Esophageal intubation detector with indicator

• US 5,487,731 A
• Filed: 02/22/1994
• Issued: 01/30/1996
• Est. Priority Date: 02/22/1994
• Status: Expired due to Fees

• Current Assignee: Wolfe TORY Medical Incorporated
• Original Assignee: Wolfe TORY Medical Incorporated
• Inventors: Denton, Marshall T.
• Primary Examiner(s): MCDERMOTT, CORRINE MARIE
• Application Number:
  US08/199,628
• Time in Patent Office: 707 Days
• Field of Search: 604/100, 128/200.24, 128/200.26, 128/202.22, 128/205.23, 128/207.14, 128/207.15
• US Class Current: 604/100.01
• CPC Class Codes: A61M 16/0078 Breathing bags
• CPC Class Codes: A61M 16/0084 self-reinflatable by elasticity, e.g. resuscitation squeeze bags
• CPC Class Codes: A61M 16/0411 with means for differentiating between oesophageal and tracheal intubation
• CPC Class Codes: A61M 16/0463 combined with suction tubes, catheters or the like; Outside connections
• 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 16/08 Bellows; Connecting tubes having means for taking samples G01N1/22; Water traps; Patient circuits
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 16/0858 Pressure sampling ports
• CPC Class Codes: A61M 16/208 Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0413 with detectors of CO2 in exhaled gases
• CPC Class Codes: A61M 2205/073 Syringe, piston type
• CPC Class Codes: A61M 2205/581 by audible feedback
• CPC Class Codes: A61M 2205/587 Lighting arrangements

Abstract

An esophageal intubation detector with an indicator is used to determine whether the hollow tip of an endotracheal tube is in the esophagus or trachea of a patient. In a preferred embodiment, the esophageal intubation detector includes a syringe which is connected to the endotracheal tube through an adapter to which the indicator is connected. In practice, a clinician places the endotracheal tube into, for example, a patient'"'"'s mouth and throat. The esophageal intubation detector is connected to the endotracheal tube creating a system. The system volume increases through retraction of a syringe plunger or self-inflation of a depressed bulb. If the tube tip is in the esophagus, the tube tip will become occluded with the walls of the esophagus as the system volume increases, causing the system pressure to decrease. A decrease in system pressure causes activation of the indicator, implying that the endotracheal tube is in the esophagus. By contrast, if the tube tip is in the trachea, the tube tip remains open as the system volume increases and free aspiration of air occurs. The system pressure remains relatively constant and the indicator is not activated, implying the endotracheal tube is in the trachea. Activation of the indicator may result in audible or visual (or both) signs to inform the clinician of the position of the tube tip.

Claims

1. An esophageal intubation detection system for use in determining whether a tip of an endotracheal tube is in a patient'"'"'s esophagus or in the patient'"'"'s trachea, the system comprising:

the endotracheal tube including the tube tip;

volume changing means having a cavity, for changing the volume of cavity, the cavity being connected to the endotracheal tube; and

an indicator that is activated in response to a significant pressure differential across the indicator and that thereby provides an indication regarding the position of the tube tip, the indicator being pneumatically connected to the endotracheal tube and the volume changing means,

whereby, if the tube tip is in the esophagus, the tube tip becomes occluded musing the significant pressure differential across the indicator as the volume of the cavity changes activating the indicator, and if the tube tip is in the trachea, the tube tip is not occluded and there is no significant pressure differential as the volume of the cavity changes.

2. The system of claim 1 in which the volume changing means is a syringe.

3. The system of claim 1 in which the endotracheal tube is connected to the volume changing means through an adapter and the indicator is directly connected to the adapter.

4. The system of claim 1 in which the endotracheal tube is connected to the volume changing means through an adapter and the indicator is positioned adjacent the adapter.

5. The system of claim 1 in which the cavity is selectively pneumatically connected to the indicator.

6. The system of claim 1 in which the indicator makes an audible sound when activated.

7. The system of claim 6 further comprising an extension tube and an ear piece, and wherein the extension tube is connected between the indicator and the ear piece.

8. The system of claim 6 further comprising a transducer proximate the indicator and amplifier that receives signals from the transducer and that amplifies the audible sound in response to the signals from the transducer.

9. The system of claim 1 in which the indicator includes a movable element that changes position when the indicator is activated, thereby providing a visual indication that the endotracheal tube is in the patient'"'"'s esophagus.

10. The system of claim 9 in which the moveable element glows in the dark.

11. The system of claim 1 further comprising a communication device and in which the indicator is a transducer that provides a signal to the communication device.

12. The system of claim 11 in which the communication device has a display that displays words indicating whether intubation was proper.

13. The system of claim 11 in which the transducer includes a transmitter and the communication device includes a receiver.

14. The system of claim 1 in which the indicator is a first indicator and the system further comprises a connector tube and a second indicator, and the first and second indicators are connected by the connector tube.

20. The system of claim 1 in which the indicator is non-vented.

15. An esophageal intubation detection system for use in determining whether a tip of an endotracheal tube is in a patient'"'"'s esophagus or in the patient'"'"'s trachea, the system comprising:

the endotracheal tube including the tube tip;

a syringe having a barrel with first and second orifices and a plunger with a plunger seal that fits into the barrel, the syringe being connected to the endotracheal tube through the first orifice; and

an indicator that is positioned over the second orifice and that is activated in response to a significant pressure differential across the indicator, whereby if the endotracheal tube is placed in the esophagus, the tube tip is occluded and air pressure in the barrel decreases as the plunger is pulled until the plunger seal passes the second orifice at which time the significant pressure differential is created causing activation of the indicator, indicating that the endotracheal tube is in the esophagus; and

if the endotracheal tube is placed in the trachea, the tube tip is not occluded and the air pressure in the barrel remains relatively constant so that the significant pressure differential is not created when the plunger seal passes the second orifice and the indicator is not activated, indicating the endotracheal tube is in the trachea.

16. The system of claim 15 in which the indicator makes an audible sound when activated.

17. The system of claim 15 in which the indicator includes a movable element that changes position when the indicator is activated, thereby providing a visual indication that the endotracheal tube is in the patient'"'"'s esophagus.

18. The system of claim 15 in which the syringe is connected to the endotracheal tube through the first orifice and an adapter.

19. The system of claim 15 in which the indicator is activated in response to flow of air through the indicator caused by the significant pressure differential.

21. An esophageal intubation detection system for use in determining whether a tip of an endotracheal tube is in a patient'"'"'s esophagus or in the patient'"'"'s trachea, the system comprising:

an adapter having an orifice;

the endotracheal tube including the tube tip, the endotracheal tube being connected to the adapter;

a syringe having a plunger and a barrel with a barrel tip, the syringe being connected to the adapter; and

an indicator positioned over the orifice of the adapter, the indicator being activated in response to a significant pressure differential across the indicator;

whereby, if the tube tip is in the esophagus, the tube tip becomes occluded as the syringe plunger is pulled away from the barrel tip causing the pressure in the adapter to decrease until the significant pressure differential exists across the indicator activating the indicator which indicates that the tube tip is in the esophagus; and

if the tube tip is in the trachea, the tub tip does not become occluded as the syringe plunger is pulled away from the barrel tip, the pressure in the adapter does not significantly decrease, and the indicator is not activated.

22. An esophageal intubation detection system for use in determining whether a tip of an endotracheal tube is in a patient'"'"'s esophagus or in the patient'"'"'s trachea, the system comprising:

the endotracheal robe including the tube tip;

a collapsible self inflating cavity;

an adapter including an orifice, the adapter being connected to the endotracheal tube and the collapsible self inflating cavity; and

an indicator that is positioned over the orifice and that is activated in response to a signifier pressure differential across the indicator, whereby if the endotracheal tube is placed in the esophagus, the tube tip is occluded and air pressure in the adapter decreases as the collapsible self inflating cavity inflates causing the significant pressure differential and activation of the indicator, indicating that the endotracheal tube is in the esophagus; and

if the endotracheal tube is placed in the trachea, the robe tip is not occluded and the air pressure in the adapter remains relatively constant as the self inflating cavity inflates so that the significant pressure differential is not created and the indicator is not activated, indicating the endotracheal tube is in the trachea.