US20070181130A1 - Ventilator to tracheotomy tube coupling - Google Patents

Abstract

A coupling for connecting a ventilator tube to a tracheotomy tube has a latching mechanism which prevents the coupling from axially displacing a tapered tubular extension of the tracheotomy tube after they have been mated in a pneumatically discrete path. For use with known adult tracheotomy tubes which have inner and outer cannulas, the latching mechanism engages the coupling with the leading end of the outer cannula collar with the inner cannula collar sandwiched therebetween. For use with known one piece children's tracheotomy tubes, the latching mechanism is a clamshell contoured to concentrically grip the tapered tubular extension of the tracheotomy tube. Interlocking the coupling and the tracheotomy tube prevents them from inadvertently axially displacing from each other. Non-axial force disengages the coupling from the tracheotomy tube so that the coupling can be axially displaced without exertion of excessive axial force on the system and the patient.

Description

BACKGROUND OF THE INVENTION
• This invention relates generally to medical equipment and more particularly concerns devices used to connect ventilators to tracheotomy tubes.
• For adult patients, two-piece tracheotomy tubes having inner and outer cannulas are presently in common use. The outer cannula is inserted into the patient's windpipe and the inner cannula is inserted into or removed from the outer cannula for use or for replacement, cleaning or disinfecting, respectively. The outer cannula of these two-piece devices has a collar on its trailing end which is configured to be positively engaged with a collar on the leading end of the inner cannula. The cannulas cannot be disengaged from each other affirmative release of their positive engagement. The trailing end of the combined cannulas has a tapered tubular extension which plugs into or into which is plugged, depending on the diameter of the tubular extension of the particular tracheotomy tube, the leading end of a flexible connector. The trailing end of the flexible connector is connected to a tube extending from the ventilator or other external equipment. The present tapered tubular extension connection to the ventilator is dependent on mere insertion of a tapered tube into a constant diameter tube in the hope of achieving a snug fit. To assist in making this connection, the flexible connectors have annular flanges with significantly wider diameters than the tubular portions of the connectors so as to facilitate manipulation of the connectors with the thumb and forefinger.
• For children, a smaller, one piece tracheotomy tube is made from a very soft, pliant material. The entire tracheotomy tube must be frequently removed, at least once a week, from the child's trachea, cleaned and disinfected and reinserted into the trachea. The same flanged flexible connector used with the adult devices is also used with the children's devices. The tapered tubular extension of the children's tracheotomy tube is integral with the pliant tracheotomy tube and has a hard plastic outer sleeve which is inserted directly into the flexible connector. An annular flange on the trailing end of the tubular extension of the child's tracheotomy tube holds the hard plastic sleeve in place on the extension.
• Because of their structural configuration and operational steps, there are some problems inherent in the known one or two piece tracheotomy tubes, in the known flexible connectors and in their combination.
• One set of problems is related to the comfort of the patient. The profile of the flanged flexible connectors, falling generally between the underside of the patient's chin and the patient's chest, fosters a breakdown of skin and tissue on the chin or chest, depending on the head movements of the patient. This is especially true for children, their chin-to-chest cavity being comparatively small. This concern is sometimes addressed by after-market removal of all or a portion of the flange, but this solution generally results in a damaged connector, increasing the likelihood of infection-causing secretions and also becomes less secure due to removal of the firm portion of the connector. Also, the manipulation of the flange to connect or disconnect the connector to or from the tubular extension can cause considerable discomfort to the patient, since this often requires the application of manual pressure to the patient's neck, chin or chest. It is common practice to extend rubber bands from one side of a neck plate on the tracheotomy tube collar to the flexible connector and back to the other side of the neck plate in an effort to hold the flexible connector in place, but the rubber bands are likely either too elastic or too inelastic to properly accomplish this purpose. While a child's tracheotomy tube is smaller than an adult's, the available space between the chin and chest is significantly smaller and the flexible connector flange is the same size as used for adults, so the smaller device affords no relief for the connector flange related comfort problems. And, since the child's tracheotomy tubes are of one piece construction, the force necessary to disconnect the flexible connector may be directly applied to the patient's neck or windpipe.
• A second set of problems is related directly to the ability, or inability, of the system to accomplish its primary purpose of keeping the patient's trachea connected to the ventilator. To begin with, tapered connections tend to easily separate in the best of circumstances, there being minimal surface contact between the tapered and constant diameter components. Moreover, the connector and tracheotomy tube parts are always wet and slippery due to the very nature of their application and are not very tightly mated because of the neck pressure problems. The end result is a connection so tenuous that a mere sneeze, cough or turn or tip of the head can cause the connector and the tapered tubular extension to separate, defeating the operation of the system. Even without a sneeze, cough, turn or tip, the flange itself functions as a lever against the chin or chest in response to the patient's head movements, and the reciprocal levering by the flange will eventually cause the connector and the tubular extension to disconnect.
• A third set of problems concerns the performance of the medical staff as a result of these other problems. The inherent comfort issues result in more pains-taking, time-consuming effort by the staff in an effort to reduce the impact of these discomforts on the patient. And, because of the ease of inadvertent disconnection of the system, the staff unnecessarily spends valuable time monitoring and reconnecting the connectors to the tubular extensions of the tracheotomy tubes.
• It is, therefore, a primary object of this invention to provide an improved tracheotomy tube coupling. Another object of this invention is to provide a tracheotomy tube coupling which reduces a likelihood of associated patient discomfort. It is also an object of this invention to provide a tracheotomy tube coupling which is more suitably profiled for positioning between a patient's chin and chest. Still another object of this invention is to provide a tracheotomy tube coupling which is profiled to reduce a likelihood of skin or tissue breakdown on a patient's chin and chest. A further object of this invention is to provide a tracheotomy tube coupling which simplifies manipulation of the coupling in relation to the patient. Yet another object of this invention to provide a tracheotomy tube coupling which reduces a likelihood of exertion of discomforting pressure on the chin, neck, chest or windpipe of a patient during connection or disconnection of the coupling from the tracheotomy tube. An additional object of this invention is to provide a tracheotomy tube coupling which makes inadvertent disconnection of the tracheotomy tube from the connected medical equipment less likely. Another object of this invention is to provide a tracheotomy tube coupling which does not rely on tapered to constant diameter connections to maintain connection between the tracheotomy tube and its related equipment. It is also an object of this invention to provide a tracheotomy tube coupling which is profiled to reduce a likelihood that the coupling will operate as a self-disconnecting lever. Still another object of this invention to provide a tracheotomy tube coupling which can be easily connected and disconnected from the tracheotomy tube by the medical staff. A further object of this invention is to provide a tracheotomy tube coupling which can reduce the time expended by the medical staff to monitor and maintain the coupling connections. Yet another object of this invention is to provide a tracheotomy tube coupling which facilitates more rapid disassembly and reassembly of associated components from the tracheotomy tube for cleaning and disinfecting purposes.
SUMMARY OF THE INVENTION
• In accordance with the invention, a coupling is provided for connecting a ventilator tube to a tracheotomy tube. The ventilator tube has a connector at its leading end and the tracheotomy tube has a tapered tubular extension on its trailing end. The coupling is a preferably expandable, flexible tubular member with a first adapter on its trailing end for connecting its trailing end in a pneumatic flow path to the ventilator tube leading end connector and a second adapter on its leading end for mating its leading end in a pneumatic flow path with the trailing end of the tracheotomy tube. The second adapter has a latching mechanism for engaging the leading end of the coupling to the tracheotomy tube to prevent the leading end of the tubular member from axially displacing from the trailing end of the tracheotomy tube after they have been mated in the pneumatic flow path. An unlatching mechanism is provided for disengaging the latching mechanism from the tracheotomy tube so as to permit the leading end of the tubular member to axially displace from the trailing end of the tracheotomy tube. The unlatching mechanism is operated by non-axial forces so that the coupling can be disengaged from the tracheotomy tube without exertion of excessive axial force on the patient's neck.
• Some known adult tracheotomy tubes have an inner cannula inserted into a trailing end of an outer cannula with the tubular extension on the trailing end of the inner cannula. For such tracheotomy tubes, the coupling tubular member has a first means on its leading end for mating the tubular member in the pneumatic flow path with the tubular extension of the inner cannula which is operable by motion of the mating means in a generally axial direction relative, to the tubular extension. A second means is provided on the mating means for engaging with the outer cannula during mating to prevent the leading end of the tubular member from axially displacing from the tubular extension after mating. A third means is provided on the inner cannula for disengaging the engaging means from the outer cannula by application of force to the mating means in other than the generally axial direction to permit the leading end of the tubular member to axially displace from the tubular extension of the inner cannula. Typically, the trailing end of the outer cannula has opposed annular flanges and the engaging means consists of opposed means for resiliently snapping over the flanges. The disengaging means consists of means on the inner cannula for spreading the opposed flanges during rotational motion of the mating means about a longitudinal axis of the tubular member.
• Other known adult tracheotomy tubes have an inner cannula inserted into a trailing end of an outer cannula with the tubular extension on the trailing end of the inner cannula. For such tracheotomy tubes, the coupling tubular member has a first means on a leading end of the tubular member for mating the tubular member in the pneumatic flow path with the tubular extension of the outer cannula by motion of the mating means in a generally axial direction relative to the tubular extension. A second means is provided on the mating means for engaging with the outer cannula during mating to prevent the tubular member from axially displacing from the tubular extension after mating. A third means is provided on the outer cannula which is operable by application of force on the mating means in a direction other than the generally axial direction for disengaging the engaging means from the outer cannula to permit the tubular member to axially displace from the tubular extension of the outer cannula. Typically, the trailing end of the outer cannula has annularly opposed flat notches. The disengaging means consists of means on the outer cannula for spreading the opposed flanges during rotational motion of the mating means about a longitudinal axis of the tubular member.
• Known child tracheotomy tubes have a tubular extension on their trailing end. For such tracheotomy tubes, the coupling tubular member has a first means for mating the leading end of the tubular member in the pneumatic flow path with the tubular extension of the tracheotomy tube by motion of the mating means in a generally axial direction relative to the tubular extension. A second means is provided on the mating means for engaging with the tracheotomy tube to prevent the leading end of the tubular member from axially displacing from the tubular extension after mating. A third means is provided on the mating means which is operable by application of force on the mating means in other than the generally axial direction for disengaging the engaging means from the tracheotomy tube to permit the tubular member to axially displace from the tubular extension of the tracheotomy tube. The mating means consists of a nozzle insertable into the tubular extension. The engaging means consists of a clamshell, the clamshell and the tubular extension having complementary three-dimensional surfaces which prevent axial displacement of the clamshell from the tubular extension gripped therein. Half of the clamshell has diametrically opposite lugs and another half of the clamshell has diametrically opposite fingers which resiliently snap over the lugs when the clamshell is closed. The disengaging means consists of means on the fingers for spreading the fingers in response to inward radial pressure on the spreading means to release the lugs.
BRIEF DESCRIPTION OF THE DRAWINGS
• Other objects and advantages of the invention will become apparent upon reading the following detailed description and upon reference to the drawings in which:
• FIG. 1 is a perspective view of a first type of known tracheotomy tube outer cannula;
• FIG. 2 is a perspective view of a first embodiment of an inner cannula for use with the outer cannula ofFIG. 1;
• FIG. 3 is a perspective view of a first embodiment of a coupling connected to the inner cannula ofFIG. 2;
• FIG. 4 is a side elevation assembly view of the coupling and cannulas ofFIGS. 1-3;
• FIG. 5 is a top plan assembly view from the line5-5 ofFIG. 4;
• FIG. 6 is a side elevation view of the assembled coupling and cannulas ofFIGS. 1-3;
• FIG. 7 is a perspective assembly view of the leading end adapter of the coupling ofFIG. 3 and the outer cannula ofFIG. 1;
• FIG. 8 is a side elevation view of the assembled leading end adapter of the coupling ofFIG. 3 and inner cannula ofFIG. 2;
• FIG. 9 is a trailing end elevation view of the assembly ofFIG. 8;
• FIG. 10 is a top plan view of the assembly ofFIG. 8;
• FIG. 11 is a leading end elevation view of the assembly ofFIG. 8;
• FIG. 12 is a leading end perspective view of the leading end adapter of the coupling ofFIG. 3;
• FIG. 13 is a trailing end perspective view of the leading end adapter of the coupling ofFIG. 3;
• FIG. 14 is a side elevation view of the leading end adapter of the coupling ofFIG. 3;
• FIG. 15 is a trailing end elevation view of the trailing end adapter of the coupling ofFIG. 3;
• FIG. 16 is a top plan view of the leading end adapter of the coupling ofFIG. 1;
• FIG. 17 is a leading end perspective view of the inner cannula ofFIG. 2 and leading end adapter of the coupling ofFIG. 3 in an operatively assembled condition;
• FIG. 18 is a leading end perspective view of the inner cannula ofFIG. 2 and leading end adapter of the coupling ofFIG. 3 in a ready-to-disconnect condition;
• FIG. 19 is a perspective assembly view of a second embodiment of the coupling and inner cannula in relationship to a second type of known tracheotomy tube outer cannula;
• FIG. 20 is a top plan assembly view of the coupling and cannulas ofFIG. 19;
• FIG. 21 is a trailing end view of the leading end of the coupling ofFIG. 19;
• FIG. 22 is a leading end view of the leading end of the coupling ofFIG. 19;
• FIG. 23 is a side elevation view of the leading end of the coupling ofFIG. 19;
• FIG. 24 is a top plan view of the leading end of the coupling ofFIG. 19;
• FIG. 25 is a side elevation assembly view of the cannulas and coupling ofFIG. 19;
• FIG. 26 is a side elevation view of the assembled cannulas and coupling ofFIG. 19;
• FIG. 27 is a perspective assembly view of a third embodiment of the coupling in relationship to a third type of known tracheotomy tube;
• FIG. 28 is a top plan assembly view of the coupling and tracheotomy tube ofFIG. 27;
• FIG. 29 is a leading end perspective view of the coupling ofFIG. 27 in an open condition;
• FIG. 30 is a leading end elevation view of the coupling ofFIG. 27 in the open condition;
• FIG. 31 is a top plan view of the leading end of the coupling ofFIG. 27 in the open condition;
• FIG. 32 is a side elevation view of the leading end of the coupling ofFIG. 27 in the open condition;
• FIG. 33 is a side elevation assembly view of the coupling and tracheotomy tube ofFIG. 27;
• FIG. 34 is a side elevation view of the coupling and tracheotomy tube ofFIG. 27 with the leading end of the coupling in the open condition; and
• FIG. 35 is a side elevation view of the assembled coupling and tracheotomy tube ofFIG. 27.
• While the invention will be described in connection with preferred embodiments thereof, it will be understood that it is not intended to limit the invention to those embodiments or to the details of the construction or arrangement of parts illustrated in the accompanying drawings.
DETAILED DESCRIPTION
• Tracheal Inserts: Adult tracheotomy tubes are illustrated inFIGS. 1-18, showing a tracheotomy tube with outer andinner cannulas100 and130 and a taperedtubular extension139 on the trailing end of theinner cannula130 andFIGS. 19-26, showing a tracheotomy tube with outer andinner cannulas200 and230 and a taperedtubular extension223 on the trailing end of theouter cannula200. A child's tracheotomy tube is illustrated inFIGS. 27-35. A child's tracheotomy tube has only one cannula which, for purposes of explanation of the invention is identified as anouter cannula300.
• All three knownouter cannulas100,200 and300 are, in some respects, substantially similar, being arcedtubes101,201 or301 of approximately a quarter circle extending from aleading end103,203 or303 to acollar105,205 or305 at the trailingend107,207 or307 of the arcedtube101,201 or301. Acuff109,209 or309 on the leading half of the arcedtube101,201 or301 is inflatable via anair supply line111,211 or311. The arcedtube101,201 or301 is the tracheal insert portion of the tracheotomy tube and, once inserted, thecuff109,209 or309 is inflated to hold and seal thetube101,201 or301 in position in the trachea. Each of theouter cannulas100,200 or300 has aneck plate115,215 or315 which positions theouter cannulas100,200 or300 against the patient's neck and is adapted to maximize its manipulability relative to thecollar105,205 or305 by connectinghinges117 or byopenings217 orcontours317 in its body. Each of theneck plates115,215 or315 also hasopenings119,219 or319 for connection of an adjustable strap to pass around and secure theneck plates115,215 or315 against the patient's neck. The adultouter cannulas100 and200 are comparatively hard and the child'souter cannula300 is very soft. From thecollars105,205 and305 on the trailing ends of the arcedtubes101,201 and301 toward the trailing ends of theouter cannulas100,200 and300, the configurations of theouter cannulas100,200 and300 are quite different.
• Bothinner cannulas130 and230 are also, in some respects, substantially similar, being arcedtubes131 or231 of approximately a quarter circle extending from aleading end133 or233 to acollar135 or235 on a trailingend137 or237 of the arcedtube131 or231. Theinner cannulas130 and230 are inserted at their leading ends131 and231 into the trailing ends of theirouter cannulas100 and200 until their trailing ends mate. From thecollars135 and235 toward the trailing ends of theinner cannulas130 and230, theinner cannulas130 and230 are quite different.
• Theouter cannulas100,200 and300 and their associated known inner cannulas have mechanisms which positively engage them against separation in their mated condition. They all present tapered tubular extensions for connection with known flexible connectors. The connection to known flexible connectors is universally accomplished by mere insertion of a tapered end of a tube into a constant diameter tube. The following illustrated embodiments of theouter cannulas100,200 and300 are substantially the same as the known outer cannulas. The illustrated embodiments of theinner cannulas130 and230 and the flexible connectors orcouplings160,260 and360 are substantially different from the known inner cannulas and connectors so as to permit a positive engagement of the outer cannulas with their flexible connectors. However, they have been configured to work with the knownouter cannulas100,200 and300. The principles of the invention, however, are fully applicable to the connection of flexible connectors to outer cannulas other than those herein illustrated.
• First Adult Tracheotomy Tube Embodiment: Looking now atFIGS. 1-18, the first, type of adult tracheotomy tube is illustrated. As best seen inFIG. 1, thecollar105 on theouter cannula100 has anannular ring121 which is concentric about the trailingend107 of theouter cannula tube101 and has top and bottom quarter arcs123 which extend concentrically on and in a trailing direction from thering121. Aconcentric groove125 is also provided in the face of the trailingend107 of theouter cannula tube101.
• Looking atFIGS. 1-3 and8-11, theinner cannula130 applies the principles of the invention to theouter cannula100. A soft arcedtube131 extends upwardly and rearwardly from its leadingend133 to ahard collar135 on its trailingend137. Thecollar135 tapers outwardly to a wider, concentric, hard, taperedtubular extension139 which extends in a trailing direction from thecollar135. Theextension139 tapers toward its trailingend face141. Thecollar135 has a pair of diametricallyopposed latches143, as shown appearing at approximately the 2 and 8 o'clock orientations when looking at the trailingend face141 of theinner cannula130. Thelatches143 havefingers145 which extend radially inwardly therefrom for engagement against the trailing face of theannular ring121 on the trailingend103 of theouter cannula100. Thefingers145 extend in the leading end direction from resilientlyflexible supports147 on thecollar135.Squeeze plates149 extend in the trailing end direction from thefingers145. The leading faces151 of thefingers145 are beveled so that, as theinner cannula130 is inserted into theouter cannula100 and the beveled faces contact theannular ring121, thesupports147 flex to widen the distance between thefingers145. Once thefingers145 pass over theannular ring121, the supports return to their unbiased condition in which the trailing faces of thefingers145 engage the leading face of thering121, thus locking theinner cannula130 in place on theouter cannula100. Thesqueeze plates149 provide suitable surfaces and leverage for the thumb and forefinger to apply pressure to flex thesupport147 and spread thefingers145 so that thefingers145 can be disengaged from theannular ring121. Thesqueeze plates149 have alignment indicia such asarrows153, as shown diametrically opposed and pointing in the trailing end direction. As best seen inFIGS. 6, 8,9,11,17 and18, thecollar135 also has diametrically opposed rotational andlongitudinal ramps155 and157 andlongitudinal beads159 for reasons hereinafter explained.
• Looking atFIGS. 1-16, theflexible connector160 for use with the above outer andinner cannulas100 and130 has aleading end adapter161, best seen inFIGS. 5, 7 and12-15. Theleading end adapter161 has a hardouter sleeve167 with asoft tube liner169. The trailingend171 of thesleeve167 is of narrower diameter so as to provide a connectingring173 for reasons hereinafter explained. Theouter sleeve167 has diametrically opposedposts175 on its wide circumference at the leading end of the connectingring173. A pair of diametrically opposed resilientlyflexible arms177 extend longitudinally from thesleeve167 to radially inwardly extendingfingers179. Thesleeve167 also has alignment indicia such asarrows181 pointing in the leading end direction. Theflexible connector160 is in proper rotational orientation for connection to the outer andinner cannulas100 and130 when thearrows153 on theinner cannula130 are aligned with thearrows181 on theconnector sleeve167. As best seen inFIG. 6, when thearrows153 and181 are aligned, theconnector arms177 can pass under thesqueeze plates149 of the inner cannula latches143 with theflexible connector fingers179 at approximately the 4 and 10 o'clock orientations. This positions theconnector fingers179 on the clockwise side of the rotational andlongitudinal ramps155 and157 when theconnector160 is connected to the outer andinner cannulas100 and130. The leading faces183 of theconnector fingers179 are beveled so that, as theflexible connector160 is moved longitudinally into the taperedtubular extension139 of theinner cannula130, thefingers179 will be spread apart by and slide across thering121, on theouter cannula100. Once thefingers179 pass thering121 they resiliently close to secure theflexible connector160 to theouter cannula100. Theinner cannula collar135 is sandwiched between them.
• As best seen inFIG. 12, the interior surfaces of theconnector arms177 are provided withlongitudinal grooves185 and the counterclockwise inside edges of theconnector arms177 are provided withlongitudinal bevels187. To remove theflexible connector160 from the outer andinner cannulas100 and130, theconnector160 is rotated counterclockwise, as indicated by therotational arrows189, using the thumb and forefinger on theposts175. As theconnector160 rotates, thelongitudinal bevels187 on theconnector arms177 ride on therotational ramps155 on theinner cannula collar135 to unlatch theconnector fingers179 from thecollar135. The rotation is limited to the point of abutment of the inner cannula andconnector fingers145 and179, whereuponlongitudinal beads159 on theinner cannula collar135 andgrooves185 on theconnector arms177 engage to provide an audible click indicating that theconnector160 can be longitudinally displaced and disconnected from the outer andinner cannulas100 and130. As theconnector160 is withdrawn in the trailing direction, theconnector fingers179 ride on thelongitudinal ramp157 of theinner cannula collar135 to assure that theconnector fingers179 cannot relatch during the process.
• Second Adult Tracheotomy Tube Embodiment: Turning toFIGS. 19-26, the other type of adult tracheotomy tube is illustrated. Thecollar205 of theouter cannula200 has a hardannular ring221 which is concentric about the trailingend207 of theouter cannula tube201. The hard taperedtubular extension223 of thering221 narrows toward the trailingend225. Top and bottom approximatelyquarter notches227 are provided in the outer circumference of the taperedtubular extension223 at the trailing end of thering221.
• Theinner cannula230 applies the principles of the invention to theouter cannula200. A soft arcedtube231 extends upwardly and rearwardly from its leadingend223 to aconcentric collar235 on its trailingend237. A taperedtubular extension239 extends in a trailing direction from thecollar235 to a trailingend face241 of anannular ring243 on theextension239. The outside wall of theextension239 hasannular ridges245 which complement theannular grooves229 in the inside wall of the outer cannula taperedextension223 to secure theinner cannula230 in place in theouter cannula200. A pair of vertically alignedstuds247 are provided on the trailingend face241 of theinner cannula extension239 for reasons hereinafter explained. Aconcentric pull ring249 is hinged251 to the bottom of theend face241 of theextensions239 to facilitate removal of theinner cannula230 from theouter cannula200. An annularouter flange253 on the midportion of the inner cannula arcedtube231 helps to hold theinner cannula tube231 concentrically within theouter cannula tube201.
• Theflexible connector260 for use with the above outer andinner cannulas200 and230 has aleading end adapter261, best seen inFIGS. 21-24. Theleading end adapter261 has a hardouter sleeve267 with asoft tube liner269. The trailingend271 of thesleeve267 is of narrower diameter so as to provide a connectingring273 for reasons hereinafter explained. Theouter sleeve267 has acorrugated surface275 to facilitate manipulation of theflexible connector260. Diametrically vertically opposedarms277 with radially inwardly extendingfingers279 at their leading ends are defined bylongitudinal slots281 in thesleeve267. Thefingers279 are contoured to engage in theopposed notches227 in the outer cannula taperedtubular extension223. As best seen inFIG. 23,valleys283 in the inner and outer surfaces of thearms277 at their trailing ends permit thearms277 to flex easily. As best seen inFIGS. 21 and 22, the leading face of the connectingring273 of theleading end adapter261 hasnotches285 which receive thestuds247 on the trailingend face241 of theinner cannula230. Thenotches285 extend clockwise from the point of longitudinal insertion of thestuds247 tostops287. Counterclockwise rotation of theleading end adapter261 of theconnector260, indicated by therotational arrows289 on thesleeve267, is terminated by thestuds247 striking thestops287. At this point, theconnector arms277 will have flexed sufficiently to disengage theconnector fingers279 from thenotches227 in theouter cannula extension223 so that theconnector260 can be longitudinally withdrawn from the outer andinner cannulas200 and230.
• Child Tracheotomy Tube Embodiment: Turning toFIGS. 27-35, the child's tracheotomy tube is illustrated. As best seen inFIG. 27, thecollar305 on thesoft tube301 has a concentricannular ring321 extending in a trailing direction with a softtapered extension323 extending in a trailing direction from thering321. Theextension323 hasannular ridges325 in its circumference and abeveled flange327 with anannular groove329 in its trailing end face. Ahard sleeve331 is tapered to concentrically cover thetapered extension323. Thehard sleeve331 has a pair ofannular flanges333 at its leading end defining anannular groove335 therebetween. When thesleeve331 is mounted on the softtapered extension323, the leadingface337 of thesleeve331 abuts the trailing end face of thering321 on thecollar305 and the trailingend face341 of thesleeve331 abuts the leading end face of thebeveled flange327 on thetapered extension323, locking thehard sleeve331 in place on thesoft extension323.
• Looking atFIGS. 27-35, theflexible connector360 for use with thecannula300 has aleading end adapter361, best seen inFIGS. 29-32. Theleading end adapter361 is a clamshell-type grip with bottom andtop shells367 and369. Theshells367 and369 extend from a trailingend face371 on a trailing connectingring373 to a leading connectingring375 separated by anarrower body377. As best seen inFIG. 35, theshells367 and369 are defined by aradial cut379 splitting the top half of the trailing connectingring373 and a horizontal diametric cut381 extending from theradial cut379 through the leading connectingring375. Theshells367 and369 are hinged383 at the top of theradial cut379. The leading connectingring375 hasgrooves385 defining aridge387 which will engage in thegroove335 on the leading end of thehard sleeve331 mounted on the soft taperedtubular extension323 of thecannula300. Atapered nozzle397 extends in a leading direction from the leading face of the trailing connectingring373. Thenozzle397 has anannular bead399 on the perimeter of its leading face. Aconcentric bead401 is provided on the leading face of the trailing connectingring373 around thenozzle397. Theannular bead399 on thenozzle397 abuts the inside wall of the soft taperedtubular extension323 of thecannula300 and theconcentric bead401 on the leading connectingring375 seats in thegroove329 on the leading face on thebeaded flange327 of the soft taperedtubular extension323 of thecannula300 when thesoft extension323 with thehard sleeve331 are longitudinally inserted into the clamshell of theconnector360. As best seen inFIGS. 29-32, flexiblyresilient supports403 extend radially outwardly from the top shell portion of thebody377 at thediametric cut381.Arms405 extend downwardly, considering the clamshell in the closed condition ofFIG. 35, from each of thesupports403 tofingers407 which extend diametrically inwardly from thearms405. The fingers40 havebeads409 on their upper inside edges. Thearms405 also extend upwardly from thesupports403 tocorrugated squeeze plates411 which aid in manually flexing thearms405 between the thumb and forefinger. To cooperate with thefingers407, L-shapedlugs413 extend upwardly, again considering the clamshell in the closed condition ofFIG. 35, from the bottom shell portion of thebody377 at thediametric cut381. When thetop shell369 is closed on thebottom shell367, thefingers407 snap under thelugs413 and thebeads409 engage the inside edges of thelugs413 to assure a stable engagement.
• Common Connector Components: Each of theflexible connectors160,260 and360 has its own uniqueleading end adapter161,261 and361 as above described. The trailingend adapters163,263 and363 andintermediate tubes165,265 and365 are substantially the same. Each of theintermediate tubes165,265 and365 has a hardannular seat191,291 and391 at its leading end. The connectingring173,273 and373 at the trailing end of eachleading end adapter161,261 and361 fits in and is fixed to theseat191,291 and391 of the leading end of theintermediate tube165,265 and365, as by ultrasonic welding. The trailingend adapters163,263 and363 have hardtubular extensions193,293 and393 withannular flanges195,295 and395 to facilitate manipulation of theconnectors160,260 and360 during attachment to the ventilator. The trailingend adapters161,261 and361 are fixed to the trailing ends of theirintermediate tubes165,265 and365, also as by ultrasonic welding.
• Common Operational Features of the Embodiments: For each of the different tracheotomy tubeouter cannulas100,200 and300, the correspondingcoupling160,260 and360 has aleading end adapter161,261 and361 which interlocks with its respective tracheotomy tubeouter cannulas100,200 and300 preventing them from inadvertently axially displacing from each other. However, non-axial force applied to the unlatching mechanisms disengage the associatedadapters161,261 and361 from its tracheotomy tubeouter cannula100,200 and300 so that thecoupling160,260 and360 can be axially displaced without exertion of excessive axial force on the system and the patient.
• Thus, it is apparent that there has been provided, in accordance with the invention, a ventilator to tracheotomy tube coupling that fully satisfies the objects, aims and advantages set forth above. While the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art and in light of the foregoing description. Accordingly, it is intended to embrace all such alternatives, modifications and variations as fall within the spirit of the appended claims.

Claims (16)

1. For connecting a ventilator tube having a connector at a leading end thereof to a tubular extension at a trailing end of a tracheotomy tube, a coupling comprising:

a tubular member;

means on a trailing end of said tubular member for connecting said trailing end of said tubular member in a pneumatic flow path to the ventilator tube leading end connector;

means on a leading end of said tubular member for mating said leading end of said tubular member in said pneumatic flow path with the tubular extension of the tracheotomy tube by motion of said mating means in a generally axial direction relative to the tubular extension; and

means on said means for mating for engaging with the tracheotomy tube during mating to prevent said leading end of said tubular member from axially displacing from the tubular extension after mating.

2. A coupling according toclaim 1 further comprising means on said means for engaging operable by application of force in a direction other than said generally axial direction for disengaging said engaging means from the tracheotomy tube.

3. For connecting a ventilator tube having a connector at a leading end thereof to a tracheotomy tube having an outer cannula and an inner cannula, the inner cannula being inserted into a trailing end of the outer cannula and having a tubular extension on a trailing thereof, a coupling comprising:

a tubular member;

means on a trailing end of said tubular member for connecting said trailing end of said tubular member in a pneumatic flow path to the ventilator tube leading end connector;

means on a leading end of said tubular member for mating said leading end of said tubular member in said pneumatic flow path with the tubular extension of the inner cannula by motion of said mating means in a generally axial direction relative to the tubular extension; and

means on said means for mating for engaging with the outer cannula during mating to prevent said leading end of said tubular member from axially displacing from the tubular extension after mating.

4. A coupling according toclaim 3 further comprising means on the inner cannula for disengaging said engaging means from the outer cannula by application of force to said mating means in other than said generally axial direction to permit said leading end of said tubular member to axially displace from the tubular extension of the inner cannula.

5. A coupling according toclaim 4, the trailing end of the outer cannula having opposed annular flanges and said means for engaging comprising opposed means for resiliently snapping over said flanges.

6. A coupling according toclaim 5, said means for disengaging comprising means on the inner cannula for spreading said opposed flanges during rotational motion of said mating means about a longitudinal axis of said tubular member.

7. For connecting a ventilator tube having a connector at a leading end thereof to a tracheotomy tube having an outer cannula and an inner cannula, the inner cannula being inserted into a trailing end of the outer cannula and the outer cannula having a tubular extension on a trailing thereof, a coupling comprising:

a tubular member;

means on a trailing end of said tubular member for connecting said trailing end of said tubular member in a pneumatic flow path to the ventilator tube leading end connector;

means on a leading end of said tubular member for mating said leading end of said tubular member in said pneumatic flow path with the tubular extension of the outer cannula by motion of said mating means in a generally axial direction relative to the tubular extension; and

means on said means for mating for engaging with the outer cannula during mating to prevent said leading end of said tubular member from axially displacing from the tubular extension after mating.

8. A coupling according toclaim 7 further comprising means on the outer cannula operable by application of force on said mating means in a direction other than said generally axial direction for disengaging said engaging means from the outer cannula to permit said leading end of said tubular member to axially displace from the tubular extension of the outer cannula.

9. A coupling according toclaim 8, the trailing end of the outer cannula having annularly opposed flat notches and said means for engaging comprising opposed means for resiliently snapping into said notches.

10. A coupling according toclaim 9, said means for disengaging comprising means on the outer cannula for spreading said opposed flanges during rotational motion of said mating means about a longitudinal axis of said tubular member.

11. For connecting a ventilator tube having a connector at a leading end thereof to a tracheotomy tube having a tubular extension on a trailing thereof, a coupling comprising:

a tubular member;

means on a trailing end of said tubular member for connecting said trailing end of said tubular member in a pneumatic flow path to the ventilator tube leading end connector;

means on a leading end of said tubular member for mating said leading end of said tubular member in said pneumatic flow path with the tubular extension of the tracheotomy tube by motion of said mating means in a generally axial direction relative to the tubular extension; and

means on said means for mating for engaging with the tracheotomy tube to prevent said leading end of said tubular member from axially displacing from the tubular extension after mating.

12. A coupling according toclaim 11 further comprising means on said mating means operable by application of force on said mating means in other than said generally axial direction for disengaging said engaging means from the tracheotomy tube to permit said leading end of said tubular member to axially displace from the tubular extension of the tracheotomy tube.

13. A coupling according toclaim 12, said mating means comprising a nozzle insertable into the tubular extension.

14. A coupling according toclaim 13, said engaging means comprising a clamshell, said clamshell and said tubular extension have complementary three-dimensional surfaces preventing axial displacement of said clamshell from said tubular extension gripped therein.

15. A coupling according toclaim 14, a half of said clamshell having diametrically opposite lugs and another half of said clamshell having diametrically opposite fingers for resiliently snapping over said lugs when said clamshell is closed.

16. A coupling according toclaim 15, said means for disengaging comprising means on said fingers for spreading said fingers to release said lugs in response to inward radial pressure on said spreading means.

Images