CA1295905C - Device for inserting a nasal tube - Google Patents
Device for inserting a nasal tubeInfo
- Publication number
- CA1295905C CA1295905C CA000556636A CA556636A CA1295905C CA 1295905 C CA1295905 C CA 1295905C CA 000556636 A CA000556636 A CA 000556636A CA 556636 A CA556636 A CA 556636A CA 1295905 C CA1295905 C CA 1295905C
- Authority
- CA
- Canada
- Prior art keywords
- distal
- sleeve
- nasal
- dilating
- proximal
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2210/00—Anatomical parts of the body
- A61M2210/06—Head
- A61M2210/0618—Nose
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
Abstract
DEVICE FOR INSERTING A NASAL TUBE
ABSTRACT OF THE DISCLOSURE
A device for inserting a nasal tube through the nose into the oropharynx. The device includes an elongate collapsible sleeve to which is attached an elongate, relatively slender arcuate member along a longitudinal dimension of the sleeve. A soft, blunt distal tip is formed on the arcuate member and juts beyond the distal end of the sleeve. Prior to insertion in the nasal cavity, the distal end of the sleeve is sealed. The device is inserted, distal tip first, through the nasal cavity and nasopharynx so that the distal tip extends into the oropharynx. The curvature of the arcuate member enables the device to round the corner at the rear of the nasopharynx. Once the device is in place, a tube can be inserted through the sleeve and guided through the nose to the oropharynx by the sleeve and the arcuate member. The sleeve protects the nasal mucosa from damage and keeps bacteria-laden mucus from being carried by the tube from the nose into the trachea. If the nasal mucosa is swollen, the sleeve can be erected into its tubular configuration and a channel through the passageway of the nasal cavity can be dilated by means of an arcuate dilating member. The dilating member is formed from a resilient material which compresses when inserted through the sleeve into the nasal passageway. Once the dilating member has been inserted through the sleeve, the sleeve is erected, and the nasal passageway is dilated. The dilating member is then withdrawn, permitting intubation to proceed [AUGKPA.K08]
through the now-erect sleeve, within the dilated channel of the nasal passageway.
[AUGKPA.K08]
ABSTRACT OF THE DISCLOSURE
A device for inserting a nasal tube through the nose into the oropharynx. The device includes an elongate collapsible sleeve to which is attached an elongate, relatively slender arcuate member along a longitudinal dimension of the sleeve. A soft, blunt distal tip is formed on the arcuate member and juts beyond the distal end of the sleeve. Prior to insertion in the nasal cavity, the distal end of the sleeve is sealed. The device is inserted, distal tip first, through the nasal cavity and nasopharynx so that the distal tip extends into the oropharynx. The curvature of the arcuate member enables the device to round the corner at the rear of the nasopharynx. Once the device is in place, a tube can be inserted through the sleeve and guided through the nose to the oropharynx by the sleeve and the arcuate member. The sleeve protects the nasal mucosa from damage and keeps bacteria-laden mucus from being carried by the tube from the nose into the trachea. If the nasal mucosa is swollen, the sleeve can be erected into its tubular configuration and a channel through the passageway of the nasal cavity can be dilated by means of an arcuate dilating member. The dilating member is formed from a resilient material which compresses when inserted through the sleeve into the nasal passageway. Once the dilating member has been inserted through the sleeve, the sleeve is erected, and the nasal passageway is dilated. The dilating member is then withdrawn, permitting intubation to proceed [AUGKPA.K08]
through the now-erect sleeve, within the dilated channel of the nasal passageway.
[AUGKPA.K08]
Description
l~S~05 BACKGROUND 0~ T~E INVEN~ION
The invention is in the field of inserting a na~al tube through the nose into the trachea or esophagus of a patient.
As is known, endotracheal and naso-gastric tubes are inserted into a patient through the nose for purposes which include the administration of anesthesia, ventilation of airways, and pumping of stomach fluids.
When intubation is through the nose, the attending physician can encounter a number of potential problems.
Customarily, the intubation consists of simply inserting a flexible plastic hollow tube through a nostril, feeding it through the nasal cavity, the nasopharynx and oropharynx into the trachea or esophagus.
As is known, nasal intubation can traumatize the nasal mucosa, causing bleeding. Such trauma can result from laceration of - or formation of a submucosal ~false channel~
through - the mucosa. Often it is difficult to distinguish the resistance of mucosa from the resistance presented by the turbinates and a tube can be channeled through the mucosa with the application of sufficient pressure.
Insertion of an endotracheal tube through the nasal passageway is greatly facilitatea by application of a local anesthetic to the mucosa in order to relieve discomfort.
Fre~uently, in order to decrease mucosal swelling and to suppress bleeding resulting from abrasion of the mucosa, a vasoconstrictor is also applied topically. Presently, there is no effective way to topically apply an anesthetic or a [AUGKPA.K08]
~s~)s vasoconstrictor in the nasal passageway prior to or concurrently with intubation.
Nasal insertion of an endotracheal tube fre~uently results in the transport of bacteria-laden mucus from the nose and nasopharynx to the trachea. This can result in pneumonia or systemic infection, as i8 borne out by the fre~uent inci~ence of measurable blood-borne bacteria after nasal intubation.
Finally, difficulty is often encountered in ~making the corner n between the nasal cavity and the oropharynx; as shown in ~igure 1, the near 90 transition between the nasal cavity 10 and the oropharynx 12 is difficult to traverse and the tip 14 of an endotracheal tube 16 can lacerate or perforate the posterior wall of the oropharynx in attempting to round the corner.
A number of prior art devices are available for facilitating the introduction of tubes into the trachea or esophagus. Such devices are primarily for guiding tubes through the oropharynx into the proper passageway. In this regard, a naso-gastric tube insertion guide is disclosed in U. S. Patent No. 4,175,564, which teaches the use of an arcuate, perforated tube formed from rubber or plastic which is fed through the mouth into the pharynx and then the esophagus. A naso-gastric tube is then fed throuqh the positioned guide to the stomacn. If used in the nose, this guide would pose the same danger to ~he nasal mucosa and po~terior pharynx as tbe naso-gastric tube itself: the sharp edges of the distal end of the guide can abrade or channel through the nasal mucosa and lacerate the rear of the oropharynx during insertion. Further, such a guide [AUGKPA.K08]
1'?5'5~05 makes no provision for topicalization with local anesthetics prior to or duriny insertion. Another curved guiue tube for feeding an en~otracheal tube through the mouth lnto the trachea is taught in U. S. Patent No. 4,211,234. Again, 5 this guide can teaumatize throat tissue and has no provision for topicalization.
The prior art also provides other means for feeding tubes through curved bodily passageways by the provision of guide tubes having contours which conform to the contour of 10 the passageways (1~. S. Patent No. 3,754,554) or by flexible members which are manipulated by an operator to assume the contour of a passageway into which a tube is being fed (U.
S. Patent Nos. 3,802,440 and 4,244,362).
None of the prior art intubation guide devices address 15 the problems discussed above. Their use in the nose would still present the potential o tissue injury and the devices make no provision for topicallzation.
SUHMARY OF ~E INVEtlTlOI~
The invention is founded upon the critical observation 20 made by the inventors that tissue traumatization during tubal insertion can be avoided by providing a protective channel through the nose which is contoured to gui~e a nasally-inserted tube into the oropharynx. In the invention, this channel has the form of a protective sleeve.
25 It was al~o observed that construction of the protective sleeve from a fluid-wicking material would provide a convenient means of conducting a local anesthetic to the nasal mucosa and throat passageways through which a tube i~
to be guided.
[AllGRPA.R08]
1295gO5 The inventors have further realized that effectiveness of a protective sleeve in a nasal cavity occluded by swollen nasal tissue can be enhanced by provi~ion of a dilator to dilate the passageway through the swollen ti~sues prior to insertion of a tube.
The invention is expressed from one aspect as a device for introaucing a nasal tube which includes an elongate, porous sleeve formed from a collapsible material, the sleeve forming a generally tubular pasageway having proximal and distal openings. The device also includes an elongate, relatively slender, arcuate guiding member attached to the sleeve along a longitudinal sleeve dimension extending between the proximal and distal openings. A soft, blunt distal tip is formed on the guiding member and extends beyond the distal opening. Tbe device is inserted, di~tal tip fir~t, through a nostril and is fed through the nasal cavity and nasopharynx to the oropharynx where the arcuate shape of the guiding member conforms the sleeve to the 90 corner in the nasopharynx connecting the nasal cavity with the oropharynx. Thus positioned, the sleeve provides a protective passageway for the insertion of a tube, and also provides a fluid-conducting means for topicalizing the nasal tissue with local anesthetics.
In consideration of the inventors' observation concerning swollen nasal tissue, the invention extends also to a dilating device for dilating a nasal passageway, which con~ists of an elongate, arcuate dilating member formed from a resilient, porou~ material which is compre~sed when inserted into a nasal pasfiageway. The dilating device includes a member having a blunt, rounded distal end and a AUGKPA.R08]
12~s~)s proximal end. The device also includes a stop formed on the proximal end for preventing the entry of the proximal end into a nasal opening when the member is inserted into a nostril, di~tal end first. The dilating device i6 completea by provision of an arcuate, relatively slender, pliable stylet disposed substantially in the central axis of the dilating member. When inserted through a nostril, distal end first, the device displaces swollen tissue and opens a passageway for intubation. Since the dilating member is formed from a porous material, the dilated passageway can be topicalized by fluid local anesthetics conductea through the member.
The invention also resides in an apparatus which combines the nasal tube introaucing device and the dilating device into an apparatus for introducing a tube into a dilated nostril. The apparatus includes a tube introducer having an elongate, porous sleeve formed from a collapsible material and including proximal and distal openings. The introducer also includes an elongate, relatively slender, arcuate guiding member attached to the sleeve along a longitudinal sleeve dimension extending between the proximal and distal openings. The introducer has a soft, blunt aistal tip formed on the guiding member and extending beyond the dist~ opening of the sleeve. The apparatus combines the tube introducer with a nasal passageway dilator having a dilating means formed from a resilient, porous material and insertable into the ~leeve $or erecting the sleeve from a collap~ed, compact configuration into a tubular configuration and for dilating the nasal passageway into which the tube introducer has been inserted. The dilating [AUGXPA.R08]
l~5~0S
6 ~1498-14 means ls compresslble when lnserted, through the sleeve, lnto a nasal passageway. The dllator also lncludes means for conductlng fluld from outslde a nostrll openlng to the dllatlng means when the dllatlng means ls lnserted lnto a nostrll through the sleeve.
Flnally, the lnventlon ls embodled ln a method of lntroduclng a tube through a body orlflce. In a flrst step, an elongate, porous sleeve ls placed lnto an elongate collapsed conflguratlon. The sleeve ln the collapsed conflguratlon ls lnserted lnto a bodlly orlflce wlth one end extendlng out of the orlflce. After lntroductlon of the sleeve lnto the bodlly passageway communlcatlng wlth the orlflce, a tube ls lntroduced lnto the orlflce by lnsertlng the tube lnto the sleeve through the end of the sleeve whlch extends out of the orlflce.
In accordance wlth the present lnventlon there ls provlded a devlce for lntroduclng a nasal tube, comprlslng. an elongate, porous sleeve formed from a collapslble materlal whlch ls non-self-sustalnlng and tends to collapse wlthout lnternal support, the sleeve havlng proxlmal and dlstal ends wlth openlngs at sald proxlmal and dlstal ends; an elongate, relatlvely slender arcuate guldln~ member attached to sald sleeve along a longltudlnal sleeve dlmenslon extendlng between sald proxlmal and dlstal ends; and a soft, blunt dlstal tlp formed on sald guldlng member and extendlng beyond sald dlstal end.
In accordance wlth the present lnvention there ls also provlded a devlce for dllatlng a nasal passageway, comprlslng, an elongate, arcuate dllatlng member of generally solld constructlon formed from a reslllent, porous materlal whlch 19 compresslble when lnserted lnto a nasal passageway, said dllatlng member havlng ;-~1 :.
~J .
l~S~(~S
6a 71498-14 a central axls, a blunt, rounded dlstal end and a proxlmal end; a stop means formed on said proxlmal end for preventlng the entry of sald proxlmal end lnto a nasal openlng when sald dllatlng member ls lnserted lnto a nostrll, distal end flrst; and an arcuate, relatlvely slender, pliable shaft embedded substantlally ln the central axls of sald dilatlng member.
In accordance wlth the present lnventlon there 18 alYO
provlded an apparatus for lntroduclng a tube lnto a dllated nostrll, comprlslng: a tube lntroducer, lncludlng: an elongate, porous sleeve formed from a collapslble materlal, and havlng proxlmal and dlstal openlngs; an elongate, relatlvely slender arcuate guldlng member attached to sald sleeve along a longltudlnal sleeve dlmenslon extendlng between sald proxlmal and dlstal openlngs; and a soft, blunt dlstal tlp formed on sald guldlng member and extendlng beyond sald dlstal openlng; and a nostrll dllator, lncludlng: a dllatlng means formed from a reslllent, porous materlal and lnsertable lnto sald sleeve for erectlng sald sleeve from a collapsed, compact conflguratlon lnto a tubular conflguratlon and for dllatlng a nasal passageway lnto whlch sald tube lntroducer has been lnserted, sald dllatlng means belng compresslble when lnserted, through sald sleeve, lnto a nasal passageway; and means for conductlng fluld from outslde a nostrll openlng to sald dllatlng means when sald dllatlng means ls lnserted lnto a nostrll.
A prlnclpal ob~ect of the summarlzed lnventlon ls to prevent in~ury to nasal tlssues durlng nasal lntubatlon.
~.~J ~
12~5~05 6~ 71498-14 Another ob~ect of the lnventlon ls to provlde for effectlve toplcallzatlon of nasal tlssue wlth local anesthetlcs, prlor to or durlng lntubation.
Stlll another ob~ect ls to prevent the transport of bacterla-laden mucus from the nasal paqsageway lnto the trachea.
Flnally, an ob~ect of the lnventlon 18 to effectlvely gulde a tube around the corner from the nasal cavlty lnto the oropharynx, whlle preventlng pharyngeal laceratlon resultlng from lntubatlon.
These ob~ects and other attendant advantages of the lnventlon wlll be manlfest wlth a readlng of the followlng 5~05 aescription in connection with the below-sumrnarizea drawing figures.
BRIEF D~SCRIPTION OF T~ DRAWINGS
Pigure 1 illustrates conventional nasal intubation.
Figure 2 illustrates the positioning of a device according to the invention for introducing a nasal tube, with the device shown in cross-section~ in the collapsea configuration.
Figure 3 illustrates the ~evice of Figure 2 in position, facilitating nasal intubation.
Figure 4 illustrates the device of Figure 2 in combination with a dilating device.
Figure 5 is a perspectlve view of the device of Figure 2 in an erected configuration.
Figure 6 is a perspective view of the dilating device.
DETAILED DESCRIPTION OF T~ PREFERRED EnBODIMEUT
Referring again to Figure 1, the application environment of the invention can be understood. The nasopharyngeal space 10, 11, 12 is snown in the cutaway side view of Fig~re 1. The space is entered through a nostril 17. Initial penetration into the space passes through the nasal cavity 10, makes the curve in the nasopharynx 11, past the uvula 20, into the oropharynx 12 and drops down through the oropharynx to the epiglottis 19. All nasal intubation follows thi~ path whether the destir.ation is the trachea or the esophagus. Prior art intubation is characteristically performed as illustrated in Figure 1 and consiæt~ o~ ~eeding a tube such as the endotracheal tube 16 through the no tril along the path just described.
[AUGKPA.K08~
1'~9S~()5 The invention can be understood with references to Figures 2-4. Figure 2 illustrates the upper portion o~ the cutaway view of the nasopharyngeal space illustrated in Figure 1, and shows a device for introducing a tube into the space.
In Figure 2, the device for introducing a na~al tube includes an elongate, porous sleeve 21 which is formed fron~
a collapsible material, suitable for wicking or conducting ~luid. The sleeve 21 forms an elongate protective sheath having a proximal opening 22 and a distal opening 24. An elongate, relatively slender arcuate guiding member 26 i8 attachea to the sleeve 21 along a longitudinal dimension extending generally between the proximal ana distal openings 22 and 24. The guiding member can compri~e a stylet or relatively slender catheter. The guiding member 26 includes apertured distal and proximal tip 28 and 30 connected by an interior channel 32. A stop 34 is formed on the proximal opening 22 of the sleeve 21 and comprises, for example, an annular ring or collar made of a non-collapsible material which posse6ses a flexibility that is somewhat less than the flexibility of the sheath materiai.
A blunt, rounded distal tip 38 is formed on the end of the device and covers and surrounds the distal tip 28 of the guiding member 26. As seen in Figure 4, the tip 38 is formed by a padding of spongy, porous material ~9 which is enclosed by a lower extension of the sleeve 21, the lower extension protruding outwardly from the portion of the sleeve below the distal opening 24. Figure 2 also shows the pronounced curvature of the tube introduction device, which results from the arc formed in the guiding member 26.
[AUGKPA.R08]
lZ~S~O~
g In use, the device is inserted, distal tip 38 first through the nostril 17, an~ is fea through tbe nasal cavity and nasopharynx 11 into the oropharynx 12. As can be appreciated, the 60ft, blunt di~tal tip 38 significantly S reduces the prospect of abrading, lacerating, or penetrating the nasal mucosa or the posterior wall of the nasopharynx 11. The guiaing member 26 imparts a relative stiffness to the device which permits lt to be a~vanced through the nasopharyngeal space 10, 11, 12 by pressure applied to the proximal portion of the guiding member 26. The curvature of the device essentially conforms it to the curvature of the space being traversed and enables the device to ~make the curve~ in the nasopharynx 11. The stop 34 formea on the proximal opening 22 of the sleeve 21 prevents the device from being inserted altogether into the nostril and retains the proximal opening 22 in place just outsiàe the no~tril 17. While the device is being inserted through the nostril, it will be appreciated that the collapsible property of the sleeve 21 will permit the sleeve to conform to the interior terrain of the nasal cavity 10. Thus, if the nasal mucosa are swollen, the sleeve 21 will be relatively fully collapsed, yet will form a ailatable, protective channel within the nasal passageway.
Topicalization of the nasal cavity with local anesthetics is accomplished by the guiding member 26. As the device is being inserted into the nasal passageway, a local anesthesia and/or a vasoconstrictor can be fed in fluid form from a syringe 40 which i~ in communication with the apertured distal tip 30 of the member 26. The fluid is conducted through the channel 32 to the apertured distal tip [AUGKPA.K08]
1'~95505 28, where it exits into the material 39 of the blunt distal tip 38. Since the material 39 ano the material of the sleeve 21 are porous, the fluid exiting the distal tip 28 wlll be conducted to the outer surface of the sleeve 21 whence it will be transferred by contact to the pharyngeal tissue. It should be evident that pin holes can be also made along the length of the member 26 to facilitate a more evenly-distributed conduction of fluid from the channel of the member to the sleeve 21. Thus, effective topicalization of the nasal passageway can be accomplished by the device as the device is being inserted into the passageway, and can be continued for so long as the device is in place in the passageway.
Prior to insertion, the distal opening 24 is sealed, preferably by a relatively weak adhesive or heat seal which yields with little resistance to a probing force exerted through the sleeve 21 in the direction of the distal opening 24. This sealing will prevent the migration o~ mucus and other bacteria-laden material into the sleeve 21 while it is being inserted. This preserve~ the prophylactic nature of the passageway and effectively reduces the chance of infection because the tube is being fed through the sleeve 21.
With reference now to Figure 3, the use of the tube-introducing device of the invention can be understood. Whenthe device is fed through the nasal passageway, it forms a protective tubular channel through which a tube 41 can be fed. The channel protects the pharyngeal tissue from injury and penetration, keeps the tip 42 of the tube free of bacteria-bearing material, and forms a curved passageway AUGKPA.X08~
~ ~3S~ S
which conforms to the transition between the nasal cavity and oropharynx. As the tube 41 is feo, tip 42 first, through the proximal opening 22 of the sleeve 21, the tube travels through the nasal passageway within the sleeve, and traverses the corner at the nasopharynx 11. At this point the tube can be fed further down the oropharynx for insertion into the trachea or the esophagus.
In Figure 4 a nasal dilating device is illustrated in combination with the tube introducing device of Figures 2 ana 3. The dilating device is shown in perspective in ~igure 6. The dilating device is useful for dilating a passageway between swollen nasopharyngeal tissues prior to introduction of a tube as illustratea in Figure 3. In Figures 4 and 6, the dilating device consists of an - 15 elongate, arcuate dilating member 50 which is formed from a soft, porous material which is compressible, yet which resumes its original shape when compression is removed. The dilating member 50 has a blunt, rounded distal tip 51 and transitions at its proximal end to an annular nasal stop 52.
Disposed in the central axis of the dilating member 50 is an arcuate, relatively slender and pliable shaft or member 54, which conform in all essential respects to the guiding member 26 of the tube-introducing device. The central shaft is curvea, and this curvature is imposed generally on the dilating member 50. The central shaft 54 has proximal and distal openings 56 ana 58, reEpectively, that are connected by an interior channel. This permits topicalization by introduction of fluid local anesthetics into the porous material of the dilator, from a syringe attached to the proximal tip 56, which is conducted through the channel of [AUGKPA.K08]
S~O~
the shaft 54 to the distal tip 58. Alternatively, the shaft can be apertured with pinholes along its length to permit a relatively even flow of fluid into the porous material of the ailating member S0. Since the dilating member material is porous, the fluid i8 con~ucted to the surface of the member, where it is transferred by contact to the nasopharyngeal tissue~. As shown in Figure 4, the dilating device can be used in combination with the tube introducing device of Figure 2 to perform a dual function. First, the dilating device can be usea after insertion of the tube introducing device to dilate a passageway between the swollen nasal tissues, for the introauction of a tube through the sleeve 21. At the same time that the swollen nasal tissue is dilated, tbe dilating device places the sleeve 21 into a relatively erect, open configuration through which a tube of relatively large diameter can be easily fed. The dilating device is preventea from entering wholly into the nostril by the nasal stop 52 formed on its proximal end.
It will be appreciate~ that the dilating device, being formed of a soft, compressible material, does not abruptly force an opening in swollen nasal tissue. Rather, if the tissue is relatively tightly swollen, the ailating member compresses somewhat, yet gently thrusts open a passageway when inserted, distal tip first, into the sleeve 21. It will be appreciated that the blunted distal tip 51 prevents damage to nasal tissue, while the curvature of the dilating device enables it also to ~make the corner.~
The dilating device can be used alone, witbout the tube introaucing device, to dilate nasal tissue. In this regard, [AUGKPA.K08~
s~ o~
the dilating device i8 simply inserted, aistal tip 51 first, through a nostril and into the nasal passageway. It will be obvious that the catheter-like structure of the shaft 54 and tne porosity of the material from which the dilating aevice is formed permit topicalization of nasal tissue while the dilator is used alone.
As illustratea in Figure 5, the tube introducing device can be provided with a nascent slit 60 which extends, generally longitudinally, along the sleeve from the aistal opening 24 to the proximal opening 22 and which transitions to the nasal stop 34. As is known, such a slit is useful for removing the device once it has been used to feed a nasal tube from the nostril into either the trachea or esophagus. When the tube is in place, the slit 60 can be perforated, beginning at the nasal stop 34 and the proximal opening 22 so that the device can be removed without disturbing the in-place tube. In this regard, as the device is withdrawn from the nose, the slit 60 is continuously perforated from the nasal stop 34 to the distal opening 24 so that the device can be removed from the tube as it is being extracteà from the nasal passageway.
It will be appreciated that the aetailed description and drawings are to be regarded as illustrative of the invention and that the invention may be changed, modified, or elaborated without departing fro~ the spirit of the invention or the scope of the appended claims.
We claim:
[AUGKPA.K08~
The invention is in the field of inserting a na~al tube through the nose into the trachea or esophagus of a patient.
As is known, endotracheal and naso-gastric tubes are inserted into a patient through the nose for purposes which include the administration of anesthesia, ventilation of airways, and pumping of stomach fluids.
When intubation is through the nose, the attending physician can encounter a number of potential problems.
Customarily, the intubation consists of simply inserting a flexible plastic hollow tube through a nostril, feeding it through the nasal cavity, the nasopharynx and oropharynx into the trachea or esophagus.
As is known, nasal intubation can traumatize the nasal mucosa, causing bleeding. Such trauma can result from laceration of - or formation of a submucosal ~false channel~
through - the mucosa. Often it is difficult to distinguish the resistance of mucosa from the resistance presented by the turbinates and a tube can be channeled through the mucosa with the application of sufficient pressure.
Insertion of an endotracheal tube through the nasal passageway is greatly facilitatea by application of a local anesthetic to the mucosa in order to relieve discomfort.
Fre~uently, in order to decrease mucosal swelling and to suppress bleeding resulting from abrasion of the mucosa, a vasoconstrictor is also applied topically. Presently, there is no effective way to topically apply an anesthetic or a [AUGKPA.K08]
~s~)s vasoconstrictor in the nasal passageway prior to or concurrently with intubation.
Nasal insertion of an endotracheal tube fre~uently results in the transport of bacteria-laden mucus from the nose and nasopharynx to the trachea. This can result in pneumonia or systemic infection, as i8 borne out by the fre~uent inci~ence of measurable blood-borne bacteria after nasal intubation.
Finally, difficulty is often encountered in ~making the corner n between the nasal cavity and the oropharynx; as shown in ~igure 1, the near 90 transition between the nasal cavity 10 and the oropharynx 12 is difficult to traverse and the tip 14 of an endotracheal tube 16 can lacerate or perforate the posterior wall of the oropharynx in attempting to round the corner.
A number of prior art devices are available for facilitating the introduction of tubes into the trachea or esophagus. Such devices are primarily for guiding tubes through the oropharynx into the proper passageway. In this regard, a naso-gastric tube insertion guide is disclosed in U. S. Patent No. 4,175,564, which teaches the use of an arcuate, perforated tube formed from rubber or plastic which is fed through the mouth into the pharynx and then the esophagus. A naso-gastric tube is then fed throuqh the positioned guide to the stomacn. If used in the nose, this guide would pose the same danger to ~he nasal mucosa and po~terior pharynx as tbe naso-gastric tube itself: the sharp edges of the distal end of the guide can abrade or channel through the nasal mucosa and lacerate the rear of the oropharynx during insertion. Further, such a guide [AUGKPA.K08]
1'?5'5~05 makes no provision for topicalization with local anesthetics prior to or duriny insertion. Another curved guiue tube for feeding an en~otracheal tube through the mouth lnto the trachea is taught in U. S. Patent No. 4,211,234. Again, 5 this guide can teaumatize throat tissue and has no provision for topicalization.
The prior art also provides other means for feeding tubes through curved bodily passageways by the provision of guide tubes having contours which conform to the contour of 10 the passageways (1~. S. Patent No. 3,754,554) or by flexible members which are manipulated by an operator to assume the contour of a passageway into which a tube is being fed (U.
S. Patent Nos. 3,802,440 and 4,244,362).
None of the prior art intubation guide devices address 15 the problems discussed above. Their use in the nose would still present the potential o tissue injury and the devices make no provision for topicallzation.
SUHMARY OF ~E INVEtlTlOI~
The invention is founded upon the critical observation 20 made by the inventors that tissue traumatization during tubal insertion can be avoided by providing a protective channel through the nose which is contoured to gui~e a nasally-inserted tube into the oropharynx. In the invention, this channel has the form of a protective sleeve.
25 It was al~o observed that construction of the protective sleeve from a fluid-wicking material would provide a convenient means of conducting a local anesthetic to the nasal mucosa and throat passageways through which a tube i~
to be guided.
[AllGRPA.R08]
1295gO5 The inventors have further realized that effectiveness of a protective sleeve in a nasal cavity occluded by swollen nasal tissue can be enhanced by provi~ion of a dilator to dilate the passageway through the swollen ti~sues prior to insertion of a tube.
The invention is expressed from one aspect as a device for introaucing a nasal tube which includes an elongate, porous sleeve formed from a collapsible material, the sleeve forming a generally tubular pasageway having proximal and distal openings. The device also includes an elongate, relatively slender, arcuate guiding member attached to the sleeve along a longitudinal sleeve dimension extending between the proximal and distal openings. A soft, blunt distal tip is formed on the guiding member and extends beyond the distal opening. Tbe device is inserted, di~tal tip fir~t, through a nostril and is fed through the nasal cavity and nasopharynx to the oropharynx where the arcuate shape of the guiding member conforms the sleeve to the 90 corner in the nasopharynx connecting the nasal cavity with the oropharynx. Thus positioned, the sleeve provides a protective passageway for the insertion of a tube, and also provides a fluid-conducting means for topicalizing the nasal tissue with local anesthetics.
In consideration of the inventors' observation concerning swollen nasal tissue, the invention extends also to a dilating device for dilating a nasal passageway, which con~ists of an elongate, arcuate dilating member formed from a resilient, porou~ material which is compre~sed when inserted into a nasal pasfiageway. The dilating device includes a member having a blunt, rounded distal end and a AUGKPA.R08]
12~s~)s proximal end. The device also includes a stop formed on the proximal end for preventing the entry of the proximal end into a nasal opening when the member is inserted into a nostril, di~tal end first. The dilating device i6 completea by provision of an arcuate, relatively slender, pliable stylet disposed substantially in the central axis of the dilating member. When inserted through a nostril, distal end first, the device displaces swollen tissue and opens a passageway for intubation. Since the dilating member is formed from a porous material, the dilated passageway can be topicalized by fluid local anesthetics conductea through the member.
The invention also resides in an apparatus which combines the nasal tube introaucing device and the dilating device into an apparatus for introducing a tube into a dilated nostril. The apparatus includes a tube introducer having an elongate, porous sleeve formed from a collapsible material and including proximal and distal openings. The introducer also includes an elongate, relatively slender, arcuate guiding member attached to the sleeve along a longitudinal sleeve dimension extending between the proximal and distal openings. The introducer has a soft, blunt aistal tip formed on the guiding member and extending beyond the dist~ opening of the sleeve. The apparatus combines the tube introducer with a nasal passageway dilator having a dilating means formed from a resilient, porous material and insertable into the ~leeve $or erecting the sleeve from a collap~ed, compact configuration into a tubular configuration and for dilating the nasal passageway into which the tube introducer has been inserted. The dilating [AUGXPA.R08]
l~5~0S
6 ~1498-14 means ls compresslble when lnserted, through the sleeve, lnto a nasal passageway. The dllator also lncludes means for conductlng fluld from outslde a nostrll openlng to the dllatlng means when the dllatlng means ls lnserted lnto a nostrll through the sleeve.
Flnally, the lnventlon ls embodled ln a method of lntroduclng a tube through a body orlflce. In a flrst step, an elongate, porous sleeve ls placed lnto an elongate collapsed conflguratlon. The sleeve ln the collapsed conflguratlon ls lnserted lnto a bodlly orlflce wlth one end extendlng out of the orlflce. After lntroductlon of the sleeve lnto the bodlly passageway communlcatlng wlth the orlflce, a tube ls lntroduced lnto the orlflce by lnsertlng the tube lnto the sleeve through the end of the sleeve whlch extends out of the orlflce.
In accordance wlth the present lnventlon there ls provlded a devlce for lntroduclng a nasal tube, comprlslng. an elongate, porous sleeve formed from a collapslble materlal whlch ls non-self-sustalnlng and tends to collapse wlthout lnternal support, the sleeve havlng proxlmal and dlstal ends wlth openlngs at sald proxlmal and dlstal ends; an elongate, relatlvely slender arcuate guldln~ member attached to sald sleeve along a longltudlnal sleeve dlmenslon extendlng between sald proxlmal and dlstal ends; and a soft, blunt dlstal tlp formed on sald guldlng member and extendlng beyond sald dlstal end.
In accordance wlth the present lnvention there ls also provlded a devlce for dllatlng a nasal passageway, comprlslng, an elongate, arcuate dllatlng member of generally solld constructlon formed from a reslllent, porous materlal whlch 19 compresslble when lnserted lnto a nasal passageway, said dllatlng member havlng ;-~1 :.
~J .
l~S~(~S
6a 71498-14 a central axls, a blunt, rounded dlstal end and a proxlmal end; a stop means formed on said proxlmal end for preventlng the entry of sald proxlmal end lnto a nasal openlng when sald dllatlng member ls lnserted lnto a nostrll, distal end flrst; and an arcuate, relatlvely slender, pliable shaft embedded substantlally ln the central axls of sald dilatlng member.
In accordance wlth the present lnventlon there 18 alYO
provlded an apparatus for lntroduclng a tube lnto a dllated nostrll, comprlslng: a tube lntroducer, lncludlng: an elongate, porous sleeve formed from a collapslble materlal, and havlng proxlmal and dlstal openlngs; an elongate, relatlvely slender arcuate guldlng member attached to sald sleeve along a longltudlnal sleeve dlmenslon extendlng between sald proxlmal and dlstal openlngs; and a soft, blunt dlstal tlp formed on sald guldlng member and extendlng beyond sald dlstal openlng; and a nostrll dllator, lncludlng: a dllatlng means formed from a reslllent, porous materlal and lnsertable lnto sald sleeve for erectlng sald sleeve from a collapsed, compact conflguratlon lnto a tubular conflguratlon and for dllatlng a nasal passageway lnto whlch sald tube lntroducer has been lnserted, sald dllatlng means belng compresslble when lnserted, through sald sleeve, lnto a nasal passageway; and means for conductlng fluld from outslde a nostrll openlng to sald dllatlng means when sald dllatlng means ls lnserted lnto a nostrll.
A prlnclpal ob~ect of the summarlzed lnventlon ls to prevent in~ury to nasal tlssues durlng nasal lntubatlon.
~.~J ~
12~5~05 6~ 71498-14 Another ob~ect of the lnventlon ls to provlde for effectlve toplcallzatlon of nasal tlssue wlth local anesthetlcs, prlor to or durlng lntubation.
Stlll another ob~ect ls to prevent the transport of bacterla-laden mucus from the nasal paqsageway lnto the trachea.
Flnally, an ob~ect of the lnventlon 18 to effectlvely gulde a tube around the corner from the nasal cavlty lnto the oropharynx, whlle preventlng pharyngeal laceratlon resultlng from lntubatlon.
These ob~ects and other attendant advantages of the lnventlon wlll be manlfest wlth a readlng of the followlng 5~05 aescription in connection with the below-sumrnarizea drawing figures.
BRIEF D~SCRIPTION OF T~ DRAWINGS
Pigure 1 illustrates conventional nasal intubation.
Figure 2 illustrates the positioning of a device according to the invention for introducing a nasal tube, with the device shown in cross-section~ in the collapsea configuration.
Figure 3 illustrates the ~evice of Figure 2 in position, facilitating nasal intubation.
Figure 4 illustrates the device of Figure 2 in combination with a dilating device.
Figure 5 is a perspectlve view of the device of Figure 2 in an erected configuration.
Figure 6 is a perspective view of the dilating device.
DETAILED DESCRIPTION OF T~ PREFERRED EnBODIMEUT
Referring again to Figure 1, the application environment of the invention can be understood. The nasopharyngeal space 10, 11, 12 is snown in the cutaway side view of Fig~re 1. The space is entered through a nostril 17. Initial penetration into the space passes through the nasal cavity 10, makes the curve in the nasopharynx 11, past the uvula 20, into the oropharynx 12 and drops down through the oropharynx to the epiglottis 19. All nasal intubation follows thi~ path whether the destir.ation is the trachea or the esophagus. Prior art intubation is characteristically performed as illustrated in Figure 1 and consiæt~ o~ ~eeding a tube such as the endotracheal tube 16 through the no tril along the path just described.
[AUGKPA.K08~
1'~9S~()5 The invention can be understood with references to Figures 2-4. Figure 2 illustrates the upper portion o~ the cutaway view of the nasopharyngeal space illustrated in Figure 1, and shows a device for introducing a tube into the space.
In Figure 2, the device for introducing a na~al tube includes an elongate, porous sleeve 21 which is formed fron~
a collapsible material, suitable for wicking or conducting ~luid. The sleeve 21 forms an elongate protective sheath having a proximal opening 22 and a distal opening 24. An elongate, relatively slender arcuate guiding member 26 i8 attachea to the sleeve 21 along a longitudinal dimension extending generally between the proximal ana distal openings 22 and 24. The guiding member can compri~e a stylet or relatively slender catheter. The guiding member 26 includes apertured distal and proximal tip 28 and 30 connected by an interior channel 32. A stop 34 is formed on the proximal opening 22 of the sleeve 21 and comprises, for example, an annular ring or collar made of a non-collapsible material which posse6ses a flexibility that is somewhat less than the flexibility of the sheath materiai.
A blunt, rounded distal tip 38 is formed on the end of the device and covers and surrounds the distal tip 28 of the guiding member 26. As seen in Figure 4, the tip 38 is formed by a padding of spongy, porous material ~9 which is enclosed by a lower extension of the sleeve 21, the lower extension protruding outwardly from the portion of the sleeve below the distal opening 24. Figure 2 also shows the pronounced curvature of the tube introduction device, which results from the arc formed in the guiding member 26.
[AUGKPA.R08]
lZ~S~O~
g In use, the device is inserted, distal tip 38 first through the nostril 17, an~ is fea through tbe nasal cavity and nasopharynx 11 into the oropharynx 12. As can be appreciated, the 60ft, blunt di~tal tip 38 significantly S reduces the prospect of abrading, lacerating, or penetrating the nasal mucosa or the posterior wall of the nasopharynx 11. The guiaing member 26 imparts a relative stiffness to the device which permits lt to be a~vanced through the nasopharyngeal space 10, 11, 12 by pressure applied to the proximal portion of the guiding member 26. The curvature of the device essentially conforms it to the curvature of the space being traversed and enables the device to ~make the curve~ in the nasopharynx 11. The stop 34 formea on the proximal opening 22 of the sleeve 21 prevents the device from being inserted altogether into the nostril and retains the proximal opening 22 in place just outsiàe the no~tril 17. While the device is being inserted through the nostril, it will be appreciated that the collapsible property of the sleeve 21 will permit the sleeve to conform to the interior terrain of the nasal cavity 10. Thus, if the nasal mucosa are swollen, the sleeve 21 will be relatively fully collapsed, yet will form a ailatable, protective channel within the nasal passageway.
Topicalization of the nasal cavity with local anesthetics is accomplished by the guiding member 26. As the device is being inserted into the nasal passageway, a local anesthesia and/or a vasoconstrictor can be fed in fluid form from a syringe 40 which i~ in communication with the apertured distal tip 30 of the member 26. The fluid is conducted through the channel 32 to the apertured distal tip [AUGKPA.K08]
1'~95505 28, where it exits into the material 39 of the blunt distal tip 38. Since the material 39 ano the material of the sleeve 21 are porous, the fluid exiting the distal tip 28 wlll be conducted to the outer surface of the sleeve 21 whence it will be transferred by contact to the pharyngeal tissue. It should be evident that pin holes can be also made along the length of the member 26 to facilitate a more evenly-distributed conduction of fluid from the channel of the member to the sleeve 21. Thus, effective topicalization of the nasal passageway can be accomplished by the device as the device is being inserted into the passageway, and can be continued for so long as the device is in place in the passageway.
Prior to insertion, the distal opening 24 is sealed, preferably by a relatively weak adhesive or heat seal which yields with little resistance to a probing force exerted through the sleeve 21 in the direction of the distal opening 24. This sealing will prevent the migration o~ mucus and other bacteria-laden material into the sleeve 21 while it is being inserted. This preserve~ the prophylactic nature of the passageway and effectively reduces the chance of infection because the tube is being fed through the sleeve 21.
With reference now to Figure 3, the use of the tube-introducing device of the invention can be understood. Whenthe device is fed through the nasal passageway, it forms a protective tubular channel through which a tube 41 can be fed. The channel protects the pharyngeal tissue from injury and penetration, keeps the tip 42 of the tube free of bacteria-bearing material, and forms a curved passageway AUGKPA.X08~
~ ~3S~ S
which conforms to the transition between the nasal cavity and oropharynx. As the tube 41 is feo, tip 42 first, through the proximal opening 22 of the sleeve 21, the tube travels through the nasal passageway within the sleeve, and traverses the corner at the nasopharynx 11. At this point the tube can be fed further down the oropharynx for insertion into the trachea or the esophagus.
In Figure 4 a nasal dilating device is illustrated in combination with the tube introducing device of Figures 2 ana 3. The dilating device is shown in perspective in ~igure 6. The dilating device is useful for dilating a passageway between swollen nasopharyngeal tissues prior to introduction of a tube as illustratea in Figure 3. In Figures 4 and 6, the dilating device consists of an - 15 elongate, arcuate dilating member 50 which is formed from a soft, porous material which is compressible, yet which resumes its original shape when compression is removed. The dilating member 50 has a blunt, rounded distal tip 51 and transitions at its proximal end to an annular nasal stop 52.
Disposed in the central axis of the dilating member 50 is an arcuate, relatively slender and pliable shaft or member 54, which conform in all essential respects to the guiding member 26 of the tube-introducing device. The central shaft is curvea, and this curvature is imposed generally on the dilating member 50. The central shaft 54 has proximal and distal openings 56 ana 58, reEpectively, that are connected by an interior channel. This permits topicalization by introduction of fluid local anesthetics into the porous material of the dilator, from a syringe attached to the proximal tip 56, which is conducted through the channel of [AUGKPA.K08]
S~O~
the shaft 54 to the distal tip 58. Alternatively, the shaft can be apertured with pinholes along its length to permit a relatively even flow of fluid into the porous material of the ailating member S0. Since the dilating member material is porous, the fluid i8 con~ucted to the surface of the member, where it is transferred by contact to the nasopharyngeal tissue~. As shown in Figure 4, the dilating device can be used in combination with the tube introducing device of Figure 2 to perform a dual function. First, the dilating device can be usea after insertion of the tube introducing device to dilate a passageway between the swollen nasal tissues, for the introauction of a tube through the sleeve 21. At the same time that the swollen nasal tissue is dilated, tbe dilating device places the sleeve 21 into a relatively erect, open configuration through which a tube of relatively large diameter can be easily fed. The dilating device is preventea from entering wholly into the nostril by the nasal stop 52 formed on its proximal end.
It will be appreciate~ that the dilating device, being formed of a soft, compressible material, does not abruptly force an opening in swollen nasal tissue. Rather, if the tissue is relatively tightly swollen, the ailating member compresses somewhat, yet gently thrusts open a passageway when inserted, distal tip first, into the sleeve 21. It will be appreciated that the blunted distal tip 51 prevents damage to nasal tissue, while the curvature of the dilating device enables it also to ~make the corner.~
The dilating device can be used alone, witbout the tube introaucing device, to dilate nasal tissue. In this regard, [AUGKPA.K08~
s~ o~
the dilating device i8 simply inserted, aistal tip 51 first, through a nostril and into the nasal passageway. It will be obvious that the catheter-like structure of the shaft 54 and tne porosity of the material from which the dilating aevice is formed permit topicalization of nasal tissue while the dilator is used alone.
As illustratea in Figure 5, the tube introducing device can be provided with a nascent slit 60 which extends, generally longitudinally, along the sleeve from the aistal opening 24 to the proximal opening 22 and which transitions to the nasal stop 34. As is known, such a slit is useful for removing the device once it has been used to feed a nasal tube from the nostril into either the trachea or esophagus. When the tube is in place, the slit 60 can be perforated, beginning at the nasal stop 34 and the proximal opening 22 so that the device can be removed without disturbing the in-place tube. In this regard, as the device is withdrawn from the nose, the slit 60 is continuously perforated from the nasal stop 34 to the distal opening 24 so that the device can be removed from the tube as it is being extracteà from the nasal passageway.
It will be appreciated that the aetailed description and drawings are to be regarded as illustrative of the invention and that the invention may be changed, modified, or elaborated without departing fro~ the spirit of the invention or the scope of the appended claims.
We claim:
[AUGKPA.K08~
Claims (18)
1. A device for introducing a nasal tube, comprising:
an elongate, porous sleeve formed from a collapsible material which is non-self-sustaining and tends to collapse without internal support, the sleeve having proximal and distal ends with openings at said proximal and distal ends;
an elongate, relatively slender arcuate guiding member attached to said sleeve along a longitudinal sleeve dimension extending between said proximal and distal ends; and a soft, blunt distal tip formed on said guiding member and extending beyond said distal end.
an elongate, porous sleeve formed from a collapsible material which is non-self-sustaining and tends to collapse without internal support, the sleeve having proximal and distal ends with openings at said proximal and distal ends;
an elongate, relatively slender arcuate guiding member attached to said sleeve along a longitudinal sleeve dimension extending between said proximal and distal ends; and a soft, blunt distal tip formed on said guiding member and extending beyond said distal end.
2. The device of Claim 1 further including stop means on said proximal end for preventing the entry of said proximal end into a nasal opening when said device is inserted into a nostril, distal tip first.
3. The device of Claim 1 further including means for maintaining said distal opening closed and for yielding in response to a probing force exerted through said sleeve in a direction toward said distal opening to open said distal opening.
4. The device of Claim 1 wherein said guiding member comprises a catheter with a distal end opening into said distal tip, a proximal end, and a fluid-conducting passageway connecting said distal and proximal ends.
5. The device of Claim 1 wherein said sleeve is formed from a liquid wicking material.
6. The device of Claim 1 wherein said distal tip is formed on said distal end and comprises a mass of woven, permeable material for conducting fluid outwardly from said distal end.
7. A device for dilating a nasal passageway, comprising:
an elongate, arcuate dilating member of generally solid construction formed from a resilient, porous material which is compressible when inserted into a nasal passageway, said dilating member having a central axis, a blunt, rounded distal end and a proximal end;
a stop means formed on said proximal end for preventing the entry of said proximal end into a nasal opening when said dilating member is inserted into a nostril, distal end first; and an arcuate, relatively slender, pliable shaft embedded substantially in the central axis of said dilating member.
an elongate, arcuate dilating member of generally solid construction formed from a resilient, porous material which is compressible when inserted into a nasal passageway, said dilating member having a central axis, a blunt, rounded distal end and a proximal end;
a stop means formed on said proximal end for preventing the entry of said proximal end into a nasal opening when said dilating member is inserted into a nostril, distal end first; and an arcuate, relatively slender, pliable shaft embedded substantially in the central axis of said dilating member.
8. The device of Claim 7 further including channel means for conducting fluid from a location proximal to said stop means to said dilating member when said dilating member is inserted into a nostril, distal end first.
9. The device of Claim 8 wherein said pliable shaft is a catheter with proximal and distal openings and is disposed in said dilating member such that said proximal opening extends out of said stop means while said distal opening is contained within said dilating member and said channel means is a fluid-conducting channel in said pliable shaft connecting said proximal and distal openings.
10. An apparatus for introducing a tube into a dilated nostril, comprising:
a tube introducer, including:
an elongate, porous sleeve formed from a collapsible material, and having proximal and distal openings;
an elongate, relatively slender arcuate guiding member attached to said sleeve along a longitudinal sleeve dimension extending between said proximal and distal openings; and a soft, blunt distal tip formed on said guiding member and extending beyond said distal opening; and a nostril dilator, including:
a dilating means formed from a resilient, porous material and insertable into said sleeve for erecting said sleeve from a collapsed, compact configuration into a tubular configuration and for dilating a nasal passageway into which said tube introducer has been inserted, said dilating means being compressible when inserted, through said sleeve, into a nasal passageway; and means for conducting fluid from outside a nostril opening to said dilating means when said dilating means is inserted into a nostril.
a tube introducer, including:
an elongate, porous sleeve formed from a collapsible material, and having proximal and distal openings;
an elongate, relatively slender arcuate guiding member attached to said sleeve along a longitudinal sleeve dimension extending between said proximal and distal openings; and a soft, blunt distal tip formed on said guiding member and extending beyond said distal opening; and a nostril dilator, including:
a dilating means formed from a resilient, porous material and insertable into said sleeve for erecting said sleeve from a collapsed, compact configuration into a tubular configuration and for dilating a nasal passageway into which said tube introducer has been inserted, said dilating means being compressible when inserted, through said sleeve, into a nasal passageway; and means for conducting fluid from outside a nostril opening to said dilating means when said dilating means is inserted into a nostril.
11. The apparatus of Claim 10 further including stop means on said proximal end for preventing the entry of said proximal end into a nasal opening when said device is inserted into a nostril, distal tip first.
12. The apparatus of Claim 10 further including means for maintaining said distal opening closed and for yielding in response to a probing force exerted through said sleeve in a direction toward said distal opening to open said distal opening.
13. The apparatus of Claim 10 wherein said tube introducer member comprises a catheter with a distal end opening into said distal tip, a proximal end, and a fluid-conducting passageway connecting said distal and proximal ends.
14. The apparatus of Claim 13 wherein said distal tip is formed on said distal end and comprises a mass of woven, permeable material for wicking fluid outwardly from said distal end.
15. The apparatus of Claim 10 wherein said dilating means comprises:
an elongate arcuate member formed from a resilient, porous material which is compressible when inserted into a nasal passageway, said dilating member having a blunt, rounded distal end and a proximal end;
a stop means formed on said proximal end for preventing the entry of said proximal end into a nasal opening when said dilating member is inserted into a nostril, distal end first; and an arcuate, relatively slender, pliable shaft disposed substantially in the central axis of said dilating member.
an elongate arcuate member formed from a resilient, porous material which is compressible when inserted into a nasal passageway, said dilating member having a blunt, rounded distal end and a proximal end;
a stop means formed on said proximal end for preventing the entry of said proximal end into a nasal opening when said dilating member is inserted into a nostril, distal end first; and an arcuate, relatively slender, pliable shaft disposed substantially in the central axis of said dilating member.
16. The apparatus of Claim 15 wherein said means for conducting fluid includes a channel means in said shaft for conducting fluid from a location proximal to said stop means to said dilating member when said dilating member is inserted into a nostril, distal end first.
17. The apparatus of Claim 15 wherein said pliable shaft is a catheter with proximal and distal openings and is disposed in said dilating member such that said proximal opening extends out of said stop means while said distal opening is contained within said dilating member and said channel means is a fluid-conducting channel in said pliable shaft connecting said proximal and distal openings.
18. The device of Claim 1, wherein the arcuate guiding member has a curvature approaching 90 degrees for enabling the device to round the corner at the rear of the nasopharynx.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/003,752 US4819619A (en) | 1987-01-16 | 1987-01-16 | Device for inserting a nasal tube |
| US003,752 | 1987-01-16 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1295905C true CA1295905C (en) | 1992-02-18 |
Family
ID=21707413
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000556636A Expired - Fee Related CA1295905C (en) | 1987-01-16 | 1988-01-15 | Device for inserting a nasal tube |
Country Status (2)
| Country | Link |
|---|---|
| US (1) | US4819619A (en) |
| CA (1) | CA1295905C (en) |
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Also Published As
| Publication number | Publication date |
|---|---|
| US4819619A (en) | 1989-04-11 |
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