CN212347389U - Uplifting throat organizer and device for difficult airways - Google Patents
Uplifting throat organizer and device for difficult airways Download PDFInfo
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- CN212347389U CN212347389U CN201820282906.0U CN201820282906U CN212347389U CN 212347389 U CN212347389 U CN 212347389U CN 201820282906 U CN201820282906 U CN 201820282906U CN 212347389 U CN212347389 U CN 212347389U
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Abstract
The utility model provides a lifting throat organizer, belonging to the technical field of medical instruments, comprising a lifting handle and a lifting bent piece component which are detachably connected, wherein the lifting bent piece component is provided with a bent piece, the thickness of the bent piece is 0.5-1 mm, and the width of the bent piece is 1-2 cm; the tail end of the bent piece is fixedly connected with the lifting handle, and the front end of the bent piece can enter from the oral cavity and is at the bottom of the throat of a patient. The lifting throat organizer can expand the oropharynx space of a patient with severely limited mouth opening, so that the oropharynx of the patient forms a wide and unobstructed ventilation or intubation path, and a doctor can conveniently perform fiberbronchoscopy or other intubation auxiliary equipment trachea intubation. The utility model also provides a device for difficult air flue.
Description
Technical Field
The utility model belongs to the technical field of medical instrument, concretely relates to lift throat organizer and be used for device of difficult air flue.
Background
A difficult airway is a clinical situation where an anesthesiologist with more than five years of anesthesia experiences difficulty in mask ventilation or tracheal intubation.
"the patient will die only from the failure of ventilation and will not die from the failure of intubation", in clinic, once the ventilation is difficult, the patient is easy to enter the anoxic state to cause the death by asphyxia. The prior art solutions for difficult ventilation and the existing drawbacks are mainly as follows:
(1) placing into a nasopharyngeal airway for pressurization and ventilation: but some patients still cannot improve ventilation due to obesity, pachynsis of soft palate or tongue body, overlong nasal passage, obstruction of posterior nasal orifice and poor position of nasopharyngeal airway;
(2) placing the artificial trachea cannula into supraglottic ventilation tools such as an oropharynx air passage, a laryngeal mask, an esophagus-trachea combined catheter, a laryngeal tube and the like for pressurizing and supplying oxygen: however, the device needs to be placed in an opening degree of about 2-3 cm, and cannot be placed in patients with openings smaller than 2cm, 1cm and 0.1 cm; even if the tool is placed into a patient with partial unrestricted mouth opening, the clinical situation that the ventilation cannot be improved due to obesity, the fat soft palate or tongue body, the overlong or overlong neck length, the poor placement position and the like can also occur;
(3) another tracheal intubation: although the method has a little success rate, the defect that the laryngoscope cannot be placed still exists in the patient with limited opening, and the patient who does not meet the intubation condition is forcibly intubated, so that the clinical situations which are also dangerous to life, such as larynx spasm, bronchospasm and the like are easily induced.
(4) Emergency cricothyroid membrane puncture catheterization or tracheotomy: the method is an invasive method, is easy to damage the air passage, causes serious sequelae, and still has the defects of puncture or incision failure and long time consumption.
(5) The visual ventilation laryngoscope (patent number: 201220117131.4) granted by the national intellectual property office of the people's republic of China and the visual ventilation intubation laryngoscope (patent number: 201210417431.9) granted by the invention patent have the following defects: firstly, the ventilation of the two is realized through a ventilation handle, the ventilation handle comprises a ventilation tube cavity and a visual structure, the handle is required to have a certain thickness which is about 2.5-3 cm, the difficult ventilation condition of a part of patients with normal or slightly limited opening degree is only solved, and the ventilation handle cannot play a role because the ventilation handle cannot be placed in the patients with difficult ventilation with limited opening degree (such as the opening degree is less than 2cm, 1cm and 0.1cm) and tumor or foreign body occupation in the mouth; and both can only ventilate through the oral cavity, can not ventilate through the nasal cavity. Secondly, the former (patent No. 201220117131.4) still has the problem that the connection between the mask and the handle is relatively stiff and the mobility is small, the change of the handle position can be adjusted according to the pharyngeal exposure condition in clinical application, the change of the handle position can lead the mask to generate close following linkage such as upwarp and offset, and the like, thereby further causing the defects that the mask can not be tightly attached to the face of a patient and serious air leakage and even failure of ventilation, and the former has the problem that the mask can not be subjected to oral or transnasal tracheal intubation during ventilation. Thirdly, in the latter (patent No. 201210417431.9), because the ventilation is carried out by closing the oropharyngeal cavity with the air bag, when the closed air bag is positioned in the pharynx, the ventilation and the tracheal intubation can not be carried out simultaneously by the air bag which plays a role of closing the oral cavity or the nasal trachea intubation; if the closed air bag is not positioned in the pharynx and is only positioned in the mouth, the defect that the air pressurized into the oropharyngeal cavity overflows out of the nose through the retronasal hole exists.
In addition, in the existing difficult airway treatment scheme, for a patient with severely limited opening, a technical scheme of guiding the lower trachea cannula by a conscious fiberoptic bronchoscope is selected. The trachea cannula in the waking state is a very feared physical and psychological experience for patients, can cause huge fluctuation of hemodynamics, and even can endanger life due to cardiovascular and cerebrovascular accidents. Currently, for patients with restricted ostia and no predicted ventilation, a few physicians attempt to induce bronchofiberscope-guided transnasal intubation of patients with diminished respiration and with rapid sequential general anesthesia. The intubation scheme can increase pharyngeal cavity space within a certain range by means of the lower jaw support to improve glottic exposure, but has limited help for patients with small lower jaw, serious tongue body falling back and thick, loose and collapsed pharyngeal soft tissues, and the implementation of the operation scheme is carried out in a patient deoxygenation state, and if the glottic exposure time is too long or the exposure fails, suffocation and death of the patients can occur. Therefore, difficult fiberoptic bronchoscopic endotracheal tubes lack a means to increase the exposure of the pharyngeal cavity to a patient with restricted stoma.
SUMMERY OF THE UTILITY MODEL
In order to overcome the defect that above-mentioned prior art exists, the utility model aims to provide a lift throat organizer, it can expand the severely limited patient's of a mouthful oropharynx space, makes patient oropharynx form wide unobstructed intubate route, makes things convenient for the doctor to carry out fiberoptic bronchoscope or other supplementary intubate equipment trachea cannula.
An object of the utility model is also to provide a device for difficult air flue, it can show the ventilation situation that improves the patient, solves the clinical critical condition that fails to ventilate that appears, also can realize ventilating the patient to the difficulty simultaneously with the help of fiberoptic bronchoscope or other intubate supplementary trachea cannula of supplementary implementation, continuously gives effectual face guard and ventilates.
The utility model discloses a realize through following technical scheme:
a lifting throat organizer comprises a lifting handle and a lifting bent piece assembly which are detachably connected, wherein the lifting bent piece assembly is provided with a bent piece, the thickness of the bent piece is 0.5-1 mm, and the width of the bent piece is 1-2 cm; the tail end of the bent piece is fixedly connected with the lifting handle, and the front end of the bent piece can enter from the oral cavity and is at the bottom of the throat of a patient.
Wherein the shape of the bent piece may not be specific as long as it is suitable for picking up the tongue body, the tongue base and the epiglottis and can assist in opening the pharyngeal cavity of the patient. For example, the shape of the bent piece of the present invention can be satisfied by removing the endoscope of the direct laryngoscope or the visual laryngoscope and retaining only the metal support or the metal piece portion.
Preferably, the interior of the lifting handle is provided with a lifting bent piece component embedding channel, and one side of the channel is provided with a bent piece component fixer; the upper lifting bent piece assembly also comprises a bent piece handle, and the lower end of the bent piece handle is connected with the tail end of the bent piece; the upper end of the bent piece handle extends into the embedding channel of the upward bent piece assembly and is fixedly connected with the upward handle through the bent piece assembly fixer.
Preferably, the bent piece is sleeved with a protective sleeve.
Preferably, the uplifting throat organizer further comprises a visualization assembly, the visualization assembly comprising a visual carrier handle and an endoscope; wherein the tail end of the endoscope is connected to the visual carrier handle, and the front end of the endoscope is provided with a camera and a light source; the bending of the tube body of the endoscope is consistent with the bending of the bent piece and is tightly attached to the lower part of the bent piece, the front end of the endoscope is 0.5-2 cm behind the front end of the bent piece, and the position of the front end of the endoscope meets the requirement that glottis or peripheral throat tissues can be observed by means of the endoscope; an image information transmission device is embedded in the visible carrier handle and is electrically connected with the tail end of the endoscope; a visual component embedding channel is arranged in the upper lifting handle, and a visual component fixer is arranged on one side of the visual component embedding channel; the visual carrier handle extends into the visual component embedding channel and is fixed through the visual component fixer.
Preferably, the image information transmission device comprises a wireless digital imaging transmitting module and a power supply; the wireless digital imaging transmitting module is embedded at the lower end of the visible carrier handle and is electrically connected with the tail end of the endoscope; the power supply is embedded in the upper end of the visible carrier handle and is electrically connected with the wireless digital imaging transmitting module.
Preferably, the visualization assembly further comprises a digital imaging display screen and a wireless digital imaging receiver; the wireless digital imaging receiver receives the image information sent by the wireless digital imaging transmitting module and transmits the image information to the digital imaging display screen, and the digital imaging display screen displays the picture observed by the endoscope.
Preferably, the protective sleeve is an elastic thin sleeve, a high-transparency shaped protective sleeve or a high-transparency shaped protective sleeve with an air passage.
A device for difficult airways includes a raised throat organizer and a mask provided with a mask breathing circuit interface for connection to a breathing circuit, an insertion opening for the passage of a fiberoptic bronchoscope or other intubation-assisted device, and a raised throat organizer insertion opening for insertion of the raised throat organizer.
Preferably, the insertion opening of the uplifted throat organizer is provided with an oral lip elastic connecting piece, the middle part of the oral lip elastic connecting piece is provided with a linear opening, the outer edge of the oral lip elastic connecting piece is connected with the mask, and the linear opening is used for inserting the uplifted throat organizer.
Preferably, the mask comprises a nasal anterior wall and an oral labial wall, the angle between the nasal anterior wall and the oral labial wall being coincident with the angle between the nasolabial angle: the angle of 90 degrees to 105 degrees, the mask breathing circuit interface and the fiberbronchoscope insertion opening are arranged on the front wall of the nose; the uplifted throat organizer insertion opening is disposed in the labial wall.
Compared with the prior art, the utility model discloses following profitable technological effect has:
the utility model provides a lifting throat organizer, which comprises a lifting handle and a lifting bent piece component, wherein the lifting bent piece component is provided with a bent piece, the thickness of the bent piece is 0.5-1 mm, and the width of the bent piece is 1-2 cm; the tail end of the bent piece is fixedly connected with the lifting handle. When the patient has a severely limited mouth opening, particularly when the mouth opening of the patient is about 1mm, the patient faces severe breathing difficulty due to the obstruction of a ventilation channel, and the ventilation is difficult to effectively improve by adopting pressurization ventilation due to great air resistance; and the utility model discloses a thickness of bent piece be 0.5 ~ 1mm, it can be effectively from getting into patient's oral cavity in slightly opening one's mouth to dredge the tongue etc. in the oral cavity gradually under the control of last lifting handle and to the jam of air flue, increase and open a mouthful limited patient pharyngeal cavity and expose the space, realize expanding the purpose of patient's air vent. The width of the bent piece is 1-2 cm, so that the bent piece can not only adapt to the sizes of the oral cavity and the throat, but also realize effective support on tissues and organs in the oral cavity to form an effective air passage; the handle is lifted up, so that the operation of the bent piece by a doctor is more convenient. After an effective airway is formed, the ventilation resistance of a patient is obviously reduced, and meanwhile, a doctor can conveniently perform tracheal intubation on a fiberbronchoscope or other auxiliary intubation equipment. Therefore, the utility model provides a lift throat organizer, it can expand the restricted patient's of mouth opening air flue, increases the restricted patient's pharyngeal cavity of mouth opening and exposes the space, and the patient difficulty of ventilating of releiving makes things convenient for the doctor to carry out fiberbronchoscope or other auxiliary intubation equipment trachea cannula simultaneously.
Furthermore, the distance between the lifting handle and the bent piece can be adjusted by adjusting the distance of the bent piece handle entering the lifting bent piece assembly embedding channel, so that the operation habit of different doctors can be conveniently adapted.
Further, the protective sleeve prevents the bending piece from directly contacting with the oral cavity of a patient, and a doctor can use a new protective sleeve before operation to achieve the aim of sanitation.
Further, if the patient's opening degree is slightly bigger, like 3 ~ 10mm, can select the visual subassembly that sets up the endoscope of different sizes as required to make things convenient for the doctor to dredge the operation of air flue through visual mode. When the patient has a larger opening, a visualization component with a larger endoscope diameter can be used, and the cost is slightly lower; when the patient has a small opening degree, the visualization component with the smaller diameter of the endoscope can be used, the cost is higher, and therefore the situation that the endoscope with the higher price and the smaller diameter is used for the patient with the larger opening degree can be avoided, and the expensive equipment is protected.
The utility model also provides a device for the difficult airway, which comprises a lifting throat organizer and a face mask; the mask is provided with a mask breathing circuit interface for connecting a breathing circuit, a fiberoptic bronchoscope insertion opening for the passage of a fiberoptic bronchoscope, and a lifting throat organizer insertion opening for the insertion of a lifting throat organizer. Thus, when a patient with mouth opening limited ventilation difficulty is encountered, the mask covers the mouth and the nose of the patient, and then the mouth opening of the patient is penetrated through the mouth opening of the throat lifting organizer by using the throat lifting organizer, and the airway of the patient is expanded in the oral cavity, so that the exposure space of the mouth opening limited patient in the pharyngeal cavity is increased; the mask breathing circuit interface is connected with the breathing circuit, and the airway of the patient is expanded due to the lifting of the throat organizer, so that the ventilation resistance is reduced, and the ventilation condition of the patient can be obviously improved; the fiber bronchoscope is inserted into the fiber bronchoscope insertion opening for intubation, and the wide and smooth intubation path is formed by lifting the throat organizer, so that the insertion of the fiber bronchoscope becomes easy, the intubation time is shortened, and the intubation success rate is improved.
Drawings
Fig. 1-1 is a longitudinal sectional view of the lift handle.
Fig. 1-2 are longitudinal cross-sectional schematic views of the lift tab assembly.
Fig. 1-3 are schematic longitudinal sectional views of a visualization assembly.
Fig. 1-4 are schematic cross-sectional views of the lift handle.
Fig. 1-5 are schematic cross-sectional views of a bent piece.
Fig. 1-6 are schematic cross-sectional views of an endoscope.
Fig. 1-7 are schematic diagrams of wireless digital imaging receivers.
Fig. 2-1 is a side view of the mask.
Fig. 2-2 is a schematic view of the structure of the anterior nasal wall of the mask.
Fig. 2-3 are schematic views of the structure of the orolabial wall of the mask.
Fig. 3-1 is a side view of the disposable protective elastic thin sleeve.
Fig. 3-2 is an end sectional view of the disposable protective elastic thin sleeve.
Fig. 3-3 are side view schematic illustrations of a highly transparent shaped protective sleeve.
Fig. 3-4 are schematic end cross-sectional views of a highly transparent shaped protective sleeve.
Fig. 3-5 are side views of the highly transparent shaped protective sleeve with an air passage.
Fig. 3-6 are end cross-sectional schematic views of a highly transparent shaped protective sleeve with an airway.
Figure 4 is a schematic view of the use of the device for endotracheal intubation during difficult ventilation with a flare only to allow passage of the bent tab.
Figure 5 is a schematic view of the application of the device for endotracheal intubation when the opening degree allows the simultaneous passage of the bent piece and the endoscope with difficult ventilation.
Fig. 6 is a schematic view of the use of the device for endotracheal intubation during difficult fiberoptic bronchoscopy of the nose with an opening allowing passage of only the bent tab.
Fig. 7 is a schematic diagram of the configuration of the uplift throat organizer when applied to a normal airway patient endotracheal tube.
Wherein, 1 is a lifting throat organizer, 11 is a lifting handle, 12 is a lifting bent piece assembly, 121 is a lifting bent piece assembly embedding channel, 122 is a bent piece handle, 123 is a bent piece, 124 is a disposable protective sleeve bent piece fixing projection, 13 is a visualization assembly, 131 is a visualization assembly embedding channel, 132 is a visual carrier handle, 133 is an endoscope, 1331 is a camera, 1332 is a light source, 134 is a wireless digital imaging transmitting module, 135 is a wireless digital imaging receiver, 1352 is a digital imaging display screen, 136 is a power supply, 137 is a disposable protective sleeve visualization fixing projection, 2 is a mask, 21 is a labial wall, 2111 is a linear open-hole cap, 211 is a linear open-hole, 212 is a circular open-hole cap, 2121 is a circular open-hole cap, 22 is a front wall, 23 is an inflatable cushion, 231 is an oral lip elastic connecting piece, 232 is a anterior nasal elastic connecting piece, 24 is an inflation valve, 3 is a protective sleeve, 31 is an elastic thin sleeve, 311 is a lantern ring, 312 is a sleeve body, 32 is a high transparent shaping protective sleeve, 321 is a shaping bent sheet channel, 322 is an endoscope channel, 323 is a protective sleeve buckle, 33 is a high transparent shaping protective sleeve with an air passage, 331 is an air passage, 4 is a tracheal catheter, and 5 is a fiberbronchoscope.
Detailed Description
The present invention will be described in further detail with reference to the accompanying drawings:
examples 1,
A lifting throat organizer, a lifting throat organizer 1 comprises a detachable lifting handle 11, a lifting bent piece assembly 12 and a visualization assembly 13;
in a possible implementation manner, as shown in fig. 1-1 and fig. 1-4, the lifting handle 11 is provided with a lifting bent piece component embedding channel 121 and a visualization component embedding channel 131 therein, the two embedding channels are respectively provided with corresponding component holders, the lifting bent piece component 12 and the visualization component 13 can freely move up and down in the corresponding component embedding channels and can be fixed by the corresponding component holders, and the corresponding component embedding channels can be compatible with the lifting bent piece components 12 or the visualization components 13 with different shapes, models and sizes.
Further preferably, as shown in fig. 1-2 and 1-5, the upward bent piece assembly 12 is provided with a bent piece handle 122 and a bent piece 123; the upper end of the bent piece handle 122 can extend into the upper bent piece assembly embedding passage 121, and the lower end is connected with the tail end of the bent piece 123; the tail end of the bent piece 123 is provided with a disposable protective sleeve bent piece fixing bulge 124; the bent piece 123 is 0.5-1 mm thick and has certain hardness, and cannot deform due to lifting force (such as a steel sheet with a passivated food-grade edge or a medical bent piece with other materials meeting the requirements); the radian, length and width of the bent piece 123 can be consistent with the shape of a common traditional laryngoscope or video laryngoscope at home and abroad. The bent pieces 123 with different radians, lengths, widths and sizes can be simultaneously manufactured to meet the requirements of different races, different ages and special clinical conditions. The bent piece 123 can be temporarily replaced according to the specific situation of a patient during clinical use. When the bent piece 123 is replaced, the whole upward lifting bent piece assembly 12 can be replaced; the separate replacement of the bent piece 123 can also be achieved by designing the detachable connection between the bent piece shank 122 and the bent piece 123.
In a possible implementation, as shown in fig. 1-3 and fig. 1-6, and fig. 1-7, the visualization component 13 is provided with a visual carrier handle 132, an endoscope 133, a wireless digital imaging transmission module 134, a wireless digital imaging receiver 135, a power supply 136, and a disposable protective sheath visualization fixing protrusion 137 arranged at the end of the endoscope 133, and a micro camera 1331 and a light source 1332 which are processed by anti-fog are passed through the inside of the tube body of the endoscope 133; the end of the endoscope 133 is fixedly connected with the visual carrier handle 132 and electrically connected with the wireless digital imaging transmitting module 134; the bending of the tube body of the endoscope 133 is identical to the bending of the bent piece 123, and is closely attached to the lower part of the bent piece 123; a wireless digital imaging transmit module 134 and a power supply 136 are embedded in the visual carrier handle 132; the micro camera 1331, the light source 1332 and the wireless digital imaging transmitting module 134 are electrically connected with the power supply 136; the wireless digital imaging receiver 135 is configured to receive the signal transmitted by the wireless digital imaging transmitting module 134 and transmit the signal to the digital imaging display screen 1352, and the digital imaging display screen 1352 displays a picture observed by the endoscope 133.
Further preferably, the power supply 136 is connected to the micro camera 1331, the light source 1332 and the wireless digital imaging transmitting module 134, the light source 1332 is a cold light source, and the digital imaging of the micro camera 1331 is transmitted to the wireless digital imaging receiver 135 for receiving through the wireless digital imaging transmitting module 134. The wireless digital imaging receiver 135 may be a monitor, a cell phone, a computer, a multimedia display screen commonly used today, or a dedicated digital imaging terminator loaded with wireless digital imaging accepting software. The wireless transmission mode is a WIFI network transmission mode or a Bluetooth transmission mode. The endoscope 133 has a certain plastic hardness (so as to be matched with the curvature of the bent piece 123), the light transmission, video imaging and manufacturing process can be consistent with the fiber bronchoscope 5 or the visual optical rod commonly used at home and abroad, in order to increase the visual application range, the diameter of the endoscope 133 is preferably the smallest pipe diameter (under the current technical condition, the endoscope 133 with the diameter of 1-2.5mm is preferably selected), the length of the endoscope 133 in the insertion opening is changed by adjusting the depth of the visual carrier handle 132 inserted into the visual component channel according to the clinical condition, and the length of the endoscope in the insertion opening is slightly shorter than the length of the bent piece 123 (for example, the length of the endoscope is shorter than the bent piece by 0.5-2 cm).
In one possible implementation, the uplift throat organizer 1 may further comprise a protective sleeve 3; the protective sleeve 3 may be disposable in order to maintain the cleanliness and hygiene of the raised throat organizer 1. The disposable protective sleeve 3 can be designed into three forms: (1) disposable protective elastic thin sleeve 31, as shown in fig. 3-1 and 3-2: comprises a lantern ring 311 and a sleeve body 312, and the length, width and thickness of the sleeve body are consistent with the shape of the bent piece 123. The material is medical rubber, latex or other medical elastic thin sleeve materials; when the bending piece 123 and the endoscope 133 are inserted and used simultaneously, the high-transparency elastic thin sleeve is selected, so that the visual field of the miniature camera head 1331 is not affected. When leaving the factory, the condom can be processed into a shape similar to a condom, and when in use, the open end of the protective sleeve is sleeved in from the front end of the bent piece 123 and is gradually sleeved in the disposable protective sleeve bent piece fixing protrusion 124 at the tail end of the bent piece 123. (2) A highly transparent shaped protective sleeve 32, as shown in fig. 3-3 and 3-4: it includes a shaped bent piece channel 321, an endoscope channel 322 and a protective sleeve buckle 323. The disposable high-transparency hard plastic material used by the video laryngoscope which is commonly used at home and abroad can be used for reference. The bent piece 123 is sleeved in the shaping bent piece channel 321, the endoscope 133 is sleeved in the endoscope channel 322, and the protective sleeve buckle 323 is matched with the visual fixing protrusion 137 of the disposable protective sleeve and the bent piece fixing protrusion 124 of the disposable protective sleeve to fix the highly transparent shaping protective sleeve 32. (3) A highly transparent shaped protective cover 33 with ventilation ducts, as shown in figures 3-5 and figures 3-6: it comprises a shaping bent piece channel 321, an endoscope channel 322, a protective sleeve buckle 323 and an air passage 331. The bent piece 123 is sleeved in the shaping bent piece channel 321, the endoscope 133 is sleeved in the endoscope channel 322, and the protective sleeve buckle 323 is matched with the visual fixing protrusion 137 of the disposable protective sleeve and the bent piece fixing protrusion 124 of the disposable protective sleeve to realize the fixation of the high-transparency shaping protective sleeve 33 with the air passage. The air passage 331 is located below the sizing bent piece passage 321 and the endoscope passage 322, and is open at both ends. The air passage 331 has three functions: first, when the trachea cannula is used for oral intubation, the mouth opening degree is supported, and the tracheal catheter 4 can pass through the inner part or the periphery of the air passage 331; secondly, the sputum suction tube extends into the air passage 331 for laryngeal suction; thirdly, the space of the throat part is opened by lifting the throat organizer, and the high-transparency medical plastic shaping protective sleeve with the ventilation passage is left in the mouth to play the role of the oropharyngeal ventilation passage. In addition, the periphery of the protective sleeve can be provided with an air bag for fixing and sealing.
Wherein, the lifting handle 11, the lifting bent piece component 12 and the visualization component 13 have the following combination forms: first, the lifting handle 11+ the lifting bent piece assembly 12: the device is applied to clinical conditions that the opening degree can only allow the bent piece to pass, such as difficult ventilation or difficult trachea intubation through a nasal fiber bronchoscope 5 with the opening degree of about 1mm-3 mm; secondly, the lifting handle 11+ the lifting bent piece assembly 12+ the visualization assembly 13: the visual component 13 is applied to clinical conditions with opening degrees allowing the upward bent piece component 12 and the visual component 13 to exist at the same time, and the introduction of the visual component 13 can optimize and adjust the bent piece placing position and reduce the possible complications caused by simple bent piece placing.
The utility model provides a lifting throat organizer 1, which solves the problem of difficult ventilation of patients with normal mouth opening degree and limited mouth opening degree (such as 1 mm-2 cm mouth opening degree), and provides life support for the patients; the tool for increasing the pharyngeal cavity exposure space is provided, and the intubation success rate of the conventional tracheal intubation auxiliary tool is increased; a disposable protective cover 3 for lifting the throat organizer 1 is provided to avoid cross-infection between patients and damage to the apparatus by constant sterilization during use, and an oropharyngeal airway capable of opening the laryngeal space of the pharynx and visually adjusting the position by means of the lifting the throat organizer 1 is provided. In addition to being used in difficult-to-ventilate patients with restricted mouth opening, the uplift throat organizer 1 can also be widely used in the endotracheal intubation of patients with normal airways.
Example 2
A device for difficult airways having the uplift throat organizer 1 of embodiment 1 and further comprising a mask 2. The face mask 2 has a face mask breathing circuit interface 25, which can be a conventional face mask 2, and can also be an optimized face mask 2 provided by the utility model.
In one possible implementation, as shown in fig. 2-1, 2-2 and 2-3, the mask 2 includes a mask body, the front surface of the mask body is designed with an oral lip wall 21 similar to the appearance of the oral lip and a nasal front wall 22 similar to the appearance of the nasal front wall, when the mask body is covered on the oral and nasal parts of the patient, the oral lip wall 21 is located above the oral part of the patient, and the nasal front wall 22 is located in front of the nasal part of the patient and faces the nasal opening; the labial wall 21 is provided with an ascending throat organizer insertion opening, an elastic expansion and contraction material is connected to the ascending throat organizer insertion opening to form an labial elastic connecting piece 231, and the labial elastic connecting piece 231 is provided with a linear opening 211 with a linear opening cap 2111 and a circular opening 212 with a circular opening cap 2121; the anterior nasal wall 22 is provided with a fiberbronchoscope insertion opening, the fiberbronchoscope insertion opening is connected with an elastic expansion and contraction material to form a front nasal elastic connecting piece 232, the front nasal elastic connecting piece 232 is provided with two circular open holes 212 with circular open hole caps 2121, and the circular open holes 212 are opposite to nostrils. The arrangement of the elastic connecting piece enables the sealing between each inserted component and the face mask 2 to be more compact on one hand, and on the other hand, the obstruction of the hard face mask body material to the posture adjustment of each component is avoided.
Further preferably, the anterior nasal wall 22 and the labial wall 21 have a certain included angle (about 60-80 °), and the labial wall 21 is parallel to the labial plane, so as to facilitate the insertion of the lifted throat organizer 1 and the subsequent operation adjustment of the exposed throat space, and avoid the obstruction and obstruction of the mask body to the lifted throat organizer 1; the anterior nasal wall 22 is parallel to the nostril plane, which is convenient for the placement, operation and adjustment of the tracheal catheter 4 and the fiberbronchoscope 5; the elastic expansion and contraction material can be rubber, latex, plastic or silica gel material with good elasticity commonly used in medicine, and is connected with the medical plastic of the face mask in a sealing and shape-shifting way; the width and thickness of the linear opening 211 of the lip elastic connecting piece 231 are smaller than those of the upward bent piece component 12 and the visual component 13, and when the components are placed into the linear opening 211 and the subsequent adjusting position, the components can be sealed and air-tight under the elastic retraction effect of the elastic expansion and contraction material; one opening of the lip elastic connecting piece 231 and two openings of the nose elastic connecting piece 232 are smaller than the diameter of the used tracheal catheter 4, so that the tracheal catheter 4 can be sealed and air-tight when being put in. If necessary, the mask 2 can be added with a sealing ring to increase the air leakage prevention effect by relating to the sealing and connecting parts of the components.
At the lower edge of the mask body, an inflatable cushion 23 for sealing is provided, and the inflatable cushion 23 is provided with an inflation valve 24 so as to realize sealing and posture adjustment of the mask body.
Further, the utility model discloses a design theory: the upper throat organizer 1 with the protective sleeve 3 is movably and hermetically sleeved with the face mask 2, the bent piece part of the upper throat organizer 1 is placed in the mouth and lifted to open the throat space, the face mask 2 sleeved on the upper throat organizer 1 is closely attached to the lips of a patient, and oxygen is supplied by pressurizing through a breathing circuit so as to solve various conditions of difficult clinical ventilation; in the case of both difficult ventilation and difficult intubation, the endotracheal tube is administered while ventilation is achieved through the holes in the face mask 2, while the above-described method of addressing the difficult ventilation is employed.
As such, it can achieve the following effects: (1) meanwhile, the problem of difficult ventilation of patients with normal mouth opening degree and limited mouth opening degree (such as 1 mm-2 cm mouth opening degree) is solved, and the life guarantee is provided for the patients; (2) provides a tool (lifting up the throat organizer 1) for increasing the pharyngeal cavity exposed space, and increases the intubation success rate of the prior auxiliary tool for tracheal intubation; (3) the multifunctional mask 2 can be tightly attached to the uplifting throat organizer 1 and can move naturally, the structure of the multifunctional mask is more consistent with the shape of the nose and the lip, and continuous ventilation in various trachea intubation processes is realized; (4) a disposable protective cover 3 for lifting the throat organizer 1 is provided to avoid cross-infection between patients and damage to the apparatus by constant sterilization during use, and an oropharyngeal airway capable of opening the laryngeal space of the pharynx and visually adjusting the position by means of the lifting the throat organizer 1 is provided. (5) The trachea cannula has the beneficial effects, and can be widely applied to trachea cannula of patients with normal airways.
Example 3
A device for difficult airway comprises a lifting throat organizer 1, a face mask 2, a disposable protective cover 3. Firstly, the lifting throat organizer 1 consists of a detachable lifting handle 11, a lifting bent piece component 12 and a visualization component 13; the lifting handle 11 is provided with a lifting bent piece component embedding channel 121, a visual component embedding channel 131 and a component fixer 111; the upward-lifting bent piece component 12 is provided with a bent piece handle 122, a bent piece 123 and a disposable protective sleeve bent piece fixing bulge 124; the visualization component 13 is provided with a visual carrier handle 132, an endoscope 133, a wireless digital imaging transmitting module 134, a wireless digital imaging receiver 135, a power supply 136 and a disposable protective sleeve visualization fixing protrusion 137, a miniature camera head 1331 and a light source 1332 are arranged in a tube body of the endoscope 133 to pass through, the wireless digital imaging receiver 135 comprises wireless digital imaging receiving software 1351 and a digital imaging display screen 1352, the power supply 136 is connected with the camera head 1331, the light source 1332 and the wireless digital imaging transmitting module 134, and digital imaging of the camera head 1331 is sent to the wireless digital imaging receiver 135 to be received through the wireless digital imaging transmitting module 134. Secondly, the face mask 2 is provided with an oral lip wall 21, a nose front wall 22, an inflatable cushion 23, an inflatable valve 24 and a face mask breathing circuit interface 25, the oral lip wall 21 and the nose front wall 22 are both provided with elastic expansion and contraction materials to respectively form an oral lip elastic connecting piece 231 and a nose front elastic connecting piece 232, the oral lip elastic connecting piece 231 is provided with a linear opening 211, a circular opening 212 and a corresponding linear opening cap 2111 and a corresponding circular opening cap 2121, and the nose front elastic connecting piece 232 is provided with two circular openings 212 and a corresponding opening cap 2121. Thirdly, the disposable protecting sleeve 3 has three forms of a disposable protecting elastic thin sleeve 31, a high-transparency shaping protecting sleeve 32, a high-transparency shaping protecting sleeve 33 with an air passage and the like; the disposable protective elastic thin sleeve 31 is provided with a sleeve ring 311 and a sleeve body 312, and the sleeve body 312 is sleeved in the bent sheet to form a bent sheet channel 313; the high transparent shaped protective sleeve 32 is provided with a shaped bent piece channel 321, an endoscope channel 322 and a protective sleeve buckle 323; the high transparent shaped protective sleeve 33 with the ventilation channel is provided with a shaped bent piece channel 321, an endoscope channel 322, an air channel 331 and a protective sleeve buckle 323.
The first embodiment is as follows: applied to difficult ventilation cases with severely limited openness (about 1mm-3mm, only the bent piece passes). As shown in fig. 4, the bending piece grip 122 of the upper bending piece module 12 is partially inserted into the upper bending piece module insertion passage 121 of the upper handle 11 and fixed by the module holder 111 (the portion of the bending piece grip 122 not inserted into the module passage is slightly longer than the sum of the thicknesses of the mask inflatable cushion 23 and the space under the mask labial wall 21), and the disposable protective elastic thin cover 31 is fitted over the bending piece 123 and fixed to the disposable protective cover bending piece fixing projection 124. In case of difficult ventilation with mouth opening only for the bent piece to pass through, the inflatable cushion 23 of the face mask 2 is tightly attached to the face of the patient, the linear opening cap 2111 is removed, the bent piece 123 sleeved with the disposable protective sleeve 3 is placed into the throat of the patient through the linear opening 211 on the lip elastic connecting piece 231, the throat space is opened by lifting up 11 and flexibly adjusting the placing position and the lifting angle, and the emergency situation of difficult ventilation with severely limited mouth opening is solved by pressurizing and supplying oxygen through the breathing circuit connected with the breathing circuit interface 25 of the face mask.
The second embodiment: it is applied to the difficult ventilation case with moderate limited opening degree (about 4mm-20mm, which allows the bent piece and the thinnest diameter endoscope to pass). As shown in fig. 5, the bending piece handle 122 of the upward bending piece assembly 12 and the visual carrier handle 132 of the visual assembly 13 are respectively partially inserted into the corresponding assembly channels 121 and 131 (the bending piece handle 122 and the visual carrier handle 132 are not inserted into the respective assembly channel parts and are slightly longer than the sum of the thicknesses of the spaces below the mask inflatable cushion 23 and the mask lip wall 21), the visual carrier handle 132 is positioned behind the bending piece handle 122, and the endoscope 133 is positioned below the bending piece 123 and is slightly shorter than the length of the bending piece 123; secured by the pair of component holders 111, 122 and 132, respectively; sleeving the high-transparency shaped protective sleeve 32 into the combined body of the bent piece 123 and the endoscope 133, wherein the bent piece 123 corresponds to the bent piece channel 321, the endoscope 133 corresponds to the endoscope channel 322, and the protective sleeve buckle 323 is fixed on the visual fixing protrusion 137 of the disposable protective sleeve; the power supply 136 carried by the visual carrier handle 132 is switched on, so that the digital image of the endoscope 133 is imaged on the digital imaging display screen 1352 through the wireless video transmitting module 134 (the digital imaging display screen 1352 can be a mobile phone, a computer, a monitor or a video display screen commonly used at present). In the case of difficult ventilation with a mouth opening of about 4mm to 20mm, the inflatable cushion 23 of the mask 2 is placed in close proximity to the patient's face, and the combination of sleeves 123 and 233, prepared as described above, is passed through the linear opening 211 of the mask 2, by lifting the handle 11 and adjusting the placement position and lifting angle under the imaging guidance of the video display screen 1352 by opening the laryngeal space, the remainder of the procedure being as in case one.
The third embodiment is as follows: is applied to difficult trachea cannula. If the patient is ventilated, the throat space is opened by flexibly selecting the method in the case I and the case II according to different opening degrees, so that the throat space is enlarged smoothly, and after the patient meets the intubation conditions, the circular perforated cap 2121 on the elastic connecting piece is pulled out, and the tracheal intubation guided by various fiberbronchoscopes 5 or visual light bars is carried out, so that the intubation success rate is increased, and meanwhile, the ventilation can still be carried out in the tracheal intubation process. Open degree only holds difficult trachea cannula application schematic diagram that the bent piece passes through as shown in fig. 6, and the face guard is ventilated and is accomplished the back, opens circular trompil 212 on the nasal antetheca 22, and the fibre bronchoscope 5 that is cup jointed endotracheal tube 4 with the periphery gets into patient's nasal cavity through 212 and reachs the glottis and finds the glottis fast, endotracheal tube 4 get into behind the glottis, remove fibre bronchoscope 5 with the utility model discloses relevant subassembly to accomplish trachea cannula smoothly.
The fourth embodiment is as follows: the method is applied to ventilation of patients with normal airways. The linear opening 211 and the circular opening 212 of the mask 2 are sealed by respective sealing caps (e.g., linear opening cap 2111 and circular opening cap 2121) when the trachea is not difficult to ventilate or difficult to intubate, as in a conventional mask.
The fifth embodiment: the visible trachea cannula is applied to patients with normal airways. For normal airway patients, as shown in fig. 7-1 and 7-2, the bending piece handle 122 of the upward bending piece assembly 12 and the visual carrier handle 132 of the visual assembly 13 are respectively and completely inserted into the corresponding assembly channels 121 and 131, the visual carrier handle 132 is positioned behind the bending piece handle 122, the endoscope 133 is positioned below the bending piece 123 and is slightly shorter than the length of the bending piece 123, and is respectively fixed by the assembly fixer 111 pairs 122 and 132; the combined body of 123 and 133 is sleeved with a high transparent shaped protective sleeve 33 with an air passage, so that 123 and 133 correspond to the bent piece passage 321 and the endoscope passage 322 respectively, and the air passage 331 is positioned below 322. When in use, the prepared throat lifting organizer 1 is inserted into the oral cavity of a patient, and the throat space is opened under the guidance of the video display screen 1352 to expose the glottis and complete trachea intubation; if the laryngeal space is opened or the glottis is exposed, the laryngeal space is excessively secreted and can be removed by suction through the airway 331.
The sixth implementation case: is applied to the condition that the traditional oropharyngeal airway is blocked or the position of the implantation is not good. As in the method of using the uprising throat organizer 1 of the fifth embodiment, after passing the airway high transparent shaped shield 33 through the obstructed area of the throat, it is separated from the uprising throat organizer 1 under the direction of the video display 1352, leaving only the airway high transparent shaped shield 33 in the patient's mouth, allowing airway 331 to function as an oropharyngeal airway.
The implementation case is seven: the method is applied to the situation that the light bar or the visible light bar is placed or the exposure is blocked. During trachea cannula, if hold in the palm trachea cannula that the lower jaw can not effectual promotion throat space and help the optical wand or visual optical wand guide down, can with the help of the utility model provides a lift unobstructed in the assurance throat space of 1 maximize of throat organizer, and then shorten the intubate time and improve the intubate success rate.
Claims (10)
1. The lifting throat organizer is characterized by comprising a lifting handle (11) and a lifting bent piece assembly (12) which are detachably connected, wherein the lifting bent piece assembly (12) is provided with a bent piece (123), the thickness of the bent piece (123) is 0.5-1 mm, and the width of the bent piece (123) is 1-2 cm; the tail end of the bent piece (123) is fixedly connected with the lifting handle (11); the front end of the bent piece (123) can enter from the oral cavity and is arranged at the bottom of the throat of the patient.
2. The uplifted throat organizer of claim 1, wherein the uplifting handle (11) is internally provided with an uplifting bent piece assembly embedding channel (121) and a bent piece assembly fixer is arranged on one side of the channel;
the upward lifting bent piece assembly (12) further comprises a bent piece handle (122), and the lower end of the bent piece handle (122) is connected with the tail end of the bent piece (123); the upper end of the bent piece handle (122) extends into the upward bent piece component embedding passage (121) and is fixedly connected with the upward lifting handle (11) through a bent piece component fixer.
3. A device for organizing the lifted throat according to claim 1, wherein the bent piece (123) is sleeved with a protective cover (3).
4. The uplift throat organizer of any one of claims 1 to 3, further comprising a visualization assembly (13), wherein the visualization assembly (13) comprises a visual carrier handle (132) and an endoscope (133); wherein,
the tail end of the endoscope (133) is connected to the visual carrier handle (132), and the front end of the endoscope is provided with a camera (1331) and a light source (1332); the bending of the tube body of the endoscope (133) is consistent with the bending of the bent piece (123), and is tightly attached to the lower part of the bent piece (123), the front end of the endoscope (133) is 0.5-2 cm behind the front end of the bent piece (123), and the position of the front end of the endoscope meets the requirement that glottis or peripheral throat tissues can be observed by means of the endoscope;
the visual carrier handle (132) is embedded with an image information transmission device, and the image information transmission device is electrically connected with the tail end of the endoscope (133);
a visual component embedding channel (131) is arranged in the lifting handle (11), and a visual component fixer is arranged on one side of the visual component embedding channel (131); the visual carrier handle (132) extends into the visual component embedding passage (131) and is fixed by the visual component fixer.
5. The uplift throat organizer of claim 4, wherein the image information transmission device comprises a wireless digital imaging transmission module (134) and a power supply (136); the wireless digital imaging transmitting module (134) is embedded at the lower end of the visible carrier handle (132) and is electrically connected with the tail end of the endoscope (133); the power supply (136) is embedded in the upper end of the visual carrier handle (132) and is electrically connected with the wireless digital imaging transmitting module (134).
6. The uplift throat organizer of claim 5, wherein the visualization assembly (13) further comprises a digital imaging display screen (1352) and a wireless digital imaging receiver (135); the wireless digital imaging receiver (135) receives the image information sent by the wireless digital imaging transmitting module (134) and transmits the image information to the digital imaging display screen (1352), and the digital imaging display screen (1352) displays the picture observed by the endoscope (133).
7. A uplift throat organizer according to claim 3, wherein the protective sleeve (3) is a thin elastic sleeve (31), a high transparent shaped protective sleeve (32) or a high transparent shaped protective sleeve (33) with an airway.
8. A device for difficult airways comprising a raised throat organizer according to any one of claims 1 to 7 and a face mask (2), the face mask (2) being provided with a mask breathing circuit interface for connection of a breathing circuit, a fiberbronchoscope insertion opening for passage of a fiberbronchoscope (5) and a raised throat organizer insertion opening for insertion of the raised throat organizer.
9. The device for a difficult airway as claimed in claim 8 wherein the insertion opening of the uplifted throat organizer is provided with an elastic connection member (231) of lips, the elastic connection member (231) of lips is provided with a linear opening (211) in the middle, the outer edge is connected with the mask, and the linear opening (211) is used for insertion of the uplifted throat organizer.
10. Device for difficult airways according to claim 9, characterized in that the mask (2) comprises a nasal front wall (22) and an orolabial wall (21), the nasal front wall (22) being at an angle of 90 ° to 105 ° to the orolabial wall (21), the mask breathing circuit interface and the fiberoptic bronchoscope insertion opening being provided in the nasal front wall (22); the uplifted throat organizer insertion opening is arranged on the labial wall (21).
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CN108175918A (en) * | 2018-02-28 | 2018-06-19 | 中国人民解放军第四军医大学 | Above carry throat tissue device and the device for difficult airway |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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CN108175918A (en) * | 2018-02-28 | 2018-06-19 | 中国人民解放军第四军医大学 | Above carry throat tissue device and the device for difficult airway |
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