Esophageal intubation detector with indicator

• US 5,591,130 A
• Filed: 06/07/1995
• Issued: 01/07/1997
• 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): Green, Randall L.
• Assistant Examiner(s): VANOVER, PERRY
• Application Number:
  US08/484,936
• Time in Patent Office: 580 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: 604/100.02
• 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 16/0816 Joints or connectors
• 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 16/12 by mixing different gases
• 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
• CPC Class Codes: A61M 29/00 Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00

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 (or a bulb) connected to the endotracheal tube through an adapter to which the indicator is connected. The bulb may be associated with a resuscitator bag. 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 and causing 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 intubation detection system for use in determining whether a tip of a tubular airway controlling device is in a patient'"'"'s esophagus or in the patient'"'"'s trachea, the system comprising:

the tubular airway controlling device including the tube tip;

a volume changing device connected to the tubular airway controlling device;

an indicator that is pneumatically connected to the volume changing device and that is 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 volume changing device increases in volume creating the significant pressure differential across the indicator which activates the indicator indicating that the tube tip is in the esophagus; and

if the tube tip is in the trachea, the tube tip does not become occluded as the volume changing device increases in volume, the significant pressure differential across the indicator is not created, and the indicator is not activated.

2. The system of claim 1 in which the volume changing device is a syringe including a plunger and the volume increases by pulling the plunger.

3. The system of claim 1 in which the volume changing device is a bulb having a first bulb shape to which the bulb returns after being squeezed.

4. The system of claim 3 further comprising a ventilating bag connected to the tubular airway controlling device through a pressure valve, the ventilating bag having a first ventilating bag shape to which the ventilating bag returns after being squeezed, the pressure valve allowing flow of air out of the ventilating bag while the ventilating bag is being squeezed, but not after the ventilating bag has been squeezed and is returning to the first ventilating bag shape.

5. The system of claim 1 in which the indicator is connected adjacent the volume changing device.

6. The system of claim 1 in which the tubular airway controlling device is an endotracheal tube.

7. The system of claim 1 in which a venting ON-OFF switch is placed between the volume changing device and the tubular airway controlling device.

8. The system of claim 1 in which the volume changing device is connected to the tubular airway controlling device through an adapter and the indicator is connected over an orifice in the adapter.

9. The system of claim 8 in which the adapter is connected to the volume changing device and in which the tubular airway controlling device includes an end adapter that attaches to the adapter connected to the volume changing device.

10. The system of claim 1 in which the indicator is connected over an orifice in the tubular airway controlling device.

11. The system of claim 1 in which the indicator includes a sound enhancer that increases sound output.

12. The system of claim 11 in which the sound enhancer includes a tube having a length that maximizes sound output.

13. An intubation detection system for use in determining whether a tip of a tubular airway controlling device is in a patient'"'"'s esophagus or in the patient'"'"'s trachea, the system comprising:

the tubular airway controlling device including the tube tip;

a bulb connected to the tubular airway controlling device, the bulb having a first bulb shape to which the bulb returns after being squeezed;

an indicator that is pneumatically connected to the bulb and activated in response to a significant pressure differential across the indicator;

a pressure valve;

a ventilating bag connected to the tubular airway controlling device through the pressure valve, the ventilating bag having a first ventilating bag shape to which the ventilating bag returns after being squeezed, the pressure valve allowing flow of air from the ventilating bag while the ventilating bag is being squeezed, but not after the ventilating bag has been squeezed and is returning to the first ventilating bag shape;

whereby, if the tube tip is in the esophagus, the tube tip becomes occluded as the bulb returns to the first bulb shape creating the significant pressure differential across the indicator which activates the indicator indicating that the tube tip is in the esophagus; and

if the tube tip is in the trachea, the tube tip does not become occluded as the bulb returns to the first bulb shape, the significant pressure differential across the indicator is not created, and the indicator is not activated.

14. The system of claim 13 further including a venting switch to disconnect the bulb from the tubular airway controlling device.

15. The system of claim 13 in which the bulb is inside the ventilating bag.

16. The system of claim 13 in which the bulb is connected to the tubular airway controlling device through a connecting tube.

17. The system of claim 16 in which the indicator is positioned over an orifice in the connecting tube.

18. The system of claim 13 in which the indicator is positioned over an orifice in the bulb.

19. An intubation detection system for use in determining whether a tip of a tubular airway controlling device is in a patient'"'"'s esophagus or in the patient'"'"'s trachea, the system comprising:

the tubular airway controlling device including the tube tip;

an adapter having a cavity and an orifice;

a syringe connected to the tubular airway controlling device through the adapter, the syringe having a plunger and a barrel with a barrel tip; and

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

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 cavity of the adapter to decrease until the pressure in the cavity has significantly decreased activating the indicator which indicates that the tube tip is in the esophagus; and

if the tube tip is in the trachea, the tube 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.

20. The system of claim 19 in which the syringe and adapter are connected through a luer lock.

21. The system of claim 19 in which the indicator includes a tube having a length that maximizes sound output.

22. The system of claim 19 in which the indicator makes an audible sound when activated.

23. An intubation detection system for use in determining and providing an indication of a position of a tip of a tubular airway controlling device in a throat of a patient, the system comprising:

an adapter including an orifice suitable for connection with the tubular airway controlling device;

a volume changing device including a cavity having a volume that is selectively changed, the volume changing device being connected to the adapter; and

an indicator pneumatically connected to the adapter, the indicator being activated in response to a change in pressure in the adapter, and the indicator including a communication device that is responsive to whether the indicator is activated and that provides an indication as to the position of the tip in the throat.

24. The system of claim 23 in which the change in pressure occurs because of a flow of gas through the indicator.

25. The system of claim 24 in which the indicator detects the flow of gas and is activated in response to the detection of the flow of gas.

26. The system of claim 24 in which the gas is air.

27. The system of claim 23 in which the communication device is a visual display that provides a visual presentation of whether intubation is proper.

28. The system of claim 27 in which the visual presentation includes words.

29. The system of claim 23 in which the communication device is a visual display that includes lights.

30. The system of claim 23 in which the indicator is directly connected to the adapter.

31. The system of claim 23 in which the indicator is directly connected to the tubular airway controlling device.

32. The system of claim 23 in which the volume changing device has a cylinder and a plunger and in which the volume of the cavity changes as the plunger moves with respect to the cylinder.

33. The system of claim 23 further comprising the tubular airway controlling device and in which the tubular airway controlling device is connected to the orifice of the adapter.

34. The system of claim 33 in which the tip is a first tip and the tubular airway controlling device is an esophageal tracheal combitude including the first tip and a second tip, and in which the indicator provides an indication of whether the second tip is in the patient'"'"'s esophagus or in the patient'"'"'s trachea.

35. The system of claim 23 in which if the tip is in the trachea, the indicator indicates that the tip is in the trachea, and if the tip is in the esophagus, the indicator indicates that the tip is in the esophagus.

36. An intubation detection system for use in determining and providing an indication of a position of a tip of a tubular airway controlling device in a throat of a patient, the system comprising:

the tubular airway controlling device;

a pressure changing source connected to the tubular airway controlling device that changes pressure in the tubular airway controlling device depending on the position of the tip in the patient'"'"'s throat; and

an indicator pneumatically connected to the tubular airway controlling device, the indicator being activated in response to a change in pressure in the indicator, and the indicator providing an indication of the position of the tip in the throat of the patient.

37. The system of claim 36 in which the indicator is directly connected to the tubular airway controlling device.

38. The system of claim 36 further comprising an adapter that is connected between the pressure changing source and the tubular airway controlling device, and the indicator being directly connected to the adapter.

39. The system of claim 36 in which the pressure changing source includes a cavity having a volume that is selectively changed.