Methods for tracheostomy visualization

• US 8,534,287 B2
• Filed: 08/04/2010
• Issued: 09/17/2013
• Est. Priority Date: 02/06/2009
• Status: Active Grant

• Current Assignee: SunMed Group Holdings LLC
• Original Assignee: Endoclear LLC (Avanos Medical, Inc.)
• Inventors: Vazales, Brad E., Bertolero, Arthur
• Primary Examiner(s): Yu, Justine
• Assistant Examiner(s): TSAI, MICHAEL JASPER
• Application Number:
  US12/850,549
• Publication Number:
  US 20110023887A1
• Time in Patent Office: 1,140 Days
• Field of Search: 128/207.14, 128/207.29, 128/898, 128/920, 128/922, 128/204.18, 128/200.24, 600/103, 600/101, 600/109, 600/112, 600114-116, 600/120, 600/160, 600166-182
• US Class Current: 128/207.14
• CPC Class Codes: A61B 1/00045 Display arrangement
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/00142 with means for preventing contamination, e.g. by using a sanitary sheath
• CPC Class Codes: A61B 1/00165 with light-conductive means, e.g. fibre optics A61B1/07 takes precedence
• CPC Class Codes: A61B 1/04 combined with photographic or television appliances
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 1/0661 Endoscope light sources
• CPC Class Codes: A61B 1/0669 at proximal end of an endoscope
• CPC Class Codes: A61B 1/07 using light-conductive means, e.g. optical fibres
• CPC Class Codes: A61B 1/267 for the respiratory tract, e.g. laryngoscopes, bronchoscopes
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 2090/701 for flexible tubular instruments, e.g. endoscopes
• CPC Class Codes: A61B 90/70 Cleaning devices specially adapted for surgical instruments
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0418 with integrated means for changing the degree of curvature, e.g. for easy intubation
• CPC Class Codes: A61M 16/0427 with removable and re-insertable liner tubes, e.g. for cleaning
• CPC Class Codes: A61M 16/0431 with a cross-sectional shape other than circular
• CPC Class Codes: A61M 16/0434 Cuffs
• CPC Class Codes: A61M 16/0463 combined with suction tubes, catheters or the like; Outside connections
• CPC Class Codes: A61M 16/0472 : Devices for performing a tracheostomy
• CPC Class Codes: A61M 16/0484 : at the distal end
• CPC Class Codes: A61M 16/0486 : Multi-lumen tracheal tubes
• CPC Class Codes: A61M 16/0833 : T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 2016/0413 : with detectors of CO2 in exhaled gases
• CPC Class Codes: A61M 2202/203 : Bacteria

Abstract

Systems, devices, and methods are disclosed for the cleaning of an endotracheal tube while a patient is being supported by a ventilator connected to the endotracheal tube for the purpose of increasing the available space for airflow or to prevent the build up of materials that may constrict airflow or be a potential nidus for infection. In one embodiment, a mechanically-actuated endotracheal tube cleaning device is configured to removably receive a visualization member to provide cleaning of the endotracheal tube under direct visualization.

Claims

1. A method for facilitating the conversion from an endotracheal tube to a tracheostomy tube, the method comprising:

providing a T-connector having an in-line inlet port, a side inlet port, and an outlet port;

coupling the outlet port of the T-connector to a proximal end of an indwelling endotracheal tube;

coupling a side inlet port of the T-connector to an external ventilator, said external ventilator configured to deliver air through the outlet port of the T-connector;

inserting an endotracheal tube cleaning device comprising a visualization lumen having a window at a sealed distal end into the in-line inlet port of the T-connector;

inserting a visualization scope within the visualization lumen;

withdrawing the endotracheal tube to a position such that the distal end of the endotracheal tube is adjacent to a larynx within a trachea of a patient;

performing a percutaneous tracheostomy while visualizing the trachea beyond the distal tip of the endotracheal tube using the visualization scope;

inserting a tracheostomy tube within the trachea;

confirming the proper positioning of the tracheostomy tube; and

removing the endotracheal tube from the patient.

2. The method of claim 1, wherein the internal diameter of the visualization lumen is less than 2 mm.

3. The method of claim 2, wherein the outer diameter of the visualization scope is less than the internal diameter of the visualization lumen.

4. The method of claim 1, further comprising coupling the tracheostomy tube to the external ventilator.

5. The method of claim 1, further comprising coupling the visualization scope to a display monitor, wherein images captured by the visualization scope are displayed on the display monitor.

6. The method of claim 5, wherein the visualization scope is coupled to the display monitor using an optical connection.

7. The method of claim 1, further comprising verifying proper insertion of a hollow needle within the trachea.

8. The method of claim 1, further comprising verifying proper insertion of a guidewire through the hollow needle of the trachea.

9. The method of claim 8, further comprising verifying proper insertion of tracheostomy dilators within the trachea over the guidewire.

10. The method of claim 1, further comprising recording an image of the tracheostomy tube after insertion.

11. The method of claim 1, further comprising inflating a balloon cuff of the endotracheal tube after withdrawing the endotracheal tube to the position such that the distal end of the endotracheal tube is just distal to the patient'"'"'s larynx within the trachea.

12. The method of claim 1, wherein confirming the proper positioning of the tracheostomy tube comprises analyzing images captured by the visualization scope.

13. The method of claim 1, further comprising removing the visualization scope from the endotracheal tube cleaning device.

14. The method of claim 1, wherein air flow through the endotracheal tube is maintained during the percutaneous tracheostomy.

15. A method for facilitating the conversion from an endotracheal tube to a tracheostomy tube, the method comprising:

coupling an outlet port of a multi-port connector to a proximal end of an indwelling endotracheal tube, wherein the multi-port connector comprises an in-line inlet port, a side inlet port and an outlet port;

coupling the side inlet port of the multi-port connector to an external ventilator, said external ventilator configured to deliver air through the outlet port of the multi-port connector;

inserting an endotracheal tube cleaning device comprising a visualization lumen having a viewing window at a sealed distal end into the in-line inlet port of the multi-port connector;

inserting a visualization scope within the visualization lumen;

withdrawing the endotracheal tube to a position such that the distal end of the endotracheal tube is adjacent to a larynx within a trachea of a patient;

performing a percutaneous tracheostomy while visualizing the trachea beyond the distal tip of the endotracheal tube using the visualization scope;

inserting a tracheostomy tube within the trachea;

confirming the proper positioning of the tracheostomy tube; and

removing the endotracheal tube from the patient.

16. The method of claim 15, further comprising coupling the visualization scope to a display monitor, wherein images captured by the visualization scope are displayed on the display monitor.

17. The method of claim 15, further comprising verifying proper insertion of a hollow needle within the trachea.

18. The method of claim 15, further comprising verifying proper insertion of a guidewire through the hollow needle of the trachea.

19. The method of claim 15 further comprising recording an image of the tracheostomy tube after insertion.

20. The method of claim 15, wherein air flow through the endotracheal tube is generally maintained during the percutaneous tracheostomy.