KR20140016465A

KR20140016465A - The position maintenance device for the airway management

Info

Publication number: KR20140016465A
Application number: KR1020120082948A
Authority: KR
Inventors: 오영민
Original assignee: 가톨릭대학교 산학협력단
Priority date: 2012-07-30
Filing date: 2012-07-30
Publication date: 2014-02-10
Also published as: WO2014021518A1

Abstract

The present invention relates to a posture maintenance device for securing an airway of an emergency patient, and more particularly, having a segmented portion at a position of the head, cervical spine, and thoracic vertebrae of the patient, and for managing the airway of the patient so that each segment is angulated. A posture maintenance device.
An object of the present invention has a plurality of segments, the head, cervical spine, thoracic spine having a drive unit for driving each segment to be angularized respectively, the posture maintenance device for airway management having a control unit for controlling the drive unit To provide.

Description

Posture maintenance device for airway management {THE POSITION MAINTENANCE DEVICE FOR THE AIRWAY MANAGEMENT}

The present invention relates to a posture maintenance device for securing an airway of an emergency patient, and more particularly, having a segmented portion at a position of the head, cervical spine, and thoracic vertebrae of the patient, and for managing the airway of the patient so that each segment is angulated. A posture maintenance device.

The patient's best posture for emergency intubation is a head-elevated laryngoscopy position (HELP), with a slight disagreement but usually a head-high and neck-down position. To improve visibility at intubation, you can use a roll-up sheet behind your head and an assistant to hold your head in an emergency, but it's often difficult to know at what height the seat needs to be supported, so additional adjustments are often required.

FIG. 1 shows the patient's posture appropriate for tracheal intubation, with OA representing the Oral Axis, PA representing the Pharyngeal Axis, and LA representing the Laryngeal Axis. Figure 1 (a) shows that the angle between the oral axis, pharyngeal axis and larynx axis when the patient is lying on a flat floor is very large. 1 (b) shows that the angle between the axis of the pharynx and larynx is reduced by raising the head using a cushion or the like on the patient's head. Figure 1 (c) shows that by tilting the patient's head back in Figure 1 (b) can be quite close to the angle to the oral axis.

Figure 2 shows the optimal posture for the airway management of the patient, the angle between the chest and the jaw line of the patient's head is maintained at 35 degrees, the straight line of the patient's eyes and jaw line and the horizontal line passing through the patient's nose When the angle is maintained at 15 degrees, it is shown that the position for optimal airway management.

The concept of optimizing head and neck positions to facilitate intubation has been in almost every text since it was first mentioned in 1895. In recent years, there has been a growing emphasis on creating proper posture for highly obese patients. Still, textbooks still teach you how to make this posture by rolling up the sheets on your bed and holding them behind your back. Indeed, it is very difficult and in some cases impossible to roll a seat in such a patient. Also, if possible, it may be necessary to stop and re-form during intubation attempts if the optimal position cannot be made at once. Increasing the intubation, ie, the need to remove the laryngoscopy from the patient's mouth, is a situation that is likely to be avoided by practitioners in charge of airway management because complications associated with intubation increase the likelihood of intubation failure.

Typically, when the view of the gate of the laryngoscopy is not satisfactory, the laryngoscope is removed and the height is adjusted again with a bed sheet.Increasing the number of laryngoscopes increases the likelihood of a 'failed airway' situation, especially obesity. Patients with shorter safe apnea times, such as heart disease and respiratory disease, are at greater risk.

3 shows the incidence of complications in the city at the time of intubation more than three times for airway management. It is showing an increase.

The answer to the question, "How high should the patient's head be raised?", Although there is some disagreement, the ramp is made so that the height of the patient's ear canal (the ear canal) and the dress dent (concave above the sternum) coincide. This is a common method, which comes from the experience that adjusting the height of these two points optimizes the field of vision when manipulating the laryngoscope.

In general, hospital beds can be divided into electric / manual methods, but the upper and lower body can be raised in common, and consists of three parts. When the tracheal intubation is composed of a single upper body part, there is a problem that the operator and the assistant have to make an effort to optimize the angle of the head and cervical spine of the patient by using a sheet or a pillow. Some models of hospital beds support the backrest tilt and leg lift by electric, but there is no bed that can adjust head height and cervical spine angle required for emergency airway management.

In addition, the devices developed as positioning devices for the conventional airway management should be placed in the head part before the patient is placed on the bed, and since the power and operation are performed separately from the operation of the bed, intubation may be delayed in an emergency situation. There is a high likelihood problem (approximately 56 seconds to mount and position). Once the patient has been in bed and later the tracheal intubation is determined by changes in the patient's condition, the device is placed underneath the patient's upper body. It is not easy, especially in obese patients, the problem is very difficult or impossible.

In addition, since these products are supposed to take a uniform posture, there is a problem that it is difficult to create a customized position according to the patient's physique and airway structure.

The present invention has been proposed to solve the above problems, an object of the present invention has a plurality of segments, and has a drive unit for driving the segment to be each angular for each head, cervical spine, thoracic vertebrae part of the patient, It is to provide a posture maintenance device for airway management having a control unit that can be controlled.

In addition, by using a pentaprism device and a display device to store the operator's field of vision, it is possible to check whether the patient is properly treated, and to manage the airway management to save image data for clinical practice education. It is to provide a posture maintenance device.

In order to achieve the above object, the present invention provides a posture maintenance device for maintaining a patient's posture that is optimal for emergency intubation, having a plurality of segments to segment the head, cervical spine, thoracic spine of the patient separately; A driving unit for individually moving the segment; It provides a posture maintenance device for airway management, including; a controller for adjusting the drive unit.

In addition, the segment is characterized in that consisting of 3 to 10.

The apparatus may further include a shock absorber positioned at an upper portion of the segment and configured to prevent an impact of the patient due to the position adjustment of the segment.

In addition, the controller is located on the right side of the upper end of the bed, it characterized in that the controller to adjust the position of the segment by a joystick or a reduced model of the segment.

In addition, the controller is characterized in that the operator to ensure the airway of the patient with both hands in the form of footswitch.

In addition, the driving unit is separately attached to the segment portion to move separately, characterized in that the hydraulic device.

In addition, the band portion for preventing the movement of the head of the patient when attempting to intubate the cervical spine can be fixed to the segment located in the patient's head portion of the segment; characterized in that it further comprises a.

The apparatus may further include a storage device and a display device connected to the main frame and configured to store a patient's airway acquisition situation using a pentaprism device connected to the operator's head.

When attempting intubation using the existing posture maintenance method, if the laryngoscope is removed and a new posture is taken during the intubation procedure to change the patient's posture, the number of laryngoscope manipulations increases each time. If the intubation is not performed until the three times, the insertion and reinsertion are repeated, they fall into the 'failed airway' category, which can cause fatal complications such as hypoxia and brain damage, or death. The patient bed according to the present invention makes a certain posture before intubation, and instead of the conventional method of changing the patient's posture during intubation, the angle can be adjusted by the operator's right hand while operating the laryngoscope with the left hand, while blowing the gate of the gate. It can be optimized in real time during the procedure. This angle adjustment allows the operator to secure an optimal field of view according to the patient's body shape and airway structure.

In addition, the recent increase in moderate or more obese patients or late pregnancy patients, it is very difficult to additionally support the back and neck seats in order to improve the patient's posture during the procedure as well as in the preparatory stage. Moreover, because these patients have a relatively shortage of potential oxygen reservoirs compared to those who do not, the 'safe apnea time' is even shorter, which is particularly dangerous when the intubation is delayed. It is easy to proceed with the situation. The new device makes it easier, faster, safer, and more precise for posture control even under these adverse conditions. In addition, since the operator can directly operate with one hand, it is possible to avoid problems due to communication and does not require multiple assistants.

In addition, the posture maintenance device according to the present invention is determined to be particularly useful in emergency centers, intensive care units, recovery rooms, etc. where tracheal intubation is frequently performed, and in particular, in the operating room situation where numerous tracheal intubation is performed every day, it is easy to intubate various patients during anesthesia induction. It provides an easy posture, and can be easily and safely provided to switch back to the optimal posture during surgery, and to return to the optimal posture for airway maintenance at the time of recovery and extubation.

It is also recommended in textbooks to maintain optimal posture for patients with spontaneous respiratory failure but who are spontaneously breathing before intubation. This optimal position is intended to avoid the potential risks of keeping the patient in a flat position (elevation of the diaphragm, reduction of the upper and lower airways, compression of the rib cage by gravity, etc.). Vulnerable to risk In this case, if the patient who is observing the respiratory insufficiency or determines the intubation for other reasons, the posture maintenance device according to the present invention can easily and quickly provide an appropriate posture for intubation even when creating an environment suitable for intubation.

Figure 1 shows the position of the patient appropriate for tracheal intubation.
Figure 2 shows the optimal posture for airway management of the patient.
3 shows the incidence of complications in the city at the time of intubation three or more times for airway management.
Figure 4 shows the state before operation of the posture maintenance device in one embodiment according to the present invention.
Figure 5 shows the state after the operation of the posture maintenance device in one embodiment according to the present invention.
6 is a plan view of the posture maintaining apparatus according to an embodiment according to the present invention.
Figure 7 is a schematic diagram of a posture maintenance device equipped with a display device and a device for storing the operator's field of view in accordance with an embodiment of the present invention.

Hereinafter, with reference to the accompanying drawings will be described in detail preferred embodiments of the posture maintenance device for airway management according to the present invention. In the drawings, the same reference numerals are used to designate the same or similar components throughout the drawings. In the following description of the present invention, a detailed description of known functions and configurations incorporated herein will be omitted when it may make the subject matter of the present invention rather unclear.

Figure 4 shows the state before operation of the posture maintenance device in one embodiment according to the present invention. Referring to Figure 4, the posture maintenance device for airway management has the following configuration.

Looking at the main components of the posture maintenance device 100, the segment 10, the drive unit 20, the main frame 40, the controller 30 and the bed is composed of the basic components.

Segment part 10 is characterized in that the partial operation is possible to adjust the angle of the cervical spine and head. The segment 10 may be composed of 3 to 10 columns, and is disposed between the head, cervical spine, and thoracic spine of the patient to induce an optimal 'HELP' posture. The segment 10 is advantageously provided with a number of segments arranged between the head, cervical and thoracic vertebrae of the patient and angulated respectively.

The segment 10 may be moved up and down by the driving unit 20 disposed at the lower part. In this case, in order to prevent the impact caused by the movement of the segment 10 from being transmitted to the patient, The upper portion may be further provided with a shock absorbing portion 11 for preventing the impact. The shock absorbing part 11 is for preventing the patient from directly receiving the shock generated by the movement of the segmental part 10 of the patient, and generally uses a shock absorbing material made of a soft material such as latex.

The driving unit 20 is a device that allows the segment 10 to move up and down individually, and maintains a curve while adjusting the curvature of the bed with a small force by using a hydraulic device. The driving unit 20 is disposed according to the number of the segmentation units 10.

The main frame 40 supports the segment part 10 and the driving part 20, and has separate additional devices. The controller 30 and the foot switch 31 are connected to the main frame 40.

The controller 30 is disposed on the right side of the posture maintaining apparatus 100, and has a form that can be easily operated by an operator or an assistant during laryngoscope intubation. By operating a joystick or a reduced model, such as an automobile seat adjuster, the angle and the degree of the segment 10 may be adjusted.

In addition, the foot switch 31 may be used by the operator to adjust the angle and the degree of the segment 10 by the foot. By using the foot switch 31, both hands of the operator can be used freely has the advantage that the patient's airway can be secured more precisely.

The foot switch 31 is connected to the controller 30 through a cable.

Figure 5 shows the state after the operation of the posture maintenance device in one embodiment according to the present invention.

The driving unit 20 moves up and down, respectively, so that the segment 10 maintains the 'HELP' posture. The drive unit 20 may use a well-known hydraulic device, or may use another device.

The posture maintenance device 100 according to the present invention allows the cervical spine segment 10 of the patient to be placed higher than the head segmental segment 10 of the patient, thereby making the posture of raising the head of the patient and tilting the neck backward easily. There is an advantage that it can.

In FIG. 5, the embodiment in which the number of the segment portions 10 is arranged is shown as seven, but as described above, the number may be three to ten. The third segment 10 located from the top is the highest position, which is generally the part where the patient's head and the cervical spine meet. In this case, the above-described "HELP" posture can be easily made.

FIG. 6 is a plan view of the posture maintenance device to prevent the head of the patient from moving when the tracheal intubation is attempted while the cervical spine is fixed in the segment where the patient's head is located among the plurality of segmental portions 10. An embodiment having a band unit 60 is shown.

When the patient's head is moved when the laryngoscope is inserted, it may be difficult to secure airways. Therefore, in order to prevent this, it is necessary to provide a band part 60 to fix the patient's head, and the band part 60 has various forms such as a velcro band. The band of can be applied.

7 is a schematic diagram of a posture maintenance device having a display device and a device for storing the operator's field of view as an embodiment of the present invention.

Since there is no way to confirm whether the patient's airway is properly secured other than the operator, in order to share the operator's field of vision, the pentaprism device 70 is attached to the operator's field of view so that the image of the operator securing the airway is separated. It may be stored in the storage device 80, so that it is displayed on the display device 90 to allow an assistant other than the operator to confirm whether the correct procedure is performed. By using the device, a clinical data base can be established for airway acquisition for various types of patients.

The operation method of the posture maintaining device according to the present invention will be described with reference to FIGS. 4 to 7.

After the patient is lying on the posture maintaining device 100, the operator drives the plurality of driving units 20 using the controller 30, and moves the segment 10 connected to the driving unit to obtain an optimal posture to secure the airways. Make. The surgeon can secure the airway and at the same time change the posture, making it easier to secure the airway compared to the way of rolling up the patient's head by using a conventional seat or using a separate device, which greatly reduces the number of intubation attempts. Can be.

Using the posture maintenance device 100 according to the present invention can reduce the number of emergency intubation, it is possible to obtain the effect of reducing the complications caused by emergency intubation.

The foregoing description is merely illustrative of the technical idea of the present invention and various changes and modifications may be made by those skilled in the art without departing from the essential characteristics of the present invention. Therefore, the embodiments disclosed in the present invention are intended to illustrate rather than limit the scope of the present invention, and the scope of the technical idea of the present invention is not limited by these embodiments. The scope of protection of the present invention should be construed according to the following claims, and all technical ideas within the scope of equivalents should be construed as falling within the scope of the present invention.

10: segment
11: shock absorber
20:
30: Controller
31: Footswitch
40: main frame
60: band section
70: pentaprism device
80: storage device
90: display device
100: posture holding device

Claims

In the posture maintenance device for maintaining the patient's posture optimal for emergency intubation,
Segments having a plurality of segments in the upper part of the bed to angulate the patient's head, cervical and thoracic vertebrae separately;
A driving unit for individually moving the segment;
And a controller for adjusting the driving unit.

The method of claim 1,
Posture maintenance device for airway management, characterized in that the segment is composed of 3 to 10.

The method of claim 1,
Located at the top of the segment, the shock absorbing unit for preventing the impact of the patient due to the position adjustment of the segment; further comprising a posture maintenance device for airway management.

The method of claim 1,
The controller is located on the right side of the upper end of the bed, the posture maintenance device for airway management, characterized in that the controller to adjust the position of the segment in a reduced model of the joystick or the segment.

The method of claim 1,
The controller is a posture maintenance device for airway management, characterized in that the operator to ensure the patient's airway with both hands in the form of a footswitch.

The method of claim 1,
The driving unit is attached separately to the segment to move individually, posture maintenance device for airway management, characterized in that the hydraulic device.

The method of claim 1,
Maintaining posture for airway management, characterized in that it further comprises a band portion to prevent the movement of the patient's head when the tracheal intubation in a state fixed to the cervical spine is fixed to the segment located in the head portion of the patient; Device.

The method of claim 1,
And a storage device and a display device connected to the main frame and configured to store a patient's airway securing situation using a pentaprism device connected to the operator's head.