Abstract:
Forceps with a pair of scissor-like arms that are pivotally connected to each other and that continue past the pivot to form a catheter guide. At least two and preferably three bends are disposed in the arms immediately before the pivot, which allow the medical professional to place the guiding end of the forceps in the correct place while maintaining good visual contact with the patient&#39;s vocal cords. An alternative embodiment provides a fourth bend near the guiding end of the forceps that allows for easier insertion of a catheter in some patients, such as children.

Description:
FIELD OF THE INVENTION  
       [0001]     The present invention relates generally to medical equipment. More particularly, the present invention relates to intubation aides, such as forceps, used to guide tubes during insertion into a patient&#39;s body.  
       BACKGROUND OF THE INVENTION  
       [0002]     Medical professionals have used various tools and implements in their treatment of patients, both human and animal, since the beginning of the profession. (For ease of reference, patients hereinafter will be discussed as human patients. It is understood that the invention described herein could be used on any animal.) Various procedures involve insertion of a catheter into a patient, including oral or nasal endotracheal intubation, during which a medical professional inserts a nasal or oral endotracheal tube into the patient&#39;s trachea to assist with the patient&#39;s ventilation.  
         [0003]     In order to assist with endotracheal intubation, an implement, such as forceps, is used by the medical professional to guide and/or direct the catheter into the proper place. Another implement, called a laryngoscope, is used during nasal and oral endotracheal intubation to secure the patient&#39;s tongue and lift the mandible, i.e. jaw, to expose the vocal cords. When the patient&#39;s head is tilted back, as is done during the intubation procedure, and the tongue and jaw are stabilized and properly secured, the medical professional performing the intubation will have an unobstructed view of the patient&#39;s vocal cords, provided there are no foreign objects or fluids in the patient&#39;s mouth. However, when the medical professional inserts any of the currently-available guiding forceps into the patient&#39;s mouth, the medical professional&#39;s view is severely obstructed by his or her hand and by the forceps. Also, the currently-available forceps do not grasp and control the tube adequately. This makes the process of endoctracheal intubation more difficult and more time-consuming, which could mean the difference between life and death for a patient that requires assistance with ventilation.  
         [0004]     One example of currently-available forceps is described in U.S. Pat. No. 3,316,913 to Swenson. The Swenson patent discloses locking catheter-guiding forceps that have a slight bend in the handles. When closed, the ends of the forceps define opposed gripping surfaces that are used to guide insertion of a catheter. The angle of the bend in the handles makes using the forceps disclosed in the Swenson patent difficult because the medical professional&#39;s hand will block his or her view into the patient&#39;s body.  
         [0005]     U.S. Pat. No. 4,552,143 to Lottick, U.S. Pat. No. 5,797,919 to Brinson, U.S. Pat. No. 5,591,203 to Fahy, and U.S. Pat. No. 5,476,479 to Green all disclose medical implements that have an end that, when the implements&#39; handles are closed, define a circular opening through which various items can be passed. These implements are all lacking, however, in that they do not allow the medical professional to have clear view and access to difficult areas to reach in a patient&#39;s body, such as during nasal or oral endotracheal intubation.  
         [0006]     In endotracheal intubation situations, a key problem with many currently-available medical forceps is that the medical professional is required to grip or grab the nasally or orally-inserted catheter tube in the back of the pharynx and try to place the tube through the patient&#39;s vocal cords by frequently gripping and re-gripping the lubricated catheter tube, which is also coated with nasal and oral secretions and possibly blood in a traumatic situation. These forceps frequently have serrated edges or teeth, which assist in gripping the catheter tube but also can snag or catch on the soft tissues inside the patient&#39;s mouth and throat and damage the patient&#39;s vocal cords. Even if the patient is not harmed, these sharp edges on the forceps can rupture the balloon on the lower end of the catheter, which must be inflated once the catheter is inserted past the patient&#39;s vocal cords to create an air-tight seal and allow for ventilation.  
         [0007]     Therefore, there exists a need to provide catheter-guiding forceps that allow a medical professional to have easy access to difficult-to-reach areas of a patient&#39;s body, such as in an oral or nasal endotracheal intubation, while simultaneously allowing the medical professional to have an unobstructed or virtually unobstructed view of the area in the patient&#39;s body in which the medical professional is working, such as the patient&#39;s vocal cords. Further, there exists a need to provide forceps that allow a catheter tube to easily pass through the forceps instead of requiring frequent re-gripping of the slippery catheter tube.  
       SUMMARY OF THE INVENTION  
       [0008]     Generally, the present invention comprises forceps with a pair of scissor-like handles that are pivotally connected to each other and that continue past the pivot to form a pair of arms. There are at least two key bends in the handles immediately before the pivot, which allow the medical professional to place the distal, guiding end of the forceps in the correct place within the pharynx while simultaneously permitting good visual contact with the area of concern, particularly the patient&#39;s vocal cords, because the medical professional&#39;s hand holding the forceps is not in his or her line of sight of the area through which the tube is to be placed while using the forceps. During endotracheal intubation, the medical professional places the forceps into the area of the patient&#39;s oropharynx (i.e., the back of the throat). Then, the catheter tube can be guided through the forceps and past the patient&#39;s vocal cords through the glottis (i.e., the aperture through the vocal cords), where ventilation is maintained. The medical professional does not have to grip and re-grip the catheter tube during this process, eliminating the risk of harm to the patient and damage to the catheter tube that re-gripping may cause. Further, this invention does not have sharp edges or ridges to catch or snag either the patient&#39;s tissue or the balloon-like portion associated with the catheter tube. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0009]      FIG. 1  is a left side elevational view of a prior art medical implement.  
         [0010]      FIG. 2  is a left side elevational view of the implement of the present invention with the arms closed.  
         [0011]      FIG. 3  is a left side elevational view of the implement of  FIG. 2  with the arms open.  
         [0012]      FIG. 4  is a top plan view of  FIG. 2 .  
         [0013]      FIG. 5  is a right side elevational view of  FIG. 2 .  
         [0014]      FIG. 6  is a left side elevational view of an alternative embodiment of the present invention.  
         [0015]      FIG. 7  is a side cutaway view illustrating the use of the present invention in a patient.  
         [0016]      FIG. 8  is a diagrammatic representation showing the use of the present invention in a patient.  
         [0017]      FIG. 9  is a plan view showing the invention being used in a patient.  
         [0018]      FIG. 10  is a left side elevational view of a further a further embodiment of the invention.  
         [0019]      FIG. 11  is a left side elevational view of a still further embodiment of the invention.  
         [0020]      FIG. 12  is an enlarged detail of the distal end of the device of the embodiment of  FIG. 11 .  
         [0021]      FIG. 13  is plan view of the distal end shown in  FIG. 12 . 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0022]     A catheter guiding device  1  that currently exists in the art is depicted in  FIG. 1 . A pair of handles  5 ,  10  each defines an aperture  2 ,  3  for a user to insert a finger and thumb. The handles  5 ,  10  are integrally connected to a pair of arms  15 ,  20 . The handle  5  and arm  15  is pivotally connected to the handle  10  and arm  20  through a pivot  50 . Each arm  15 ,  20  has an end  30 ,  35 , respectively, that is D-shaped with parallel, sharp serrations on the interior surfaces. When using this device to insert a catheter into a patient, a medical professional will insert his or her fingers into the apertures  2 ,  3  and open the handles  5 ,  10 , which correspondingly open the arms  15 ,  20 . The health care professional will then close the handles  5 ,  10 , accordingly closing the arms  15 ,  20 , so that the ends  30 ,  35  grip the catheter. The device  1  is then used to push the catheter through the patient&#39;s vocal cords to allow ventilation or to insert the catheter into any other part of the patient&#39;s body as deemed necessary by the medical professional.  
         [0023]     The device  1  does not allow for guiding of the catheter because the ends  30 ,  35  must grip the catheter and are used to push the catheter a short distance, which is repeated numerous times so as to advance the catheter. Further, because of the presence of his or hand due to the bent section  60  of the device  1 , the medical professional using the device  1  will be blocked from viewing of the patient&#39;s vocal cords or other body part into which the catheter will be inserted.  
         [0024]     The present invention can be more fully understood with reference to  FIGS. 2-11 , in which like reference numerals designate like items.  FIG. 2  depicts the forceps  101 , which is an improvement over the device  1  currently in use. The pair of handles  105 ,  110  of the forceps  101  each defines a gripping section  102 ,  103 , respectively, upon which the medical professional can place his or her fingers to use the forceps  101 . Gripping sections  102 ,  103  can be of any shape. The shape shown is only illustrative. The handles  105 ,  110  are integrally connected to a pair of arms,  115 ,  120 . The handle  105  and arm  115  is pivotally connected to the handle  110  and arm  120  at a pivot  150 . Each arm  115 ,  120  has an end  130 ,  135 , respectively, that is substantially semicircular in shape; however, the shape of the ends  130 ,  135  may, within the scope of the invention, be any shape that would allow the ends  130 ,  135  to form a guide when in the closed position such that a catheter may be easily passed therethrough. When the arms  115 ,  120  are in the closed position as shown in  FIGS. 2 and 4 - 7 , the ends  130 ,  135  together form a hollow guide adapted to receive and guide the catheter so that the catheter can be advanced through the patient&#39;s vocal cords. In the closed position, the interior surface of the hollow guide formed by the ends  130 ,  135  is preferably slightly larger than 8 mm across, which is slightly larger than the diameter of a standard-sized catheter used for medical purposes today. It is understood that the size of the guide formed by the ends  130 ,  135  may be varied within the scope of this invention depending upon the diameter of the catheter, including but not limited to catheters that are used in infant patients. All that is required is that the catheter be able to be slid or translated within the guide when the guide is in the closed position.  
         [0025]     When using this device to insert a catheter into a patient, a health care professional will insert his or her fingers into the apertures  102 ,  103  and open the handles  105 ,  110 , which correspondingly open the arms  115 ,  120 .  FIG. 3  depicts the forceps  101  in the open position. The catheter is then inserted through the circular aperture defined by the ends  130 ,  135  of the arms  115 ,  120 . The arms  115 ,  120  are positioned so that the guide is placed in registry with the patient&#39;s glottis (the opening in the vocal cords) so that the catheter can be accurately inserted into the proper location in the patient&#39;s body, such as through the patient&#39;s vocal cords. The first bend  140  and the second bend  145  allow the medical professional to have an unobstructed view of the patient&#39;s vocal cords or other body part into which the catheter is to be inserted. This allows for faster and more accurate insertion of the catheter, without the risk of harm to the patient or damage to the catheter that arises when the medical professional must grip and re-grip the catheter as with currently-available devices, such as the device depicted in  FIG. 1 .  
         [0026]      FIG. 4  depicts the forceps shown in  FIG. 2  from the top. The first bend  140 , second bend  145 , and third bend  147  are clearly visible from this view. The combination of the first bend  140  and second bend  145  provides the medical professional with an unobstructed view of the patient&#39;s vocal cords because the user&#39;s hand that holds the forceps is off to the side of the mouth while the guide is in registry with the glottis. The third bend  147  contributes to the unobstructed view of the patient&#39;s vocal cords. The first bend  140  is bent about an axis A to create an obtuse angle. The second bend  145  is bent about an axis B to create an obtuse angle that is preferably, but not necessarily, approximately 120°. The third bend  147  is bent about an axis C to create an obtuse angle that is preferably, but not necessarily, approximately 150°.  
         [0027]      FIG. 5  is a right side view of the forceps shown in  FIG. 2 . The arms  115 ,  120  and the ends  130 ,  135  are smooth, having no sharp edges or teeth that could harm a patient&#39;s tissue or damage the balloon portion of a catheter.  
         [0028]     An alternative embodiment of the forceps  201  is depicted in  FIG. 6 . The pair of handles  205 ,  210  of the forceps  201  each defines an aperture  202 ,  203  through which the medical professional can insert his or her fingers to use the forceps  201 . The handles  205 ,  210  are integrally connected to a pair of arms  215 ,  220 . The handle  205  and arm  215  is pivotally connected to the handle  210  and arm  220  at a pivot  250 . Each arm  215 ,  220  has an end  230 ,  235 , respectively, that is substantially semicircular in shape; however, the shape of the ends  230 ,  235  may, within the scope of the invention, be any shape that would allow the ends  230 ,  235  to form a guide when in the closed position such that a catheter may be easily passed therethrough. When the arms  215 ,  220  are in the closed position as shown in  FIG. 6 , the ends  230 ,  235  together form a hollow guide adapted to receive and guide the catheter so that the catheter can be advanced into the patient&#39;s glottis. In the preferred embodiment, when the arms are in their closed position, the interior surface of the hollow guide formed by the ends  230 ,  235  is preferably slightly larger than 8 mm across, which is slightly larger than the diameter of a standard-sized catheter used for medical purposes today. It is understood that the size of the guide formed by the ends  230 ,  235  may be varied within the scope of this invention depending upon the diameter of the catheter, including but not limited to catheters that are used in infant patients.  
         [0029]     The forceps  201  has a first bend  240  and a second bend  245  that together allow the medical professional to have an unobstructed view of the patient&#39;s glottis and vocal cords or other body part into which the catheter is to be inserted. The difference between the forceps  101  and the forceps  201  is that the forceps  201  has a fourth bend  280  located immediately before the ends  230 ,  235 . The fourth bend  280  rotates the ends  230 ,  235  approximately fifteen degrees clockwise from their standard position, although a greater or lesser magnitude of bend may be desirable as will occur to the person of skill in the art. Also, the bend  280  may be as shown (acute) or may rotate the ends  230 ,  235  in the opposite direction, creating an obtuse angle. The angle of insertion of a catheter through the ends  230 ,  235  is changed by the fourth bend  280 , allowing for an easier insertion in patients that have a shorter neck, such as children or small adults. It is understood that the degree of the angle of the fourth bend  280  may vary according to the needs of a particular situation within the scope of this invention.  
         [0030]      FIGS. 7 through 9  illustrate the use of the forceps  101  and a laryngoscope  450  in a patient. Nasal endotracheal intubation is illustrated in  FIG. 7 , wherein a ventilation tube  400  is inserted into the patient&#39;s nose and passed through the patient&#39;s sinus cavity into the back of the patient&#39;s throat. A laryngoscope  450  is used to secure the patient&#39;s tongue and provide light to the patient&#39;s throat. As the medical professional holds the forceps  101  in registry with the patient&#39;s glottis  500 , a medical assistant, such as a nurse, will advance the ventilation tube  400  through the ends  130 ,  135  of the forceps  101  and through the patient&#39;s glottis  500 . After being properly located, the balloon portion  420  of the ventilation tube  400  is inflated to secure a seal and allow for proper ventilation.  
         [0031]     An alternative embodiment of the forceps  601  is depicted in  FIG. 10 . The pair of handles  605 ,  610  of the forceps  601  each defines an aperture  602 ,  603  through which a medical professional can insert his or her fingers to use the forceps  601 . The handles  605 ,  610  are integrally connected to a pair of arms  615 ,  620 , respectively. The handle  605  and arm  615  is pivotally connected to the handle  610  and arm  620  at pivot  650 . Each arm  615 ,  620  has an end  630 ,  635 , respectively, that is substantially shaped as half of a cone (or, alternatively, as half of a cylinder); when the arms  615 ,  620  are in the closed position as shown in  FIG. 10 , the ends  630 ,  635  together form a cone-shaped (or cylindrically-shaped) guide adapted to receive and guide a catheter so that the catheter can be advanced into the patient&#39;s glottis. The diameter of the cone-shaped ends  630 ,  635 , when closed, is preferably slightly larger than 8 mm across at its narrowest point. The portion of the ends  630 ,  635  that is closer to the handles  605 ,  610  preferably has a diameter larger than 8 mm. In the closed position, the interior surface of the hollow guide formed by the cone-shaped ends  630 ,  635  acts as a funnel of sorts to allow the medical professional to more easily guide the end of a catheter through the cone-shaped ends  630 ,  635 . It is understood that the size of the guide formed by the ends  630 ,  635  may be varied within the scope of this invention depending upon the diameter of the catheter, including but not limited to catheters that are used in infant patients. The forceps  601  has a first bend  640  and a second bend  645  that together allow the medical professional to have an unobstructed view of the patient&#39;s glottis and vocal cords or other part into which the catheter is to be inserted.  
         [0032]     Another alternative embodiment of the forceps  701  is depicted in  FIGS. 11-13 . The pair of handles  705 ,  710  of the forceps  701  each defines an aperture  702 ,  703  through which the medical professional can insert his or her fingers to use the forceps  701 . The handles  705 ,  710  are integrally connected to a pair of arms  715 ,  720 , respectively. The handle  705  and arm  715  is pivotally connected to the handle  710  and arm  720  at a pivot  750 . Each arm  715 ,  720  has an end  730 ,  735 , respectively, that is substantially semi-circular in shape. However, the shape of the ends  730 ,  735  may, within the scope of the invention, be any shape that would allow the ends  730 ,  735  to form a guide when in the closed position such that a catheter may be easily passed therethrough. When the arms  715 ,  720  are in the closed position as shown in  FIG. 11 , the ends  730 ,  735  together form a hollow guide adapted to receive and guide the catheter so that the catheter can be advanced into the patient&#39;s glottis. In the closed position, the interior surface of the hollow guide formed by the ends  730 ,  735  is preferably slightly larger than  8 mm across, which is slightly larger than the diameter of a standard-sized catheter used for medical purposes today. It is understood that the size of the guide formed by the ends  730 ,  735  may be varied within the scope of this invention depending upon the diameter of the catheter, including but not limited to catheters that are used in infant patients.  
         [0033]     The forceps  701  has a first bend  740  and a second bend  745  that together allow the medical professional to have an unobstructed view of the patient&#39;s glottis and vocal cords or other body parts into which the catheter is to be inserted. Ends  730 ,  735  are pivotally connected to arms  715 ,  720 , respectively, by joints  775 ,  780 . The joints  775 ,  780  are preferably located about the same axis, as indicated in  FIG. 12 . The ends  730 ,  735  are permitted to rotate about the joints  775 ,  780  to allow for immediate adaptation of the forceps  701  to the angle of insertion required by a patient&#39;s body. Any suitable means may be employed for releasably retaining the ends  730 ,  735  in any desired angular position relative to arms  715 ,  720 , such as opposed serrations or teeth (not shown). Other retention structure will be apparent to those of skill in the art. However, retention structure need not necessarily be used. In this manner, the medical professional using the forceps  701  is not required to change the instrument he or she is using upon discovering that a different angle of insertion of a catheter is required by a particular patient&#39;s anatomy.  
         [0034]     Benefits, other advantages, and solutions to problems have been described above with regard to specific embodiments of the present invention. However, the benefits, advantages, solutions to problems, and any element(s) that may cause or result in such benefits, advantages, or solutions to become more pronounced are not to be construed as a critical, required, or essential feature or element of any or all the claims. As used herein and in the appended claims, the terms “comprises,” “comprising” or any other variation thereof is intended to refer to a non-exclusive inclusion, such that a process, method, apparatus, or article of manufacture that comprises a list of elements does not include only those elements in the list, but may include other elements not expressly listed or inherent to such process, method, apparatus, or article of manufacture.