Patent Publication Number: US-2022233066-A1

Title: Laryngoscopy apparatus having means for clearing material from its viewing window

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims priority to co-pending U.S. Provisional Application Ser. No. 63/142,444, filed Jan. 27, 2021, which is hereby incorporated by reference herein in its entirety. 
    
    
     BACKGROUND 
     Video laryngoscopy is often used during emergency breathing tube placement to save lives. However, liquids, such as airway secretions, gastric fluid, blood, and/or solids, such as regurgitated food, can cover the viewing window of the laryngoscope camera and, therefore, obscure the view of the airway. This can lead to breathing tubes being misplace within the esophagus instead of the trachea. Because the patient may not be breathing at the time, the attending medical professional is under extreme time pressure to place a laryngoscope and breathing tube within the patient&#39;s airway to restore respiration and prevent aspiration. If he or she cannot achieve this in a timely manner, the result can be blood hypoxia, acidosis, and even death. 
     In view of these facts, it can be appreciated that it would be desirable to have a video laryngoscopy apparatus that includes means for clearing material that could obscure the view of a patient&#39;s airway during insertion of the apparatus into the trachea. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The present disclosure may be better understood with reference to the following figures. Matching reference numerals designate corresponding parts throughout the figures, which are not necessarily drawn to scale. 
         FIG. 1  is a front perspective view of an embodiment of a laryngoscopy apparatus. 
         FIG. 2  is a top view of the laryngoscopy apparatus of  FIG. 1 . 
         FIG. 3  is a front view of the laryngoscopy apparatus of  FIG. 1 . 
         FIG. 4  is a first perspective detail view of a distal end of the laryngoscopy apparatus of  FIG. 1 . 
         FIG. 5  is a second perspective detail view of the distal end of the laryngoscopy apparatus of  FIG. 1 . 
         FIG. 6  is a top detail view of the distal end of the laryngoscopy apparatus of  FIG. 1 . 
     
    
    
     DETAILED DESCRIPTION 
     As described above, it would be desirable to have a laryngoscopy apparatus that includes means for clearing material, such as patient liquids and/or solids, that could obscure the view of a patient&#39;s airway during insertion of the apparatus into the trachea. Examples of such an apparatus are disclosed herein. In one embodiment, a laryngoscopy apparatus is configured as a sleeve having a handle from which an elongated blade extends. The laryngoscopy apparatus is configured to receive a video device, such as a video baton, and the blade is configured to be inserted by a medical professional into the trachea of a patient for the purpose of intubation (i.e., placing a tracheal tube within the trachea). The apparatus comprises a first channel that extends through the handle and the blade, and terminates with a clear viewing window. When a camera of the video device is positioned against or adjacent to the viewing window, the internal anatomy of the patient can be viewed via images captured by the camera during insertion of the blade. The apparatus further includes a second channel that facilitates clearing of the viewing window of the laryngoscopy apparatus with a jet of fluid and a third channel that can be used to remove the ejected fluid and any material that has been cleared by the jet. 
     In the following disclosure, various specific embodiments are described. It is to be understood that those embodiments are example implementations of the disclosed inventions and that alternative embodiments are possible. Such alternative embodiments include hybrid embodiments that include features from different disclosed embodiments. All such embodiments are intended to fall within the scope of this disclosure. 
       FIG. 1  illustrates an example embodiment of a laryngoscopy apparatus  10  that includes means for clearing material from a viewing window of the apparatus. The example apparatus  10  of  FIG. 1  is configured as a video laryngoscope sleeve that is configured to receive a video device, such as a video baton. The apparatus  10  generally includes a handle  12  that is configured to be gripped by an operator and an elongated curved blade  14  that is configured for insertion through the mouth and into the trachea for the purpose of intubating a patient. In some embodiments, the handle  12  and blade  14  are unitarily formed from an inexpensive material, such as a polymer material, so the laryngoscopy apparatus  10  can be inexpensively produced and, therefore, is suitable for one-time use and disposability. As is apparent from  FIG. 1 , the blade  14  includes a relatively thick proximal portion  16  that extends from the handle  12  and a relatively thin distal portion  18  that extends from the proximal portion. The distal portion  18  forms a distal tip  20  of the blade  14 . 
     Extending through the handle  12  and the proximal portion  16  of the blade  14  is a first or primary channel  22  that is configured to receive the video device. In some embodiments, the primary channel  22  is specifically configured to receive, through a proximal opening  24  of the channel formed by the handle  12 , a particular model of video baton (not shown) that comprises a body, a camera, and a shaft that extends between the body and camera. By way of example, a body of the baton can be positioned within a proximal portion of the primary channel  22  formed by the handle  12 , the shaft can extend through a distal portion of the channel, and the camera can be positioned adjacent to a first distal opening  26  of the channel formed by the blade  14 . As shown most clearly in  FIGS. 2 and 4 , the primary channel  22  can, in some embodiments, have a generally rectangular (e.g., square) cross-section. 
     With reference to  FIGS. 1 and 3-6 , provided at the first distal opening  26  of the primary channel  22  is a clear viewing window  28  through which images and/or video (video being a series of sequential images) can be captured by the camera of the video device that is used with the laryngoscopy apparatus  10 . The viewing window  28  at least covers and seals the first distal opening  26  of the primary channel  22  so that material, such as liquids and/or solids from within the patient, cannot enter the primary channel. As is described below, however, the viewing window  28  can, in some embodiments, extend beyond the first distal opening  26  to serve a further purpose, such as forming a nozzle from which fluid can be ejected to clear material from the window. By way of example, the viewing window  28  can also made of a polymer material. 
     It is noted that, although a video baton has been identified as an example video device that can be received by and used with the laryngoscopy apparatus  10 , other video devices could be used with the apparatus. Indeed, substantially any video device having a camera that can be securely positioned within the distal portion of the primary channel  22  against or adjacent to the viewing window  28  could be used. Furthermore, it is noted that the video device need not include a camera that is positioned within the blade  14  or even the handle  12  of the laryngoscopy apparatus  10 . For example, one or more optical waveguides, such as optical fibers, could be inserted through the primary channel  22  in a manner in which their distal ends are positioned in contact with or adjacent to the viewing window  28 . In such a case, the one or more optical waveguides could transmit images to a camera that is either positioned within or outside of the laryngoscopy apparatus  10 . 
     Referring again to  FIG. 1 , the laryngoscopy apparatus  10  also includes a second or fluid delivery channel  30 . In the illustrated embodiment, the fluid delivery channel  30  forms part of and extends along a first lateral side of the handle  12  and the blade  14  (in particular, the proximal portion  16  of the blade). The fluid delivery channel  30  originates with a first proximal tube  32  that extends from the proximal end of the handle  12  and terminates with a second distal opening  34  that is positioned laterally adjacent to the first distal opening  26  of the primary channel  22 . In the illustrated embodiment, the viewing window  28  that covers and seals the first distal opening  26  of the primary channel  22  also covers and seals the second distal opening  34  of the fluid delivery channel  30 . As is most clearly apparent in  FIG. 6 , in such a case, the viewing window  28  includes an integrated fluid nozzle  36  unitarily formed with the viewing window that is in fluid communication with the second distal opening  34 . The fluid nozzle  36  is configured to eject a high-velocity jet of fluid transversely across an outer surface  37  (see  FIG. 6 ) of the portion of the viewing window that overlies the first distal opening  26  of the primary channel  22 . The dashed line in  FIG. 6  identifies the path of the fluid through the fluid delivery channel  30  and across the surface  37  of the viewing window  36 . The ejected fluid can comprise a gas, a liquid, or a combination of the two. Example gases include air and oxygen. Example liquids include water, saline, as well as solutions that contain one or more beneficial ingredients, such as one or more medications. When a jet of fluid is ejected across the viewing window  28 , material, such as fluids and/or solids from within the patient, are driven off of that outer surface so they will not obscure the view of the camera (or optical waveguide(s)) positioned behind the viewing window. 
     With reference to  FIG. 4 , provided on the opposite side of the fluid delivery channel  30  is a third channel  38 , which, depending upon how it is used, can serve as a suction channel or a working channel. For the remainder of this disclosure, the third channel  38  will be referred to as an “auxiliary” channel. The auxiliary channel  38  of the illustrated embodiment forms part of and extends along a second lateral side of the handle  12  and the blade  14  (in particular, the proximal portion  16  of the blade). The auxiliary channel  38  originates with a second proximal tube  40  that extends from the proximal end of the handle  12  and terminates with a third distal opening  42  that is positioned laterally adjacent to the first distal opening  26  of the primary channel  22 . As is apparent in  FIG. 4 , the third distal opening  42  is positioned on the opposite side of the primary channel  22  than the second distal opening  34  of the fluid delivery channel  30 . 
     In a first use case, the auxiliary channel  38  is used as a suction channel. In such a case, a suction source (not shown) can be connected to the second proximal tube  40  so that material can be removed from the area adjacent the viewing window  28 , as depicted by the dashed line in  FIG. 6 . This material can include any fluid ejected from the nozzle  36  as well as patient liquids and/or solids that the jet of fluid ejected from the nozzle has removed from the viewing window  28 . Accordingly, the nozzle  36  and the auxiliary channel  38  can be used together to clear and remove material that could otherwise obstruct the view of the patient airway. As is most clearly apparent in  FIGS. 4-6 , the blade  14  can include a lateral flange  44  that extends between the distal end of the proximal portion  16  of the blade and the distal portion  18  of the blade next to the third distal opening  42 . When provided, the flange  44  that serves as a backstop for the ejected fluid and removed material that moves across the viewing window  28  to assist in the removal of the fluid and material. It is further noted that, in some embodiments, the auxiliary channel  38  and/or its opening  42  can be optimized and positioned so as to configured to remove aerosolized virus from the patient. 
     In a second use case, the auxiliary channel  38  is used as a working channel through which other medical instruments can be passed. For example, a suction catheter (not shown) can be passed through the auxiliary channel  38  and used to clear the ejected fluid and/or patient material in similar manner to when the auxiliary channel is used as a suction channel. In addition, however, such a suction catheter can be extended beyond the distal end of the blade  14  to remove any material that exist beyond the third distal opening  42 . As another example, a guidewire (not shown) can be passed through the auxiliary channel  38  to facilitate the insertion of another medical instrument into the patient. In such a case, the laryngoscopy apparatus  10  also functions as an introducer. 
     Although the example laryngoscopy apparatus disclosed above has been described as being configured as a sleeve adapted to receive a separate video device, such as a video baton, it is noted that, in other embodiments, the laryngoscopy apparatus can include it&#39;s own integrated camera device, in which case the apparatus is actually a video laryngoscope. The term “laryngoscopy apparatus” is used broadly herein to include both sleeves for use with separate video devices as well as video laryngoscopes having their own fully integrated cameras.