Endotracheal intubation assembly and related method

• US 5,400,771 A
• Filed: 01/21/1993
• Issued: 03/28/1995
• Est. Priority Date: 01/21/1993
• Status: Expired due to Term

• Current Assignee: Leon Pirak, Peter J. Wilk
• Original Assignee: Leon Pirak, Peter J. Wilk
• Inventors: Wilk, Peter J., Pirak, Leon
• Primary Examiner(s): Apley, Richard J.
• Assistant Examiner(s): LEUBECKER, JOHN P
• Application Number:
  US08/007,056
• Time in Patent Office: 796 Days
• Field of Search: 128/4, 128/6, 128/10, 128/11, 128/200.26, 128/207.14, 128/662.06, 358/98, 358/105, 358/107, 348/129, 348/130, 348/135, 348/180
• US Class Current: 600/109
• CPC Class Codes: A61B 1/042 characterised by a proximal camera, e.g. a CCD camera
• CPC Class Codes: A61B 1/06 with illuminating arrangements
• CPC Class Codes: A61B 1/267 for the respiratory tract, e.g. laryngoscopes, bronchoscopes
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61M 16/0486 Multi-lumen tracheal tubes
• 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

Abstract

In an endotracheal intubation method, during and after insertion of an endotracheal tube into a trachea of a patient, an image is transmitted along the endotracheal tube from a distal end to a proximal end thereof, thereby enabling an operator to determine proper placement of the endotracheal tube. The image transmitted from the distal end of the endotracheal tube may be automatically monitored by a computer. Upon determination that an incoming image is different from a stored reference image, an alert signal is automatically issued to an operator, thereby indicating that the distal end of the endotracheal tube has moved from a predetermined position within the patient'"'"'s trachea. A desired image is selected upon insertion of a distal end portion of the endotracheal tube into a patient'"'"'s trachea.

Claims

1. An endotracheal intubation method, comprising the steps of:

inserting an endotracheal tube into a trachea of a patient;

during said step of inserting, emitting ultrasonic pressure waves from a distal end portion of said endotracheal tube in the direction of insertion of said endotracheal tube;

automatically sensing ultrasonic waves reflected from internal tissues in the patient;

automatically analyzing the sensed ultrasonic waves to determine internal structures of said patient;

generating a video image of said internal structures in response to said steps of sensing and analyzing;

in response to said video image, manipulating said endotracheal tube to position a distal end thereof in a desired location in the trachea of the patient;

upon the manipulating of said endotracheal tube to said desired location, storing, as a reference image, a selected image of internal structures of the patient;

upon the storing of said reference image, automatically comparing said video image with said reference image; and

upon detecting a difference between said video image and said reference image in said step of comparing, automatically indicating to an operator that said distal end of said endotracheal tube has moved from said desired location.

2. The method defined in claim 1 wherein said steps of emitting and sensing are implemented via an elongate rod slidably inserted into an ancillary channel on said endotracheal tube, further comprising the step of inserting said elongate rod into said ancillary channel prior to the insertion of said endotracheal tube into the trachea of the patient.

3. The method defined in claim 1, further comprising the step of displaying said video image on a video monitor.

4. An endotracheal intubation assembly, comprising:

a tubular member having a proximal end and a distal end, said tubular member being provided with openings at said proximal end and said distal end;

emission means disposed at said distal end of said tubular member for emitting an ultrasonic pressure waveform from said distal end of said tubular member;

pickup means disposed at a distal end of said tubular member for sensing ultrasonic pressure waves reflected from internal tissues in the patient;

analyzing means operatively connected to said pickup means for automatically analyzing reflected ultrasonic pressure waves sensed by said pickup means to determine internal structures of a patient;

memory means for storing a reference;

comparator means operatively connected to said analyzing means and said memory means for automatically comparing a detected internal structure with the stored reference; and

alert means operatively connected to said comparator means for automatically indicating to an operator that said distal end of said endotracheal tube has moved from a predetermined position within the patient'"'"'s trachea.

5. An endotracheal intubation assembly, comprising:

a tubular member having a proximal end and a distal end, said tubular member defining a longitudinally extending lumen having openings at said proximal end and said distal end;

radiation transmission means attached to said tubular member for transmitting electromagnetic radiation from said proximal end to said distal end of said tubular member along a first path separate from said lumen;

image transmission means attached to said tubular member for transmitting an image from said distal end to said proximal end of said tubular member along a second path separate from said lumen;

analyzing means operatively connected to said image transmission means for automatically monitoring image information carried by said image transmission means; and

alert means operatively connected to said analyzing means for indicating to an operator that said distal end has moved from a predetermined position within a patient'"'"'s trachea.

6. The assembly defined in claim 5 wherein said ancillary tube is provided at said distal end with a transparent end cap.

7. The assembly defined in claim 6 wherein said end cap is attached to said ancillary tube in a fluid tight seal.

8. The assembly defined in claim 5, further comprising selection means for programming said analyzing means to recognize a selected image upon insertion of a distal end portion of the assembly into a patient'"'"'s trachea.

9. The assembly defined in claim 5 wherein said analyzing means includes comparator means for comparing, with a selected image, the image carried by said image transmission means.

10. The assembly defined in claim 5 wherein said image transmission means includes a fiberoptic cable removably attached to said tubular member.

11. The assembly defined in claim 10 wherein an ancillary tube is connected to said tubular member and extends longitudinally therealong from said proximal end to said distal end, said fiberoptic cable being removably inserted into said ancillary tube.

12. An endotracheal intubation method, comprising the steps of:

providing an endotracheal tube having a longitudinally extending lumen and a distal end and a proximal end;

inserting said endotracheal tube into a trachea of a patient;

upon placement of said endotracheal tube at a desired position within the patient'"'"'s trachea, connecting said endotracheal tube to a respirator machine so that said lumen communicates with said respirator machine in a closed system;

upon connection of said respirator machine to said endotracheal tube, performing a surgical operation on the patient;

maintaining said lumen free of obstructions during performance of said operation;

during performance of said operation, transmitting electromagnetic radiation along said endotracheal tube from said proximal end to said distal end thereof;

also during performance of said operation, transmitting, along said endotracheal tube from said distal end to said proximal end thereof, encoded structural information pertaining to internal organic structures of the patient;

upon placement of said endotracheal tube at said desired position within the patient'"'"'s trachea and prior to the performance of said surgical operation, storing, as reference data in encoded form, selected internal organic structures of the patient at said desired location; and

during performance of said operation, monitoring the encoded structural information transmitted from the distal end of said endotracheal tube, to determine whether said distal end of said endotracheal tube has moved from said desired position, said step of monitoring including the step of automatically comparing the transmitted encoded structural information with said reference data.

13. The method defined in claim 12 wherein said step of transmitting includes the step of transmitting a video image along said endotracheal tube from said distal end to said proximal end thereof, said encoded structural information being contained in said video image, said reference data including a reference image, said step of monitoring including the step of comparing said video image with said reference image.

14. The method defined in claim 13 wherein said step of monitoring includes the step of operating a comparator device to compare said video image with said reference image automatically to determine that said distal end of said endotracheal tube has moved from said predetermined position.

15. The method defined in claim 13 further comprising the step, performed prior to said step of inserting, of inserting an optical fiber bundle into a channel provided on said endotracheal tube, said video image being transmitted along said optical fiber bundle.

16. The method defined in claim 13, further comprising the step of displaying said video image on a video monitor.

17. The method defined in claim 15 wherein insertion of said optical fiber bundle into said channel is stopped upon a distal end of said optical fiber bundle abutting a transparent end cap at a distal end of said channel.

18. An endotracheal intubation method, comprising the steps of:

inserting an endotracheal tube into a trachea of a patient;

during said step of inserting, transmitting optical radiation along said endotracheal tube from a proximal end to a distal end thereof;

during said step of inserting, transmitting an image along said endotracheal tube from a distal end to a proximal end thereof, thereby enabling an operator to determine proper placement of said endotracheal tube;

upon placement of said endotracheal tube at a desired position within the patient'"'"'s trachea, selecting a correlated image of tracheal or bronchial structures of the patient, corresponding to said desired position;

storing said correlated image as a reference image;

also upon placement of said endotracheal tube at said desired position within the patient'"'"'s trachea, continuing to transmit the image along said endotracheal tube from a distal end to a proximal end thereof; and

additionally upon placement of said endotracheal tube at said predetermined position, automatically monitoring the image transmitted from the distal end of said endotracheal tube and automatically indicating to an operator that said distal end of said endotracheal tube has moved from said predetermined position, said step of monitoring including the step of automatically comparing the image transmitted from the distal end of said endotracheal tube with said reference image.

19. An endotracheal intubation method, comprising the steps of:

providing an endotracheal tube having a longitudinally extending lumen and a distal end and a proximal end;

inserting said endotracheal tube into a trachea of a patient;

upon placement of said endotracheal tube at a predetermined position within the patient'"'"'s trachea, connecting said endotracheal tube to a respirator machine so that said lumen communicates with said respirator machine in a closed system;

upon connection of said respirator machine to said endotracheal tube, performing a surgical operation on the patient;

maintaining said lumen free of obstructions during performance of said operation;

during performance of said operation, emitting ultrasonic pressure waves from a distal end portion of said endotracheal tube in the direction of insertion of said endotracheal tube;

automatically sensing ultrasonic waves reflected from internal tissues in the patient;

automatically analyzing the sensed ultrasonic waves to determine internal structures of the patient;

generating a video image of said internal structures in response to said steps of sensing and analyzing;

upon the placement of said endotracheal tube at said predetermined position and prior to said step of performing said surgical operation, storing, as a reference image, a selected image of internal structures of the patient;

upon the storing of said reference image, automatically monitoring the video image to determine whether said distal end of said endotracheal tube has moved from said predetermined position, said step of monitoring including the step of automatically comparing said video image with said reference image.

20. An endotracheal intubation method, comprising the steps of:

providing an endotracheal tube having a longitudinally extending lumen and a distal end and a proximal end;

inserting said endotracheal tube into a trachea of a patient;

upon placement of said endotracheal tube at a predetermined position within the patient'"'"'s trachea, connecting said endotracheal tube to a respirator machine so that said lumen communicates with said respirator machine in a closed system;

upon connection of said respirator machine to said endotracheal tube, performing a surgical operation on the patient;

maintaining said lumen free of obstructions during performance of said operation;

during performance of said operation, emitting ultrasonic pressure waves from a distal end portion of said endotracheal tube in the direction of insertion of said endotracheal tube;

automatically sensing ultrasonic waves reflected from internal tissues in the patient;

automatically analyzing the sensed ultrasonic waves to determine an internal structure of the patient;

upon placement of said endotracheal tube at said predetermined position within the patient'"'"'s trachea and prior to the performance of said surgical operation, storing, as reference data in encoded form, selected internal organic structures of the patient at said predetermined position; and

during performance of said operation, automatically comparing the automatically determined internal structure with said reference data to determine whether said distal end of said endotracheal tube has moved from said predetermined position.