Abstract:
A ventilator tube holder is provided in the form of a soft patch having opposed ends which are Velcroed to underlying tracheostomy ties, with a central portion having a circular orifice through which the ventilator tube passes and is held. In one embodiment the circular orifice is provided with a notch or slit for easy mounting of the patch around the ventilator tube or for quick removal of the ventilator tube, whereas in a further embodiment a soft elastic tie or strip is Velcroed from one side of the orifice to the other to hold the ventilator tube in place or to tighten the ventilator tube to the patch during any kind of deformation or stretching that may occur.

Description:
FIELD OF THE INVENTION 
       [0001]    This invention relates to a tracheostomy ventilator tubes and more particularly to a retention device for holding the ventilator tube to the tracheostomy tube in a secure but releasable fashion. 
       BACKGROUND OF THE INVENTION 
       [0002]    As is well known ventilator tubes, called vent tubes, are attachable to a tracheostomy tube or trach tube in which the ventilator tube is pressed fit to the tracheostomy tube. 
         [0003]    In pediatric tracheostomy often times the ventilator tube becomes disassembled or falls off the tracheostomy tube and when this happens an alarm sounds and the ventilator tube must be quickly reattached to the tracheostomy tube to continue the air flow to the patient. 
         [0004]    The problem of the detachment of the ventilator tube to the tracheostomy tube is particularly severe in pediatric patients. This is because young patients are restless, move around and this gives rise to detachment of the ventilator tube. 
         [0005]    It is noted that the ventilator tube is utilized to pump air into the patient&#39;s lungs and to evacuate the patient&#39;s lungs on a periodic basis. Also the ventilator tubing is sometimes attached to a humidifier. 
         [0006]    In short, the ventilator tubing is attached to the tracheostomy tube to help a child to breath. It is a very common occurrence that the ventilator tube keeps disconnecting from the tracheostomy tube, due to patient movement as well as when the patient must be suctioned. 
         [0007]    While there have been attempts to clip the ventilator tube to the tracheostomy tube as shown in U.S. Pat. No. 6,588,426, such attachment methods involving detent clips for preventing unwanted separation of the tubes are difficult to utilize due, to the stiff nature of the attachment device. 
         [0008]    In the prior art a so-called Strong Man attachment device is used in an attempt to keep the ventilator tube from falling off the tracheostomy tube. In this device two straps run between separated clips, with each clip attached to an associated tracheostomy tie. The problems with such device are first and foremost that the straps utilized to surround the ventilator tube are stiff and irritates the patient&#39;s neck. The second problem is that often times it is necessary to quickly detach the ventilator tube from the tracheostomy tube to suction the patient. In order to do so with the Strong Man type device the clips must be unclipped from their tracheostomy ties. This is often times difficult due to the fact that the clips involve separating the opposed ends of the u-shaped clip so that the clip may be slipped out from around the tracheostomy tie. 
         [0009]    As a result, both due to the irritation and the inability to quickly release the Strong Man system, this device is largely in disuse. Moreover, the two straps that are supposed to clamp the body of the ventilator tube to the tracheostomy tube become separated and the ventilator tube separates from the tracheostomy tube, regardless of strap tension. 
         [0010]    In an effort to solve the irritation and detachment problem associated with the Strong Man tracheostomy appliance, Iris Dillworth, the inventor of the subject invention invented a new method for securing the ventilator or tube to the tracheostomy tube. In order to do this the Dillworth system used a foam patch having arms at either end and a large center portion, with the center portion provided with a slit through which the ventilator tube passes. The arms of the patch are provided with Velcro patches to attach them to respective tracheostomy tube ties for securing the ventilator tube to the tracheostomy tube. The patch is soft in construction, having a central foam portion with soft backing and facing material. 
         [0011]    In order to hold the ventilator tube to the tracheostomy tube the slit engages the ventilator tube to hold the ventilator tube securely onto the tracheostomy tube. 
         [0012]    However, as is often the case, it is necessary to disconnect the ventilator tube to suction the patient. This may be done as many as fifty times in an eight hour time period and requires that one end of the patch be pulled off its tracheostomy tie. With the ventilator tube removed to one side it is possible to suction the patient as well as to clean around the tracheostomy tube, often times with a Q-tip. As the tracheostomy tube is usually covered with secretions. A buildup of secretions can cause inflammation at the tracheostomy site leading to infection. It is therefore important to be able to clean around the tracheostomy tube site in a convenient manner. 
         [0013]    Most importantly however, with constant patient motion the ventilator tube moves and comes off of the tracheostomy tube because the slit stretches and widens with usage. Thus, when the slit stretches and the ventilator tube can slip and can become disengaged from the tracheostomy tube. 
         [0014]    Note that in practice the useful lifetime of such a slit patch is oftentimes no more that ten removal and attachment cycles, for instance for suctioning, requiring another solution to the secure holding of the ventilator tube to the tracheostomy tube. 
       SUMMARY OF THE INVENTION 
       [0015]    Rather than utilizing the Strong Man straps or the slitted patch, in the subject invention the patch is provided with a circular orifice within the enlarged portion of the patch in which the diameter is made coincident with the diameter of the ventilator tube. In one embodiment the top portion of the orifice is slitted or notched so that the ventilator tube can be easily slipped from the circular orifice, when for instance removal for suctioning is required. This means that the ventilator tube can be removed without detaching the patch as was required with the slitted patch. 
         [0016]    Note, the circular orifice does not stretch to any great degree, unlike the slit and is therefore much more secure than the slitted patch. 
         [0017]    Moreover, in order to more securely attach the ventilator tube to the tracheostomy tube a cotton elastic strap is used to hold the ventilator tube to the patch. In this case the cotton strap is made to overlie the ventilator tube to keep it in place, with the cotton strap being Velcroed from one side of the circular orifice to the other utilizing Velcro pads on the patch to either side of the orifice. The elastic strap in one embodiment is a cotton strap which does not irritate the child&#39;s neck or throat area such that rather than irritating the child&#39;s neck as is the case with the Strong Man system, the soft cotton strap is merely there to hold the ventilator tube in place against patient movement. 
         [0018]    The subject elongated patch with a circular orifice serves two purposes. The first purpose is to more securely attach the ventilator tube to the tracheostomy tube and is especially useful to prevent stretching due to the circular configuration. 
         [0019]    Secondly, the utilization of a securing strap across the ventilator tube from one side of the orifice to the other is convenient both to tighten up the connection to the patch and also to permit quick removal of the ventilator tube from the tracheostomy tube for instance, to suction the patient without having to unhitch one end of the patch. 
         [0020]    With the slitted patch, the patch had to be swung away to remove the ventilator tube from the tracheostomy tube since the tracheostomy tube could not come out of the slit. In one embodiment the patch may be kept in place and the ventilator tube removed simply by undoing the strap and removing the tube through the upper slit in the circular orifice. 
         [0021]    Additionally, removal of the ventilator tube may be accomplished by detaching one of the ends of the patch from its associated tracheostomy tie which in one embodiment is a Velcro type attachment such that the ventilator tube and patch may be swung away from the tracheostomy tube to permit suctioning of patients. 
         [0022]    Due to the requirement of frequent suctioning a patient this quick disconnect is an important factor in the design of the subject ventilator tube holder. 
         [0023]    Moreover, because the strap which holds the ventilator tube in the circular orifice may be quickly removed from one side or the other, the tracheostomy tube area can be cleaned with a Q-tip, without removing the ventilator tube. Additionally, since the ventilator tube can be removed quite quickly by removing the strap and slipping the ventilator tube out of the orifice slit, cleaning is quickly achieved because the areas of secretion around the tracheostomy tube are exposed with the removal of the ventilator tube. 
         [0024]    In one embodiment, the ends of the subject patch are shorter for instance than the lengths of the tracheostomy ties which are themselves Velcroed to a collar around the patient. 
         [0025]    What this means is that the tracheostomy tube may be removed simply by removing one of the ends of the patch from its associated tracheostomy tie as by simply ripping off the Velcro and swinging the patch and ventilator tube away from the tracheostomy tube. Secondly, in an emergency operation the tracheostomy tie as well as the patch it carries may be stripped away from the tracheostomy collar for quick removal of the apparatus. 
         [0026]    As can be seen, because of the difference in the length of the end of the patch versus the end of the tracheostomy tie, a number of different functions can be achieved. First the patch may be swung away from the tracheostomy tube by merely unVelcroing the end from the tracheostomy tie. Secondly, the entire apparatus including tracheostomy tube and ventilator tube may be removed in an emergency simply by ripping off the tracheostomy tie which carries with it the patch and the ventilator tube. 
         [0027]    While the subject holder has been described for pediatric patients, it is likewise applicable to adult use, with the size of the patch elongated for adult use. 
         [0028]    In summary, a ventilator tube holder is provided in the form of a soft patch having opposed ends which are Velcroed to underlying tracheostomy ties with a central portion having a circular orifice through which the ventilator tube passes and is held. In one embodiment the circular orifice is provided with a notch or slit for easy mounting of the patch around the ventilator tube or for quick removal of the ventilator tube, whereas in a further embodiment a soft elastic tie or strip is Velcroed from one side of the orifice to the other to hold the ventilator tube in place or to tighten the ventilator to the patch during any kind of deformation or stretching that may occur. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0029]    These and other features of the subject invention will be better understood in connection with the Detailed Description, in conjunction with the Drawings, of which: 
           [0030]      FIG. 1  is a diagrammatic illustration of the attachment of a ventilator tube to a tracheostomy tube which is held in place by tracheostomy ties that are Velcroed to a collar around the neck of a patient; 
           [0031]      FIG. 2  is a diagrammatic illustration of a disconnection between the ventilator tube and the tracheostomy tube which often times is fatal and which disconnection is often alarmed so as to let the personnel know to quickly reattach the ventilator tube; 
           [0032]      FIG. 3  is a diagrammatic illustration of the Strong Man type holder for a ventilator tube, illustrating strap-holding clips that are clipped to the tracheostomy tube ties, also illustrating an area of irritation on a patient&#39;s neck above the tracheostomy tube due to the stiff nature of the Strong Man straps; 
           [0033]      FIG. 4A  is a diagrammatic illustration of the Strong Man tie illustrating a strap loop secured using clips to standard tracheostomy ties; 
           [0034]      FIG. 4B  is a diagrammatic illustration of the use of the Strong Man holder of  FIG. 4  illustrating the securing of a ventilator tube to a tracheostomy tube through the Velcroing of one end of the Strong Man loop through the associated clip; 
           [0035]      FIG. 4C  is a diagrammatic illustration of the utilizing of the Strong Man holder to hold a ventilator tube in place, illustrating the looped strap of the Strong Man holder, as well as the clips that secure the loop to the tracheostomy tube ties; 
           [0036]      FIG. 5A  is a diagrammatic illustration of a prior art holder involving a patch having a foam sandwiched between facings and moving opposed ends that are Velcroed to positions on underlying tracheostomy ties, showing a slit in the large central portion of the patch; 
           [0037]      FIG. 5B  is a diagrammatic illustration of the patch of  FIG. 5A , illustrating that the slit in the holder in  FIG. 5A  is utilized to secure the ventilator tube to the tracheostomy tube, also showing one of the ends of the patch that is to be Velcroed to an underlying tracheostomy tube tie; 
           [0038]      FIG. 5C  is a diagrammatic illustration of the patches of  FIG. 5A  and  FIG. 5B , illustrating the stretching of the slit due to patient movement and the necessity of frequent suctioning resulting in dislodgement of the ventilator tube; 
           [0039]      FIG. 6A  is a diagrammatic illustration of the subject holder showing a patch having Velcroable ends, a large central portion and a circular orifice or hole in the central portion for securing a ventilator tube, with the orifice having a notched or slitted top so that a ventilator tube may be easily installed and removed, also showing a soft elastic cotton strap overlying an upper portion of the circular orifice for holding the ventilator tube in place; 
           [0040]      FIG. 6B  is a diagrammatic illustration of the patch of  FIG. 6A  showing the circular orifice, the slit and the elastic strap; 
           [0041]      FIG. 7  is a diagrammatic illustration showing the removal of the subject patch by removing one of the ends of the patch from the underlying tracheostomy tie; 
           [0042]      FIG. 8  is a diagrammatic illustration of the subject patch in place in which the ventilator tube is held securely to a tracheostomy tube with a soft elastic strap overlying the top portion of the ventilator tube, the elastic strap having been Velcroed at one end to a Velcro patch on the pad and showing it Velcroed at the other end to another Velcro pad; and, 
           [0043]      FIG. 9  is a diagrammatic illustration of two methods of removing the ventilator tube from the tracheostomy tube in an emergency showing either the removal of the patch by the lifting of one of its ends from a tracheostomy tie, or by removing the tracheostomy tie itself from the tracheostomy collar which also results in the removal of the patch as it is swung away. 
       
    
    
     DETAILED DESCRIPTION 
       [0044]    Referring now to  FIG. 1  a patient  10  is provided with a tracheostomy collar  12  to which is secured a tracheostomy tube  14  that is held in place by a holder having ends  16  and  18  secured to collar  12  utilizing tracheostomy ties  20  that pass through rings  21  and the ends  16  and  18  of the tracheostomy tube holder. Note these ties are Velcroed to themselves and to collar  12  to hold the tracheostomy tube in place. 
         [0045]    The tracheostomy tube  14  is provided with a ventilator tube  22  which is held in place in a friction fit. 
         [0046]    Referring to  FIG. 2 , tracheostomy tube  14  is shown exposed, with ventilator tube  22  becoming dislodged or removed. This causes a serious often life-threatening situation because the patient can no longer receive air. 
         [0047]    Referring to  FIG. 3 , in the prior art in order to keep ventilator tube  22  in place on tracheostomy tube  14  a so-called Strong Man device  26  is utilized to grip the ventilator tube and hold it securely to the tracheostomy tube using a strap loop. 
         [0048]    Prior to describing the strap loop it will be noted that because the strap structure is relatively stiff there is an area  28  on the neck of the patient which is abraded by the strap, with the strap causing irritation, inflammation and sometimes infection. 
         [0049]    Referring to  FIG. 4A , the Strong Man device  26  is shown to include a strap loop  30  which has one end  32  looped through a slot  34  in a clip  36  that has a u-shaped orifice  38  and a slot  40  so that this clip may be clipped around the tracheostomy tie  20  in  FIG. 3 . 
         [0050]    Also shown in  FIG. 4A  is an opposed clip  42  of a similar configuration to that of clip  36 . Here a slot  34  encircles one end of loop  30 , with the free end  44  of loop  30  being Velcroed to itself as illustrated at  46 . 
         [0051]    As illustrated in  FIG. 4B , Strong Man holder device  26  is shown in place with clip  36  surrounding tracheostomy tie  20 . Here loop  30  is clearly shown holding the ventilator tube  22  to the tracheostomy tube  14 . 
         [0052]      FIG. 4C  shows a front view of the attachment of ventilator tube  22  to tracheostomy tube  14 , clearly showing clips  36  and  42  as well as loop  30  that surrounds ventilator tube  22 . 
         [0053]    From the drawings it will be appreciated that the ability of this holder to securely hold the ventilator tube to the tracheostomy tube is in question because it requires a significant amount of loop tension on loop  30  to press against the exterior surface of the ventilator tube. Moreover, the ability to hold the ventilator tube to the tracheostomy tube is in question because the holding ability of this device is dependent upon the inelasticity of loop  30 . 
         [0054]    Also, since the clips are spaced apart and not close to the ventilator tube, a large amount of tension must be placed on loop  30  in order to properly secure the ventilator tube to the tracheostomy tube, noting the large amount of tension required due makes the loop stiffer. As mentioned above, the stiffness of the loop causes irritation to the neck of the patient. 
         [0055]    Referring now to  FIG. 5A , a prior art patch  50  is used as a holder for a ventilator tube in which the patch has opposed ends  52  and  54  that are Velcroed to the underlying tracheostomy ties. 
         [0056]    In one embodiment, the patch is made of a foam core  56  which is sandwiched between a flexible backing member  58  and a flexible facing member  60 . 
         [0057]    Patch  50  is provided with a slit  62  which as illustrated in  FIG. 5B  is expanded to accommodate ventilator tube  22  in a tight fit. When the ends  54  of patch  50  are secured to tracheostomy tie  20  for instance by Velcroing the ends to an underlying tracheostomy tie, as illustrated in  FIG. 5C  patch  50  secures ventilator tube  22  to tracheostomy tube  14 . 
         [0058]    The problem with such a patch is that during usage slit  62  becomes stretched as illustrated at  62   1  and by arrow  64 . As mentioned, this causes the ventilator tube to slip away from the tracheostomy tube which is a defect in this type of patch. 
         [0059]    In order to solve the problem of the stretching of the slit  62  and to provide a secure holder for a ventilator tube, a patch  70  is constructed with ends  72  and  74  having Velcro pads shown in dotted outline respectively at  76  and  78 . 
         [0060]    Patch  70  has an expanded portion  80  provided with a circular orifice  82  which in one embodiment has a slit or notch  84  rising vertically as shown. 
         [0061]    Patch  70  also in one embodiment has a foam core  86  faced with a flexible facing  88  and backed with a flexible backing  90 . 
         [0062]    In order to further retain the ventilator tube in orifice  82  a cotton elastic strap  92  is Velcroed at either end to Velcro pads  94  and  96  on facing  88 , the purpose of which is to retain the ventilator tube within orifice  82  and to be able to tighten this connection to counter the natural stretching of the patch during usage. 
         [0063]    Referring to  FIG. 6B , it can be seen is that end  74  is provided with a Velcro pad  76 , with the slitting  84  of orifice  82  being clearly visible. Also elastic cotton strap  92  is shown having one end to be Velcroed to Velcro pad  96 . 
         [0064]    Referring to  FIG. 7 , in an operation, ventilator tube  22  is secured to tracheostomy tube  12  by moving patch  70  and its corresponding ventilator tube onto the tracheostomy tube, whereupon end  74  is Velcroed to tracheostomy tie  20  as illustrated by arrow  95 . 
         [0065]    Referring to  FIG. 8 , what is seen that patch  70  securely mounts ventilator tube  22  to tracheostomy tube  14  through the Velcro fastening of for instance end  72  to the underlying tracheostomy tie  20 . Here it can be seen that orifice  82  tightly surrounds ventilator tube  22  and with the securing of patch  72  at either end to the tracheostomy ties the ventilator tube is securely fastened to the tracheostomy tube. Moreover, as can be seen, cotton elastic strap  92  is Velcroed at end  74  to the Velcro pad  78  on patch  70 . 
         [0066]    It is noted that due to the softness of the elastic strip as well as the softness of the patch itself very little if any irritation of the patient occurs. 
         [0067]    Referring to  FIG. 9 , when ventilator tube  22  is to be removed from tracheostomy tube  14  a quick release is achieved either through removal of elastic strap  92  as illustrated by  100  or by the removal of patch  70  by the stripping of distal end  74  from the Velcro attachment point  102  to tracheostomy tie  20  as illustrated by arrow  104 . A third way of emergency removal is to remove the tracheostomy tube itself by pulling off the end  106  of tracheostomy tie  20  as illustrated by dotted arrow  108 . 
         [0068]    Thus, the subject system allows for emergency removal of the ventilator tube either through slipping it out of orifice  82  via slot  84  by removal of strip  92 ; or by removal of patch  70 ; or finally by the removal of the tracheostomy tube itself along with all connected apparatus. 
         [0069]    While the present invention has been described in connection with the preferred embodiments of the various figures, it is to be understood that other similar embodiments may be used or modifications or additions may be made to the described embodiment for performing the same function of the present invention without deviating therefrom. Therefore, the present invention should not be limited to any single embodiment, but rather construed in breadth and scope in accordance with the recitation of the appended claims.