Endotracheal Tubes

SUMMARY OF THE ENDOTRACHEAL TBUE

Technology helps patients more comfortable,we get so much from new tech.The prior art endotracheal tube is a cylinder shaped tube that is used as a passage way to administer oxygen and special gases to a patient. It also serves a secondary function in that it blocks the trachea and prevents pulmonary aspiration (entering of food, foreign bodies or stomach contents into the lungs). The endotracheal tube is primarily used in surgery, although its placement is of utmost importance in a vast number of emergency situations.

In surgery, the patient is rendered unconscious by administration of drugs or gases. The patient’s mouth is opened and a lyringoscope blade is placed into the mouth. The blade slides down into the throat of the patient and a lifting force is applied in order to visualize the correct anatomical structures. The glottis, which is the opening between the vocal cords, is the target area in which the balloon end of the endotracheal tube of the present invention will enter the trachea. When the tube enters the glottis it is advanced into the trachea and the balloon is inflated with air to create an air tight seal of the trachea and lungs.

Patient anatomies differ greatly from one to another therefore, different tube curls may be required. In the patient with an anterior glottis (the vocal cords and glottis positioned high in the patient’s neck) intubation which is the act of placing the tube through the glottis, can be extremely difficult. This condition is usually undetectable until the vocal cords and glottis are actually visualized with a lyringoscope and blade. If the endotracheal tube can not be placed through the glottis because the angle is too great another attempt must be made. Therefore the endotracheal tube of the prior art and lyringoscope blade must be withdrawn and a stylet (a semi-rigid wire) must be placed into the endotracheal tube. The stylet is then bent to the approximate angle giving the endotracheal tube an upward lift or a “U” shaped appearance. Once this is accomplished another attempt must be made and pressure on the neck is usually applied to force the glottis down decreasing the anatomical angle and facilitating the intubation process. One must realize that this extra procedure takes more time to complete the intubation. Time is of utmost importance with patients who are in dire need of oxygen or those with full stomachs in which food could be regurgitated and aspirated into the lungs. Although both methods are used they leave much to be desired. For instance, placement of the stylet into the tube must be done either before or after the first intubation attempt has been made. The amount of bend or angle placed in the stylet is a mere guess that it will fit the patient’s natural anatomy. If the angle or curvature of the endotracheal tube and stylet are too great or not great enough the intubation progress must again be terminated momentarily and the stylet and tube must be reshaped. Again keep in mind that time is a very important factor and its prolonging could be crucial to the safety of the patient.

Another danger point with the stylet is that it can be advanced beyond the balloon tip of the endotracheal tube and protrude past the end of the tube. During intubation the protruding end of the stylet could puncture delicate soft tissue. If for instance, the vocal cords were damaged it could cause a permanent speech impediment. Therefore the stylet can assist with intubations but it can also cause major complications.

The other method of obtaining difficult intubations is by applying pressure to the neck. Patients with a severe anterior placed glottis, pressure will not bring the glottis low enough to intubate. In fact, in some cases when more pressure is required to decrease the anatomical angle, it can partially collapse the glottis opening. This decreases the internal diameter of the glottis and hinders the endotracheal tube from entering the trachea because of a size misfit

Originally published here.