Abstract:
A medical tube holder that includes a variable in size head band and a medical tube receiving loop depending therefrom. The loop is formed by a strap that has opposite end portions thereof overlying one another and the terminal ends thereof secured to the headband. The loop is spaced a selected distance from the headband by a necked down provided by the overlapping end portions. A member is slidably mounted on the necked down portion and provides means to selectively vary the size of the loop. The slide member has a locking mechanism movable from one to the other of a slider locked and unlocked state. The holder can be used in association with a bite block and perform the dual function of retaining the medical tube in position on a patient and retain the bite block in position on the medical tube. Also disclosed is a bite block that has an adjustably variable in size hole for receiving and clampingly engaging the medical tube.

Description:
RELATED APPLICATIONS 
       [0001]    This application and claims priority from U.S. application Ser. No. 12/384,247 filed on Apr. 2, 2009 hereby incorporated by reference in its entirety. 
     
    
     FIELD OF INVENTION 
       [0002]    This invention relates generally to medical tube holders and more particularly an endotracheal tube holder having a head strap with a loop depending therefrom each of which is variable in size and adjustment thereof independent of one another with a member that is slidably disposed on the loop serves to space the loop a selected distance from the head strap and also vary the size of the loop. The loop being adjustably variable in size can receive tubes of widely varying diameters. 
         [0003]    The invention also is directed to the forgoing holder in combination with a bite block wherein the holder performs the dual function of retaining the bite block on the medical tube and holding the medical tube in position on the intubuated patient. 
       BACKGROUND OF THE INVENTION 
       [0004]    An endotracheal tube (ET) is used to assist in ventilation of a patient during medical procedures. It is inserted into and through a patient&#39;s trachea in order to ensure that the airway is maintained in an open condition for cycling of air to and from the lungs. In order to retain the tube in an intended position and orientation for optimal patient benefit, medical personnel have utilized tape but being ad hoc in nature the procedure is subject to variations inherent to different medical personnel training and experience. 
         [0005]    ET holders are preferred to tape due to their holding the tube more consistently than tape in the intended position and orientation on the patient As for known, or proposed, tube holders, reference may be had to the following patents and printed publications:
   U.S. Patent Application Publication No. 2009/0255538 by Thomson et published Oct. 15, 2009;   U.S. Patent Application Publication No. 2007/0272251 by Hodge published Nov. 29, 2007;   U.S. Pat. No. 7,063,088 by Christopher issued on Jun. 20, 2006; U.S. Pat. No. 5,042,477 by Lewis issued on Aug. 27, 1991; and U.S. Pat. No. 4,437,463 by Ackerman issued on Mar. 20, 1984.   
 
         [0009]    The devices disclosed in the foregoing U.S. Pat. Nos. 5,042,477 and 4,437,463 have a relatively massive assembly that tends to cover the patients mouth (or at least a major portion thereof making it uncomfortable for the patient and difficult for the care giver. Ackerman discloses a device in which the loop for the tube is varied in size by the neck strap. 
       SUMMARY OF INVENTION 
       [0010]    This invention relates generally to medical tube holders and more particularly an endotracheal tube holder having a head strap with a loop depending therefrom each of which is variable in size and adjustment thereof independent of one another. A member that is slidably disposed on the loop serves to space the loop a selected distance from the head strap and also vary the size of the loop. 
         [0011]    The invention also is directed to the forgoing holder in combination with a bite block wherein the holder performs the dual function of retaining the bite block on the medical tube and holding the medical tube in position on the intubuated patient. 
         [0012]    The loop being adjustably variable in size can receive tubes of widely varying diameters. 
         [0013]    The present invention comprises, consists essentially of, and/or consists of a medical tube holder that includes a variable in size head band and a medical tube receiving loop depending therefrom. The loop is formed by a strap that has opposite end portions thereof overlying one another and the terminal ends thereof secured to the headband. The loop is spaced a selected distance from the headband by a necked down provided by the overlapping end portions. A member is slidably mounted on the necked down portion and provides means to selectively vary the size of the loop. The slide member has a locking mechanism movable from one to the other of a slider locked and unlocked state. The holder can be used in association with a bite block and perform the dual function of retaining the medical tube in position on a patient and retain the bite block in position on the medical tube. Also disclosed is a bite block that has an adjustably variable in size hole for receiving and clampingly engaging the medical tube. 
         [0014]    A principal object of the present invention is to provide an ET holder in which the head band and loop for the endotracheal tube are adjustably variable in size independent of one another 
         [0015]    Another object of the present invention is to provide an ET holder that is simple in construction, has relatively few parts and a relatively small amount of mass in front of the mouth of an intubuated patient. 
         [0016]    A further principal object of the present invention is to provide an ET holder in which a loop for the tube is adjustably variable in size and spaced a selected distance from the lip engaging portion of the head band 
         [0017]    In keeping with the forgoing there is provided in accordance with the present invention an ET holder comprising a head band, a strap having opposite end portions overlying one another with the terminal ends thereof secured to said head band providing a loop that is spaced a selected distance from the headband by a necked down portion of the loop, a member slidably mounted on said necked down portion providing means to selectively vary the size of the loop and releasably lock means on said slide member cooperatively engagable with said necked down portion of the loop to selectively lock and unlock the slider to respectively prevent and allow movement of the slider relative to the loop. 
         [0018]    The tube holding loop is spaced a selected distance from the head band portion to which it is secured whereby only the loop portion of the holder is in front of the patients mouth and also the head band portion, to which the loop is attached, is positioned to abut only an upper portion of the patients lip proximate their nose. 
         [0019]    Each of the head band and tube holding loop are selectively adjustable in size with adjustment of one being independent of adjustment of the other. 
         [0020]    Other objects, features, and advantages of the invention will be apparent with the following detailed description taken in conjunction with the accompanying drawings showing a preferred embodiment of the invention. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0021]    A better understanding of the present invention will be had upon reference to the following description in conjunction with the accompanying drawings in which like numerals refer to like parts throughout the several views and wherein: 
           [0022]      FIG. 1  side oblique view of an endotracheal tube holder provided in accordance with an aspect of the present invention; 
           [0023]      FIG. 2  is a frontal oblique view of the holder shown in  FIG. 1 ; 
           [0024]      FIG. 3  is a side oblique view of the holder shown in  FIGS. 1 and 2  grippingly engaging an endotracheal tube and a portion of a bite block retaining the same in a preselected location thereon; 
           [0025]      FIG. 4  is a side view of the bite block shown in  FIG. 3 ; 
           [0026]      FIG. 5  is a front view of  FIG. 4 ; 
           [0027]      FIG. 6  is a view illustrating a specific bite block provided by applicant that on and grippingly engages the airway tube without the presence of a tube holder; 
           [0028]      FIG. 7  is an exploded, part sectional, view of the bite block shown in  FIG. 6 ; 
           [0029]      FIG. 8  is a is a sectional view taken essentially along line  3 - 3  of  FIG. 7 ; and 
           [0030]      FIG. 9 , similar to a portion of  FIG. 7 , illustrates modifications to a portion of the bite block shown in  FIG. 7 . 
       
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
       [0031]    Illustrated in  FIGS. 1 and 2  is an endotracheal tube holder comprising a head strap  1  having an adjustably variable in size loop  50  depending therefrom.  FIG. 1  illustrates the head strap  1  lying in a first plane and the loop  50  in a second plane with such planes being at an angle to one another. The preferred angle approximates 90 degrees such that with the head strap going around the patients head, just above the ears, the loop overlies the patients mouth having an at rest position that places little or no twisting force on an ET passing there through. The head strap forms an adjustably variable in size head band. 
         [0032]    The head strap includes a central portion  3 , from which the loop depends, connected at opposite ends thereof to respective strap portions  4 ,  5  the free outer ends of which have respectively an anchoring tab  6  and an open eye  7 . The free end of the strap portion  4  can be threaded through the open eye  7  and the tab  6  then anchored to that strap portion to form a closed band. The tab and strap for example may be a hook and loop fastener or the tab could if desired be a hock that snags the strap portion at preselected or at an infinite number of positions there along. At least one of respective portions  4 ,  5  is elastically stretchable thereby permitting the strap to be suitably tensioned for a comfortable fit and remain in place on the patient. 
         [0033]    The strap portion  3  is for example circular in outline cross-section shape and preferably has, at least, an outer layer of a soft cushioning material for patient comfort. 
         [0034]    The loop  50  is formed by a rectangular in cross-section strap  52  having opposite end portions overlying one another providing a necked down portion  53  intermediate the loop and the head strap to which it is secured. The strap  52  terminates in opposite ends that are securely anchored as at  54  to the head band portion  3 . The strap  52  is made of a non-toxic, slip and moisture resistant material. 
         [0035]    A member  60  is mounted on the loop necked down portion  53  spacing the tube receiving portion thereof a selected distance from the head strap portion  3 . The preferred spacing locates the head band portion  3  on the patients upper lip at the patients nose or proximate thereto. 
         [0036]    The member  60  is selectively slidable along the loop necked down portion  52  and thereby permits one to selectively vary the size of the loop. In the loops largest size an endotracheal tube is readily insertable but once the tube is suitably located therein the size is reduced bringing the inner face of the strap  52  into pressured engagement with the outer peripheral surface of the tube. The flat face of the strap provides large surface contact resisting sliding of the loop along the tube. 
         [0037]    Means for securing in place comprises a spring loaded finger engagable lock and release mechanism wherein the release button  61  is mounted on the member  60  and has a portion cooperatively engaging the strap  52  to releasably engage the same to selectively restrain and allow sliding movement of the member  60 . 
         [0038]    Illustrated in  FIG. 3  is a known airway tube  10  with a bite block  70  thereon. The tube holder, as previously described, retains the tube in position on the patient by a medical attendant tightening the loop around the tube of a suitably intubuated patient but in this embodiment the loop  50  of the tube holder also restrains the bite block from movement along the tube. 
         [0039]    The bite block  70  has a hub portion  71  with flanges  72 ,  73  at respective opposite ends thereof. There is a hole  74  through which a medical tube can be inserted. The flange  72  extends radially further from the hub than flange  73  and during use is located outside of the patients mouth. A pair of lugs  75 ,  76  project from the flange  72  and are located respectively on opposite sides of the hole  74  at positions adjacent thereto. These lugs if desired may have an end tab  77  directed outwardly and spaced from the flange so that the loop strap  52  will fit there between. In this embodiment the bite block lugs are held captive between the inner surface of the loop strap  52  and the outer surface of the medical tube  10  as the loop is brought into tight pressured contact with the outer peripheral surface of the tube. In this manner the holder loop  50  anchors the bite block to the tube and at the same time holds the tube in position on the patient. The through hole  74  is a one size fits all with flexing of the lugs  75 ,  76  allowing the bite block to accommodate differing tube diameters. 
         [0040]      FIG. 6  is similar to  FIG. 3  but illustrates applicants specifically constructed bite block  20  on a known airway tube  10 . The bite block has an adjustably variable in size through hole that allows the tube to pass there-through. Airway tubes are available with differing outer diameters dictated generally by whether the patient is an adult or child, male or female. At least a portion of the through hole is selectively adjustably variable in diameter from a maximum diameter, that is slightly greater than the outer diameter of a tube to used in association therewith, to a minimum diameter that is smaller than the outer diameter of such tube. The portion that can be reduced in diameter is resiliently biased to it&#39;s maximum diameter which is its normal at rest state. 
         [0041]    Referring now in more detail to  FIGS. 6 to 9  the bite block  20  comprises respective first and second components  30 ,  40  in which the first component  30  is an elongate open ended tubular sleeve having an externally threaded portion  31  extending from one end of the sleeve in a direction toward the other end. There is a slit  32  in the wall of the sleeve that extends from the above mentioned one end in a direction toward the other end. In the preferred embodiment, illustrated in  FIG. 7 , the slit  32  extends along the entire length of the tubular sleeve while in the embodiment illustrated in  FIG. 9  the slit extends only along a portion of the length of the sleeve. The purpose of the slit is to accommodate changing the internal diameter of the sleeve from it&#39;s normal at rest state of maximum diameter that is greater than the outer diameter of the tube  10  being used in association therewith to a minimum diameter that is smaller than that outer diameter of the tube  10 . At this minimum diameter the bite block tightly grips the tube  10 . 
         [0042]    The sleeve  30  is preferably made of a transparent plastics material (preferably food grade or medical grade) permitting progressive tube length designations  11  imprinted on the tube  10  to be seen through the wall of the sleeve. The wall thickness of the sleeve is chosen taking into account the stiffness of the material such that the sleeve internal diameter can be readily varied using only finger grip to rotate the components relative to one another about the longitudinal axis of the sleeve  30 . The characteristics of the material such as resilience, flexibility and elasticity are considered and chosen so that the sleeve is resiliently biased to a normal at rest maximum diameter and permitting repeated usage by staying within the elastic limits as the sleeve is deformed. 
         [0043]    The second component  40  is a rigid or relatively stiff body member made of a plastics, metal, or rubber like material or combinations thereof. The body has spaced apart ridges  41 ,  42  interconnected by a hub  43 . Ridge  42  projects further from the hub than the ridge  41  and when in use abuts against the outer upper and lower lip portions of the patient. The hub  43  has a layer  44  of soft resilient material located, at least, in appropriate positions for abutting the patients respective upper and lower teeth. This padding of softer material may, for example, be a suitable plastics material such as a thermoplastic, elastomer material, plastisol, neoprene or a rubber or rubber like material that protects the teeth from chipping or other damage. The ridges  41 ,  42  may be circular flanges with one having a larger diameter than the other as shown and together with the hub interconnecting the same provide a body having the general appearance of a spool. The hub of the spool is surrounded by an annular cushioning member. Alternatively the flanges  41  and  42 , at minimum, could each consist of a pair of ribs projecting radially in opposite directions away from the hub. 
         [0044]    There is an open ended hole  45  through the body member  40  with at least a portion thereof having internal screw threads  46 . In the embodiment illustrated in  FIG. 2  these threads are located in a tapered portion decreasing in diameter in a direction from flange  41  toward flange  42 . The sleeve  30  external threads  31  mate with the threads  46  and as components  30 ,  40  are rotated relative to one another to increase penetration of component  30  into component  40  the tapering of the threads causes the internal diameter of the sleeve to progressively decrease in size. The width of the slit  32  is so chosen as to allow a selected reduction in diameter. The amount of taper of the threads is chosen such that the reduction in diameter is sufficient for the sleeve to tightly grasp the tube  10  used in association therewith and without exceeding the elastic limit of the sleeve. 
         [0045]    To use the bite block the sleeve is slide over the airway tube just past the patients teeth after such tube has placed in the trachea. While holding the sleeve the body portion of the bite block is slid onto the tube and rotated to thread it onto the sleeve. Rotation of the body portion is stopped when the bite block is secure on the tube and the patients teeth are positioned on the soft outer hub portion of the body member. 
         [0046]    By having the bite block tightly grasp the airway tube it is independent and secure without the need for a separate anchoring means that can hinder and obstruct access to the airway. 
         [0047]    The bite block is preferably made of a transparent (clear) material and this allows the health care practitioner to visually see the airway features and centimeter markings on the oral or tracheal tube making it easier to note the correct position of the tube. 
         [0048]    The foregoing detailed description is given primarily for clearness of understanding and no unnecessary limitations are to be understood therefrom, for modification will become obvious to those skilled in the art upon reading this disclosure and may be made upon departing from the spirit of the invention and scope of the appended claims. Accordingly, this invention is not intended to be limited by the specific exemplifications presented herein above. Rather, what is intended to be covered is within the spirit and scope of the appended claims.