Carbon dioxide detection

• US 5,197,464 A
• Filed: 12/14/1990
• Issued: 03/30/1993
• Est. Priority Date: 02/26/1988
• Status: Expired due to Fees

• Current Assignee: Albert L. Babb, Gary L. Tarbox, Michael P. Hlastala
• Original Assignee: Albert L. Babb, Gary L. Tarbox, Michael P. Hlastala
• Inventors: Hlastala, Michael P., Babb, Albert L., Tarbox, Gary L.
• Primary Examiner(s): Burr, Edgar S.
• Assistant Examiner(s): Lewis, Aaron J.
• Application Number:
  US07/629,055
• Time in Patent Office: 837 Days
• Field of Search: 128/207.14, 128/207.15, 128/205.23, 422/55, 422/56, 422/58, 422/61, 422/86, 436/165
• US Class Current: 128/207.14
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61M 16/0488 Mouthpieces; Means for guiding, securing or introducing the tubes guiding or introducing with laryngoscopes A61B1/267; holding devices on the body A61M25/02
• CPC Class Codes: A61M 16/0816 Joints or connectors
• CPC Class Codes: A61M 16/085 Gas sampling
• CPC Class Codes: A61M 2016/0413 with detectors of CO2 in exhaled gases
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)
• CPC Class Codes: G01N 31/223 for investigating presence of specific gases or aerosols G01N31/221, G01N31/222 take precedence; actuation of fire alarm by presence of smoke or gases G08B17/10

Abstract

Methods and apparatus for ascertaining whether there is at least a threshold concentration of carbon dioxide in gases being monitored. Reversible hydration of the carbon dioxide to generate excess hydrogen ions and trigger a color change in a pH sensitive indicator is employed in represenative embodiments of the invention to provide a indication that the threshold concentration of carbon dioxide is present in the gases. The methods and apparatus may be used to distinguish between tracheal and esophageal intubation of human and other nammalian patients.

Claims

1. A method of determining whether an airway tube has been placed in the trachea or esophagus of a patient, said method comprising the steps of:

directing gases discharged from said tube into a controlled environment where carbon dioxide can be reversibly hydrated to produce an excess of H³⁰ ions;

providing in said environment, in an effective amount and in solution, an indicator which will;

(a) rapidly change character in the presence of a concentration of said H³⁰ ions capable of triggering the change in character and indicative of a concentration of carbon dioxide consistent with tracheal intubation being present in said sample and (b) revert to its original character at a slower rate once the concentration of carbon dioxide in the controlled environment decreases to a level below that concentration;

isolating said indicator solution from said controlled environment with a barrier through which carbon dioxide can diffuse while substances that might affect the activity of the indicator are excluded from the controlled environment;

adding to the indicator solution a catalyst which is effective to so promote the reversion of the indicator to its orginal character that the reversions of the indicator to its original character will occur at a speed approaching that with which the indicator changes character in the presence of a concentration of H³⁰ ions capable of effecting the change in character of the indicator, thereby insuring that such changes and reversions of the indicator to its original character are essentially time-limited only by the rate at which carbon dioxide can diffuse across said barrier and that the indicator will change character with each exhalation of the patient and will revert to its original character between the exhalations of the patient;

so observing the indicator by direct visual observation over a series of exhalations as to determine whether;

(a) there is only a change of character and subsequent reversion that may be attributable to the presence of carbon dioxide in the esophagus, or (b) a series of character changes and reversions coincident with the exhalations of the patient; and

employing a change in character of said indicator and a reversion of the indicator to its original character coincident with each of exhalations in said series as an indication of tracheal intubation.

2. A method as defined in claim 1 which includes the step of flushing carbon dioxide from said controlled environment between exhalations to promote the tendency of the indicator to revert to its original color between exhalations.

3. A method as defined in claim 1 in which the catalyst is one of the following:

Carbonic Anhydrase,

NaOCl,

Na Selenite, or

Na₂ SO₃.

4. A method as defined in claim 3 wherein the catalyst is an isozyme of carbonic anhydrase or a mixture of such isozymes.

5. A method as defined in claim 1 which includes the step of buffering said indicator solution to alter that concentration of carbon dioxide required to effect a change in the color of the indicator.

6. A method as defined in claim 5 wherein the indicator solution is buffered with a mixture of sodium barbital and hydrochloric acid, or with sodium bicarbonate, or with sodium hydroxide.

7. A method as defined in claim 1 which includes the step of isolating the catalyst from the controlled environment in which the indicator solution is provided until such time as the sequence of steps utilized in detecting the presence of carbon dioxide in a concentration above the level consistent with tracheal intubation are initiated to thereby extend the shelf life of the system employed to realize said method.

8. A method as defined in claim 1 in which the indicator solution is so applied to a wick prior to the time at which the sequence of steps utilized in distinguishing between esophageal and tracheal placement of the tube are carried out as to:

(a) promote the spread of the indicator and thereby make more readily observable changes in the carbon dioxide concentration-indicating character of the indicator, and (b) increase the area available for those reactions which result in the change of the character of the indicator and in the reversion of the indicator to the original character, thereby increasing the speed with which those reactions can take place.