Manual respirator apparatus for use with automatic respirators

A manual respirator apparatus for connection to an inhalation line connected between an automatic respirator and a patient and usable with a breathing gas supply under pressure, comprises, a block housing having a breathing gas supply inlet connected to the breathing gas supply, an inhalation line connectable to the inhalation line and an inhalation line outlet connectable to the patient and an exhalation inlet connected from the patient to the block housing. The block housing has a pressure chamber therein and is connected to an elastic breathing gas bag. A connection housing in the passage between the inlet from the gas supply line to the pressure chamber has adjusting valve means in the pressure chamber responsive to the pressure therein and to the fluctuation of the elastic breathing gas bag to permit flow of respirator gas through the connecting passage. A delivery passage is defined between the pressure chamber and the inhalation line and it contains one or more outlet valves which are openable at predetermined pressures to pass the respective gas from the pressure chamber into the inhalation line. The exhalation line is connected into the block housing at the location of a diaphragm chamber which has a diaphragm closing the exhalation gas inlet during the inhalation cycle. The diaphragm is pressured by a gas supplied from the pressure chamber and when this pressure chamber pressure goes down, the exhalation line opens to accept gas into the block housing. The exhalation gas is then passed outwardly, for example, for use in measurement devices and perhaps circulated back to the block housing for delivery through an anaesthesia gas scavenging bag and then eventual discharge to atmosphere.

FIELD AND BACKGROUND OF THE INVENTION 
This invention relates to respirators in general and, in particular, to a 
new and useful manual respirator apparatus for connection to an inhalation 
line connected between an automatic respirator and a patient, and which is 
usable with a breathing gas supply under pressure. 
DESCRIPTION OF THE PRIOR ART 
Respirators and/or anesthesia respirators are often controlled 
electronically and are thus dependent on an electirc power supply for 
their operation. In the event of a power failure, however, it is 
absolutely necessary for the patients to be continuously supplied with 
breathing gas. In this event, the breathing gas is supplied by a manual 
respirator apparatus. For the safe operation of such apparatus, it must be 
easy to connect as well as to operate. 
A known respirator for manual operation has an elastically compressible 
reservoir bag. By rhythmic compression followed by its spontaneous 
expansion by means of the elastic recoil of this bag, oxygen-enriched gas 
is drawn from a container and forced into the patient's lungs through a 
line connected with the bag. For this purpose, the reservoir bag is 
equipped at its outlet end with an outlet valve connectable to a breathing 
mask or to an endotracheal tube, and, at its inlet end, it is provided 
with an inlet valve which is connected to an oxygen supply container. Upon 
compression of the reservoir bag, the outlet valve opens to expel of the 
breathing gas present in the bag while, at the same time, the inlet valve 
closes. 
Upon expansion of the bag, the outlet valve is closed and the inlet valve 
opens, so that breathing gas can be sucked into the bag again. By means of 
a pressure equalizing vessel, which is also connected to the inlet valve, 
it is ensured that an overpressure which would cause the outlet valve to 
remain open cannot build up in the reservoir bag by the inflowing 
breathing gas. In that case, the patient would be pressurized by the 
breathing gas continuously and could not exhale. This known manually 
operated respirator cannot be connected to automatic respirators or to 
anesthesia respirators in order to take over the breathing gas supply in 
case of a power failure. (See German Offenlegungschrift DE-OS No. 24 24 
798.) 
A known respirator has a breathing gas reservoir arranged inside of a 
pressure chamber, with the interior of the reservoir being filled with 
breathing gas continuously through a check valve. By means of an 
electronic control, which operates at a given frequency and can be 
triggered additionally by spontaneous inhalation efforts of the patient, 
the pressure in the pressure chamber surrounding the breathing bladder is 
periodically increased through an injector operated by compressed air. The 
breathing gas reservoir is compressed here and its content is supplied to 
the patient via a shut-off valve which permits only this direction of 
flow. 
At the same time, during inspiration, a pneumatically controlled exhalation 
valve arranged between the patient and a line for discharge of the exhaled 
gas is kept closed by the elevated pressure in the pressure chamber. If 
the breathing gas is to be supplied to the patient by hand, the pressure 
chamber surrounding the breathing gas reservoir is detached from a bayonet 
lock and removed. A switching valve operated by the pressure chamber 
switches the pneumatic control of the exhalation valve from the pressure 
chamber to the interior of the breathing gas reservoir. Otherwise, the 
path to the breathing gas remains the same. However, the breathing gas is 
then conveyed into the patient's lungs by manual compression of the 
breathing gas reservoir. 
By the continuous supply of the breathing gas into the breathing gas 
reservoir, adaptation to fluctuations in the patient's needs is provided. 
If the supply is adjusted according to the highest need, gas losses will 
occur during other times due to outflow through the pressure limiting 
valve. Utilization of the existing breathing gas reservoir for supply of 
breathing gas by way of manual operation is possible only with respirators 
which contain a breathing gas reservoir or a breathing bag. (See German 
Offenlengungschrift DE-OS No. 26 18 949.) 
SUMMARY OF THE INVENTION 
The present invention provides a manual respirator apparatus for 
respirators and/or anesthesia respirators with which artificial 
respiration of the patient can be continued manually in case of a power 
failure. 
In accordance with the invention, a manual respirator apparatus is 
connected into an inhalation line between the respirator and the patient 
and it has an inlet connectable to a breathing gas supply from a 
respirator under pressure. The apparatus includes a block housing having 
respective inlet and outlet lines connected into the inhalation line and 
to the patient and it also has an exhalation inlet line for receiving the 
exhaled gas from the patient. A pressure chamber defined in the housing is 
connected through a connecting passage to the inlet for the pressure gas 
through a delivery passage to the inhalation line. Adjustable valve means 
are provided in the pressure chamber which is connectable to an expansible 
and contractable elastic bag and it regulates the delivery of gas through 
the connecting passage from the breathing gas supply. Additional outlet 
valves are disposed in the delivery passage between the pressure chamber 
and the inhalation line for regulating the delivery of the breathing gas 
to the inhalation line in accordance with predetermined valve setting 
pressures. 
The advantages achieved with the invention are, above all, the compact 
arrangement of the necessary elements, such as the valve block, with the 
breathing bag and the anaesthesia gas scavenging bag. Connection into the 
inhalation line is sufficient. Artificial ventilation then occurs in a 
simple and reliable manner directly through the elastic breathing bag. The 
breathing bag meters the quantity of breathing gas. Because of its 
elasticity, service personnel can feel the state of the patient's lungs 
and can then proceed accordingly in further artificial ventilation. The 
simple components can be made of materials which permit sterilization. 
Monitoring of the functional state presents no particular problems. 
In a further design, the measuring devices of the automatic respirator to 
which the manual respirator apparatus is connected can be used in a simple 
manner for control of the respiration data, e.g., pressure, rate of flow 
and/or volume. The clinical personnel are protected by the anaesthesia gas 
scavenging bag and the connected excess gas scavenging apparatus from any 
anesthesia gases still contained in the exhaled gas which may escape. 
Accordingly, an object of the present invention is to provide a manual 
respirator apparatus for connection to an inhalation line connected 
between a respirator and a patient and usable with a breathing gas supply 
from a respirator under pressure, which comprises, a block housing having 
a connection into the respirator line and to the patient and a pressure 
chamber defined therein with adjustable valve means for regulating the 
connection from the breathing gas supply into the pressure chamber, and 
wherein, the pressure chamber is connected to an elastic breathing gas bag 
and further including a delivery passage in the housing which connects 
from the pressure chamber to the inhalation line and has a plurality of 
separately set valves which are opened at predetermined pressures for 
supplying additional breathing gas to the inhalation line. 
A further object of the invention is to provide a manual respirator 
apparatus for use with automatic respirators which is simple in design, 
rugged in construction and economical to manufacture. 
The various features of novelty which characterize the invention are 
pointed out with particularity in the claims annexed to and forming a part 
of this disclosure. For a better understanding of the invention, its 
operating advantages and specific objects attained by its uses, reference 
is made to the accompanying drawing and descriptive matter in which a 
preferred embodiment of the invention is illustrated.

DESCRIPTION OF THE PREFERRED EMBODIMENT 
Referring to the drawing in particular, the manual respirator apparatus in 
accordance with the invention, comprises, a valve block 1 with an elastic 
breathing gas bag 2 and a anaesthesia gas scavenging bag 3. It is inserted 
by the connections 4 and 5 into an inhalation line 17 between the patient 
40 and the respirator 42. 
The breathing gas from the respirator or from a separate supply 6 is fed 
into the inlet 7 in the valve block 1 under a pressure of up to 5 bar. The 
inlet valve 8 following inlet 7 is controlled by the pressure in chamber 9 
or, respectively, by the pressure in the breathing gas bag 2. For this 
purpose, the desired pressure is adjusted by means of the compression 
spring 11 via an adjusting knob or setting knob 10. The pressure in 
chamber 9 acts on the valve disc 14 through the diaphragm or membrane 12 
and rocker arm ("tilting lever") 13. At equilibrium between the pressure 
in chamber 9 and the compression spring 11, the rocker arm 13 is in an 
inoperative position, in which the inlet valve 8 is closed. 
After the desired pressure has been reached, the breathing gas 2 is filled 
with the breathing gas. By compression, its content of respiratory gas is 
forced into the inhalation line 17 via the outlet valves 15 and 16. It 
then flows to the patient via the inhalation line or hose 18 which is 
connected at 4. Undue pressures in the inhalation tract are prevented by 
the adjustable overpressure valve 20 inserted via channel 19 behind the 
outlet valve 15. 
Exhalation occurs via a mouthpiece 44 from the patient 40 to the exhalation 
line 21, connected in a known manner via a Y-piece. The exhalation line 21 
is connected to the valve block 1 through the spout 22. During the 
inhalation phase, spout 22 is kept closed by the diaphragm or membrane 23 
used as the exhalation valve. To this end, it is pressurized by the 
pressure of the breathing gas to be inhaled via channels 19 and 24. 
Exhalation starts with the relief of the breathing bag 2. The outlet valves 
15 and 16 close with decreasing pressure. Diaphragm 23 is thereby 
relieved, so that the exhaled gas can flow out. Any slight leakage at the 
outlet valves 15 and 16 does not present any obstacle. The small 
quantities of gas are vented into the atmosphere through the nozzle vent 
25. 
A spring biases valve 15 closed when the pressure in chamber 9 is equal to 
that in line 17. When the bag is compressed, pressure builds in chamber 9 
to overcome the spring on valve 15. Valve 16 which is biased closed only 
by the pressure in line 17, now opens. The spring of valve 15 is strong 
enough to hold the pressure of chamber 9 when bag 2 is not compressed and 
valve 16 closes the inhalation line 17 to the channels 19, 24 and 25 at 
the same time. 
For the determination of data, e.g., pressure, rate of flow and/or volume, 
the exhaled gas is supplied behind the diaphragm 23 through channel 26 and 
connection line 27 to the respective measuring devices of the respirator 
and is returned via connection 28. It then flows via connection line 29 
into the anaesthesia gas scavenging bag 3, from which it is then removed 
by excess gas scavenging apparatus through the lines 30 and 31. 
While a specific embodiment of the invention has been shown and described 
in detail to illustrate the application of the principles of the 
invention, it will be understood that the invention may be embodied 
otherwise without departing from such principles.