Patent Description:
<CIT> (Ambu International A/S) discloses a disposable resuscitator comprising an elastically compressible elongated squeeze bag having a first opening, a one-way valve for the intake of oxygen-containing gas into the bag mounted in said first opening, a second opening which is in airtight communication with a valve housing in the form of a transparent pipe having a pipe stub for the attachment of the resuscitator to a facial mask, and an outlet for exhalation air.

<CIT> discloses a bag mask resuscitator including a flexible tubing having a proximal end and a distal end with the proximal end engaged to a resuscitation bag and the distal end adapted for engagement with a valve assembly. The valve assembly includes a coupling member adapted for quick engagement and disengagement of the flexible tubing from the valve assembly using a simple action.

<CIT> discloses a portable artificial respirator in the form of two bellows arranged one inside the other. The inner bellows form a volume for the intake of fresh air.

The volume made up by the space between the inner bellows and the outer bellows is for the extraction of foul air. A drilled plate placed outside air intake valves may be provided with a breathing filter. The device has a T-tube that also acts as a handle so the operator can pump in an up down movement to alternately fill the inner volume with air by pulling the handle up and ventilate the air to the patient by pressing the handle down towards the patient's face. However, the device is not self-inflating and does not include an elastic squeeze bag.

<CIT> discloses a closed circuit breathing bag for a person that breathes spontaneously and is not a resuscitator that assists in ventilating a patient. The exhaled CO2 is converted to O2 in the filter in a carbon filter that contains potassium superoxide. This allows the person to re-breath his/her own exhalation air as it is enriched with O2 when passing the carbon filter. Therefore, this is a completely different technology compared to a resuscitator which is being used for ventilating persons that are not breathing spontaneously.

<CIT>, <CIT> and <CIT> relate to resuscitator bags provided with an air filter at the air intake end.

Resuscitator bags are used for manual ventilation of patients in emergency care (pre-hospital) or in hospital care, e.g. by anaesthetists in the initial phase of anaesthesia for surgical procedures.

However, the aerosols contained in the surrounding air may contain particles and/or microbial or viral pathogens. Thus, there is a risk that particles and/or pathogens may be transferred to the patient resulting in a risk that the patient catches diseases of bacterial or viral origin (e.g. Covid-<NUM> or other airways related diseases) if the inspiratory air contains such particles and/or pathogens.

Furthermore, the aerosols contained in the expiration air form the ventilated patient may contain microbial or viral pathogens that are spread to the environment surrounding the patient and thus also the operator and/or clinician (anaesthetist, nurse, pre-hospital emergency care etc.) providing the manual ventilation to the patient. Thus, there is a risk that pathogens may be transferred from the patient to the operator resulting in a risk that the operator catches diseases of bacterial or viral origin (e.g. Covid-<NUM> or other airways related diseases) if the operator inhales aerosols expelled from the patient through the outlet on the PEEP valve on the resuscitator bag.

In some situations, a filter (catching aerosols including pathogen bacteria and/or virus present herein) is provided on the patient inspiratory port and thus between the face mask, laryngeal mask or ET tube and the resuscitator bag while performing manual ventilation of the patient. This filter does, however, increase the dead space of the ventilatory pathway leading to increased rebreathing of air, which may result in hypercapnia. The dead space is that volume of previously exhaled gas which is delivered to the patient in the succeeding inflation. Also, placing the filter at the patient inspiratory port will lead to an increased inspiratory and expiratory resistance.

<CIT> discloses an application for a Positive End-Expiratory Pressure (PEEP) valve including a filter media in the air flow between a patient interface and exit vent(s). The patient interface is connected to a patient airway system and the exit vents exhaust exhalation gasses into the atmosphere. The filter prevents or reduces the passage of microbes from the patient's exhalation gasses into the atmosphere. The PEEP valve provides positive gas pressure to a patient's lungs, requiring a predetermined exhalation gas pressure to be exceeded before releasing exhalation gasses into the atmosphere. However, the filter media is arranged in a filter holder inserted between the patient airway system and the PEEP valve, thereby increasing the size of the entire resuscitator arrangement.

<CIT> discloses a resuscitator including a self-inflating squeeze bag, an inlet valve arrangement and a patient valve housing. A filter may be arranged outside the inlet valve arrangement.

<CIT> discloses a temporary patient ventilator which has guy wires attached to the inside resilient walls of the airbag which are pulled to collapse the airbag. A filter may be arranged outside the inlet valve.

An object of the present disclosure is to provide a resuscitator provided with a filter arrangement for the inspiratory air of the patient without increasing the dead space of the ventilatory pathway and without any substantial increase of the inspiratory and/or expiratory resistance.

In view of this object, the filter arrangement is located inside the squeeze bag.

The invention is defined in the appended independent claim <NUM>. Preferred embodiments are matter of the dependent claims.

By filtering the inspiratory air of the patient before the air reaches the patient valve arrangement from the squeeze bag, the dead space associated with the patient connection port and its connection with the patient airway device (e.g. face mask, supraglottic airway device, tracheal tube etc.) is not influenced by the filter arrangement. Likewise, the expiratory resistance experienced by the patient is not influenced, and the inspiratory resistance may be influenced very little, depending on the size and location of the filter arrangement. Furthermore, when the squeeze bag is compressed, the inflation resistance may be influenced very little or not at all, also depending on the size and location of the filter arrangement.

By locating the filter arrangement inside the squeeze bag, the overall dimensions of the resuscitator may be unaffected by the filter arrangement, and the resuscitator will be less bulky when the filter is arranged inside the squeeze bag. Furthermore, the filter area can be made larger when arranging the filter inside the squeeze bag. This allows for maximizing the filter area which may reduce inspiratory resistance.

In an embodiment, a peripheral edge of the filter arrangement fits a cross-section of a wall of the squeeze bag, and the peripheral edge of the filter arrangement is attached to the wall of the squeeze bag.

In an embodiment, the filter arrangement is attached at the squeeze bag outlet opening.

In an embodiment, the peripheral edge of the filter arrangement has been attached to the wall of the squeeze bag by assembling the squeeze bag from two complementary squeeze bag parts and sandwiching the peripheral edge of the filter arrangement between opposed edges of the complementary squeeze bag parts. Thereby, a strong connection between the peripheral edge of the filter arrangement and the wall of the squeeze bag may be obtained.

In an embodiment, the squeeze bag is elongated in a longitudinal direction extending from the squeeze bag inlet opening to the squeeze bag outlet opening, and the filter arrangement has a longitudinal direction being arranged obliquely to the longitudinal direction of the squeeze bag. Thereby, the filter area of the filter arrangement may be maximized. In particular, the filter area of a single sheet filter may be maximized.

In an embodiment, the filter arrangement is attached at the squeeze bag inlet opening. Thereby, when the squeeze bag is compressed, the inflation resistance may be influenced very little or not at all, depending on how much or whether the filter arrangement itself is deformed when squeezing the squeeze bag. If the filter arrangement itself is not deformed when squeezing the squeeze bag, the inflation resistance may not at all be influenced by the filter arrangement.

In a structurally particularly advantageous embodiment, the filter arrangement is attached to the squeeze bag inlet valve housing.

In an embodiment, the filter arrangement has a peripheral edge attached along a corresponding edge of a filter opening of the squeeze bag inlet valve housing.

In an embodiment, the filter arrangement has the form of a flat filter.

In an embodiment, the filter arrangement includes one or more pocket filters and/or filter bags. Thereby, the effective filtration area may be increased.

In an embodiment, the filter arrangement has the form of a filter bag having a ring-formed peripheral part extending away from the squeeze bag inlet opening and being arranged adjacent an inside wall of the bag. Thereby, the influence on the filter arrangement and consequently on the inflation resistance from squeezing the squeeze bag may be minimised, because the ring-formed peripheral part extending away from the squeeze bag inlet opening may flex towards the inner of the squeeze bag when the squeeze bag is squeezed. Therefore, squeezing the squeeze bag will not result in much air being pressed through the filter bag. Furthermore, the form of the filter bag having a ring-formed peripheral part extending away from the squeeze bag inlet opening may allow packing the resuscitator for transport by pressing opposed ends of the squeeze bag, corresponding to the ends provided with the squeeze bag inlet opening and the squeeze bag outlet opening, respectively, into the interior of the squeeze bag.

In an embodiment, the filter arrangement has the form of a pocket filter or filter bag being tapered in a direction extending away from the squeeze bag inlet opening. Thereby, the influence on the filter arrangement and consequently on the inflation resistance from squeezing the squeeze bag may be minimised, because the volume of air inside the pocket filter or filter bag may be less at a central area of the squeeze bag where the squeeze bag is squeezed.

In an embodiment, the filter arrangement has the form of a number of filter bags arranged in a ring-form adjacent an inside wall of the squeeze bag. Thereby, the influence on the filter arrangement and consequently on the inflation resistance from squeezing the squeeze bag may be minimised, because the number of filter bags arranged in a ring-form may flex towards the inner of the squeeze bag when the squeeze bag is squeezed. Therefore, squeezing the squeeze bag will not result in much air being pressed through the filter bags. Furthermore, the number of filter bags arranged in a ring-form may allow packing the resuscitator for transport by pressing opposed ends of the squeeze bag, corresponding to the ends provided with the squeeze bag inlet opening and the squeeze bag outlet opening, respectively, into the interior of the squeeze bag.

In an embodiment, the one or more pocket filters and/or filter bags is/are adapted to be maintained in shape by means of a flexible skeleton. Thereby, it may be ensured that the one or more pocket filters and/or filter bags are maintained in their optimal shape for filtering when the squeeze bag flexes elastically back to its normal form after it has been squeezed.

In an embodiment, the filter arrangement includes a filter material having an effective filtration area which is greater than, preferably at least <NUM> times, more preferred at least <NUM> times, and even more preferred at least <NUM> times a minimum cross-sectional flow area of the patient connection port. Thereby, even if the filter arrangement is located inside the squeeze bag, when the squeeze bag is compressed, the inflation resistance may be influenced very little or not at all.

In an embodiment, the filter arrangement includes a filter material based on textiles. The filter material may generally form a bacterial and/or viral filter.

In an embodiment, the patient expiration outlet port is provided with a PEEP valve for the control of the flow and/or pressure at the patient expiration outlet port, and the PEEP valve has a PEEP valve filter. This may reduce and/or eliminate that the operator is exposed to pathogens (bacteria and/or virus) while manually ventilating a contagious patient using the resuscitator. Additionally, the risk of spreading of pathogens to the surroundings ( e.g. in airborne aerosols) may be reduced and/or eliminated.

In an embodiment, the PEEP valve includes a PEEP valve housing having a peripheral PEEP valve housing wall, the peripheral PEEP valve housing wall is provided with a number of patient expiration outlet openings for outlet of exhaled gas from the PEEP valve housing to the surroundings, and the PEEP valve filter is arranged to filter air flowing through the patient expiration outlet openings.

In an embodiment, the peripheral PEEP valve housing wall is cylindrical.

In an embodiment, the peripheral PEEP valve housing wall is tapering in a direction away from the squeeze bag.

In an embodiment, the PEEP valve filter is covering an outside of the peripheral PEEP valve housing wall.

In an embodiment, the PEEP valve filter is integrated in the PEEP valve.

In an embodiment, the PEEP valve filter is adapted to click on the PEEP valve.

The present disclosure furthermore relates to a PEEP valve as described above for attachment to a patient expiration outlet port of a resuscitator of any suitable type. The PEEP valve is adapted for the control of the flow and/or pressure at the patient expiration outlet port, and the PEEP valve has a PEEP valve filter.

The disclosure will now be explained in more detail below by means of examples of embodiments with reference to the very schematic drawing, in which.

In the following, generally, similar elements of different embodiments have been designated by the same reference numerals.

<FIG> shows a well-known prior art resuscitator <NUM> including a self-inflating elastic squeeze bag <NUM>, without filtration of the inspiratory air. The resuscitator <NUM> may in a manner well-known in the art be used for manual ventilation of patients in emergency care (pre-hospital) or in hospital care, e.g. by anaesthetists in connection with anaesthesia during surgical procedures. The self-inflating elastic squeeze bag <NUM> may for instance be made of styrene-ethylene-butylene-styrene block copolymer (SEBS) or poly vinyl chloride (PVC). The self-inflating function of the squeeze bag <NUM> is obtained in that the material of the squeeze bag <NUM> is an elastic material. Therefore, the squeeze bag <NUM> may be compressed by an operator from it relaxed state as illustrated in the figures to a compressed (not shown) state. Subsequently to being compressed by the operator, the compressed squeeze bag <NUM>, when let free from its compression by the operator, will by means of its elasticity return to its relaxed state and thereby drag respiration air into the squeeze bag.

As seen in <FIG>, the self-inflating squeeze bag <NUM> has a squeeze bag inlet opening <NUM> and a squeeze bag outlet opening <NUM>. The squeeze bag inlet opening <NUM> accommodates a squeeze bag inlet valve housing <NUM> including a squeeze bag inlet valve arrangement <NUM> (not visible in <FIG>) being adapted to allow inflow of air into the squeeze bag <NUM> and being adapted to prevent outflow of air from the squeeze bag <NUM> through the squeeze bag inlet opening <NUM>. The squeeze bag outlet opening <NUM> accommodates a patient valve housing <NUM> including a patient valve arrangement <NUM> (not visible in <FIG>) being adapted to allow outflow of air from the squeeze bag <NUM> into the patient valve housing <NUM> and being adapted to prevent inflow of air into the squeeze bag <NUM> through the squeeze bag outlet opening <NUM>. The patient valve housing <NUM> further includes a patient connection port <NUM> for directing air to and from the patient airways and a patient expiration outlet port <NUM> for outlet of exhaled gas from the patient valve housing <NUM> to the surroundings. As seen in <FIG>, the patient connection port <NUM> is provided with a face mask <NUM> for ventilation of a patient, but, alternatively, among others, the patient connection port <NUM> could be provided with a laryngeal mask or an endotracheal tube (ET tube) for ventilation of a patient.

As further seen in <FIG>, the patient valve housing <NUM> is provided with a manometer port <NUM> with cap, a so-called M-port <NUM> for installation of medication or measurement of CO<NUM> and a pressure limiting valve <NUM>, and the patient expiration outlet port <NUM> is provided with splash guards <NUM> in order to prevent an operator from splashes of fluid. Optionally, the patient expiration outlet port <NUM> may be provided with a PEEP valve <NUM> as illustrated in <FIG> in order to control the pressure in a patient's lungs at the end of expiration. The squeeze bag inlet valve housing <NUM> is further provided with an oxygen reservoir bag <NUM> and an oxygen inlet connector <NUM> (not visible in <FIG>) adapted to fill the oxygen reservoir bag <NUM> with oxygen from an oxygen supply. The squeeze bag <NUM> is provided with a support strap <NUM>.

<FIG> and <FIG> illustrate different embodiments of a resuscitator <NUM> of the same type as illustrated in <FIG>, however, according to the present disclosure, provided with a filter arrangement <NUM> located upstream the squeeze bag outlet opening <NUM> in order to filter air before reaching the patient valve arrangement <NUM> from the squeeze bag <NUM>. <FIG> illustrate different embodiments of a resuscitator <NUM> of a somewhat different type than that of <FIG>, however, according to the present disclosure, also provided with a filter arrangement <NUM> located upstream the squeeze bag outlet opening <NUM>. In the different embodiments illustrated in <FIG> and <FIG>, the filter arrangement <NUM> is located inside the squeeze bag <NUM> (according to the principle of the invention), at the squeeze bag inlet opening <NUM> or outside the squeeze bag <NUM> (outside the invention).

However, it is understood that according to the present disclosure, the filter arrangement <NUM> may also be located at the squeeze bag outlet opening <NUM>, in arrangements corresponding to those illustrated at the squeeze bag inlet opening <NUM>, and the filter arrangement <NUM> may further be located at the squeeze bag outlet opening <NUM> inside or outside the squeeze bag <NUM>. <FIG> illustrates an embodiment in which the filter arrangement <NUM> is located inside the squeeze bag <NUM> at the squeeze bag outlet opening <NUM> in that the filter arrangement <NUM>, in the form of a flat filter <NUM>, is attached to the squeeze bag patient valve housing <NUM>. The resuscitator <NUM> illustrated in <FIG> is of the same type as the resuscitator illustrated in <FIG>, however, the patient valve housing <NUM> has been adapted somewhat in order to provide for a larger diameter of the patient valve housing <NUM> at the connection to the squeeze bag outlet opening <NUM>. Thereby, the illustrated flat filter <NUM> may have a larger diameter. It is noted that the illustrated flat filter <NUM> in both the embodiment illustrated in <FIG> and the embodiment illustrated in <FIG> could be covered on one or both its sides by means of a respective possibly detachable grid, grille, perforated plate or other arrangement suitable to maintain the shape of the flat filter <NUM> and suitable to hold the flat filter <NUM> in place.

It is noted that in the embodiment illustrated in <FIG>, the patient valve housing <NUM> may be connected detachably to the squeeze bag <NUM> so that the filter arrangement <NUM> may easily be replaced, if the need should arise, for instance because of a polluted filter. In fact, in all embodiments in which the filter arrangement <NUM> is located inside the squeeze bag <NUM>, it could be advantageous if the patient valve housing <NUM> and/or the squeeze bag inlet valve housing <NUM> would be connected detachably to the squeeze bag <NUM> so that the filter arrangement <NUM> could easily be replaced. Likewise, filter arrangements <NUM> having constructions as shown in any of the <FIG>, <FIG>, <FIG>, <FIG> to <FIG> and being attached to the inlet valve housing <NUM>, could alternatively be arranged at the squeeze bag outlet opening <NUM> as an alternative to the flat filter shown in <FIG>.

The inlet valve arrangement <NUM> and the patient valve arrangement <NUM> which are not visible in <FIG> are illustrated in the cross-sectional views of <FIG> and <FIG>. In the embodiments illustrated in <FIG>, the inlet valve arrangement <NUM> is of a different type than that illustrated in <FIG> and <FIG>, whereas the patient valve arrangement <NUM> is of the same type as that illustrated in <FIG> as well as <NUM> and <NUM>. The oxygen inlet connector <NUM> is not visible in <FIG>, but may be seen in <FIG>, <FIG>, <FIG>, <FIG> and <FIG>. Furthermore, an oxygen inlet port <NUM> arranged in the squeeze bag inlet valve housing <NUM> and connected to the oxygen inlet connector <NUM> is visible in <FIG>. In all illustrated embodiments, the squeeze bag inlet valve housing <NUM> is provided with an oxygen reservoir bag connector port <NUM> to which the oxygen reservoir bag <NUM> is connected. As it is understood from the figures, the oxygen reservoir bag <NUM> may be filled with oxygen directly from the oxygen inlet connector <NUM> without any intermediate valves.

In the embodiments illustrated in <FIG> and <FIG>, the inlet valve arrangement <NUM> is arranged in the squeeze bag inlet valve housing <NUM> as follows. As indicated in <FIG>, the squeeze bag inlet valve housing <NUM> has a circular disc <NUM> which along its periphery is attached to the squeeze bag inlet opening <NUM>. The central part of the circular disc <NUM> has the shape of a valve seat with holes <NUM> which are covered by a thin circular elastic valve flap <NUM> located on the interior side of the circular disc <NUM> and which is attached to the valve seat by a centrally located pin <NUM>. The circular elastic valve flap <NUM> together with the valve seat forms a main inlet one-way valve <NUM> of the inlet valve arrangement <NUM>. The exterior side of the disc <NUM> is integral with the squeeze bag inlet valve housing <NUM> having two parallel side walls <NUM> with holes <NUM>, these side walls forming valve seats for an ambient air intake valve <NUM> mounted on the inside of the squeeze bag inlet valve housing <NUM> and a relief valve <NUM> mounted on the outside of the squeeze bag inlet valve housing <NUM>, respectively. The ambient air intake valve <NUM> comprises in addition to the holes <NUM> a thin circular valve flap <NUM> which is attached to the valve seat by a pin <NUM>. Similarly, the relief valve <NUM> comprises another thin circular valve flap <NUM> which is attached to the valve seat by means of a pin <NUM>. The squeeze bag inlet valve housing <NUM> is at the end opposite to the disc <NUM> provided with the oxygen reservoir bag connector port <NUM>.

In the embodiments illustrated in <FIG>, the inlet valve arrangement <NUM> is arranged in the squeeze bag inlet valve housing <NUM> as follows. As indicated in <FIG>, the squeeze bag inlet valve housing <NUM> has a main inlet one-way valve <NUM> corresponding largely to the main inlet one-way valve <NUM> of the embodiment of <FIG> and <FIG>, although of slightly different construction. The end <NUM> of squeeze bag inlet valve housing <NUM> facing away from the squeeze bag <NUM> is provided with an ambient air inlet valve <NUM> corresponding to the ambient air inlet valve <NUM> of the embodiment of <FIG> and <NUM> to <NUM>. As seen in <FIG>, the end <NUM> of squeeze bag inlet valve housing <NUM> is also provided with a relief valve <NUM> corresponding to that of the embodiment of <FIG> and <NUM> to <NUM>.

The skilled person will understand that although different types of the squeeze bag inlet valve housing <NUM> and inlet valve arrangement <NUM> have been illustrated in the figures, all different types of filter arrangements <NUM> described and illustrated in the different figures may be employed irrespectively of the type of squeeze bag inlet valve housing <NUM> and inlet valve arrangement <NUM> employed. Nevertheless, some simple modifications of the squeeze bag inlet valve housing <NUM> and inlet valve arrangement <NUM> may be necessary in order to fit a different type of filter arrangement <NUM> that shown in the respective figures.

For instance, the filter arrangements <NUM> illustrated in <FIG>, <FIG>, <FIG>, <FIG>, <FIG> and <FIG>may be applied to the squeeze bag inlet valve housing <NUM> and inlet valve arrangement <NUM> illustrated in <FIG> without any substantial modifications of the squeeze bag inlet valve housing <NUM> or the inlet valve arrangement <NUM>. The other way around, the filter arrangement <NUM> illustrated in <FIG> may be applied to the squeeze bag inlet valve housing <NUM> and inlet valve arrangement <NUM> illustrated in <FIG>, <FIG>, <FIG>, <FIG>, <FIG> and <FIG> without any substantial modifications of the squeeze bag inlet valve housing <NUM> or the inlet valve arrangement <NUM>.

In all illustrated embodiments, as seen for instance in <FIG>, the patient valve arrangement <NUM> includes a single elastic valve flap <NUM> closing against a squeeze bag outlet valve seat <NUM> of the patient valve housing <NUM> in its relaxed state when the squeeze bag <NUM> is not compressed by an operator. In this state, the single valve flap <NUM> allows the patient to exhale through the patient connection port <NUM> and the patient expiration outlet port <NUM>, and further prevents inflow of air into the squeeze bag <NUM> through the squeeze bag outlet opening <NUM>. On the other hand, when the squeeze bag <NUM> is compressed by an operator or the patient is inhaling spontaneously through the resuscitator, the single elastic valve flap <NUM> abuts a patient expiration outlet valve seat <NUM>, thereby preventing communication between the patient connection port <NUM> and the patient expiration outlet port <NUM>, and the single valve flap <NUM> allows outflow of air from the squeeze bag <NUM> through the squeeze bag outlet opening <NUM>, into the patient valve housing <NUM> and further into the patient connection port <NUM> in order to ventilate the patient. The single elastic valve flap <NUM> is held by a valve pin <NUM>.

In the embodiments illustrated in <FIG>, <FIG>, <FIG>, <FIG>, <FIG>, <FIG> and <FIG>, which fall within the scope of the present disclosure, the filter arrangement <NUM> is located inside the squeeze bag <NUM>. This may have the advantage that the overall dimensions of the resuscitator <NUM> may be unaffected by the filter arrangement <NUM>, and the resuscitator <NUM> will be less bulky when the filter arrangement <NUM> is located inside the squeeze bag <NUM>. Furthermore, it may be an advantage that the effective filtration area may be maximised which may reduce inspiratory resistance.

In the embodiment illustrated in <FIG>, a peripheral edge <NUM> of the filter arrangement <NUM> fits a cross-section of a wall <NUM> of the squeeze bag <NUM>, and the peripheral edge <NUM> of the filter arrangement <NUM> is attached to the wall <NUM> of the squeeze bag <NUM>. In this embodiment, the filter arrangement <NUM> may be a flat filter <NUM> or a flat arrangement of a corrugated filter that collapses and expands with the compression and re-expansion of the squeeze bag <NUM>. The filter arrangement <NUM> may be attached to an inside wall <NUM> of the squeeze bag <NUM>, e.g. by gluing, hot melt etc. Alternatively or in addition, the filter arrangement <NUM> could be provided with a flexible rim that is attached and held in position by friction or by being glued, e.g. between protrusions or shoulders, on the inside wall <NUM> of the squeeze bag <NUM>.

In a further variation of the embodiment illustrated in <FIG>, the peripheral edge <NUM> of the filter arrangement <NUM> has been attached to the wall <NUM> of the squeeze bag <NUM> by assembling the squeeze bag <NUM> from two complementary squeeze bag parts and sandwiching the peripheral edge <NUM> of the filter arrangement between opposed edges of the complementary squeeze bag parts. After arranging the filter arrangement <NUM> inside a first squeeze bag part, the two squeeze bag parts of the squeeze bag is assembled, e.g. by gluing and/or hot melt, etc. The filter arrangement <NUM> may thereby be attached to the inside of the squeeze bag <NUM> prior to or during assembly of the bag, e.g. by gluing and/or hot melt etc..

As further seen, in the embodiment illustrated in <FIG>, the squeeze bag <NUM> is elongated in a longitudinal direction <NUM> extending from the squeeze bag inlet opening <NUM> to the squeeze bag outlet opening <NUM>, and the filter arrangement <NUM> has a longitudinal direction <NUM> being arranged obliquely to the longitudinal direction <NUM> of the squeeze bag <NUM>. Thereby, the filter area of the filter arrangement <NUM> may be maximized. In particular, the filter area of a flat filter <NUM> in the form of a single sheet filter may be maximised.

In the embodiments illustrated in <FIG>, <FIG>, <FIG>, <FIG>, <FIG>, <FIG> and <FIG>, the filter arrangement <NUM> is attached at the squeeze bag inlet opening <NUM>. Thereby, when the squeeze bag is compressed, the inflation resistance may be influenced very little or not at all, depending on how much or whether the filter arrangement <NUM> itself is deformed when squeezing the squeeze bag <NUM>. If the filter arrangement <NUM> itself is not deformed when squeezing the squeeze bag <NUM>, the inflation resistance may not at all be influenced by the filter arrangement <NUM>. It is noted that when placing the filter arrangement <NUM> at the squeeze bag inlet opening <NUM>, the compressed squeeze bag <NUM>, when let free from its compression by an operator, will by means of its elasticity in practice drag respiration air in through the filter arrangement <NUM>.

As an example, in the embodiment of <FIG>, the filter arrangement <NUM> takes up a relatively large part of the inner volume of the squeeze bag <NUM> and is therefore substantially deformed when squeezing the squeeze bag <NUM>. On the other hand, in the embodiment of <FIG>, the filter arrangement <NUM> takes up a relatively small part of the inner volume of the squeeze bag <NUM> and is arranged so that it is relatively little deformed when squeezing the squeeze bag <NUM>. Therefore, when the squeeze bag of the embodiment of <FIG> is compressed, the inflation resistance may be influenced relatively more than it is the case when the squeeze bag of the embodiment of <FIG> is compressed.

Furthermore, in the embodiments illustrated in <FIG>, <FIG>, <FIG>, <FIG>, <FIG>, <FIG> and <FIG>, the filter arrangement <NUM> is advantageously attached to the squeeze bag inlet valve housing <NUM>. More specifically, the filter arrangement <NUM> has a peripheral edge <NUM> attached along a corresponding edge <NUM> of a filter opening <NUM> of the squeeze bag inlet valve housing <NUM>. However, alternatively, in these embodiments, the filter arrangement <NUM> could be attached directly to the inside wall <NUM> of the squeeze bag <NUM>.

Apart from the embodiment illustrated in <FIG>, also in the embodiment illustrated in <FIG> and <FIG>, the filter arrangement <NUM> has the form of a flat filter <NUM>. According to these embodiments, the filter arrangement <NUM> does not need to be flexible, because compression of the squeeze bag <NUM> does not also compress the flat filter <NUM>. In the embodiment of <FIG>, the filter arrangement <NUM> may be attached by means of a compression ring <NUM> having a protrusion <NUM> mating with a corresponding cut-out <NUM> at the end of the squeeze bag inlet valve housing <NUM> arranged inside the squeeze bag <NUM>. Alternatively, the filter arrangement <NUM> may be attached to the squeeze bag inlet valve housing <NUM> by means of gluing or by using hot melt.

In the embodiments illustrated in <FIG>, <FIG>, <FIG>, <FIG>, <FIG> and <FIG>, the filter arrangement <NUM> includes one or more pocket filters and/or filter bags <NUM>.

In particular, in the embodiment illustrated in <FIG>, the filter arrangement <NUM> has the form of a filter bag <NUM> having a ring-formed peripheral part <NUM> extending away from the squeeze bag inlet opening <NUM> and being arranged adjacent an inside wall <NUM> of the squeeze bag <NUM>. Thereby, the influence on the filter arrangement <NUM> and consequently on the inflation resistance from squeezing the squeeze bag <NUM> may be minimised, because the ring-formed peripheral part <NUM> extending away from the squeeze bag inlet opening <NUM> may flex towards the inner of the squeeze bag <NUM> when the squeeze bag is squeezed. Therefore, squeezing the squeeze bag <NUM> will not result in much air being pressed through the filter bag <NUM>. Furthermore, the form of the filter bag <NUM> having a ring-formed peripheral part <NUM> extending away from the squeeze bag inlet opening <NUM> may allow packing the resuscitator for transport by pressing opposed ends of the squeeze bag <NUM>, corresponding to the ends provided with the squeeze bag inlet opening <NUM> and the squeeze bag outlet opening <NUM>, respectively, into the interior of the squeeze bag <NUM>.

In particular, in the embodiments illustrated in <FIG>, <FIG> and <FIG>, the filter arrangement <NUM> has the form of a pocket filter or filter bag <NUM> being tapered in a direction extending away from the squeeze bag inlet opening <NUM>. Thereby, the influence on the filter arrangement <NUM> and consequently on the inflation resistance from squeezing the squeeze bag <NUM> may be minimised, because the volume of air inside the pocket filter or filter bag <NUM> may be less at a central area of the squeeze bag <NUM> where the squeeze bag <NUM> is squeezed.

In particular, in the embodiment illustrated in <FIG>, the filter arrangement <NUM> has the form of a relatively large balloon-formed pocket filter or filter bag <NUM> taking up most of the internal volume of the squeeze bag <NUM> when the squeeze bag <NUM> is not compressed by an operator. Thereby, the effective filtration area may be maximised. According to this embodiment, the internal wall of the squeeze bag <NUM> could be provided with a number of protrusions, such as dot-like knobs or bosses, providing for a certain space between the balloon-formed pocket filter or filter bag <NUM> and the internal wall of the squeeze bag <NUM> and thereby avoiding that the filter material contacts the internal wall. Furthermore, it is preferred that the balloon-formed pocket filter or filter bag <NUM> is prevented from being pressed close against the inlet of the patient valve arrangement <NUM>. This could be done by adapting the size of the balloon-formed pocket filter or filter bag <NUM>, in particular in its lengthwise direction, or by providing the circumference of the inlet of the patient valve arrangement <NUM> in the squeeze bag <NUM> with protrusions or indentations.

In particular, in the embodiment illustrated in <FIG>, the filter arrangement <NUM> has the form of a pocket filter or filter bag <NUM> being tapered in a direction extending away from the squeeze bag inlet opening <NUM>. As seen, the pocket filter or filter bag <NUM> is provided with a circular peripheral edge <NUM> attached along a corresponding edge <NUM> of a filter opening <NUM> of the squeeze bag inlet valve housing <NUM>. Alternatively, the filter arrangement <NUM> could be attached directly to the inside wall <NUM> of the squeeze bag <NUM>. According to this embodiment, the pocket filter or filter bag <NUM> is rather flat and slightly V-formed when seen from above in <FIG>, as illustrated in <FIG>. On the other hand, when seen in the vertical cross-section of <FIG>, the pocket filter or filter bag <NUM> has a rectangular circumference. As seen in <FIG>, the pocket filter or filter bag <NUM> has a thin vertically arranged free end part. When the squeeze bag <NUM> is operated, it is held by the handle <NUM> and compressed symmetrically about the vertical cross-sectional plane. Thereby, the influence on the filter arrangement <NUM> and consequently on the inflation resistance from squeezing the squeeze bag <NUM> may be minimised, because the pocket filter or filter bag <NUM> is so thin in the compression direction of the squeeze bag <NUM> that the pocket filter or filter bag <NUM> is very little compressed.

In the embodiment illustrated in <FIG>, the filter arrangement <NUM> has the form of a number of filter bags <NUM> arranged in a ring-form <NUM> adjacent an inside wall <NUM> of the squeeze bag <NUM>. Thereby, the influence on the filter arrangement <NUM> and consequently on the inflation resistance from squeezing the squeeze bag <NUM> may be minimised, because the number of filter bags <NUM> arranged in the ring-form <NUM> may flex towards the inner of the squeeze bag <NUM> when the squeeze bag is squeezed. Therefore, squeezing the squeeze bag <NUM> will not result in much air being pressed through the filter bags <NUM>. Furthermore, the number of filter bags <NUM> arranged in the ring-form <NUM> may allow packing the resuscitator <NUM> for transport by pressing opposed ends of the squeeze bag, corresponding to the ends provided with the squeeze bag inlet opening <NUM> and the squeeze bag outlet opening <NUM>, respectively, into the interior of the squeeze bag <NUM>.

Alternatively, according to the embodiment illustrated in <FIG>, the filter arrangement <NUM> may have the form of a number of tapering filter bags <NUM> arranged evenly or in any suitable distribution over the cross-sectional area of the squeeze bag <NUM>. Advantages of the tapering filter bags <NUM> may be as described above.

As illustrated in the embodiments seen in <FIG>, the one or more pocket filters and/or filter bags <NUM> is/are adapted to be maintained in shape by means of a flexible skeleton <NUM>. Thereby, it may be ensured that the one or more pocket filters and/or filter bags <NUM> are maintained in their optimal shape for filtering when the squeeze bag <NUM> flexes elastically back to its normal form after it has been squeezed. A flexible skeleton <NUM> may likewise be employed in the pocket filters and/or filter bags <NUM> of the embodiments of <FIG> and <FIG>.

In the embodiments illustrated in <FIG> and <FIG>, which do not fall within the scope of the present invention, the filter arrangement <NUM> is located outside the squeeze bag <NUM>.

In the embodiments illustrated in <FIG> and <FIG>, the squeeze bag inlet valve housing <NUM> has a peripheral inlet valve housing wall <NUM> which extends beyond the squeeze bag inlet opening <NUM> and is provided with a number of ambient air inlet openings <NUM> for the intake of air from the surroundings into the squeeze bag inlet valve housing <NUM>. In the embodiments illustrated in <FIG>, the peripheral inlet valve housing wall <NUM> is cylindrical. In the embodiments illustrated in <FIG>, <FIG>and <FIG>, the peripheral inlet valve housing wall <NUM> is tapering in a direction away from the squeeze bag <NUM>.

In particular, in the embodiments illustrated in <FIG>, the filter arrangement <NUM> is arranged to filter air flowing through the ambient air inlet openings <NUM>.

In particular, in the embodiment illustrated in <FIG>, the filter arrangement <NUM> has the form of a filter material <NUM> covering an inside of the peripheral inlet valve housing wall <NUM>.

In particular, in the embodiments illustrated in <FIG> and <FIG>, the filter arrangement <NUM> has the form of a filter material <NUM> covering an outside of the peripheral inlet valve housing wall <NUM>. Of course, in these embodiments, filter material <NUM> could be protected by some sort of external cage or perforated wall, screen, grille, etc..

In particular, in the embodiment illustrated in <FIG>, the filter arrangement <NUM> has the form of a ring-formed filter bag <NUM> arranged on an outside of the peripheral inlet valve housing wall <NUM>.

In particular, in the embodiment illustrated in <FIG>, the ring-formed filter bag <NUM> extends beyond the inlet valve housing <NUM> in a direction away from the squeeze bag <NUM>. Furthermore, as seen, in this embodiment, a part <NUM> of the ring-formed filter bag <NUM> surrounds an oxygen reservoir bag <NUM> arranged at an end <NUM> of the squeeze bag inlet valve housing <NUM> opposed to the squeeze bag <NUM>.

In the embodiments illustrated in <FIG> and <FIG>, the ring-formed filter bag <NUM> may be adapted to be maintained in shape by means of a not shown flexible skeleton. Thereby, similar advantages as those discussed above in connection with the embodiments of <FIG> may be achieved.

As mentioned above, in the embodiments illustrated in <FIG>, the squeeze bag inlet valve housing <NUM> has an inlet valve housing end wall <NUM> facing away from the squeeze bag <NUM>, and the inlet valve housing end wall <NUM> is provided with an ambient air inlet valve <NUM>.

In the embodiments illustrated in <FIG>, the filter arrangement <NUM> has the form of a tubular filter <NUM> extending from the ambient air inlet valve <NUM>. As further seen, the tubular filter <NUM> extends in a direction away from the squeeze bag <NUM>, which direction may be in a longitudinal direction of the squeeze bag <NUM>, as seen in <FIG>, or in a transverse direction to the inlet valve housing <NUM>, as illustrated in <FIG>. It is noted that in the embodiment as illustrated in <FIG>, the oxygen inlet connector <NUM> is hidden behind the tubular filter <NUM>.

It may be preferred that the filter arrangement <NUM> includes a filter material having an effective filtration area which is greater than, preferably at least <NUM> times, more preferred at least <NUM> times, and even more preferred at least <NUM> times a minimum cross-sectional flow area of the patient connection port <NUM>. Thereby, even if the filter arrangement <NUM> is located inside the squeeze bag <NUM>, the inspiratory resistance may be influenced very little. An effective filtration area (EFA) can be defined as the total area of the filter media that is exposed to the flow of liquid or air, that is usable for filtration. This may for instance be designated in square centimetres (cm<NUM>).

The filter arrangement <NUM> may include a filter material based on textiles. The filter arrangement <NUM> may generally include a bacterial and/or viral filter. Such a filter arrangement <NUM> may be able to remove up to <NUM>,<NUM>% or <NUM>,<NUM>% of bacteria or virus from air.

The filter arrangement <NUM> may typically include a single layer or usually multiple layers of non-woven textiles made from fibres of polyester, polypropylene, acrylics or polystyrene or mixtures thereof. Alternatively, two, three or more layers (e.g. of different arrangements) of the same fibre or fibre mixture may be used. Each layer may be of different fibres and/or different arrangements. The filter arrangement <NUM> may typically include at least one (such as two or three) layers of non-woven polypropylene fibres, or a triple layer filter with acrylic/polystyrene nonwoven fibres.

The filter arrangement <NUM> preferably includes a non-woven polymer fibre layer with a scrim layer on each surface. The filters may be flat or shaped filters with a non-woven fibre layer (e.g. of spun polymer fibers, such as a blend of different synthetic polymer fibers, or one type of fibers, such as spun polypropylene (PP) fibers). The fibres may be treated to have an electrostatic, preferably positive, charged surface. The density of this non-woven filter layer is e.g. between <NUM>/m2 and <NUM>/m2 (Grams Per Square Meter). The density of the non-woven filter layer is preferably <NUM>-<NUM>, more preferred <NUM>-<NUM> even more preferred <NUM>-<NUM> and most preferred <NUM>-<NUM>/m2. The filter may be provided with scrim layers, such as thin (<NUM>/m2) layers of hydrophobic textile membrane (of non-woven polymer, e.g. a polypropylene (PP)) on both surfaces of the non-woven layer.

The electrostatic charge on the surface of the fibres attract aerosols or particles that may carry microbes or virus. Most airborne bacteria and virus use aerosols as a transport media. The aerosols are produced when people sneeze or cough. The surface charge of the aerosols results in that the aerosols are attracted to the electrostatically charged filter material, thus providing an improved filter efficiency. An example of suitable commercially available electrostatic filters are e.g. TECHNOSTAT ® or TECHNOSTAT PLUS by Hollingsworth & Vose.

As mentioned above, the patient expiration outlet port <NUM> of a prior art resuscitator as illustrated in <FIG> or of a resuscitator according to the present disclosure as illustrated in any of the <FIG>, may be provided with a PEEP valve <NUM> for the control of the flow and/or pressure at the patient expiration outlet port <NUM>. <FIG> illustrates a PEEP valve <NUM> according to the present disclosure, which PEEP valve <NUM> may be fitted on any of the resuscitators as illustrated in <FIG>, or on any other suitable prior art resuscitator, wherein the PEEP valve <NUM> has a PEEP valve filter <NUM>. This may reduce and/or eliminate that the operator is exposed to pathogens (bacteria and/or virus) while manually ventilating a contagious patient using the resuscitator.

As seen in <FIG>, the PEEP valve <NUM> includes a PEEP valve housing <NUM> having a peripheral PEEP valve housing wall <NUM>, wherein the peripheral PEEP valve housing wall <NUM> is provided with a number of patient expiration outlet openings <NUM> for outlet of exhaled gas from the PEEP valve housing <NUM> to the surroundings, and wherein the PEEP valve filter <NUM> is arranged to filter air flowing through the patient expiration outlet openings <NUM>.

Furthermore, the PEEP valve <NUM> includes a rotatable handle <NUM> threaded onto the PEEP valve housing <NUM> in order to adjust the valve opening of a valve element <NUM> in relation to a valve seat <NUM>. The rotatable handle <NUM> is acting on the valve element <NUM> by means of a compression spring <NUM> and the valve element <NUM> is guided by means of a spindle <NUM>. Furthermore, a tubular element <NUM> may be arranged between the compression spring <NUM> and the valve element <NUM> as seen in <FIG>.

In the embodiment of <FIG>, the peripheral PEEP valve housing wall <NUM> is cylindrical.

In the embodiment of <FIG>, the peripheral PEEP valve housing wall <NUM> is tapering in a direction away from the squeeze bag <NUM>.

As further seen, the PEEP valve filter <NUM> is covering an outside of the peripheral PEEP valve housing wall <NUM>.

The PEEP valve filter <NUM> may be integrated in the PEEP valve <NUM>, or the PEEP valve filter <NUM> may be adapted to click on the PEEP valve <NUM>.

Claim 1:
A resuscitator (<NUM>) including a self-inflating squeeze bag (<NUM>) having a squeeze bag inlet opening (<NUM>) and a squeeze bag outlet opening (<NUM>), the squeeze bag inlet opening (<NUM>) accommodating a squeeze bag inlet valve housing (<NUM>) including a squeeze bag inlet valve arrangement (<NUM>) being adapted to allow inflow of air into the squeeze bag (<NUM>) and being adapted to prevent outflow of air from the squeeze bag (<NUM>) through the squeeze bag inlet opening (<NUM>), the squeeze bag outlet opening (<NUM>) accommodating a patient valve housing (<NUM>) including a patient valve arrangement (<NUM>) being adapted to allow outflow of air from the squeeze bag (<NUM>) into the patient valve housing (<NUM>) and being adapted to prevent inflow of air into the squeeze bag (<NUM>) through the squeeze bag outlet opening (<NUM>), the patient valve housing (<NUM>) further including a patient connection port (<NUM>) for ventilation of a patient and a patient expiration outlet port (<NUM>) for outlet of exhaled gas from the patient valve housing (<NUM>) to the surroundings, and wherein the resuscitator (<NUM>) includes a filter arrangement (<NUM>) located upstream the squeeze bag outlet opening (<NUM>) in order to filter air before reaching the patient valve arrangement (<NUM>) from the squeeze bag (<NUM>), characterised in that the filter arrangement (<NUM>) is located inside the squeeze bag (<NUM>).