JPS6034460A - Instrument for treating breathing obstacle - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a device for the emergency treatment of intratracheal (i,a,) respiratory disorders in the human body.

For example, acute upper respiratory disorders such as epiglottitis caused by the introduction of foreign substances into the mouth or throat, allergic reactions, insect bites, etc. are particularly common in children, but adults can also suffer from them, resulting in serious complications. All first aid healthcare facilities must have sufficient capacity to administer appropriate treatment for such respiratory problems. It also needs to be treated quickly and easily by emergency medical services, surgical medical services, and military medical services.

However, this does not exclude some specialized medical services. This is because there is no simple, safe and suitable device to relieve respiratory problems.

Instruments developed to date are instruments intended to cut the cricothyroid membrane, such as the conus ligament dissection instrument as disclosed in Swedish Patent Application No. 731.6352-9, which are expensive. Not only that, it is dangerous to use on children under the age of 5 or 6, and many doctors are afraid to use it on children under the age of 5 or 6. No other equipment is actually used;
It's not even in the literature. In other words, in an emergency situation such as the one described above, many doctors, not to mention trained medical staff, were unable to actually take professional action and voluntarily took unnecessary chances. When there is an upper respiratory disorder and it is necessary to urgently remove the disorder and create an airway (in many cases, the patient is unable to breathe spontaneously, and even if they are able to do so, the force is weak and the patient is in a state of hypercapnia). tracheostomy is the only option left. However, this is almost always performed in a hospital operating room and is a risky procedure. There is usually not enough time for a tracheostomy in cases of urgent upper respiratory problems. This is true even if the patient has already arrived at a hospital capable of emergency surgical treatment. At best, the following five methods can only create an unobstructed airway, and are almost impossible or completely impossible to adequately aid breathing.

ml method, ventilation using a bag through a mask. This is of little use in cases of severe upper respiratory disorders such as acute epiglottitis.

The second method is endotracheal intubation. This is extremely difficult and usually impossible even for trained anesthesiologists.

The third method is cricothyrotomy using a scalpel. This is a surgical procedure performed by a specialist or doctor as a last resort when there is no other option. This surgery involves extreme pressure risks and cannot be performed in time for emergencies because breathing assistance or oxygen cannot be immediately provided.

The fourth method is cricothyroid cartilage incision using the conus ligament incision instrument described above. This is done in principle in the same manner as the third method. This device allows the surgery to be semi-automated and makes it easier to insert thin tubes. However, although most Scandinavian medical students are taught how to use conus ligament dissection instruments, which are standard equipment in most emergency medical facilities, many doctors do not Not interested in the method. The conus ligament dissection instrument is a last resort in very urgent situations and is not suitable for children under the age of 5 or 6 years.

A fifth method is to percutaneously perforate the cricothyroid membrane using a thick cannula, such as a large cannula used to perforate the knee joint chamber or a large cannula used to insert a syringe. . This method is currently considered the most appropriate for children and the least dangerous of the insertion methods. Moreover, according to the opinion of the authorities, this method may be able to allow the patient to breathe adequately. The prerequisite for this is that the uppermost respiratory obstruction forms a one-way valve at or just below the vocal cords. Breathing gas is introduced through a relatively fine cannula, and exhaled air is often able to be forced through the respiratory obstruction by auxiliary chest compression if necessary. It may be better to insert two needles to increase the cross-sectional area for inspiration. However, with this method, the posterior wall of the trachea, the esophagus, the mediastinal mucosa, and the subcutaneous air 1
There is a risk of damaging the 11i etc. Furthermore, the respiratory support necessary for life support cannot be provided satisfactorily. 1s,
Physicians are forced to ventilate the cannula, which is impractical, difficult, and inefficient.

Oxygen is only supplied when the patient is breathing spontaneously and there is an imminent danger that the respiratory reflex will disappear due to hypercapnia during sleep; - They are forced to ventilate the area. The position of the cannula allows it to move easily, which can cause injury and allow blood to enter the airway.

This is because the cannula is made of a non-elastic material and its tip is sharp and non-flexible. Also, if the cannula moves out of its correct position, respiratory support is immediately stopped and a new puncture must be made.

If the patient is not unconscious, he must be kept at rest to avoid injury from the hard, sharp needle. Ultimately, there is currently no safe, easy, and efficient way to create an open airway and provide respiratory assistance in emergency situations such as those described above.

Another example of a situation in which it is currently impossible to give respiratory assistance without extremely serious consequences is when a person suffers a contusion of the neck in a road traffic accident, resulting in unconsciousness or difficulty in breathing. Ivy (both of these can occur) occurs when a person is seated in a car seat with their safety belt on, and the person's chin is bent toward the chest. The only way emergency personnel can help the victim breathe is by bending the victim's head back and ventilating the victim, for example through a mask. If the neck is injured in the neck, there is a great risk of injury to the spinal cord by bending the head backwards, and the injured person may die instantly or suffer permanent neurological incapacity such as quadriplegia. I will continue on.

In other situations involving respiratory arrest, such as myocardial infarction or respiratory arrest in heart patients, conventional equipment is used to provide artificial ventilation and administer life-sustaining drugs to patients. However, we often encounter extremely difficult situations such as those mentioned above.

SUMMARY OF THE INVENTION An object of the present invention is to solve the problems of conventional methods for removing respiratory disorders and to provide a simple and inexpensive device for emergency treatment of respiratory disorders.

According to the present invention, in an instrument for emergency treatment of endotracheal respiratory disorders in humans by percutaneous perforation of the trachea, one end opens at the front end of the body adapted to be positioned on the patient's neck and the other end opens at the front end of the body and the other end a tube adapted to be inserted into the patient's trachea, which projects from the front end of the body and forms an extension of the passageway; the stylet is retractably disposed within the passageway and/or the tube, and in its fully inserted position, its cut end abuts the outer end of the tube; the tube is made of a flexible resilient material; the tube is made of a flexible resilient material; is equipped with a standard size fitting that allows the drug to be ejected with a conventional syringe; and the rear part of the body consists of a cylindrical adapter integrally formed with the body; , having standard dimensions for coupling it to a respiratory or anesthesia device;

By using the device of the present invention, the following effects can be obtained.

First, percutaneous perforation of the trachea (especially through the cricothyroid membrane)
is safer and easier than incision. external or internal (
Blood flow to the lungs, etc.) is minimal and the area of perforation is easily defined. Once the trachea has been perforated, it is not difficult to subsequently perform tracheostomy or endotracheal intubation, and these incisions can be performed while the instrument remains in place. Additionally, drilling techniques are commonly performed by medical staff.

Second, flexible tubes and catheters have less risk of damaging the subglottic space, and by using optical techniques to locate within the space, an airway can be created while avoiding damage.

Third, by providing an attachment device at the posterior end of the stylet, drugs such as local anesthetics or adrenaline can be injected into the subglottic space while the device is being inserted. The technique of resistive loss can also be used to ensure that a plastic or glass syringe fits precisely over the distal end of the stylet by inhaling or injecting when the stylet enters the supraglottic space. In this way, the procedure can be performed safely and effectively without damaging the posterior wall of the trachea, the esophagus, or other parts of the body.

Fourth, by providing an attachment device at the rear end of the tube, once the device is in place and the stylet or needle is retracted, a conventional plastic syringe can be used to inject the drug. As the drug, for example, an anesthetic, adrenaline, etc. are used. Adrenaline injected directly into the windpipe and lungs has been shown to be at least as effective as intravenous injection. Anti-shaving agents may be used when shaving occurs or there is an injury to the head.

Fifth, the device's tubular adapter, which has standard dimensions, fits into standard ventilator bags and anesthesia machine connectors. This instrument can also be used to perform a technique called the Venturi method, which has been popular in recent years. Unlike conventional cannula attachment devices, the tubular adapter is easy to hold with the lips in the absence of a venting device, thus allowing air to be delivered to the patient by mouth and the device. The structure of the device is also suitable for venting oxygen or air with controlled positive pressure.

Sixth, the device can be inserted anywhere in the larynx that provides access to the trachea. However, select the location where percutaneous perforation of the cricothyroid membrane is considered to be the safest.

Seventh, the device can be used quickly and without any preparation, and can be used by all physicians and can still be used by those trained in first aid, and even by laymen. No special surgical techniques are required; the basic knowledge and training known to all physicians and those in many other medical fields is sufficient.

Eighth, this device is simple, safe and easy to use. The desired concentration of oxygen can be insufflated at a controlled positive pressure to deliver drugs into the trachea of patients with respiratory arrest or respiratory compromise when conventional treatments have failed or are ineffective. Can be easily injected. There is no need to inject it into a vein. The device is free of blood flow, making it less uncomfortable and dangerous than using other traditional devices.

Ninth, it can be applied not only to adults but also to children regardless of their weight.

First, the configuration of the device is suitable for application to provide respiratory support to patients with neck column injuries without lifting the head at least halfway forward.

Certain embodiments of the present invention allow for the infusion of drugs directly into the patient's trachea and lungs while providing respiratory assistance, always leaving the lungs intact. In addition, it is composed of a small number of parts so that it can be widely applied to small children, large children, and adults.

Several embodiments of the invention are also set forth in the claims.

Using the device of the present invention, drugs such as epinephrine, atropine, ridecaine, and anticonvulsants can be injected directly into a patient's trachea or lungs. Intravascular absorption of many drugs is, according to some scientists, very effective. In accordance with the present invention, the pressure within the lungs during controlled positive pressure ventilation is adjusted to the best positive end exhalation pressure (PE).
This is particularly effective because it can maintain EP>.

Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings, but these embodiments are not intended to limit the scope of the present invention.

Referring to FIG. 1, there is shown a preferred embodiment of the device according to the invention, which as can be seen basically comprises a body 2 having a through hole 3; is open at the front end 2c of the body on the one hand and at the rear end 2d of the body on the other hand. The length of the body 2 measured on the upper side and the lower side in the mid-plane is preferably (according to angle B) 45-55 mm and 25-45 mm respectively.

The rear part 2b of the body consists of a tubular adapter 4, which is formed integrally with the body and positioned substantially concentrically with the end of at least a through hole opening at the rear end of the body. This adapter has standard dimensions so that it can be connected to a normal ventilation device, this is the so-called ISO
According to the standard, the rear end 2d of the body has an outer diameter of 15mm.

Furthermore, the body has at least two wings 5, the purpose of which is as follows. Like the adapter, these wings are integrally formed with the body and the material from which they are made is preferably a suitable rigid plastic such as clear polypropylene or rigid PVC or polystyrene.

The front part 2α of the body 2 can be tapered towards the front end 2C of the body so that it does not interfere with the larynx when the instrument is inserted into the larynx.

In this connection, the upper and lower sides of the body may be inclined by approximately 10-15° (angle A) relative to the longitudinal axis of the instrument. The front part 2α can also be completely straight or sloped only on its underside (see Figures 3a and 3).
c), this results in a more secure attachment of this front part to the patient's neck, which has a large surface. In this case, only the lower side of the body can be inclined, for example by approximately 25°, relative to the longitudinal axis of the instrument. In embodiments involving straight catheters, the anterior end 2C of the body is also at an angle of 15 to 60° relative to a plane perpendicular to the longitudinal axis of the instrument.
It can preferably be inclined at an angle B) of 40 to 601, the purpose of which is to facilitate the correct oblique insertion of the catheter into the trachea.

A tube or catheter 6 is attached to the through hole 3 so as to protrude from the front end 20 of the body to form a continuous portion of the through hole 3. The forward protrusion of this catheter is approximately 2.
It has a length of 5 to 5 cIrL and, although in the illustrated embodiment is formed as a straight series of through holes, other configurations are possible (see Figures 3a, J and 3C). A stainless steel needle or stylet 7 is provided within the catheter 6 with its front end 7cL projecting from the outer end of the catheter. In use, this catheter 6 is intended to be introduced into the trachea after being punctured by the outer incision point 7a of the stylet. The stylet, preferably made of stainless steel, is ground at its anterior end to about 20-45°, preferably 30-40° (angle C) for this incision, and also has a so-called bevel to more easily penetrate the tissue. A cutting blade or surface may be provided. The incision point is preferably siliconized and positioned so that the incision cuts transversely at 90 degrees to the longitudinal axis of the trachea.

The catheter is made of a non-rigid plastic such as ethylene-tetrafluoroethylene (ETFE) or Thea-on (P
TFE), but polyurethane plastics have been shown to be particularly suitable materials due to their high biocompatibility and flexibility, and can be made from e.g. Through hole 3
Preferably, it is integrally molded with. The catheter can be selectively positioned within the through-bore, but is preferably positioned such that it extends into the through-hole such that its rear end protrudes a small distance from the rear end of the body 2d. It will be done. FIG. 3b shows a further embodiment in which the adapter 4 is formed by a thin wall so that the through hole 3 and the rear end of the catheter 6 open approximately into the middle of the body. . The advantage of this is that less material is consumed and the device is lighter.

To facilitate insertion of the catheter into the trachea, its anterior end 6α is chamfered such that its wall thickness decreases from about 0.2 mm to about 0.05 mm over a length of about 2-3 mm. ing.

Preferably, the device is made in two or more dimensions, particularly a child model and an adult model, and in the child model the catheter is sized 2.0 mm and 4.0 m.
m, preferably between 2.5 mm and 3.5 mm, and an outer diameter of 1.5 mm to 3.5 mm, preferably 2.0 mm
-2.5 mm inner diameter. The question of whether catheters of relatively small size are sufficient for the ventilation of children has recently been discussed in Sweden as well as by foreign experts. However, this possibility is not generally accepted and has been questioned by many experts. Our studies on live pigs of various sizes with identical requirements for the air volume supplied have clearly demonstrated that smaller dimensions are quite sufficient (the results of the above studies are Presented at the International Congress of Swedish Institute Medical Sciences, Stockholm, Sweden, November 30, 1983 and the 8th Congress of Anesthesiologists, Manila, Philippines, January 25, 1984). If positive pressure ventilation with a respirator bag is used, its effectiveness is substantially enhanced and is sufficient to provide basic ventilation even for adults.

In adult models, catheter length is 3.5 to 5.0 m.
M% preferably 3. 'J vrm ~4.5 mrn
outer diameter of 3.0 mm to 4.6 mm, preferably 3.0 to 4 mm
,0. It has an inner diameter of mm. For both models the catheter wall thickness is approximately 0.1 mrn as mentioned above.
It is desirable to set the thickness to 0.5 mm, preferably 0.2 mm to 0.3 mm.

The front part of the catheter has a diameter of 1.0 m+i to ensure that ventilation is not obstructed so that the opening at the front end of the plastic catheter will inadvertently come into contact with mucous membranes and become occluded when inserted into the trachea. A plurality of lateral openings 9, preferably 2 to 4, of ~1.5 mm are provided.

The steel stylet may have an outer diameter equal to or slightly less than the inner diameter of the catheter, allowing the stylet to be withdrawn from the device without difficulty after being inserted into the trachea. The inner diameter of this stylet, at least at the anterior end closest to the incision point, is about 1 m to 1 m.
The deviation should not exceed 5 mm, which reduces the risk of occlusion during insertion. This is critical as tissue molecules enter the stylet and flow down into the patient's lungs with injection of drug through the stylet. Another advantage of the relatively narrow inner passageway of this stylet is that the injection of drug through the stylet produces a spray or jet effect on the drug as it exits the stylet, which can be used, for example, to locally anesthetize the insertion area. And to enhance this spraying effect when uniform dissemination of the anesthetic agent (e.g. Ridecaine) is desired, the inner passageway may also be provided with a very sharp triangular shape (for example a triangular shape) at the point opening at the front end of the stylet. 2) or a cross-shaped nozzle is provided. Furthermore, this stylet has a length such that the other end 7b protrudes from the adapter 4 by about 5 mm when the stylet is in its fully inserted position, that is, when its incision point protrudes a predetermined distance from the front end 6α of the catheter. are doing. In some embodiments, if the steel stylet has a stop means (not shown), it is preferred that the incision point protrude 3 mm to 6 mm or more from the front end of the catheter.

At the rear end of the stylet 7 a tapered fitting 10 is provided, which accepts a conventional syringe (so-called Luer fitting), and a corresponding fitting 10 is also provided at the rear end of the through-bore 3 or Separately from this, it is provided at the rear end of the catheter 6. In the latter case the fitting is formed integrally with the catheter. These fittings allow medication to be injected through the device during insertion and even after the device has been withdrawn with the steel stylet 7 into position.

In conjunction with the fitting 10, the steel styler 17 is also provided with a plastic cap to facilitate withdrawal of the stylet 1 after tracheal puncture. To ensure that this stylet is always correctly positioned within the instrument, i.e. rotated such that the incision point is in the correct position for insertion into the trachea, the fitting at the rear end of the stylet is A lug, not shown, is provided which engages a corresponding notch in the tapered fitting at the rear end of the tube when the stylet is in its correct position.

The front end 2α of the main body is provided with fixing means for attaching the instrument to the patient's neck after insertion. According to a preferred embodiment, the fastening means 12 are made of transparent PVC, for example.
It consists of a pair of wings 13 made of, and is provided on both sides of the main body 20. In order to fit the patient's neck, the wings 13 are attached to the hinge 1.
4 (appropriately weakened plastic material). The wings 13 are provided with a layer of knotted plastic foam 15 on the front side (patient side);
The plastic foam 15 has a double-sided adhesive with a foil of waxed paper ready to be removed for use. The wing (plate) 13 may be provided with an opening (not shown) at the outer end. A cotton band may be passed through this opening to secure the device to the patient's neck.

Made of steel (or thin and rigid plastic)
the cylinder 16 is passed over the protrusion of the catheter and applied to the front end 2c of the body to increase the strength of this part of the catheter;
It may be made so that it is not crushed by tissue. The cylinder may be provided with a suitable collar 17 to prevent it from entering the trachea.

The embodiment shown in Figures 3α and 3C differs from the embodiment described above in that the catheter is inclined (bent) from the middle of the body. It is also necessary to adjust the angle of the main body and the length of the passage accordingly. However, the rest is the same as the embodiment described above. Further, the embodiments shown in FIGS. 4 to 7 can also be modified in various parts corresponding to the modifications shown in FIGS. 3a and 2 and 3b.

In the embodiment of FIGS. 4-7, for manufacturing convenience, the body 102 has the same cross-sectional shape over almost its entire length. The front end 102α may be formed as an extension of the rear cylindrical adapter 104 and have a reduced outer diameter in front of the wings, as will be described below. The anterior end 102C of the body is inclined at approximately 40 to 60 degrees (angle B') relative to a plane perpendicular to the longitudinal axis of the instrument, so that the instrument 101 is positioned and firmly seated in the correct location on the patient's neck when inserted. I'll do what I do. As is clear from Figures 4 and 7,
The device includes a single wing 105 extending around the entire circumference of the body 102. Desirably, the wings 105 are widest on the sides of the device and narrower on the top and bottom sides. This makes the equipment easier to handle. The wings 105 are eight inclined with respect to a plane perpendicular to the longitudinal axis of the instrument, the angle preferably corresponding to angle B' of the forward end 102C of the body. The purpose of tilting the wings 105 in this manner is to maintain the instrument in place by passing a cotton band through the openings 105a of the wings 105 (only one of which is shown in FIG. 7) and passing it around the patient's neck. This is to further increase stability.

A notch 105b may be provided in the wing instead of the opening 105α (which may also be used in combination). If you use the Notsuchi 105b, it is easy to insert a small band. If the blades are straight, the device will tend to tilt, but if the blades are tilted and a tight band is used, the device will be much more stable.

Compared to the embodiment of FIG.
The central passage 103 into which the is inserted is widened. A catheter 106 is mounted within the central opening of the insert 118, which catheter 1.06 corresponds completely to the catheter 6 of the previously described embodiment. Therefore, the catheter 106
Then install the steel stylet 1 in the same manner as described above.
07 is accommodated. To removably mount the insert 118 within the body 102, the insert 118 is locked within the body by a type of ionette mount.

The bayonet mount is preferably mounted at the rear end 10 of the body.
Two grooves 11 formed in the rear part 102b connected to 2d
Consisting of 9a. The grooves 119α extend along the periphery of the passageway 103 in opposition to each other, and preferably form an angle of about 9
It shall be 0° or more. Furthermore, a linear groove 119b (only one is shown in FIG. 5) is provided in the main body, and this groove 119
b extend from each corresponding end of the circumferential groove 119a. For the locking effect, two diametrically opposed lugs 120 are provided on the outside of the insert. The lug 120 is guided along the groove 119b and inserted into the body by entering the circumferential groove 119α. The insert is then rotated within passageway 103 until lug 120 hits the bottom of groove 119a. In this way, the grooves, in combination with the locking lugs of the stylet's rear fitting as described above, ensure correct positioning of the stylet's incision point 107a relative to the body. It is understood that other locking means may be used to releasably lock the insert 118.

The advantage of this insert is that the same body with the same size passageway 103 can be used in devices for children, larger children, and adults. That is, separate inserts or cartridges (with correspondingly sized catheters 106S and stylets 107) may be used for each patient. The difference is that the insert 1
It is only that the wall thickness of 18 varies depending on the size of the catheter and stylet. The outer shape of the insert is always the same and fits within the passageway 103 of the body 102.

This embodiment allows the powerful cylinder 16 described with respect to FIG.
12 is preferably chamfered to fit inside the catheter 106.

The insert 118 is preferably made from the same material as the body 102, but other materials can be used.

For example, an injection channel 111a is formed throughout the body 102 in order to directly inject a drug into the patient's trachea when breathing is assisted through a ventilator connected to the rear end 102d of the body. At one end thereof (1) the injection channel opens into an external orifice 111b, which is provided about half way along the upper side of the body relative to the operating position. The other end of the injection channel 111a opens into an internal orifice 111G in the central passageway 103 of the body. Furthermore, the continuous part 111d of the injection channel 1llcL is the insert 1
182 and catheter 106. The continuous portion 111d of this channel is positioned in such a manner that the continuous portion is in communication with the injection channel 111α when the insert is inserted into the body and locked in its proper position. In connection with the connection between the channel 111α and its continuation 1]1d, one or both of the channels are formed wide so that proper communication between the channels is always guaranteed independent of possible manufacturing tolerances. It is preferable to be there.

At the location of the orifice 111b of the injection path 111α, a connecting tube 111e made of stainless steel or other suitable material is provided. Luer lock adapter 1 is placed on the free end of the connecting pipe 111e.
There is a thin plastic hose connected to 11f.

The drug is injected into the connecting tube 11], the 6% injection route 111 (Z, the route 111d, and the catheter 106) through the Luer lock adapter 1] and 1f.

Preferably, the injection path 111α and its extension or continuation 111d are at an acute angle to the longitudinal axis of the device.

This angle points toward the anterior end of the instrument. This configuration provides the most ideal injection flow path from the pathway to the catheter and from the catheter to the patient.

The embodiment of FIG. 1 can also be provided with an injection path that allows simultaneous injection and ventilation in exactly the same way. In such cases, the adapter tube must be connected to the adapter of the device, thus providing a large amount of space for connecting the breathing device. This is particularly relevant in the case of child patients, who have a narrow space between the chin and the upper part of the chest. This adapter can be straight or angled. Straight tubes are used when the patient is sleeping on his or her back or when the patient is a child.
A slanted tube is appropriate when the patient is in the NATD position. Both the angled tube and the straight tube are dimensioned so that one end of the tube fits into the adapter of the device and the other end fits into the breathing device. Preferably, the adapter tube is made of a hard plastic, preferably the same material as the instrument.

The actuator may also be provided with markings (e.g., "patient", "breathing apparatus") at each end to facilitate connection.

The device of the present invention is used in the following manner. The patient's head is bent as far back as possible and the device of the invention is grasped with three fingers. For example, place your thumb on the stylet attachment device.
Grip by placing your index finger around one side of the wing and your middle finger around the other side of the wing. If a neck fracture is suspected, the device of the invention is inserted into the patient's trachea without bending the patient's head backwards. The cricothyroid membrane is positioned with the side markings (eg, the "top") facing away from the patient's jaw or neck.

If necessary, administer local anesthesia with adrenaline additives at the insertion site and into the trachea.

Correctly position the instrument and push it through the skin and cricothyroid membrane. To test whether the tip of the stylet has reached the trachea, try inhaling with a syringe through the stylet attachment device. After puncturing the trachea with the tip of the stylet, the steel stylet is carefully withdrawn and the plastic catheter is pushed inward and downward.

The device of the present invention is moved slowly until the front end 2c of the main body rests on the skin of the neck. The device of the invention is secured to the patient's neck by means of a fixation device, after which an adapter tube is connected, if necessary. In the embodiment of FIGS. 1-3, the necessary injections or injections should be made previously by means of a syringe through a fitting located at the rear end of the passageway. In the embodiments shown in FIGS. 4 to 7, injection? , injection path 11
14, the patient's lungs can be inflated and licked simultaneously. Finally, the breathing apparatus (for example, Ambu, Rauldenope, etc.) can be connected directly to the Reuben's artificial respirator (Rada, or a breathing apparatus with a suitable noklub and oxygenator), either directly or through a fitting tube. Connect to the device's agefuri.

Even if the patient is in such a condition that respiratory support may threaten the patient's life, injecting the drug formula 1j directly into the patient's trachea and lungs using the device of the present invention 2 is effective. Rapid absorption into the blood is highly desirable i,).Such a situation may occur in cases of cessation of heartbeat, etc. Intravenous injections are not possible due to shock and rupture of the vein.

The device of the present invention can be sterilized for single use. In the embodiment of FIGS. It is preferable to pack together two or preferably three inserts having the same properties as each other, so that the body can be used in combination with inserts selected according to the patient to be treated.This task (G) uses the minimum number of parts.
This can be done quickly and easily. The insert 118 and/or the attachment device 110 are preferably colored to clearly indicate the dimensions of the catheter. The device of the present invention is intended to be used in first aid rooms, operating rooms, ambulances, emergency rooms, and places with limited treatment in hospitals. As mentioned above, for limited procedures, such as tracheostomy surgery, it is preferable to hold the device of the present invention in place and operate it to perform the surgery.

The present invention is capable of various changes and modifications without departing from its technical scope. More positive examples of this include selecting the material and adjusting the angle and size.

The present invention also includes those in which the various embodiments described above are replaced with other structural solutions. Various changes can be made.

[Brief explanation of drawings]

FIG. 1 is a side sectional view of the device of the present invention. FIG. 2 is a perspective view of the instrument of the present invention from the front side. Figures 3a-c are partial cross-sectional views of another embodiment of the device of the invention. FIG. 4 is a side sectional view of yet another embodiment of the device of the present invention. FIG. 5 is a view similar to FIG. 4 with the insert removed. FIG. 6 is a side cross-sectional view of the removed insert. FIG. 7 is a partial perspective view of the device shown in FIG. 4, viewed from the front side. Patent applicant Kokonomedica Sweden Abbe (5 others) Procedural amendments Showa Daku 1st year Patent Office Kyoto official Shiga Gakuden 1, Indication of case Showa, +f year Patent application No. 7 Da Otsu 7 No. 2 , the name of the invention is <1"F*',
TZmetsu5 N3;Kariζ6, Relationship with the case of the person making the amendment Patent applicant's address, Fuyusaisen Kunodika Schediso Abbe4
, Agent 5, Written amendment to the procedure to be amended (method) % Formula % 6, Person making the amendment - Relationship to the case Applicant's address Kao? agent

Claims (1)

[Scope of Claims] (1) An instrument for emergency treatment of endotracheal breathing disorder in humans by percutaneous perforation of the trachea, the front end of the main body (2C, 102
c) and the other end is the rear part of the main body (2b, 102b)
The main body (
2,102); a tube (6,106) adapted to be inserted into the patient's trachea;
) is coaxially disposed within the passageway such that it projects from the front end of the body and forms an extension of the passageway; the stylet (7, 107) is disposed within the passageway and/or tube(
6,106), and
In its fully inserted position, its cut end (7α, 107
α) is adapted to project beyond the outer end of the tube (6, 106); the tube (6, 10, 6) is manufactured from a flexible elastic material; the rear end or passageway of the tube; and/or the rear end of the main body (2b,
The open end of the stylet proximate to 102b) is equipped with a standard-sized fitting (10, 110) that allows for ejection of the drug with a conventional syringe; The rear part <2b, 102b) is
Device characterized in that it consists of a cylindrical adapter (4) formed integrally with the body and having standard dimensions for connecting it to a respiratory or anesthetic device. (2) An instrument according to claim 1, in which the outer diameter of the tube (6) approximately corresponds to the cross-sectional dimension of the passageway (3), and the tube is stationary within the passageway. (3) The device according to claim 1, wherein the tube (106) has a diameter smaller than the cross-sectional dimension of the passageway (103), and the tube (106) has an outer diameter that is smaller than the cross-sectional dimension of the passageway (103).
3) and resting within an insert (1, 18) which corresponds approximately to the cross-sectional dimensions of (1) and is retractably positioned from the passageway (103). (4) In the device according to claim 3, the insert (118) has a mounting mechanism (119α, 119b).
and 120) fixed in a predetermined fixed position in the passageway (103). (5) In the device according to any one of claims 1 to 4, the squillette (7, 107) substantially corresponds to the inner diameter of the tube (6, 106) or It has an outer diameter slightly smaller than that, and at least the cut ends (7a, 107a
) having a cross-sectional diameter of about 1 to 1.5 mm at its forward end adjacent to the . (6) The device according to any one of claims 1 to 5, characterized in that the tube (6,106) U is 2.0-4.0 mm, preferably 2.5-4. 3.5 mm outer diameter and 1,5-3.5 mm5
Good luck is 2,0~z! A device having an inner diameter of 5 mm. (7) Izu tubes defined in claims 1 to 5 (
6,106) is 3.5 to 5. Ommz preferably 3.
The device is adapted to have an outer diameter of 9 to 4.5 mm and an inner diameter of 3.0 to 4.6 mm N, preferably 3°0 to 4.0 mm. (8) In the instrument according to any one of claims 1 to 7, the front surface (2c, 102G) of the main body is 15 to 60', preferably 40-60
° inclined and passageways and tubes (6,106
) is a device that extends approximately along the longitudinal axis of the device. (9) In the device according to any one of the dimensions of claims 1 to 8, the attachment device (10, 110) is a so-called Luer attachment device that is adapted to a conventional syringe. A device that is cut to have a sloped internal shape. (10) In the instrument according to any one of claims 1 to 9, the adder (4, 104) has a diameter of 15 mm at the rear end of the main body (2d, 102d) according to the 15O-standard. has an outer diameter of
An instrument having a slightly inclined shape in accordance with the standard. (11) In the device according to any one of claims 1 to 10, the injection path (111α, 1lld) is from an external orifice (111b) located outside the main body (102). Pipe (1
06) A device adapted to extend at the inner slit. (1) In the device according to claim 11, the external orifice (111b) connects the Luer lock adapter (11) via the connecting tube (ul, g) and the thin plastic v.
, 111) and the injection path (111CL11).
11, d) is adapted to form an acute angle with the longitudinal axis of the instrument, such that said angle points towards the anterior end (102cL) of the instrument. (1:→ The device according to any one of claims 1 to 12, wherein the main body has at least one wing-like member (5
, 105), said arm-shaped member is located at the front surface of the body (2C110) with respect to a plane perpendicular to the longitudinal axis of the instrument.
An instrument tilted at an angle corresponding to the tilt angle of 2C). (Binding) In the device according to any one of claims 1 to 13, the fixing means (12) consisting of a pair of plates (13) is attached to the main body (2).
) is provided adjacent to the front end (2α)K of the main body, and this plate is pivotally connected to the main body, and has a hard-pressed plastic form on its side with double-sided adhesive applied thereto. A device consisting of a layer of (In the device described in any one of claims 1 to 14, the reinforcing cylinder (]6) is connected to the pipe (6) through the whistle (2).
an instrument positioned proximate to the cylinder, the cylinder being provided with a collar (17) to prevent insertion of the reinforcing cylinder into the trachea; 06) In the device according to any one of claims 3 to 14, an inserter) (1
The reinforcing cylinder (18) is integrally formed with the reinforcing cylinder (18).
12). 07) The device according to any one of claims 1 to 16, wherein the drug is injected directly into the patient's trachea.