United States Patent
`
`[19]
`
`[1 1]
`
`Patent Number:
`
`4,676,241
`
`Webb et al.
`[45] Date of Patent:
`Jun. 30, 1987
`
`
`4,274,406 6/1981 Bartholomew ..................... 128/912
`
`1/1982 Weikl et al.
`4,311,136
`604/284
`4,351,328 2/1982 Bodai .......
`128/207.15
`.. .. .. .. 285/272
`4,369,991
`1/1983 Linder ... ..
`4,416,273 11/1983 Grimes
`128/912
`l.
`4,506,665
`3/1985 A d
`128/912
`4,521,038 6/1985
`.................. 128/204.18
`OTHER PUBLICATIONS
`
`
`
`t
`
`[54] VENTILATION TUBE SWIVEL
`_
`_
`[75]
`Inventors: Richard 13- Webb, San_Antomo. Tex-;
`Charles S- L’HommedIeu. Oklahoma
`City, Okla.
`‘
`.
`.
`173] AS5‘S"e°= W-L-G T°°h"°l°8Y~ 5P““8v Tex
`1211 APP1 N°-* 820,534
`
`“Anesthesia Apparatus and Accessories Catalog”, Ohio
`Chemical Hospital Equipment and Medical Gases Cata-
`logue
`44.
`“Connector, Adapters and Valves”, Foregger Hospital
`Equipment Catalogue, Apr. 23, 1975, pp. 2-3.
`
`Pyjmgfy Exam[ner_I-Ienry J_ Recla
`Assistant Exam[nef._Kafjn M_ Reichle
`Attorney, Agent, or Firm——James E. Bradley
`
`ABSTRACT
`1571
`A connector swivel for connecting between a supply
`tubet artictlhan indotrétiheal _tu1;e accommcildates mogleeci
`men 0
`epaien.
`esw1ve connector asan ang
`central member, with the axes of its ends intersecting
`each other at an obtuse angle. The central member has
`end pieces rotatably connected to each end. One of the
`eff P*°°’=s;S 315;; 398,169 Wj;h.i9
`integjectins all?“
`g ."“le ‘mg °'
`° °‘ °' °“ P‘°°° ‘S stmg “md °y “"
`“Ca-
`,
`4 Claims, 5 Drawing Figures
`
`[22] Filed‘
`
`Jan‘ 21’ 1986
`.
`.
`Related U.S. Application Data
`Continuation-in-part of Ser. No. 570,997, Jan. 16, 1984,
`aband0Iled~
`
`[63]
`
`Int. Cl.4 ...................... ..
`U.S. C]. ........................ ..
`123/912; 504/230; 504/233; 235/163; 235/272
`[58] Field of Search .................... .. 128/207.14, 207.15,
`12s/207.17, 207.18, 910, 912, 204.18; 64/230,
`283, 234; 285/163. 168. 181, 184, 272
`References Cited
`us‘ PATENT DOCUMENTS
`142,879
`9/1873 Weaver ............................... 285/168
`
`2,820,651
`1/1958 Phillips -------
`123/204-13
`3:223:21‘? Z1333 §1§21’§;°§J:li. ‘:1:
`::::"1:sf/‘$112112
`3,670,726 6/1972 Mahon et al.
`..
`128/204.18
`3,964,488
`6/1976 Ring et al. ......
`128/207.18
`3,983,66O 4/1976 Eross ..........
`285/272
`4,240,417 12/1980 Holever .............................. 128/912
`
`
`
`[56]
`
`
`
`RMD 1016
`
`1
`
`RMD 1016
`
`

`
`U. S. Patent
`
`Jun. 30,1987
`
`Sheet 1 of2
`
`4,676,241
`
`2
`
`

`
`U. S. Patent
`
`Jun. 30,1987
`
`4,676,241
`
`3
`
`

`
`4,67 6,241
`
`1
`
`VENTILATION TUBE SWIVEL
`
`CROSS-REFERENCE TO RELATED
`APPLICATIONS
`
`This application is a continuation-in—part of applica-
`tion Ser. No. 570,997, filed Jan. 16, 1984, now aban-
`doned.
`
`BACKGROUND OF THE INVENTION
`1. Field of the Invention
`This invention relates in general to medical equip-
`ment, and in particular to ventilation tubes, such as
`endotracheal and tracheostomy tubes.
`2. Description of the Prior Art
`Whenever hospital patients require mechanical venti-
`lation, a ventilation tube delivers air or oxygen to the
`patient from a remote source. The end of the ventilation
`tube is either inserted into the patient’s nostril, or an
`incision is made so that the tube may be inserted directly
`into the patient’s trachea. If the patient moves, the tube
`may drag against sensitive tissue inside the patient’s
`nostril or trachea, causing pain and injury.
`One experimental ventilation tube, which somewhat
`alleviated this condition, had an angled central member
`inserted between the end of the ventilation tube and the
`air or oxygen source, near the patient. The angled cen-
`tral member was brass and had a threaded connection
`on each end. The angle in the central member eased the
`pressure some, but still did not allow the patient to
`move very much.
`Swivel couplings are used in some types of medical
`equipment to allow rotational movement. For example,
`~ U.S. Pat. Nos. 4,416,273 and 4,240,417 show couplings
`for an endotracheal tube having swivel connectors on
`each end. In each of these patents the swivel coupling
`allows only rotational movement, with no axial transla-
`tion.
`
`SUMMARY OF THE INVENTION
`A swivel connector is connected between the insert
`or endotrachael tube and the supply tube. The swivel
`connector includes an angled tubular central member.
`The central member has tubular ends, each ofwhich has
`an axis that intersects the other at an obtuse angle. An
`end piece is rotatably coupled to each end of the central
`member. One of the end pieces is a straight cylindrical
`member. The other end piece is angled, also. It has an
`axis on each end that intersects the other at an obtuse
`angle. One of the end pieces is connected to the insert
`tube and the other is connected to the gas supply tube.
`The swivel connections, the angled end piece and
`angled central member allow rotational and transla-
`tional movement of the supply tube relative to the insert
`tube.
`The above as well as additional objects, features, and
`advantages of the invention will become apparent in the
`following detailed description.
`BRIEF DESCRIPTION OF THE DRAWINGS
`FIG. 1 is a side view of a ventilation tube connector
`connecting a supply tube to an endotraecheal tube in- 55
`serted into a patient’s nostril.
`FIG. 2 is an exploded side view of the connector of
`FIG. 1.
`
`2
`FIG. 3 is a perspective view of the connector of FIG.
`1, with the endotracheal tube and the supply tube not
`being shown.
`FIG. 4 is a vertical sectional view of the connector of
`FIG. 1, showing the connector in one position.
`FIG. 5 is vertical sectional view of the connector of
`FIG. 1, showing the connector in another position.
`DESCRIPTION OF THE PREFERRED
`EMBODIMENT
`
`FIG. 1 illustrates an endotracheal or insert tube 11
`inserted into the nostril of a patient 13. Insert tube 11 of
`this nature are also inserted into the trachea, with access
`provided through an incision made in the throat of the
`patient. Insert tube 11 is a flexible plastic member of
`conventional design.
`A resilient plastic swivel connector 15 is connected to
`the insert tube 11. Swivel connector 15 connects the
`insert tube 11 with a conventional supply tube adapter
`17. Referring to FIG. 2, the supply tube adapter 17 has
`three tubular ends or ports. To facilitate the description
`herein,
`the term “inner” will refer to the direction
`toward the patient, while the term “outer” will refer to
`the opposite direction. The inner end 17a inserts tightly
`over the outer end of connector 15. The outer ends 17b
`and 17c each insert over a hose 18. One of the hoses 18
`(only one shown) is connected to a supply source (not
`shown) for supplying gas for breathing. The other hose
`18 allows the exhaust of gas from the patient’s lungs. A
`valve mechanism (not shown) prevents flow from the
`supply source in one hose 18 from flowing through one
`end 17b or 17c and out the other end 17b or 17c to the
`other hose 18 to exhaust. Supply tube adapter 17 is a
`hollow plastic member, with each of the ends 1711. 17b,
`and 17c being in fluid communication with each other.
`The adapter 17 shown in the drawing has a Y configura-
`tion.
`Referring to FIG. 4, the connector 15 includes a first
`tubular end piece 19. The end piece 19 has an inner end
`21 that is a female tubular member. The first end piece
`19 has an outer end 23 that is also tubular female mem-
`ber, but is of a smaller inner diameter than the inner end
`21. This results in an internal shoulder 24 facing in-
`wardly.
`The inner end 21 is adapted to receive in tight fric-
`tional contact the outer end of the insert tube 11. The
`inner end 21 has a central axis 25 that will coincide with
`the axis of the insert tube 11 at the point where they
`connect. The first end piece 19 is angled, with the outer
`end 23 having a central axis 27 that intersects the axis 25
`of the inner end 21. The intersection point occurs about
`one-third along the total length of the first end piece 19,
`and is closer to the outer end 23 then to the inner end 21.
`The angle 29 of intersection is obtuse, being greater
`than 90 degrees. Preferably, the angle 29 is 135 degrees.
`Referring to FIGS. 2, 4 and 5, the swivel connector
`15 also includes a tubular central member 31 that con-
`nects to the first end piece 19. The central member 31 is
`also an angled member, and has an inner end 33 and an
`outer end 35, both of which are male tubular members.
`Each end 33, 35 has a protuding rim 37 at the extreme
`end. Four slots 39 are cut into the sidewall of each end
`33, 35, at the rim 37 to facilitate radial compression of
`the rim 37. The outer diameter of the inner end 33 is
`slightly less than the inner diameter of the outer end 23
`of the first end piece 19. The rim 37 locates on the inner
`side of the internal shoulder 24 to retain the first end
`piece 19 and the central member 31 together.
`
`4
`
`

`
`3
`The inner end 33 of the central member 31 has a
`central axis that is coaxial with the axis 27 of the outer
`end 23 of the first end piece 19, and thus not separately
`numbered. The outer end 35 of the central member 31
`has a central axis 41 that intersects the axis 27 at an
`obtuse angle 43, being greater than 90 degrees. Prefera-
`bly, the angle 43 is 135 degrees.
`As shown in FIG. 2, the central member has a central
`portion of larger outer diameter than the reduced outer
`diameters of the ends 33 and 35. This results in oppo-
`sitely facing external shoulders 44 and 46. Shoulder 44
`contacts the edge of the outer end 23 of the first end
`piece 19.
`A second end piece 45 is rotatably coupled to the
`outer end 35 of the central member 31. The second end
`piece 45 is a straight cylindrical member which has a
`central axis that is coaxial with axis 41 of the outer end
`35 of the central member 31, and thus not separately
`numbered. This axis 41 also is coaxial with the axis of
`the supply tube adapter inner end 17a where it is joined
`to the second end piece 45. The second end piece 45 has
`a female inner end 47 and a male outer end 49. The inner
`end 47 is smaller in diameter than the outer end 49,
`resulting in an ouwardly facing internal shoulder 51.
`The rim 37 of the outer end 35 of the central member 31
`locates outwardly of the internal shoulder 51 to retain
`the second end piece 45 on the central member 31. The
`inner diameter of the inner end 47 is slightly greater
`than the outer diameter of the central member outer end
`' 35, providing a freely rotatable connection. The edge of
`the inner end 47 of the second end piece 45 abuts against
`the external shoulder 46 on the central member 31 for
`sliding contact.
`.
`The outer end 49 of the second end piece 45 is
`adapted to be pushed into the end 17a of the supply tube
`adapter 17, where it is retained by a frictional lit. Each
`of the first and second end pieces 19 and 45 have a pair
`of lugs 53 on each side to facilitate rotation and han-
`dling. The rotatable connections between the end pieces
`19 and 45 with the central member 31 provide an unre-
`stricted passage through the swivel connector 15. Also,
`the nonrotatable, friction tit connections of the insert
`tube 11 with the first end piece 19 and the supply tube
`adapter 17 with the second end piece 45, provide unre-
`stricted passage of gas through the swivel connector 15.
`All of the connections are tight enough to form suffi-
`cient seals to withstand the normal pressures incurred
`for this type of apparatus.
`'
`The swivel connector 15 is assembled by pushing the
`end pieces 19 and 45 over the ends of the central mem-
`ber 31. The rims 37 will deflect during insertion due to
`the slots 39, but will snap into place against the internal
`shoulders 24 and 51. It will normally be preassembled
`prior to shipment.
`To install the swivel connector 15, first the tube 11
`will be inserted into the nostril of the patient or into the
`throat through an incision. The swivel connector 15 is
`connected to the insert tube 11 by pressing the end of
`the tube 11 into the first end piece 19 to form a tight
`frictional fit. The supply tube adapter 17 is connected to
`the swivel connector 15 by pressing its end 17a over the
`second end piece 45. Hoses 18 are inserted into the ends
`17b and 17c of the supply adapter 17. This allows gas to
`be transmitted between the gas supply and exhaust
`hoses 18 and the patient 13.
`The angled end piece 19 and angled central member
`31, along with the rotatable connections, allow consid-
`erable movement of the hoses 18 relative to the insert
`
`20
`
`30
`
`60
`
`65
`
`4, 676,24]
`
`4
`tube 11. As shown by comparing FIGS. 4 and 5, in one
`position, the outer end 35 of the central member 31 is
`pointing downwardly with the axis 41 being perpendic-
`ular to the axis 25. If one rotates the central member 31
`while holding the first end piece 19 stationary, the axis
`41 will rotate in a conical path about its intersection
`with the axis 27. It would define a cone, with the apex
`of the cone being at the intersection of axis 27 with axis
`41. When rotated 180 degrees from position shown in
`FIG. 4, the axis 41 will be parallel with the axis 25, but
`offset. While the central member 31 is rotated, the sec-
`ond end piece 45 is also allowed to rotate relative to the
`central member 31. The multiple positions between the
`two positions shown in FIG. 4 and FIG. 5 allow the
`patient 13 to move relative to the hoses 18 without
`painful movement of the insert tube 11.
`The invention has significant advantages. The patient
`will be allowed to move his head and body without
`moving the insert tube relative to his throat, thus avoid-
`ing pain. The connector is simple and inexpensive to
`manufacture.
`While the invention has been shown in only one of its
`forms, it should be apparent to those skilled in the art
`that it is not so limited, but is susceptible to various
`changes without departing from the scope of the inven-
`tion.
`We claim:
`1. In a ventilation system of the type having an insert
`tube adapted for insertion into a breathing passage in a
`patient, a supply tube adapter of a type having one
`proximal and two distal tubular ends in fluid communi-
`cation with each other, one of the distal ends being
`adapted to be connected to a source of gas, another of
`the distal ends being adapted to be connected to an
`exhaust hose, an improved connection means adapted to
`be releasably connected between the insert tube and the
`proximal end of the supply tube adapter, comprising in
`combination:
`an angled tubular central member having a passage
`therethrough for the passage of gas, the central
`member having two tubular ends, each of which
`has a central axis, said central axes intersecting
`with each other at an obtuse angle;
`first tubular end piece having a passage there-
`through for the passage of gas and only two tubular
`ends, the first tubular end piece having one of its
`tubular ends rotatably connected to one end of the
`central member for the passage of gas therebe-
`tween and the other of its tubular ends having
`means for releasable and frictional joining to the
`insert tube for the passage of gas therebetween,
`each end of the first tubular end piece having a
`central axis, said central axes in the first tubular end
`piece intersecting each other at an obtuse angle;
`and
`a second tubular end piece having a passage there-
`through for the passage of gas, the second tubular
`end piece having one tubular end rotatably con-
`nected to the other end of the central member for
`the passage of gas therethrough and another tubu-
`lar end having means for releasable and frictional
`joining to the proximal end of the supply tube
`adapter for the passage of gas therebetween;
`the connection of the end pieces to the central mem-
`ber and the end pieces to the insert tube and supply
`tube adapter providing a continuous passage for
`the transmission of gas;
`
`5
`
`

`
`4,676,241
`
`5
`the rotatable connections of the tubular end pieces
`with the central member along with the intersect-
`ing central axes of the angled central member ac-
`commodating relative movement between the pa-
`tient and insert tube and the supply tube adapter.
`2. The system according to claim 1 wherein the sec-
`ond end piece is a straight cylindrical tubular member.
`3. The system according to claim 1 wherein the sum
`of the two obtuse angles is substantially 270 degrees.
`4. A ventilation tube system for a patient, comprising
`in combination:
`an insert tube adapted to be inserted into a breathing
`passage of the patient;
`a supply tube adapter having a proximal tubular end
`and two tubular distal ends in fluid communication
`with each other, one of the distal ends being
`adapted to be connected to a source of gas for
`supplying gas to the patient, the other of the distal
`ends being adapted to be connected to an exhaust
`hose for exhausting gas from the patient;
`an angled tubular central member having a passage
`therethrough for the passage of gas, the central
`member having proximal and distal tubular ends,
`each of which has a central axis, said central axes
`intersecting with each other at an angle that is
`substantially 135 degrees;
`first
`tubular end piece having a passage there-
`through for the passage of gas, the first end piece
`having only two tubular ends, one of the tubular
`ends being a distal tubular end which is inserted
`within and rotatably connected to the proximal end
`of the central member for the passage of gas there-
`through, the other tubular end of the first end piece
`being a female tubular proximal end that receives
`therein in frictional contact one end of the insert
`tube for the passage of gas therethrough, each
`tubular end of the first end piece having a central
`axis, said central axes in the first end piece inter-
`secting each other at an angle that is substantially
`
`6
`135 degrees, with the central axis of the distal end
`of the first end piece being coaxial with the central
`axis of the proximal end of the central member;
`a second tubular end piece having a passage there-
`through for the passage of gas, the second end
`piece having a proximal tubular end which is in-
`serted within and rotatably connected to the distal
`end of the central member for the passage of gas
`therethrough the second end piece having a distal
`male tubular end which is inserted within and fric-
`tionally received by the proximal end of the supply
`tube adapter;
`the second tubular end piece having a straight cylin-
`drical configuration with a central axis that is coax-
`ial with the central axis of the distal end of the
`central member;
`the connection of the insert tube with the first end
`piece, the first end piece with the central member,
`the central member with the second end piece, and
`the second end piece with the supply tube adapter,
`providing a continuous passage for gas to and from
`the patient;
`the rotatable connections and the angles of the first
`end piece and the central member allowing the
`distal end of the second end piece to rotate in a
`conical path with the apex of the cone at the inter-
`section of the central axis of the second end piece
`with the central axis of the proximal end of the
`central member, the conical path defining one posi-
`tion wherein the central axis of the second end
`piece is perpendicular to the central axis of the
`proximal end of the first end piece, and another
`position wherein the central axis of the first end
`piece is parallel to the central axis of the proximal
`end of the first end piece, to accommodate relative
`movement between the patient and insert tube and
`I
`I
`3
`I
`I
`supply tube adapter.
`
`6