat and projects down into airflow communication with the patient’s respiratory system. As such, the patient either directly, or with the aid of a respiratory unit, is able to breathe more effectively through the endotracheal tube.

endotracheal tube  tracheostomy tube oxygen mask

One of the most important functions of an endotracheal tube

One of the most important functions of an endotracheal tube (ETT) is to prevent aspiration of fluid or particulate matter into the airway. This is achieved by using tracheostomy tube  with inflatable cuffs. However, these can cause tracheal damage, including rupture. Tracheal rupture occurs most commonly in cats and is often associated with dental procedures. One theory is that because of the fear of fluid aspiration during a dental prodecure, the cuffs are often overinflated. Applying gel to an oxygen mask before insertion helps it slide more easily into the trachea and prevents tissue damage, but it serves another important function: The gel enhances the seal produced by the cuff, especially high-volume, low-pressure cuffs.

I read more lubrication and dye through nonlubricated cuff cuff in the last two desktop models and one anesthetic people3, I want to see the impact of this on my own research laryngeal mask airway . I placed a high capacity, low-pressure ETT into a rigid glass tube—the first cuff was dry and the second cuff was lubricated with gel. Each cuff was inflated with the same volume of air, which was minimal in this setting. I then poured colored water into the glass tube above the ETT to simulate fluid in the trachea, and observed whether fluid appeared below the cuff. The results are obvious: The gel helps prevent “aspiration” past the cuff.

In human studies showed that dye leakage of their bench top models in the past cuff is lubricated sleeve cuffs in nonlubricated group group vs. 100% 0%. In anesthesia who leaked lubrication is 11% vs 83% at the nonlubricated group. The researchers concluded the cuff and water soluble lubricating gel can reduce the lung in patients with inhalation anesthesia.

Gel is easier to apply, the cuff is uniform expansion and cuffs should always check their integrity before each use expansion. We recommend that you check the cuff before full expansion to use it to make it expand, then gel and cuffs of endotracheal tube intubation before the deduction for. After intubation, check for a leak by listening to the patient’s airway as the reservoir bag is squeezed. Add air to the cuff in small increments until you no longer hear a leak when the pressure gauge reads 15 cm H₂O. The careful application of gel to the cuff decreases leakage past the cuff and may provide a seal with less air in the cuff, which could potentially decrease tracheal trauma.

endotracheal tube  tracheostomy tube   oxygen mask  laryngeal mask airway

In  endotracheal tube  operation

FIGS. 6 and 7 illustrate the proper handling technique and grip of my tube 10. With the endotracheal tube 10, the middle finger 20 is placed into the ring 11. The index finger 21 is placed on the uppermost boundary of the connector tip 16. Then the tube 10 is introduced into the patient’s mouth and advanced towards the glottis as best seen in FIGS. 1 and 2. The middle finger 20 is then drawn up towards the endotracheal tube connector tip 16 using the index finger 21 for leverage, shown in FIG. 7. Again the amount of cord 12 withdrawn will determine the amount of curl. Therefore, patients with extremely anterior glottis, which normally contribute to difficult intubations, can be easily intubated by merely withdrawing more  cord 12 from the tunnel 14.

The tube of the present  oxygen mask  provides a more reasonable and logical means of securing a difficult intubation. Instead of changing human anatomy by force to match the curl of a tracheostomy tube, force is applied to a tube to match the natural human anatomy, also missed attempts due to improper tube curl are eliminated because of my tube’s ability to change angles instantaneously.

In the pediatric form of my tube the tube 10 is fitted with a balloon 15 having a laryngeal mask airway  connection 15A for the inflation of the balloon 15. In the uncuffed tube, that is one without a balloon 15, the tunnel 14 and cord 12 run on the top of the endotracheal tube 10 (as with the adult type) of the tunnel 14 and cord 12 are placed between the inner and outer walls of the endotracheal tube itself or the tunnel and cord run along the inside of the tube attached to the inner wall surface.

Among the many areas of application of my tube is the very dramatic Caesarean Section (operation involving delivery of baby by cutting into the womb). My tube would contribute greatly to the safety of the mother and fetus.

The number one cause of maternal death, as a result of a general anesthetic, is caused by pulmonary aspiration. This occurs when the stomach contents are regurgitated into the trachea and lungs. Therefore it is of momentous importance that the trachea be intubated as quickly as possible after the patient has been rendered unconscious and paralyzed. Intubation blocks off the trachea from stomach contents as well as secure an airway for oxygen and other gases. It can easily be seen that if the tube 10 does not match the anatomical curvature of the patient and the trachea can not be swiftly intubated a number of serious problems may present themselves as well as death to mother and fetus.

endotracheal tube  oxygen mask  tracheostomy tube  laryngeal mask airway

Summary of the endotracheal tube

SUMMARY OF THE INVENTION

Embodiments of the invention relate to endotracheal tube and methods for using endotracheal tubes. The endotracheal tubes may be adapted for use with any suitable patient. Patients may include animals or humans of any suitable size. However, embodiments of the laryngeal mask airway are especially useful when the patients are infants such as neonates.

Another embodiment of the oxygen mask is directed to a method of inserting an endotracheal tube in a patient, the method comprising: a) obtaining an endotracheal tube comprising a tubular member including a distal end and a proximal end, and a plurality of visually distinct regions at a proximal portion of the tubular member, wherein each of the distinct regions comprises a respectively different color; b) inserting the distal end of the tracheostomy tube into a patient; and c) aligning one visually distinct region of the visually distinct regions with an anatomical structure of the patient.

Another embodiment of the invention is directed to a method of inserting an endotracheal tube in a patient, the method comprising: a) obtaining an endotracheal tube comprising a tubular member including a distal end and a proximal end, and a plurality of visually distinct regions at a proximal portion of the tubular member, wherein each visually distinct region is spaced from other visually distinct regions; b) inserting the distal end of the feeding tubes into a patient; c)

In preferred embodiments of the invention, the distinct regions on the endotracheal tube are brightly colored lines. During intubation, one of the lines is selected and localized at, for example, a fixed anatomical location such as the upper gingival ridge.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a side view of a portion of an endotracheal tube that is suitable for use with an infant.

FIG. 2 shows a side view of an endotracheal tube according to an embodiment of the invention.

FIG. 3 shows a diagram of an endotracheal tube according to an embodiment of the invention as it is being used in a newborn infant.

FIG. 4 shows a bar graph of the number of intubated infants that do or do not have right mainstem bronchial intubation (RMSBI) as a complication of their size at a given gestational age (weeks after conception).

FIG. 5 shows a bar graph of a controlled clinical trial that had one group of newborn infants use a standard endotracheal tube during intubation (Group I), while a second group of infants (Group II) had the newly invented endotracheal tube inserted during intubation.

endotracheal tube  laryngeal mask airway  oxygen mask   tracheostomy tube

Uses the endotracheal tube may reduce Issues in Anesthesia

   When a person under general anesthesia, they completely unconscious and temporarily paralyzed This means that in addition to the risk of a bad reaction to the powerful drugs used in this process, there is the added danger of the patient’s body being partially shut down during the procedure. Regular necessary functions, such as breathing, must be carefully monitored to assure that the person’s wellbeing protected. In fact, airway management(laryngeal mask airway) is one of the main areas where anesthesia complications have the potential to leave a patient permanently injured or even dead.

   In just 4 minutes of oxygen, a person’s brain can be irreversible damage; from them what is commonly referred to as “brain dead.” In the next few minutes, the body can continue to close, in cardiac arrest, leading to death. Therefore, it is clear that surgical patients to ensure safe maintenance of oxygen supply(by oxygen mask) should be one of the main problems of narcotic.

   In many cases of general anesthesia, a device known as an endotracheal tube is inserted into the patient’s windpipe to assure that it remains open and functional. This procedure carries its own risks, though. If the tracheostomy tube slips into the patient’s esophagus instead of trachea (windpipe), it will not deliver oxygen to the lungs, and the person will quickly suffer the grave consequences discussed in the previous paragraph. Also, if intubation is attempted and failed multiple times, trauma to the airway can cause swelling or obstruction, and seal the lungs off from the air they need. If this happens, an emergency tracheotomy must be performed, in which a hole is cut in the airway, allowing air to bypass the obstruction.

Ventilator was used to ensure the exchange of carbon dioxide gas in a person’s lungs can continue to function normally under anesthesia, they are. If it is misused or ventilator failure, however, this exchange does not occur properly, leading to hypoxia (oxygen shortage), or if you create too much pressure on a hole in the lung development.

   Although they are terrible, these threats are very real. General anesthesia is not a program, guard, medical professionals have a responsibility to ensure the safety of patients while they are unconscious. If a doctor’s negligence caused the injury or death of the anesthetized patients, they may face the medical litigation, and to pay compensation to the victim.

surgical mask  feeding tubes  laryngeal mask airway   endotracheal tube

There are two types of tourniquets: surgical tourniquets and emergency tourniquets. Surgical tourniquets are frequently used in orthopedic surgery while emergency tourniquets are limited to emergency situations to control blood loss.
Surgical tourniquets

Surgical tourniquets prevent blood flow to a limb and enable surgeons to work in a bloodless operative field. This allows surgical procedures to be performed with improved precision, safety and speed. Tourniquets are widely used in orthopedic and plastic surgery, as well as in intravenous regional anesthesia (Bier block anesthesia) where they serve the additional function of preventing local anesthetic in the limb from entering general circulation.
Emergency tourniquets

Emergency tourniquets are used in emergency bleeding control to prevent severe blood loss from limb trauma. Emergency tourniquets are generally used as a last resort, especially in civilian applications, for all blood flow below the application of an emergency tourniquet is stopped, and can subsequently kill the tissue, leading to eventual loss of the limb below application.

However, use of tourniquets is widespread in military applications, and have the potential to save lives during major limb trauma. Analysis has shown that in cases of major limb trauma, there is no apparent link between tourniquet application and morbidity of the limb.