Insertion aid for oral and nasal medical devices

Embodiments of the present invention include an insertion aid device with a handle, a tongue depressor, a tracheal suction catheter guide, and a guide with a recess formed by a pair of prongs. The guide may be configured to accommodate the cross-sectional shape of a tracheal suction catheter, a nasogastric tube, or an orogastric tube. The tracheal suction catheter guide may include a connection port configured to couple to an in-line suction catheter. A light source may be included with the insertion aid device.

FIELD OF THE INVENTION

The invention relates to a method and apparatus for maintaining the patient's mouth in an open position for oral cleaning and suctioning, orotracheal suctioning, and orogastric tube insertion, for uncoiling nasotracheal suctioning catheters and nasogastric tubes within the mouth during insertion, and for inserting orotracheal suctioning catheters.

BACKGROUND OF THE INVENTION

Oral cleaning instruments, oral suctioning instruments, and tracheal suctioning catheters are commonly used in health care patients with respiratory distress, critical illness, chronic illness, terminal illness, weakness, paralysis, or any patient requiring breathing support from a ventilator.

To perform oral cleaning, most caregivers use foam swabs with various antiseptic solutions to clean and moisten a patient's mouth. Oral suctioning is commonly performed by inserting a rigid plastic tube, often called a Yankauer suction, into a patient's mouth and throat to suction out saliva and mucus. The purpose of oral cleaning and oral suctioning is to remove bacteria that builds up in the mouth of patients who are unable to perform oral care, such as brushing their teeth. Various studies have shown that the buildup of bacteria in patients who are unable to perform oral care increases their risk of the nosocomial pneumonias, hospital acquired pneumonia (“HAP”) and ventilator associated pneumonia (“VAP”), due to the aspiration of saliva and secretions with high levels of bacteria.

Tracheal suctioning is commonly performed to suction out secretions when a patient is too weak to cough up secretions on their own. Tracheal suctioning may be performed via either nasotracheal suctioning or orotracheal suctioning. In either case, a tracheal suction catheter is used, which typically is a soft, pliable plastic or rubber tube. In the case of nasotracheal suctioning, the tracheal suction catheter is inserted into the naris and continues down the trachea. Once the tracheal suction catheter reaches the trachea, the unwanted secretions are suctioned out. The nasotracheal suctioning method can cause trauma and bleeding to the nasal area. In addition, the suction catheter also has a tendency to coil in the back of the throat and may trigger the patient's gag reflex.

Typically, orotracheal suctioning is attempted in patients with increased coagulation times, nasal fractures, or deviated septums, or if coiling continues to occur in the nasotracheal approach. To perform orotracheal suctioning, the tracheal suction catheter is inserted into the mouth and continues down the trachea. Once the tracheal suction catheter reaches the trachea, the unwanted secretions are suctioned out. Similar to the nasotracheal suctioning method, the suction catheter has a tendency to coil in the back of the throat and may trigger the patient's gag reflex.

Patients are usually in an altered mental state from sedation, confusion, or being frightened and sometimes do not cooperate for oral cleaning, oral suctioning, and tracheal suctioning. Patients sometimes bite down on the cleaning and suctioning instruments, which can stop the oral cleaning, oral suctioning, and tracheal suctioning processes, and sometimes break a piece of the instrument off in the patient's mouth or even bite caregivers' fingers. Other problems that exist include instrument insertion trauma to the nose or mouth and the spread of bacteria from the mouth to the lungs during tracheal suctioning.

Nasogastric tubes and orogastric tubes are commonly used in the course of health-care, most frequently in the preparation before, during, and after surgery, for tube feedings, and in healthcare patients with stomach decompression or other stomach and bowel issues. Typically, these nasogastric/orogastric tubes are formed from resilient plastic material such as polyurethane, polyethylene, or silicone polymer. In addition, these tubes may be manufactured from surgical steel. The nasogastric and orogastric tubes typically have a proximal end, a distal end, and a central lumen or passageway. Further details about such tubes can be found in U.S. Pat. Nos. 4,778,448 and 4,634,425, the disclosures of which are incorporated herein by reference.

Nasogastric tubes and orogastric tubes are either inserted in the mouth or nose, down the throat, and into the stomach. The nasogastric and orogastric tubes have been a problem for patients and clinicians for some time. When a nasogastric tube is inserted into the patient's nose, sometimes the tube coils in the back of the throat and may trigger the patient's gag reflex. Similar to the problems experienced with the oral cleaning, oral suctioning, and tracheal suctioning, patients sometimes bite down on the orogastric tubes, which can stop the process, and sometimes break a piece of the tube off in the patient's mouth or even bite caregivers' fingers.

SUMMARY

Embodiments of the present invention include an insertion aid device with a handle comprising a distal end, a tongue depressor, a tracheal suction catheter guide, and a guide with a recess formed by a pair of prongs that extend from the distal end of the tongue depressor.

The tongue depressor includes a proximal end coupled to the distal end of the handle and a distal end, wherein the tongue depressor has a progressively smaller cross-sectional shape from the proximal end to the distal end. In some embodiments, the handle of the insertion aid device may be textured. In other embodiments, the handle length may be adjustable.

The tracheal suction catheter guide includes a first opening adjacent the proximal end of the tongue depressor, a second opening adjacent the distal end of the tongue depressor, and an enclosed channel connecting the first opening to the second opening. In some embodiments, the first opening may include a connection port configured to couple to an in-line suction catheter.

The guide is coupled to the distal end of the tongue depressor. In some embodiments, the recess is configured to accommodate the cross-sectional shape of a tracheal suction catheter, a nasogastric tube, or an orogastric tube.

A light source may be included with the insertion aid device, where the light source is located adjacent the tongue depressor.

DETAILED DESCRIPTION

FIGS. 1-6illustrate one embodiment of an insertion aid device100. Alternative embodiments of the insertion aid device100are shown inFIGS. 7-8. The insertion aid device100comprises a handle102, a tongue depressor104, a tracheal suction catheter guide106, a light source108, and a guide110.

In the embodiments illustrated inFIGS. 1-8, the handle102may be constructed of rigid material, such as plastic, steel, or any other suitable material. The handle102may have a circular cross-section or other suitable cross-sectional shape including but not limited to rectilinear, oval, crescent, triangular, pentagonal, hexagonal, octagonal, D-shaped, and I-shaped. However, one of skill in the relevant art will understand that the handle102may have any appropriate shape that allows a caregiver to use the insertion aid device100to accomplish the desired task without risk of injury to the patient or the caregiver. In some embodiments, the handle102may include a textured surface to prevent the insertion aid device100from slipping during use. In other embodiments, the handle102may include indentations for the caregiver's fingers when the handle is grasped.

The tongue depressor104is adjacent the handle102, as illustrated inFIGS. 1-8. In some embodiments, the tongue depressor104is integrally formed with the handle102. In other embodiments, the tongue depressor104is coupled to the handle102and may be formed of the same or different materials than the handle102. For example, in some embodiments, the tongue depressor104may be constructed from rigid material such as plastic, steel, or any other suitable material, while the handle102is formed of similar or other materials. In other embodiments, the tongue depressor104is constructed of a flexible material such as rubber or soft plastic, while the handle102is formed of similar or other materials. In the embodiments shown inFIGS. 1-8, the tongue depressor104has a curved shape that approximately corresponds to the shape of the lower surface of a patient's mouth and tongue. The tongue depressor104is configured to contact a patient's mouth cavity without entering the patient's throat. In these embodiments, the tongue depressor104includes a declining surface along its length to aid in the depression of the tongue and to aid in the insertion of the insertion aid device100. The tongue depressor104also has a progressively reducing cross-sectional shape, which becomes increasingly smaller in the direction of the distal end. However, one of skill in the relevant art will understand that the tongue depressor104may have any appropriate shape that allows a caregiver to use the insertion aid device100to accomplish the desired task without risk of injury to the patient or the caregiver.

As shown inFIGS. 1-2,4, and7-8, the tracheal suction catheter guide106is coupled to the tongue depressor104and positioned along the longitudinal axis of the insertion aid device100. However, one of skill in the art will understand that any appropriate orientation of the tracheal suction catheter guide106may be used within the insertion aid device100. For example, the tracheal suction catheter guide106may be positioned along an external surface of the tongue depressor104. As shown inFIGS. 1-2,4, and7-8, the tracheal suction catheter guide106includes a first opening112, which is located adjacent the proximal end of the tongue depressor104. The tracheal suction catheter guide106includes a second opening114adjacent the distal end of the tongue depressor104.

In an alternative embodiment shown inFIG. 7, the first opening112includes an angled projection131to facilitate insertion of the tracheal suction catheter126by allowing the caregiver to insert the tracheal suction catheter126at an angle that is less than 90 degrees from the central axis of the handle102.

In another alternative embodiment shown inFIG. 8, the tracheal suction catheter guide106includes a connection port132. The inner cross-sectional shape of the connection port132is configured to approximately conform to the cross-sectional shape of the first opening112, while the outer cross-sectional shape of the connection port132is configured to engage with an in-line suction catheter134. Typically, the in-line suction catheter134comprises a flexible, long tube136attached on a first end138to a suction valve140. The suction valve140includes a suction port142that couples the in-line suction catheter134to a collection container and a device that generates suction (not shown). An opposing end144of the tube136is coupled to an elbow146, where the elbow includes a breathing tube (endrotracheal or tracheotomy tube) port148and a ventilator port150. Because the in-line suction catheter134is typically used with ventilated patients that are especially susceptible to infection, the tube136is enclosed in a sterile plastic sheath152to prevent the introduction of bacteria into the patient during suctioning. In the embodiment shown inFIG. 8, the suction port142of the in-line suction catheter134is coupled to the collection container and the device that generates suction (not shown). The breathing tube port148of the in-line suction catheter134is coupled to the connection port132of the insertion aid device100, instead of a breathing tube. The ventilator port150that is typically connected to the ventilator remains uncoupled or capped when the in-line suction catheter134is used with the insertion aid device100, as this port is not required for in-line suctioning with the insertion aid device100. Likewise, an irrigation port154, which typically is used to inject saline down the breathing tube to loosen secretions, is not required when using the in-line suction catheter134with the insertion aid device100, but is required to irrigate and clean out debris from the in-line suction catheter134and the tracheal suction catheter guide106. The suction valve140is used to control when suctioning is being administered through the in-line suction catheter134. As a result, the insertion aid device100is configured to retrofit with the existing components of the in-line suction catheter134.

In the embodiments illustrated inFIGS. 1-2and7-8, the light source108is coupled to the tongue depressor104. An aperture116is formed in the tongue depressor104that allows light emitted from the light source108to pass through the tongue depressor104. The light source108is coupled to a power source118. In the embodiments shown inFIGS. 1-2and7-8, the power source118is positioned within the handle102. However, one of skill in the relevant art will understand that the power source118may be positioned in any appropriate location either within or external to the insertion aid device100. The power source118may include a battery or a power cord. In some embodiments, the handle102may include a rechargeable power source118, where the handle102is placed on a battery charger between uses to re-charge the power source118, and the tongue depressor104(which includes the tracheal suction catheter guide106, the light source108, and the guide110) is removed from the handle102and disposed of after each use.

In the embodiment shown inFIGS. 1-2, a switch120is located near the proximal end of the tongue depressor104. In the alternative embodiments shown inFIGS. 7-8, the switch120is positioned near the proximal end of the handle102. In each of these embodiments, the operator of the insertion aid device100can activate the light source108by activating the switch120. The light source108may be a conventional light bulb or a light emitting diode (“LED”).

In the embodiments shown inFIGS. 1-8, the guide110is positioned at the distal end of the tongue depressor104. In some embodiments, the guide110is integrally formed with the tongue depressor104. In other embodiments, the guide110is coupled to the tongue depressor104and may be formed of the same or different materials than the tongue depressor104. For example, in some embodiments, the guide110may be constructed from rigid material such as plastic, steel, or any other suitable material, while the tongue depressor104is formed of similar or other materials. In other embodiments, the guide110is constructed of a flexible material such as rubber or soft plastic, while the tongue depressor104is formed of similar or other materials. In yet other embodiments, the guide110is constructed from rigid material such as plastic, steel, or any other suitable material, which is then covered with soft rubber or a silicone overmold. As best illustrated inFIGS. 2,7, and8, the guide110has a recess122formed by two prongs124that extend along each side of the second opening114. The recess122is shaped to accommodate the cross-sectional shape of a tracheal suction catheter126(as shown inFIGS. 3 and 4), a nasogastric tube128(as shown inFIG. 5), or an orogastric tube130(as shown inFIG. 6).

The length of the insertion aid device100may vary in accordance with the dimensions of the mouth of the patient. For example, the insertion aid device100may be used with a variety of patients ranging in age from infant to adult and having a range of sizes of mouth or oral cavities. Because the insertion aid device100may be used with a range of mouth or oral cavities, the insertion aid device100may be manufactured in a plurality of sizes, wherein each size is configured to fit a particular sized mouth or oral cavity. Typically, the insertion aid device100may be between approximately 6 inches long and 12 inches long and the circumference may be between approximately 1 inch and 3 inches. The length of the handle may be between approximately 3 inches and 4 inches. However, one of skill in the relevant art will understand that any suitable length may be used that will accomplish the desired task without risk of injury to the patient or the caregiver. In some alternative embodiments (not shown), the insertion aid device100may include a telescoping design that allows the length of the insertion aid device100to be adjusted as needed.

In use, the insertion aid device100performs several functions. Specifically, the insertion aid device100is designed to improve oral suctioning and cleaning, nasal and oral tracheal suctioning, and insertion of nasal and oral gastric tubes and feeding tubes. The steps involved in each of these procedures is discussed in detail as follows.

When performing oral suctioning and cleaning, nasotracheal suctioning, orotracheal suctioning, and orogastric tube insertion, a caregiver begins each process by inserting the insertion aid device100into the patient's mouth. The tongue depressor104is placed in contact with the lower portion of the patient's mouth and tongue. The shape of the tongue depressor104depresses the tongue and maintains the patient's mouth in an open position, preventing the patient from fighting the caregiver and providing improved viewing of the oral cavity. Once the insertion aid device100has been inserted, the caregiver may turn on the light source108for further improvement in oral cavity viewing. With the patient's mouth now held in an open position by the insertion aid device100, the caregiver may proceed to perform the specific steps associated with each of these processes.

For example, the caregiver proceeds to perform oral cleaning with a foam swab and various antiseptic solutions and/or oral suctioning without risk of the patient biting down on the swab or suctioning device.

To perform nasotracheal suctioning, as shown inFIG. 3, the caregiver inserts the tracheal suction catheter126into the patient's narias. Once the tube is visible in the back of the mouth, the caregiver then engages the guide110with the tracheal suction catheter126to position the tracheal suction catheter126into the trachea until the desired depth of the trachea is reached to suction unwanted secretions out. The guide110prevents the tracheal suction catheter126from coiling in the back of the throat and decreases the chances of triggering the patient's gag reflex.

To perform orotracheal suctioning, as shown inFIG. 4, the caregiver inserts the tracheal suction catheter126into the tracheal suction catheter guide106until the desired depth of the trachea is reached to suction unwanted secretions out. The tongue depressor104prevents the patient from biting down on the tracheal suction catheter126. The tracheal suction catheter guide106prevents the tracheal suction catheter126from coiling in the back of the throat and decreases the chances of triggering the patient's gag reflex. Furthermore, the tracheal suction catheter guide106prevents the introduction of bacteria into the oral cavity and consequently prevents the introduction of bacteria into the lungs, decreasing the risk of infection.

To perform orogastric tube insertion, as shown inFIG. 6, the caregiver inserts the orogastric tube130into the patient's mouth. Once the tube reaches the back of the patient's mouth, the caregiver then engages the guide110with the orogastric tube130to position the orogastric tube130down the throat and into the stomach. The tongue depressor104prevents the patient from biting down on the orogastric tube130. The guide110prevents the orogastric tube130from coiling in the back of the throat and decreases the chances of triggering the patient's gag reflex.

To perform nasogastric tube insertion, the caregiver begins by inserting the nasogastric tube128into the patient's narias and down into the throat. In the event the nasogastric tube128coils in the back of the patient's mouth, the caregiver inserts the insertion aid device100into the patient's mouth as described above. Once the insertion aid device100has been inserted, the caregiver may turn on the light source108for further improvement in oral cavity viewing. With the patient's mouth now held in an open position by the insertion aid device100, the caregiver retracts the nasogastric tube128until the caregiver can see the tip of the nasogastric tube128in the back of the patient's mouth. As shown inFIG. 5, once the tube is visible in the back of the patient's mouth, the caregiver then engages the guide110with the nasogastric tube128to position the nasogastric tube128down the throat and into the stomach. The guide110prevents the nasogastric tube128from coiling in the back of the throat and decreases the chances of triggering the patient's gag reflex.

The foregoing is provided for purposes of illustrating, explaining, and describing embodiments of the present invention. Further modifications and adaptations to these embodiments will be apparent to those skilled in the art. The features and aspects of the present invention have been described or depicted by way of example only and are therefore not intended to be interpreted as required or essential elements of the invention unless otherwise so stated. It should be understood, therefore, that the foregoing relates only to certain exemplary embodiments of the invention, and that numerous changes and additions may be made thereto without departing from the spirit and scope of the invention as defined by any appended claims.