ES2328129T3 - Aparato y metodo para obtener acceso a la medula osea. - Google Patents
Aparato y metodo para obtener acceso a la medula osea. Download PDFInfo
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- ES2328129T3 ES2328129T3 ES03731475T ES03731475T ES2328129T3 ES 2328129 T3 ES2328129 T3 ES 2328129T3 ES 03731475 T ES03731475 T ES 03731475T ES 03731475 T ES03731475 T ES 03731475T ES 2328129 T3 ES2328129 T3 ES 2328129T3
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Abstract
Un aparato (10) para penetrar una médula ósea que comprende: una carcasa (12); un dispositivo penetrador (14, 55, 80) operable para penetrar la médula ósea, teniendo un trócar interno removibles (50, 82) y un penetrador externo (18, 52, 84); un conector (20) operable para conectar de manera liberable el dispositivo penetrador a un eje de taladro; el eje de taladro (40) operable para conectar el dispositivo penetrador con un dispositivo de engranaje de reducción (38); el dispositivo de engranaje de reducción (38) operable para enganchar y hacer rotar el eje de taladro; un motor (30) operable para enganchar el dispositivo de engranaje de reducción e impulsar el penetrador en la médula ósea por rotación del eje de taladro (40); y una fuente de alimentación (32) y los circuitos asociados operables para alimentar el motor.
Description
Aparato y método para obtener acceso a la médula
ósea.
La presente invención se relaciona en general
con un dispositivo médico para obtener acceso a la médula ósea y
específicamente para un aparato y método para penetrar la médula
ósea con un taladro eléctrico e insertar un penetrador o una
aguja.
Cada año, millones de pacientes son tratados por
emergencias que amenazan su vida en los Estados Unidos. Tales
emergencias incluyen choques, traumas, paros cardíacos, sobredosis
de drogas, cetoacidosis diabética, arritmias, quemaduras, y estados
epilépticos sólo para nombrar unos pocos. Por ejemplo, de acuerdo
con la Asociación Americana del Corazón, más de 1.500.000 pacientes
sufren de ataques cardíacos (infartos del miocardio) cada año, con
más de 500.000 de ellos que mueren debido a sus complicaciones
devastadoras.
Un elemento esencial para tratar todas estas
emergencias es el establecimiento rápido de una línea intravenosa
(IV) con el fin de administrar fármacos y fluidos directamente en el
sistema circulatorio. Bien sea en la ambulancia por parte de
paramédicos, o en la sala de emergencias por especialistas en
emergencias, la meta es la misma- empezar una IV con el fin de
administrar fármacos y fluidos que puedan salvar la vida. Hasta un
alto grado, la capacidad para tratar exitosamente tales emergencias
críticas depende de la habilidad y suerte del operador en lograr
acceso vascular. Mientras que es relativamente fácil iniciar una IV
en algunos pacientes, los doctores, enfermeras y paramédicos
frecuentemente experimentan grandes dificultades estableciendo
accesos IV en aproximadamente el 20% de los pacientes. Estos
pacientes repetidamente son probados con agujas agudas en un
intento para resolver este problema y pueden requerir un
procedimiento invasivo para establecer finalmente una ruta
intravenosa.
Un factor de complicación adicional para
alcanzar el acceso IV ocurre "en campo" por ejemplo en la
escena de un accidente durante el transporte en ambulancia donde es
difícil ver el objetivo y el movimiento excesivo hace que el acceso
al sistema venoso sea muy difícil.
En el caso de pacientes con enfermedades
crónicas o vejez, la disponibilidad de venas fácilmente accesibles
puede verse muy disminuida. Otros pacientes pueden no tener sitios
disponibles para la IV debido a la escasez anatómica de venas
periféricas, obesidad, deshidratación extrema o previo uso de IV
para drogas. Para estos pacientes, encontrar un sitio adecuado para
administrar fármacos que puedan salvar su vida se convierte en una
tarea monumental y frustrante. Mientras que no están disponibles en
general las estadísticas de morbilidad y mortalidad, se sabe que
muchos pacientes con emergencias que amenazan su vida han muerto
después de complicaciones debidas a que el acceso al sistema
vascular con terapias IV que podrían salvar su vida se demoró o
simplemente no fue posible. Para tales pacientes, se requiere una
modalidad alternativa.
La publicación internacional de patente No. WO
99/52444 describe un aparato y un método para la administración
intraósea de anestesia a través de un catéter para conectar a una
pieza de mano dental.
La WO 96/31164 describe un aparato que comprende
medios de catéter perforador hueco para penetrar los tejidos,
medios para conectar y desconectar el catéter perforador a y desde
un eje de motor rotatorio, una barra axial adaptada para ser
insertada en el catéter perforador hueco cuando se conecta, una
carcasa y un motor operable para impulsar el catéter perforador por
rotación del eje de motor rotatorio.
De acuerdo con las enseñanzas de la presente
invención, se provee un aparato y método para ganar acceso rápido a
la médula ósea.
En una realización de la invención se provee un
aparato para penetrar una médula ósea que incluye una carcasa y un
dispositivo penetrador. El dispositivo penetrador es operable para
penetrar la médula ósea, teniendo un trócar interno removible y un
penetrador externo. Un conector operable para conectar de manera
liberable el dispositivo penetrador a un eje de taladro está
incluido. El eje de taladro es operable para conectar el
dispositivo penetrador a un dispositivo de engranaje de reducción.
El dispositivo de engranaje de reducción es operable para conectar
y rotar el eje de taladro. Un motor operable para enganchar el
dispositivo de engranaje de reducción e impulsar el penetrador
dentro de la médula ósea por rotación del eje de taladro y una
fuente de alimentación y la circuitería asociada operable para
alimentar el motor también están incluidos.
En una realización de la invención un
dispositivo penetrador operable para proveer acceso a una médula
ósea comprendiendo un penetrador externo y un trócar interno
removible operable para penetrar la médula ósea. También se incluye
un conector operable para unir liberablemente el dispositivo
penetrador al eje de taladro de la realización discutida más
arriba.
También se discute un método para tener acceso a
una médula ósea, el cual incluye insertar un dispositivo penetrador
en la médula ósea por medio de un aparato alimentado con energía
eléctrica, desconectar el aparato alimentado del penetrador,
remover un trócar interno desde un penetrador externo del
dispositivo y conectar un conector en ángulo recto al penetrador
externo.
Se discute otro método para tener acceso a una
médula ósea, el cual incluye insertar un dispositivo penetrador en
la médula ósea por medio de un aparato alimentado eléctricamente,
desconectando el aparato alimentado del penetrador, removiendo un
trócar interno desde un penetrador externo del dispositivo y
conectando un adaptador adecuado para transportar medicaciones o
fluidos hacia la médula ósea.
En aún otra realización de la presente invención
se provee un método de manufactura de un aparato operable para
penetrar una médula ósea que incluye manufacturar una carcasa que
tiene un conector operable para conectar liberablemente un
dispositivo penetrador a un eje de taladro, un dispositivo de
engranaje de reducción de taladro, un dispositivo de engranaje de
reducción operable para conectar y hacer rotar el eje de taladro,
un motor operable para conectar el dispositivo de engranaje de
reducción e impulsar el dispositivo penetrador en la médula ósea y
una fuente de alimentación y todos los circuitos asociados operables
para alimentar el motor y manufacturar un dispositivo penetrador
operable para conectar de manera liberable al conector.
En una realización adicional de la presente
invención, se provee un conjunto para su uso en la penetración de
la médula ósea en una extremidad que incluye un estuche de
trasporte, un aparato para penetrar la médula ósea incluyendo una
carcasa y dispositivos penetradores operables para penetrar la
médula ósea, un trócar interno removible y un penetrador externo
que forma porciones de por lo menos uno de los dispositivos
penetradores, por lo menos un conector operable para conectar de
manera liberable los dispositivos penetradores a un eje de taladro,
un dispositivo de engranaje de reducción operable para conectar y
hacer rotar el eje de taladro, un motor operable para conectar el
dispositivo de engranaje de reducción e impulsar por lo menos uno de
los dispositivo penetradores de la médula ósea y una fuente de
alimentación y los circuitos asociados para alimentar el motor y
una banda operable para inmovilizar el penetrador externo en un
sitio en una extremidad.
Un entendimiento más completo y profundo de las
presentes realizaciones y sus ventajas puede ser adquirido con
referencia a la siguiente descripción tomada en conjunto con los
dibujos acompañantes, en los cuales los números de referencia
indican características similares, y donde:
La Figura 1A es un dibujo esquemático que
muestra una vista isométrica de una realización de la presente
invención;
La Figura 1B es un dibujo esquemático que
muestra una vista isométrica de una realización de la presente
invención;
La Figura 2A es un dibujo esquemático que
muestra una vista isométrica de una realización de la presente
invención;
La Figura 2B es un dibujo esquemático que
muestra una vista isométrica de una realización de la presente
invención;
Las Figuras 3A - C ilustran una vista lateral y
transversal de una realización de la presente invención;
Las Figuras 4A - C ilustran diversas
realizaciones alternativas de un mecanismo de engranaje de
reducción que puede ser incluido en una realización de la presente
invención;
La Figuras 5A - C ilustra una realización de un
dispositivo penetrador de la presente invención;
Las Figuras 6A - C ilustran diversas
realizaciones alternas de un conector dispositivo penetrador de la
presente invención;
La Figura 7A ilustra una realización de un
dispositivo penetrador de la presente invención;
La Figura 7B ilustra una vista transversal de
una realización de un dispositivo penetrador de la presente
invención;
Las Figura 7C ilustra una realización de un
trócar interno en sección transversal de la presente invención;
La Figura 7D ilustra una realización de un
penetrador externo en sección transversal de la presente
invención.
Las Figuras 7E - G ilustran ejemplos de
mecanismos de liberación de la presente invención.
La Figura 8A ilustra una realización de una
punta de un dispositivo penetrador de la presente invención.
La Figura 8B ilustra una realización de una
punta de un dispositivo penetrador de la presente invención.
La Figura 9 ilustra una realización de un
conjunto para tener acceso a la médula ósea de la presente
invención; y
La Figura 10 ilustra una realización de un
conector para conectar un penetrador externo de la presente
invención.
Las realizaciones preferidas de la invención y
sus ventajas son entendidas mejor con referencia a las Figuras 1A -
10 donde los números iguales se refieren a las mismas y similares
partes.
Diversos ejemplos de un aparato operable para
tener acceso a la médula ósea de acuerdo con la presente invención
se muestran en general en las Figuras 1A y 1 B hasta 10. El aparato
10 como se muestra en las Figuras 1A y 1B incluye en general una
carcasa 12 y un dispositivo penetrador 14. La carcasa 12 incluye un
asa 16 que esta dimensionada y configurada para encajar con la mano
de un operador. El asa 16 puede incluir un conmutador de
encendido/apagado 22 y un dispositivo de seguridad 24. El
dispositivo penetrador 14 incluye un penetrador externo 18, un
trócar interno (no mostrado expresamente) y el conector dispositivo
penetrador 20.
Las Figuras 2A y 2B ilustran una realización
alternativa de la presente invención. El aparato Ioa incluye
generalmente la carcasa 12 y el dispositivo penetrador 14A. La
carcasa 12 incluye el asa 16 que está dimensionada y configurada
para encajar con la mano de un operador. El asa 16 puede incluir un
conmutador de encendido/apagado 22. El dispositivo penetrador 14A
incluye un penetrador externo 18, un trócar interno (no expresamente
mostrado) y un dispositivo penetrador conector 20. El dispositivo
penetrador 14A puede incluir un escudo de penetrador 26. Un
penetrador externo puede incluir bien sea un trócar, una aguja, una
cánula, un tubo hueco, una broca o una broca hueca.
Las Figuras 3A y 3B ilustran aún otra
realización de la presente invención. El aparato IOb generalmente
incluye una carcasa 12 y un dispositivo penetrador (no expresamente
mostrado). La carcasa 12 incluye un asa 16 y un conmutador de
encendido/apagado 22. El dispositivo penetrador puede incluir un
penetrador (no expresamente mostrado) y un conector, por ejemplo un
conector pentagonal 20 como se muestra en la Figura 3A. Como se
muestra en la Figura 3B, la carcasa 12 incluye un motor 30, una
fuente de alimentación 32, por ejemplo cuatro o más baterías AA,
cables de conexión del motor 34 entre la fuente de alimentación 32 y
el motor 30 y cables de conexión del conmutador 36 entre el
conmutador de encendido/apagado 22 y la fuente de alimentación 32.
La fuente de alimentación del aparato puede ser un número adecuado
de baterías AA o cualquier otro tipo de batería, una fuente de
corriente directa, una fuente de corriente alterna o una fuente de
potencia por aire o gas. El motor puede ser reciprocante o
rotacional. El cojinete de empuje 45, por ejemplo una empaquetadura,
puede estar localizado adyacente a la carcasa 12 donde el eje de
taladro 40 sale de la carcasa 12. El cojinete de empuje 45 previene
que la fuerza de empuje o penetración del taladro sea colocada en el
dispositivo 38 a medida que el penetrador está taladrando en el
hueso. La Figura 3C muestra una realización de la invención donde
el eje de taladro 40 puede ser separado en dos piezas que se
intercalan en 42 con el fin de permitir que los dos extremos del
eje de taladro 40 se deslicen dentro y fuera a medida que el hueso
es penetrado para evitar la aplicación de una fuerza excesiva a un
dispositivo de engranaje.
En la Figura 3B el dispositivo de engranaje 38
está acoplado con el motor 30. El dispositivo de engranaje 38 es un
dispositivo de engranaje de reducción tal que como se muestra en la
Figura 3B funciona para reducir las revoluciones por minuto (RPM)
entre el motor y el eje de taladro 40 para incrementar el torque del
eje del taladro.
A manera de ejemplo y no de limitación, se
muestra en más detalle en la Figura 4A por ejemplo un dispositivo
de engranaje de tornillos sinfín y puede incluir un primer conector
43 que conecta el eje 44 del motor 30 con el dispositivo de
engranaje de tornillo sinfín 46. El engranaje de tornillo sinfín 46
puede conectarse con un engranaje recto 47. El dispositivo de
engranaje de reducción 38 puede ser utilizado para disminuir las
RPM entre el motor y el dispositivo penetrador para proveer unas RPM
óptimas en el punto de inserción del dispositivo penetrador en el
hueso. El dispositivo de engranaje de reducción 38 también puede ser
usado para incrementar el torque del eje del taladro y la potencia
de perforación.
La Figura 4B ilustra una realización del
dispositivo de engranaje de reducción 38 donde un primer engranaje
recto 47 conecta con un segundo engranaje recto 49. La Figura 4C
ilustra una realización alternativa del dispositivo de engranaje de
reducción 38 donde el engranaje recto 47 es desviado de un engranaje
cónico 48 que puede ser preferible en algunas realizaciones de la
presente invención. Pueden usarse otros engranajes en un dispositivo
de engranaje de reducción, por ejemplo un engranaje planetario (no
expresamente mostrado) que puede ser usado solo o en combinación
con un engranaje de tornillo sinfín o un engranaje recto. En una
realización de la presente invención, el dispositivo de engranaje
puede ser cualquier dispositivo de engranaje y no está limitado a un
dispositivo de engranaje de reducción.
Las Figuras 5A - 5C ilustran una realización de
un dispositivo penetrador 55 operable para penetrar una médula
ósea, que tiene un trócar interno removible 51 y un penetrador
externo 52. También se muestra en la Figura 5A un escudo de
penetrador 26 que puede ser utilizado para proteger el dispositivo
penetrador 55 de una conexión inadvertida y también sirve para
preservar la esterilidad de la aguja. En algunas realizaciones el
penetrador externo 52 puede ser un tipo de aguja o cánula. La
Figura 5B ilustra un penetrador externo 52 que puede incluir una
pieza de conexión macho 56 operable para conectarse con una pieza de
conexión hembra complementaria 54 del trócar interno 50. Adyacente
a la pieza de conexión macho 56 está la pieza de mecanismo de
aseguramiento 58 que se asegura en posición en la pieza de conexión
hembra 54. Alternativamente el penetrador externo puede incluir una
pieza de conexión hembra adecuada para conectar una pieza de
conexión macho complementaria de un trócar interno. Un anexo de
cerrojo dentado 57 está acoplado para conectar la pieza de conexión
macho 56 para conexión con una tubuladora o jeringa intravenosa
después de que el penetrador externo está posicionado en la médula
ósea. La pieza de conexión 56 macho y la pieza de conexión 54 hembra
también puede ser del tipo de cerrojo dentado. El trócar interno
incluye un estilete 53 que evita que el penetrador externo 52 se
atasque con residuos creados durante la perforación. El estilete
53 actúa en combinación con una porción de cánula 51 del penetrador
externo. El penetrador externo 52 puede incluir una pestaña 60 que
entra en contacto o hace interfaz con la piel de un sitio de
inserción y puede ser utilizada para estabilizar un dispositivo
penetrador en el momento de la inserción. El dispositivo penetrador
55 puede incluir diversos tipos de conectores, tales como un
conector 62 que puede ser utilizado para conectar el dispositivo
penetrador 55 a un taladro alimentado eléctricamente. El conector
62 puede ser pentagonal como se muestra en las Figuras 5A y 5C.
En una realización, la invención puede incluir
un conector especializado entre el dispositivo penetrador y un
taladro alimentado eléctricamente. El conector lleva a cabo por lo
menos dos funciones, una función de conexión y una función de
liberación. La función de conexión puede ser llevada a cabo por
diversos mecanismos tales como un acople macho hembra pentagonal o
diversos mecanismos de engranaje tales como los que puede incluir
una combinación o serie de surcos y aristas o barras que pueden
coincidir e interasegurarse sobre un conector.
La función de liberación puede ser llevada a
cabo por una conexión con un anillo en O, un conector magnético, un
mecanismo portador de liberación, o un mecanismo de bola y de
tensión con y sin un resorte. En una realización la función de
liberación puede ocurrir por medio de un mecanismo disparador
mediante el cual un disparador entra en contacto con un mecanismo
de soporte y libera un penetrador o aguja. En otra realización un
mecanismo de conexión también puede incluir un disparador o una
barra de escudo retractable que se desliza hacia arriba y entra en
contacto con un mecanismo de soporte o pinza que separa y libera un
penetrador o aguja después del contacto (no mostrado
expresamente).
Las Figuras 6A - C ilustran realizaciones
alternativas de conectores operables para conectar de manera
liberable el dispositivo penetrador 55 con aparatos de taladro
alimentados eléctricamente 10. La Figura 6A ilustra un conector de
dispositivo penetrador 62 donde el conector 62 está conformado para
encajar en un receptáculo de conector 64 y asegurarse de manera
liberable en su lugar. En este ejemplo, el conector 62 y el
receptáculo conector 64 tienen forma pentagonal. Las ventajas de
esta realización pueden ser la facilidad de conexión y remoción del
dispositivo penetrador 55 del aparato de perforación alimentado
eléctricamente 10. El conector 62 del dispositivo penetrador puede
estar hecho con metal o plástico.
La Figura 6B ilustra una realización alternativa
de un conector de dispositivo penetrador donde un receptáculo
hembra pentagonal 65 es operable para encajar con una pieza de
conexión pentagonal 66 conectada a un aparato de taladro de
alimentación eléctrica 10. La Figura 6C ilustra una realización
adicional de un conector de dispositivo penetrador donde el
conector de dispositivo penetrador 68 es un diseño propio que tiene
un patrón de aristas o barras 70 que encajan en un patrón
coincidente de hendiduras 71 sobre un receptáculo conector 72.
Conectores de dispositivo penetrador de ejemplo pueden incluir
cualquier tipo de diseño de aseguramiento o un diseño pentagonal.
Los conectores del dispositivo penetrador de cualquier tipo pueden
mantenerse en su lugar bien sea mediante un magneto, un conector
con un anillo O o un mecanismo de bola y de tensión con o sin un
resorte (no expresamente mostrado).
En una realización, el dispositivo penetrado
puede incluir un penetrador externo tal como una cánula, aguja o
taladro hueco que puede ser de diversos tamaños. Las agujas pueden
ser pequeñas (para pacientes pediátricos), medias (para adultos) y
larga (para adultos de tamaño mayor). Los penetradores, cánulas o
agujas pueden ser provistos en diversas configuraciones dependiendo
del propósito clínico para la inserción de la aguja. Por ejemplo,
puede haber una configuración para administrar fármacos y fluidos y
una configuración alternativa para tomar muestras de médula ósea o
para otros propósitos de diagnostico aunque una configuración de
agujas puede ser suficiente para ambos propósitos. La configuración
de la aguja puede variar dependiendo del sitio escogido para la
inserción de una aguja.
Las Figuras 7A y 7D incluyen un dispositivo
penetrador 80 que incluye un trócar interno removible 82 y un
penetrador externo 84. La Figura 7B ilustra una vista en sección
transversal de una realización de un dispositivo penetrador que
tiene un trócar interno removible 82 y un penetrador externo 84. El
penetrador externo 84 incluye la aleta 86 y surcos de aleta 88. La
aleta 86 puede ser usada para estabilizar el dispositivo penetrador
80 contra la piel de un sitio de inserción. El surco de aleta 88 es
operable para enganchar la cubierta del penetrador plástico 94. La
superficie del penetrador externo puede incluir una serie de discos
formados a lo largo de un eje longitudinal, una serie de aristas o
algunos otros medios de agarre. Esta superficie permite que un
operador agarre el penetrador externo con dos dedos y desenganche
fácilmente el trócar interno 82 del penetrador externo 84. El
penetrador externo 84 incluye una cánula de penetrador 96 que es
hueca cuando se retira el estilete 100.
En la Figura 7C el trócar interno 82 incluye el
asa 98 que puede tener una superficie tal como una serie de discos
formados a lo largo de un eje longitudinal del trócar, o una serie
de aristas o algún otro medio de agarre. El asa 98 permite que un
operador agarre fácilmente y manipule el trócar interno 82 y lo
desenganche del penetrador externo 84. El trócar interno 82 también
incluye el estilete 100. El estilete 100 sale por un extremo de la
cánula de penetrador 96 cuando el trócar interno 82 es insertado en
el penetrador externo 84. El estilete 100 incluye una punta
cortadora y es operable para penetrar la médula ósea. En una
realización de está invención, el trócar interno 82 puede incluir
un disco metálico 95 para permitir una conexión magnética entre el
dispositivo penetrador y el taladro alimentado eléctricamente. El
receptáculo 97 también puede enganchar una pieza de conector tipo
macho del dispositivo penetrador operable para conectar el
dispositivo penetrador a un taladro alimentado eléctricamente, o
cualquier otro conector adecuado.
La Figuras 7E - 7G ilustran ejemplos de
mecanismos de liberación que pueden ser acoplados a un conector e
incluirse en un dispositivo penetrador 80. La Figura 7E ilustra una
realización de un mecanismo de liberación magnética donde el disco
magnético 70 está incluido en el trócar interno 82. En esta
realización el disco magnético 70 está en la base de un área
abierta o receptáculo 97. En realizaciones alternativas podría
incluirse el disco magnético con un conector pentagonal o un
conector de aseguramiento o cualquier otro conector adecuado.
La Figura 7F ilustra otra realización de un
mecanismo de liberación donde el anillo en O 72 está incluido en el
trócar 98 como parte de un conector. En esta realización el anillo
en O 72 está en la pared del receptáculo 97. El anillo en O 72 es
capaz de enganchar un conector de aseguramiento, un conector
pentagonal o cualquier otro conector adecuado.
La Figura 7G ilustra aún otra realización de un
mecanismo de liberación que utiliza un mecanismo de bola y de
tensión 74. En está realización el mecanismo de bola y de tensión 74
está en la pared del receptáculo 97. El mecanismo de bola y de
tensión 74 es capaz de enganchar un conector de aseguramiento, un
conector pentagonal o cualquier otro conector adecuado.
La Figura 8A ilustra una realización de una
aguja de penetrador externo 110 y un estilete interno 112. La punta
cortante 114 de la aguja de penetrador externo 110 y la punta del
estilete interno 112 son operables para penetrar la médula ósea. En
una realización de la invención la aguja de penetrador externo y el
estilete interno son puestos juntos como una unidad en el proceso
de manufactura para asegurar que las dos piezas encajan exactamente
y actúan como una unidad de perforación simple.
La Figura 8B ilustra otra realización de una
aguja de penetrador externo 96 y un estilete interno 100. La punta
cortante 102 del estilete interno 100 es operable para penetrar la
médula ósea. El estilete interno también puede incluir un surco
longitudinal 104 que corre a lo largo del lado del estilete 100 que
permite que los trozos de hueso y tejido salgan de un sitio de
inserción a medida que el dispositivo penetrador perfora más
profundamente en el hueso. El penetrador externo o aguja 96 incluye
una punta cortante 106 que facilita la inserción del penetrador
externo o aguja 96 y minimiza el daño al penetrador externo o aguja
96 a medida que el dispositivo penetrador 55 es insertado en la
médula ósea. En una realización de la invención la aguja del
penetrador externo y el estilete interno son puestos juntos como una
unidad en el proceso de manufactura para asegurar que las dos
piezas encajan exactamente y actúan como una unidad de perforación
simple.
La Figura 9 ilustra una realización del conjunto
120 para penetrar la médula ósea. El conjunto 120 incluye aparatos
10 para penetrar la médula ósea, tamaños alternativos de
dispositivos penetradores 120, y una banda 124 adecuada para
inmovilizar un penetrador externo o una extremidad durante la
inserción del dispositivo penetrador 122. También se incluye el
estuche portador 125.
Una vez que un penetrador o aguja externo es
insertado en un hueso, puede ser conectado a una fuente de fluidos
intravenosos o medicación. La Figura 10 ilustra un ejemplo de un
conector que puede ser utilizado para conectar el penetrador
externo de un dispositivo penetrador a un entubado 130, por ejemplo,
un entubado intravenoso para proveer fluidos o medicaciones
intravenosas a una persona. El penetrador externo 84 es insertado en
la médula ósea de una extremidad. El conector en ángulo recto 132
es usado entonces para conectar el entubado intravenoso 130 a un
penetrador 84 externo. El conector de ángulo recto tiene la ventaja
de permitir que el entubado sea conectado a un penetrador externo o
aguja en un ángulo que no retuerza o pince el lumen del entubado.
Otros conectores adoptadores también pueden ser utilizados para
conectar un penetrador externo a un entubado intravenoso, otro tipo
de entubado u otra jeringa para uso en el suministro de medicación o
fluidos a una persona o para su uso en la toma de una muestra de
sangre de la médula ósea.
Un método para proveer acceso a la médula ósea
incluye utilizar un taladro alimentado eléctricamente, capaz de
movimiento reciproco o rotacional, insertar un dispositivo de
penetrador que incluye un penetrador externo y un trócar interno en
una cavidad de médula ósea. El taladro alimentado eléctricamente es
liberado entonces del dispositivo penetrador y el trócar interno es
asido y removido del penetrador externo. Un conector presente en el
extremo del penetrador externo, por ejemplo un conector de giro,
está disponible para unirse bien con un adaptador, tal como un
conector de ángulo recto o directamente a un entubado intravenoso o
jeringa.
Aunque la presente invención y sus ventajas han
sido descritas en detalle, debe entenderse que diversos cambios
sustituciones y alternativas pueden hacerse aquí sin apartarse del
alcance de la invención tal como es definida por las siguientes
reivindicaciones.
Claims (30)
1. Un aparato (10) para penetrar una médula ósea
que comprende:
una carcasa (12);
un dispositivo penetrador (14, 55, 80) operable
para penetrar la médula ósea, teniendo un trócar interno removibles
(50, 82) y un penetrador externo (18, 52, 84);
un conector (20) operable para conectar de
manera liberable el dispositivo penetrador a un eje de taladro;
el eje de taladro (40) operable para conectar el
dispositivo penetrador con un dispositivo de engranaje de reducción
(38);
el dispositivo de engranaje de reducción (38)
operable para enganchar y hacer rotar el eje de taladro;
un motor (30) operable para enganchar el
dispositivo de engranaje de reducción e impulsar el penetrador en
la médula ósea por rotación del eje de taladro (40); y
una fuente de alimentación (32) y los circuitos
asociados operables para alimentar el motor.
\vskip1.000000\baselineskip
2. El aparato de la reivindicación 1 donde el
conector liberable (20) comprende un conector pentagonal acoplado a
un mecanismo de liberación.
3. El aparato de la reivindicación 1 donde un
conector liberable (20) comprende un conector de aseguramiento
acoplado a un mecanismo de liberación.
4. El aparato de la reivindicación 2, o
reivindicación 3, donde el mecanismo de liberación es seleccionado
de un grupo que consiste de un anillo en O (72) conector (95, 70)
y un mecanismo de bola y de tensión (74).
5. El aparato de la reivindicación 1 donde el
dispositivo de engranaje de reducción comprende un primer eje
conectado a un engranaje operable para enganchar con por lo menos
otro engranaje.
6. El aparato de la reivindicación 1 donde el
dispositivo de engranaje de reducción (38) comprende un engranaje
planetario.
7. El aparato de la reivindicación 1 donde el
penetrador externo (52) y el trócar interno (50) están acoplados
con una conexión de aseguramiento (57).
8. El aparato de la reivindicación 1,
comprendiendo el trócar del dispositivo de penetrador una punta
(102) que tiene un surco longitudinal (104) operable para liberar
los residuos de hueso de un sitio de inserción en la médula ósea y
teniendo el penetrador externo del dispositivo penetrador un borde
cortante.
9. El aparato de la reivindicación 1 donde el
trócar del dispositivo del penetrador comprende una punta de
paleta.
10. El aparato de la reivindicación 1 donde la
fuente de alimentación comprende una fuente de alimentación del
grupo:
(i) una pluralidad de baterías;
(ii) una fuente de corriente directa;
(iii) una fuente de corriente alterna;
(iv) por lo menos una batería recargable.
\vskip1.000000\baselineskip
11. El aparato de la reivindicación 1 donde el
motor es del grupo:
(i) alimentado por gas;
(ii) un motor reciprocante;
(iii) un motor rotacional.
\vskip1.000000\baselineskip
12. El aparato de la reivindicación 1 donde el
eje de taladro comprende un primer extremo operable para
intercalarse (42) con un segundo extremo del eje de taladro.
13. El aparato de la reivindicación 1 donde la
carcasa incluye un piñón impulsor (45).
14.El aparato de la reivindicación 1 donde el
penetrador externo es operable para conectarse con un tubo de
extensión intravenoso estándar.
15. El aparato de la reivindicación 1 donde el
penetrador externo es operable para conectarse con un conector en
ángulo recto.
16. El aparato de la reivindicación 1 donde el
dispositivo de engranaje de reducción comprende un primer eje
conectado a un engranaje de tornillos sinfín (46) operable para
enganchar con por lo menos otro engranaje.
17. El aparato de la reivindicación 1 donde el
dispositivo de engranaje de reducción está desviado en un ángulo
con respecto al motor.
18. El aparato de la reivindicación 1 donde el
eje de taladro comprende un engranaje impulsor.
19. El aparato de la reivindicación 1 donde:
el trócar interno (82) tiene un asa, incluyendo
el asa una superficie que tiene una serie de discos formados a lo
largo de un eje longitudinal del trócar que permite a un usuario
asir y manipular el dispositivo;
el trócar interno (82) es operable para
enganchar de manera liberable el conector;
el penetrador externo (84) tiene un asa,
incluyendo el asa una superficie que tiene una serie de discos
formados a lo largo de un eje longitudinal;
comprendiendo adicionalmente el dispositivo
penetrador:
un conector de aseguramiento operable para
enganchar de manera liberable el trócar interno con el penetrador
externo; y
donde el penetrador externo tiene una aleta
operable para enganchar un sitio de inserción próximo a la médula
ósea.
\vskip1.000000\baselineskip
20. El aparato de la reivindicación 19 donde la
aleta comprende por lo menos un surco circular operable para
articular con una cubierta de aguja (94).
21. El aparato de la reivindicación 19 donde el
trócar interno comprende un disco metálico (70) embebido en el
punto de conexión operable para enganchar con un magneto dispuesto
en el conector.
22. El aparato de la reivindicación 19 operable
para proveer acceso a una médula ósea donde:
el trócar interno tiene un asa, incluyendo el
asa medios de agarre que permiten a un usuario asir y manipular el
dispositivo;
el penetrador externo tiene un asa, incluyendo
el asa medios de agarre;
el penetrador externo tiene una aleta operable
para enganchar un sitio de inserción próximo a la médula ósea;
y
el trócar interno es operable para enganchar de
manera liberable el conector.
\vskip1.000000\baselineskip
23. El aparato de la reivindicación 22 donde el
conector comprende un conector de aseguramiento operable para
enganchar de manera liberable el trócar interno con el penetrador
externo.
24. El aparato de la reivindicación 22 donde el
penetrador externo es operable para conectar con una fuente de
fluidos o medicación intravenosos por medio de un conector de ángulo
recto.
25. El aparato de la reivindicación 19 donde al
trócar interno y el penetrador externo forman una unidad de
perforación coincidente que tiene un borde cortante.
\newpage
26. Un método para manufacturar un aparato
operable para penetrar una médula ósea que comprende:
manufacturar una carcasa que tiene un conector
operable para conectar de manera liberable un dispositivo penetrador
a un eje de taladro, un eje de taladro operable para conectar el
dispositivo penetrador a un dispositivo de engranaje de reducción,
un dispositivo de engranaje de reducción operable para enganchar y
hacer rotar el eje de taladro, un motor operable para enganchar el
dispositivo de engranaje de reducción e impulsar un dispositivo
penetrador dentro de la médula ósea y una fuente de alimentación y
los circuitos asociados operables para alimentar el motor.
\vskip1.000000\baselineskip
27. El método de la reivindicación 26 donde el
dispositivo penetrador comprende un penetrador externo y un trócar
interno removible.
28. El método de la reivindicación 27 donde el
penetrador externo y el trócar interno están dispuestos para formar
una punta cortante como una unidad.
29. Un conjunto (120) para usar en la
penetración de una médula ósea en una extremidad que comprende:
un estuche de transporte (125);
un aparato (10) para penetrar la médula ósea
incluyendo una carcasa y dispositivos penetradores (122) operables
para penetrar la médula ósea; y un trócar interno removible y un
penetrador externo que forma porciones de por lo menos uno de los
dispositivos penetradores, un conector operable para conectar de
manera liberable al dispositivo penetrador con un eje de taladro,
el eje de taladro operable para conectar el dispositivo penetrador
a un dispositivo de engranaje de reducción, el dispositivo de
engranaje de reducción operable para conectar y hacer rotar el eje
de taladro, un motor operable para conectar el dispositivo de
engranaje de reducción e impulsar el penetrador dentro de la médula
ósea por rotación del eje de taladro y una fuente de alimentación y
los circuitos asociados operables para alimentar el motor; y
una banda (124) operable para inmovilizar el
penetrador externo a un sitio en una extremidad.
\vskip1.000000\baselineskip
30. El conjunto de la reivindicación 29 que
comprende adicionalmente medicaciones para anestesiar y esterilizar
un sitio de inserción en la extremidad.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US38475602P | 2002-05-31 | 2002-05-31 | |
US384756P | 2002-05-31 |
Publications (1)
Publication Number | Publication Date |
---|---|
ES2328129T3 true ES2328129T3 (es) | 2009-11-10 |
Family
ID=29712091
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ES03756317T Expired - Lifetime ES2328684T3 (es) | 2002-05-31 | 2003-05-30 | Aparato para poder acceder a la medula osea. |
ES09155111T Expired - Lifetime ES2362475T3 (es) | 2002-05-31 | 2003-05-30 | Aparato de acceso a la médula ósea. |
ES03731475T Expired - Lifetime ES2328129T3 (es) | 2002-05-31 | 2003-05-30 | Aparato y metodo para obtener acceso a la medula osea. |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
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ES03756317T Expired - Lifetime ES2328684T3 (es) | 2002-05-31 | 2003-05-30 | Aparato para poder acceder a la medula osea. |
ES09155111T Expired - Lifetime ES2362475T3 (es) | 2002-05-31 | 2003-05-30 | Aparato de acceso a la médula ósea. |
Country Status (10)
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---|---|
US (19) | US20030225344A1 (es) |
EP (5) | EP1509140B1 (es) |
JP (4) | JP4938979B2 (es) |
AT (2) | ATE506894T1 (es) |
AU (2) | AU2003240970B2 (es) |
CA (4) | CA2485910C (es) |
DE (3) | DE60327625D1 (es) |
ES (3) | ES2328684T3 (es) |
IL (2) | IL165222A0 (es) |
WO (2) | WO2003101306A1 (es) |
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