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Patent 1231018 Summary

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(12) Patent: (11) CA 1231018
(21) Application Number: 476061
(54) English Title: ENDOTRACHEAL TUBE ANCHORING MECHANISM
(54) French Title: MECANISME D'ANCRAGE D'UNE SONDE ENDOTRANCHEALE
Status: Expired
Bibliographic Data
(52) Canadian Patent Classification (CPC):
  • 128/122
(51) International Patent Classification (IPC):
  • A61M 25/02 (2006.01)
(72) Inventors :
  • ROXBURG, DWIGHT W. (United States of America)
  • MAGNUSON, LINDA M. (United States of America)
(73) Owners :
  • ROXBURG, DWIGHT W. (Not Available)
  • MAGNUSON, LINDA M. (Not Available)
(71) Applicants :
(74) Agent: GOWLING LAFLEUR HENDERSON LLP
(74) Associate agent:
(45) Issued: 1988-01-05
(22) Filed Date: 1985-03-08
Availability of licence: N/A
(25) Language of filing: English

Patent Cooperation Treaty (PCT): No

(30) Application Priority Data: None

Abstracts

English Abstract


ENDOTRACHEAL TUBE ANCHORING MECHANISM

Abstract Of The Disclosure

To prevent shifting of the intubated tube (11),
an endotracheal tube (11) is provided with a plurality of
longitudinally spaced transverse apertures (14, 14')
along its outer end portion. The apertures (14) are
formed by securing a latex rubber strip (13) to the
outer surface of the tube (11) at spaced locations or the
apertures (14') are formed in a longitudinal ridge (18)
of a tube (11) having an oval cross section. A twill
tape (15) is threaded through the aperture (14, 14')
next to the tracheostomy incision and the ends of the
tape (15) are tied behind the neck of the patient. If
the tube (11) is inserted through the oral cavity, an
elongated bite block (30) having a longitudinal reentrant
side may be secured to the tube (11) with the twill tape
(15).



Claims

Note: Claims are shown in the official language in which they were submitted.


-15-
We claim:
1. An endotracheal tube comprising an elongated tube having an
interior lumen, an exterior surface and a row of preformed apertures spaced
longitudinally along and extending transversely of the tube for securing the
endotracheal tube to a patient, each aperture being exterior to the lumen and
defining a passage having opposite open ends terminating at the exterior surfaceof the tube, the tube having an exterior ridge extending longitudinally thereof
and formed by a lateral portion of the tube wall having increased radial thickness,
and wherein said apertures extend transversely through said ridge.
2. The tube defined in claim 1, in which the apertures are inverted
T-shaped slots, the crossbar of the T extending substantially parallel to the
longitudinal axis of the tube and the leg of the T having an open end terminating
at the exterior surface of the tube whereby a twill tape may be inserted into
a slot transversely of its length and inadvertent removal of the twill tape is
deterred.
3. The tube defined in claim 2, including a flap extending across
the foot of an inverted T-shaped slot adjacent the exterior surface of the tube. 4. An endotracheal tube assembly comprising the endotracheal
tube defined in claim 1 and an elongated flexible strip threaded through a selected
one of the apertures.
5. The tube assembly defined in claim 4, in which the flexible
strip has a stiffened end portion to enable easy threading of the flexible stripthrough the selected one of the apertures.
6. The tube assembly defined in claim 4, including an elongated
bite block having a transverse aperture, said bite block being removably securedto the tube by tying said bite block to the tube with the flexible strip.
7. An endotracheal tube comprising an elongated tube having an
interior lumen, an exterior surface and a row of preformed apertures spaced
longitudinally along and extending transversely of the tube for securing the
endotracheal tube to a patient, the tube having an elongated strip extending
along the elongated tube, said strip being secured to the exterior surface at
locations spaced along the elongated tube, the apertures being defined between
the exterior surface of the tube and the strip, said strip having a width substan-
tially greater than its thickness.
8. The tube defined in claim 7, in which the strip is latex rubber.

-16-
9. An endotracheal tube assembly comprising an elongated tube,
an elongated flexible strip and an elongated bite block, said tube having an
interior lumen, an exterior surface and a row of preformed apertures spaced
longitudinally along and extending transversely of the tube for securing said
tube to a patient, each aperture in said tube being exterior to the lumen and
defining a passage having opposite open ends terminating at the exterior surfaceof said tube, said elongated flexible strip being removably threaded through
a selected one of the apertures in said tube, said bite block having a transverse
aperture extending therethrough, said bite block being secured to said tube
by tying said bite block to said tube with said flexible strip passing through
a selected aperture in said tube and said aperture in said bite block.
10. The tube assembly defined in claim 9, in which the bite block
includes an elongated hard core encapsulated in a material not as hard as said
core, said core being of thickness at least substantially as great as the diameter
of the tube lumen.
11. An endotracheal tube comprising an elongated tube having
an interior lumen, an exterior surface and a row of preformed apertures spaced
longitudinally along and extending transversely of the tube for securing the
endotracheal tube to a patient, each aperture being exterior to the lumen and
defining a passage having opposite open ends, the tube having an exterior ridge
extending longitudinally thereof, said ridge having an exterior surface continuous
with the exterior surface of the tube, said apertures extending transversely
through said ridge with said opposite open ends terminating at the exterior
surface of said ridge, said ridge having a width adjacent to the apertures substan-
tially greater than its height.
12. The tube defined in claim 11, in which the ridge is a portion
of the tube wall of increased radial thickness.
13. The tube defined in claim 12, in which the ridge has a transverse
cross-section which is convex throughout.
14. An endotracheal tube assembly comprising the endotracheal
tube defined in claim 11 and an elongated flexible strip removably threaded
through a selected one of the apertures, said flexible strip having a stiffened
end portion to enable easy threading of the flexible strip through the selected
one of the apertures.
15. An endotracheal tube assembly comprising the endotracheal
tube defined in claim 11, an elongated flexible strip removably threaded through

-17-
a selected one of the apertures, and an elongated bite block having a transverseaperture, said bite block being removably secured to the tube by tying said
bite block to the tube with said flexible strip.
16. An endotracheal tube assembly comprising an elongated tube
having an interior lumen, an exterior surface and a row of preformed apertures
spaced longitudinally along and extending transversely of said tube, and a twilltape removably threaded through a selected one of the apertures, each aperture
being exterior to the lumen and defining a passage having opposite open ends
terminating at the exterior surface of the tube, said twill tape having a stiffened
end portion to enable easy threading of the twill tape through the selected one
of the apertures.
17. A bite block for use with an endotracheal tube comprising
an elongated hard core encapsulated in a block of material not as hard as said
core, said block being generally a rectangular parallelepiped configuration and
having an aperture therethrough extending transversely to said core, the aperture
defining a passage having opposite open ends terminating at the same surface
of the block.
18. A bite block for use with an endotracheal tube comprising
an elongated hard core encapsulated in a block of material not as hard as said
core, said block being generally a rectangular parallellepiped configuration
and having an elongated reentrant side, the longest dimension of the elongated
reentrant side being generally parallel to said core and means to secure said
block to an endotracheal tube such that such reentrant side is parallel and adja-
cent to said endotracheal tube.

Description

Note: Descriptions are shown in the official language in which they were submitted.



~1~3~ 8




ENDOTRACHEAL TUBE ANCHORING MECHANISM

Technical Field
The present invention relates to endotracheal tubes
and, more particularly, to an attachment means for anchor-
in endotracheal tubes. The attachment means includes discrete locations along the proximal or upper portion of
the endotracheal tube to which an attachment strap may be
secured so that the tube may be anchored to a patient with
the desired length of the tube inserted into the trachea
10 and which deters bodily shifting of the tube within the
trachea. The attachment means may be incorporated into
the various types of endotracheal tubes as well as bite
blocks.
Background Art
Endotracheal tubes are incubated, i.e., inserted
into the trachea, to provide a clear passage for air to
the lungs if the trachea has been crushed in an automobile
accident, for example. Also, a tube may be incubated
prior to anesthetizing a patient with a general anesthe-
20 tic to maintain a clear air passage in case the trachea
collapses due to relaxation of the muscles supporting
the trachea.
Endotracheal tubes may be incubated through the
mouth, designated an oral endotracheal tube; through the
25 nose, designated a nasal endotracheal tube; or through a
tracheotomy incision in the front of the neck and trachea,
designated a tracheotomy tube. In an emergency situation
I.

I


an oral endotracheal tube is normally used to provide an
air passage to the lungs. After the patient's condition
has been stabilized, which may require a week or more,
the oral endotracheal tube is removed, a tracheotomy
incision is made in the neck and trachea, and a tracheas-
toy tube is incubated through the tracheotomy incision
to provide the air passage. Since bacteria grow rapidly
within the lumen or passage of the tube, both oral endow
tracheal tubes and tracheotomy tubes are replaced daily
with new sterile tunes.
The tubes also may include an inflatable endotra-
cheat balloon or cuff which surrounds and is fixed to the
outer surface of the tube adjacent to its lower end.
After the tube is inserted into the trachea, the bulb-
shaped cuff is inflated with air through a small diameter tube connected to the cuff interior and which runs upward
along the tube to the external portion of the tube. The
inflated cuff seals the space between the endotracheal
tube and tracheal wall, preventing air from escaping from
the lungs past the exterior of the tube and preventing
saliva and other liquids from draining into the lungs.
The trachea can be stretched and permanently
deformed if the cuff is overinflated. Therefore, as the
cuff is inflated, passage of air past the cuff is monitor-
Ed using a stethoscope. When passage of air ceases inflow-
lion of the cuff is stopped. The pressure exerted by the
cuff against the tracheal wall is sufficient to prevent
passage of air past the cuff but not sufficient to prevent
movement between the cuff and the tracheal wall.
Since the trachea in children is not as pliable as
in an adult, an inflated cuff could more easily stretch
and permanently deform the trachea of a child. Therefore,
pediatric endotracheal tubes do not include inflatable
cuffs and the space between the tube and the trachea must
be suctioned frequently to deter saliva from collecting in the lungs.

I

-- 3 --

To insure that the tube is not inserted so far
that the lower end is within one of the main stem bronchi
causing one of the lungs not to inflate, bilateral chest
excursion, i.e. movement of both sides of the chest during
breathing, is observed. To verify the location of the
lower end of the tube within the trachea, an X-ray opaque
color strip may be incorporated along the length of the
tube. After the tube is inserted into the lumen of the
trachea, the cuff is inflated, the tube is anchored in
place and proper positioning of the tube is verified by
X-ray photography.
The length of the endotracheal portion of the tube,
i.e. the amount of tube which is inserted into the patient's
trachea, is dependent on the length of the patient's trachea
and, in the case of a tracheotomy tube, the location of
the tracheotomy incision. The tube should be incubated
to the proper depth, namely past the tracheal blockage in
the case of a crushed trachea and preferably until the
lower or distal end of the tube is within a few centimeters
of the bronchial bifurcation of the trachea, i.e. just
above the right and left main stem bronchi, whether there
is a tracheal blockage or the patient is to be anesthetized.
The length of the tube projecting outward from the mouth
or neck incision of the patient is dependent on the length
of the endotracheal portion.
Once the endotracheal tube, whether an oral tube or
a tracheotomy tube, has been incubated to the proper depth,
it must be anchored to the patient to prevent accidental
withdrawal of the tube causing possible asphyxiation due
to collapse of the trachea and to prevent further insertion
of the tube past the bronchial bifurcation. Since the
trachea lengthens and contracts as the patient breathes,
there will always be some relative movement between the
endotracheal tube cuff and the trachea. Such movement
causes scar tissue to form which thickens the wall of the
trachea. By anchoring the exterior portion of the tube
stationarily such movement is minimized.

)
:L23~
-- 4 --

Since the tubes are made of pliant material and a
comatose patient may bite down on an oral endotracheal
tube so that the lumen or passage through the tube is
constricted, a bite block may be inserted between the
upper and lower teeth of the patient when an oral endow
tracheal tube is used. The bite block consists off
relatively hard material which either surrounds the tube
or has a thickness approximately equal to the diameter
of the tube.
- Sheridan et at. US. Patent No. 3,973,569 discloses
a tracheotomy tube assembly which comprises a tube having
a flexible, transversely elongated, fixed flange at the
proximal or upper end of the tube; a flexible transversely
elongated, slid able flange between the fixed flange and the
patient's neck; and a plurality of detachable split rings
positioned between the two flanges. As shown in Figure 3,
the assembly is anchored to the patient's neck by a strap
inserted through slots in the outer ends of the fixed and
- slid able flanges with the slid able flange abutting the
patient's neck. my inserting a greater number of split
rings between the two flanges, the portion of the tube
extending out away from the patient's neck is increased and
the endotracheal portion is shortened. The Sheridan et at.
assembly is objectionable because it is complex comprising
numerous parts and the range of tube penetration which may
be selected is limited to about 3 centimeters.
The tracheotomy tube retainer disclosed in the
McGinnis US. Patent No. 3,987,798 surrounds the upper end
of the tube and is banded to the patient's neck by a strap
extending through slots in the retainer. The retainer
includes a pair of opposed struts which project outwardly
perpendicular to the patient's neck and have a plurality
of slots spaced longitudinally along the struts. The upper
or external end of the tube has a pair of opposed lateral
tabs which project transversely outward from the tube.
Each tab is inserted into a slot in one of the struts
to secure the tube to the retainer. The penetration of

Lo


the McGinnis tracheotomy tube is established by insert-
in the tabs into the desired slots in the retainer struts.
The McGinnis assembly has an undesirably large number of
- interacting parts. Further the retainer permits only
about a 4 cm variation in the endotracheal length and
the retainer struts project some 5 cm outwardly from the
patient's neck.
The tracheotomy tube assembly of the Sanford et at.
US. Patent No. 4,235,229 includes a tracheotomy tube and
a neck collar which has an outstanding deformable sleeve.
The collar is strapped around the patient's neck with a
tie. The outer end portion of the tube, which has a pour-
amity of ribs, protrudes through the outstanding collar
sleeve. A pair of lugs on the outer end of the sleeve
projects transversely inwardly and engages the tube
between the ribs to anchor the tube. The range of endow
tracheal length is limited to about 2.5 cm.
Ross US. Patent No. 3,946,742 discloses a bite
block secured to an oral endotracheal tube by wrapping
an elastic strap which is secured to the bite block
around the endotracheal tube and engaging a selected hole
in a strap with a post on the bite block. An attachment
strap, permanently secured to the bite block, is wrapped
around the neck and secured to a post on the bite block.
The tube is not anchored reliably because the strap around
the tube may slip, particularly if it is moistened by
saliva, allowing the longitudinal position of the tube
within the trachea to change.
The clamps disclosed in Andrew US. Patent No.
3,602,227 and Nester et at. US. Patent No. 4,249,529
encircle and grip an endotracheal tube. Such clamps are
strapped around the neck and/or head of the patient with
attachment straps. Since the tube is made of flexible
material which becomes slippery when moistened, it may
slip relative to the clamp.
In the Schultz US. Patent No. 3,927,676 and Art
US. Patent No. 3,713,448, oral endotracheal tubes are

Jo I


held with adhesive tape. However, in replacing the tubes
at least daily, repeated stripping of adhesive tape skins
the patients face. Also the adhesive, when in contact
with saliva, promotes the growth of bacteria which increases
the risk of infection.
In summary, the tracheotomy tube attachment motion-
Sims of the prior art are complex, having numerous parts,
and the range of selectable endotracheal length is too
limited. The attachment mechanisms of the prior art oral
endotracheal tubes have not reliably anchored the tube to
the patient.
Disclosure of Invention
It is an object of the present invention to provide
an endotracheal tube which, after being inserted into
the trachea to the desired location, can be anchored
reliably with an attachment strap so that bodily shifting
of the tube within the trachea is deterred.
A further object is to provide a plurality of simple
and effective anchoring means spaced longitudinally along
such an endotracheal tube.
The foregoing objects can be accomplished by an
endotracheal tube having transverse slots spaced along
its upper end portion. After the tube is inserted into
the trachea, it is anchored by threading a twill tape
through the slot in a tracheotomy tube adjacent to the
tracheotomy incision or through the slot in an oral
endotracheal tube adjacent to the mouth of the patient and
securing the twill tape around the neck or head of the
patient.
It is also an object to provide a bite block which
may be secured to such an oral endotracheal tube at
discrete predetermined locations along such tube. Such
object can be accomplished by an elongated bite block
having a longitudinal reentrant, preferably v-shaped,
side engage able with an oral endotracheal tube and a
slot extending transversely of the bite block length,



through which the anchoring strap can be threaded to tie
the bite block to the tube.
Brief Description Of Drawings
- Figure 1 is a top perspective of an oral endotracheal
tube and anchoring mechanism in accordance with the present
invention, parts being broken away.
Figure 2 is a side elevation of the Figure 1 endow
tracheal tube assembly shown partly in section and having
parts being broken away.
Figure 3 is an enlarged transverse section taken on
line 3-3 of Figure 2, parts being shown in phantom.
Figure 4 is a top perspective similar to Figure 1,
showing a modified form of the assembly.
Figure 5 is an enlarged transverse section of the
15 Figure 4 endotracheal tube assembly.
Figure 6 is an enlarged longitudinal section of
the Figure 4 endotracheal tube assembly, parts being
broken away.
Figure 7 is an enlarged longitudinal section similar
20 to Figure 6, showing another embodiment.
Figure 8 is another enlarged longitudinal section
similar to Figure 6, showing yet another embodiment.
Figure 9 is a top perspective of one component of
the assembly shown in Figure 4.
Figure 10 is a transverse section taken on line
10-10 of Figure 9, an endotracheal tube being shown in
phantom.
Figure 11 is a top perspective similar to Figure 9,
showing a second embodiment of the component.
Figure 12 is a transverse section taken on line
12-12 of Figure 11, an endotracheal tube being shown in
phantom.
Figure 13 is another top perspective similar to
Figure 9, showing a third embodiment of the component.
Figure 14 is a transverse section taken on line
14-14 of Figure 13, an endotracheal tube being shown in
phantom.

~L~23~
-- 8 --

Figure 15 is another top perspective similar to
Figure 9, showing a fourth embodiment of the component.
Figure 16 is a transverse section taken on line
16-16 of Figure 15, an endotracheal tube being shown in
phantom.
Figure 17 is yet another top perspective similar to
Figure 9, showing a fifth embodiment of the component.
Figure 18 is a transverse section taken on line
18-18 of Figure 17, an endotracheal tube being shown in
phantom.
Best Modes For Carrying jut The Invention
Referring to Figure 1, the endotracheal tube assembly
of the present invention may include an oral endotracheal
tube 11 of flexible, bendable polyvinyl chloride plastic
which is curved to conform generally to the shape of the
oral cavity and trachea. Alternatively the tube may be
a nasal endotracheal tube shaped to conform to the nasal
cavity and trachea, or a tracheotomy tube shaped
- to conform to the trachea and project out of the tracheas-
toy incision. The general shape of all three of the tubes
and the lower portion of each tube is conventional.
To enable incubation into the trachea of different
sized patients, endotracheal tubes are made in different
sizes with inside diameters or lumens graduated in 0.5
millimeter increments from 2 millimeters to 5.5 millimeters
for pediatric use and 6 millimeters to 11 millimeters for
adults. A standard adapter 12, shown in Figure 1, to
which gas supply equipment may be connected is press
fitted into the proximal or upper end of the tube. The
projecting portion of the adapter is somewhat larger in
diameter than the tube. If it is obvious that the endow
tracheal tube is of such length that the exocorporeal port
lion of the incubated tube, i.e. the external portion of
the tube, will project excessively, the adapter may be
removed from the end of the tube, a length of the upper
end portion of the tube cut off, and the adapter replaced.



An oral endotracheal tube of the present invention
is anchored by securing an elongated flexible strip to
an anchoring means such as threading a twill tape through
an aperture in the tube next to the patient's mouth and
tying the tape firmly around the patient's neck so that
the twill tape adjacent to such aperture is pressed
against the corners of the patient's mouth. As shown in
Figure 1, a latex rubber strip 13 is attached along the
exterior upper end portion of the endotacheal tube 11
10 with its length extending longitudinally of the tube. The
latex strip is surgical material which may be 5 to 10
mm wide and about 1.5 mm in thickness, It is attached to
the tube over a longitudinal portion of the tube a multi-
plicity of times the diameter of the tube, such as 8 to
15 15 times the diameter of the tube and preferably about
12 cm.
As best shown in Figure 2, longitudinally spaced
5 mm long portions of the latex strip are adhesively
bonded to the tube every 2 centimeters forming a row of
to 12 apertures in the form of slots 14 each approxi-
mutely 15 mm long between the strip and tube. Any selected
slot will receive a l/2-inch (12.7 mm) wide twill tape
15 of woven cloth which is threaded through the slot of
a tracheotomy tube nearest the tracheotomy incision or
25 the slot of an oral endotracheal tube nearest the mouth
of the patient when the tube has been inserted into the
trachea the desired amount. To facilitate such threading,
the ends of the twill tape may be bound or wrapped to
form a cylindrical end portion as shown at 16 in Figure
30 1 or starched flat. such slot arrangement will permit
2-centimeter incremental positioning of the tube. Since
the lower end of the tube should be within only a few
centimeters of the bronchial bifurcation, such spacing
is adequate. For pediatric use, however, it may be
35 desirable to secure the latex rubber strip every 1 genii-
meter.

Slav

-- 10 --

Since the latex rubber strip 13 is soft and pliable,
easily sterilized, and compatible with internal use the
tube may be incubated to the extent that the latex rubber
strip is within the oral cavity when incorporated into
an oral endotracheal tube or within the trachea when
incorporated into a tracheotomy tube without causing
undue discomfort to the patient or injury to the oral
cavity or trachea. If the length of the strip is at
least 10 centimeters, the range of length of the present
10 tube which may be inserted into the trachea is far
superior to the range of selectable endotracheal length
of the positively secured tubes of the prior art. There-
fore, tubes of the same length can be used to incubate
patients whose size extends over a greater range.
To aid in locating the tube to the proper depth
within the trachea by showing how much tube has been in-
sorted and to permit recording of the tube position after
it is incubated so that a new identical tube can be
- incubated to the same depth when the old tube is replaced,
20 the distance between the lower end of the tube and each
point of attachment of the latex rubber strip to the tube
may be indicated on the tube exterior adjacent to the
latex rubber strip or, as shown at 17 in Figure 1, the
numerals may be printed on the latex rubber strip at the
25 points of attachment to indicate the distance to the
lower end of the tube in centimeters.
In the second embodiment shown in Figures 4 and
5, the slots 14' are formed in an integral ridge 18
extending longitudinally of the upper portion of the
endotracheal tube. The slots are formed transversely of
the tube ridge as the ridged tube is injection molded.
As best shown in Figure 5, the slotted portion of the
tube may be oval in cross section with a passage of
circular cross section. However, the tube may have an
oval bore and a uniform wall thickness.
As in the first embodiment, the twill tape is
threaded through the slot in the tube wall and is tied

I

-- 11 --

around the patients neck or head. The distance between
the lower end of the tube and each slot is indicated on
the tube in centimeters. If the tube is incubated to the
extent that the lowermost slots are within the oral
cavity or tracheal, the slots will not increase discomfort
or injure the oral cavity or trachea. This is contrary
to the prior art in which the tracheotomy tube attachment
means must always remain outside the body, thereby limiting
the degree of choice of endotracheal length of the prior
art tube.
The apertures of the second embodiment may be
grooves so that the twill tape can be inserted into the
groove transversely of its length at the desired location
along the tape instead of being threaded through a slot.
The inverted T-shaped slot or double undercut slot shown
in Figure 7 at 19 has its crossbar spaced from the outer
surface of the tube. The foot of the inverted T upright
passage may be closed with a flap 20 having its root
- integral with the tube wall as shown in Figure so that
inadvertent removal of the twill tape from the groove is
deterred. The free end portion of the flap 20 may fold
into a notch 21 cut in the surface portion of the tube
opposite the flap attachment to provide a flush surface.
Bite blocks prevent the orally incubated patient
from collapsing the pliable endotracheal tube by biting
it. Previously, as disclosed in the Eross~patent No.
3,946,742, one tie, which was permanently secured to the
bite block, strapped the bite block around the neck of
the patient and a second tie, also permanently secured to
- 30 the bite block, strapped the tube to the bite block. In
the present endotracheal assembly, the twill tape may be
threaded through a slot in the bite block and tied to the
tube before the same tape is fastened around the neck of
the patient. Since the twill tape is not permanently
secured to the bite block, if the twill tape becomes
soiled it may be replaced without replacing the bite
block.

1~3~
- 12 -

As shown in Figure 9, the bite block is a generally
rectangular block typically having a width somewhat greater
than its thickness and a length a plurality of times its
thickness. The length may be 3 centimeters to 9 centimeters,
the width 1 centimeter to 3 centimeters and the thickness
1 centimeter to 2.5 centimeters Preferably the length
is about 7 centimeters, the width between 1.8 centimeters
and 2.4 centimeters and the thickness between 1.6 genii-
meters and 2 centimeters. The length is chosen to permit
the bite block to be tied to the oral endotracheal tube
next to the patient's mouth and extend into the oral cavity
between the patient's upper and lower jaw molars. The
thickness of the bite block is greater than the diameter
of the endotracheal tube without being so thick as to make
it uncomfortable to maintain the bite block between the
jaws. The width of the bite block is chosen so that there
is an adequate surface on which to kite without making the
bite block so large that the bite block and endotracheal
tube cannot be inserted comfortably into the oral cavity.
As clearly shown in Figures 9 and 10, the bite
block 30 includes an elongated cylindrical core 31 of
hard plastic material encapsulated longitudinally within
the outer layer 32 of pliable material such as polyvinyl
chloride. The diameter of the hard plastic core should
be approximately the same as the tube passage. Since the
most common sizes of oral endotracheal tubes have lumens
7.5 millimeters and 8 millimeters in diameter, preferably
the diameter of the inn core 31 is 7.5 millimeters.
Referring to Figures 9 and 10, the bite block has
at least one longitudinal side which is reentrant
over the length of the bite block, such as being concave
complemental to the outer surface of the endotracheal
tube, or preferably V-shaped so that there will be two
lines of contact between the bite block and tubes of
different size.
In the bite block shown in Figures 9 and 10, a
ridge 33 generally parallel to the core projects from a

I


major surface adjacent to the reentrant surface. The
ridge includes two or more longitudinally spaced transverse
slots 34 so that the block may project into the patient's
mouth differing amounts or be reversed end for end if the
block has two opposed reentrant surfaces. As shown in
Figure 4, the bite block is secured to the tube by thread-
in one end of the twill tape 15 through the tube slot 14'
next to the patient's mouth, wrapping the opposite end of
the twill tape around the tube and bite block, threading
10 such opposite end of the twill tape through the bite
block slot adjacent to the outer end of the bite block,
inserting the opposite end of the bite hock into the
mouth alongside the incubated endotracheal tube, and
knotting the twill tape to maintain the tube in engagement
15 with the bite block reentrant surface. The free ends of
the twill tape are than wrapped on opposite sides of the
patient's neck, the tape cinched tight and the free ends
tied behind the neck of the patient to maintain the tube
- in the desired location.
Figures 11 through 17 show a number of the bite
blocks having different apertures through which the twill
tape may be threaded to secure the bite block to the
endotracheal tube. In the embodiment of Figures 11 and
12, two or more longitudinally spaced underpass or tunnel
25 slots 35 are formed in the bite block between the inner
core and the flat major surface 36 adjacent to the
longitudinal reentrant surface. Both ends of each under-
pass are in such major surface, creating a bridge 37
parallel to the inner core. The bite block is tied to
30 the tube in a manner similar to the embodiment of Figure
19 .
The embodiment of Figures 13 and 14 has a
plurality of slots 38 penetrating through the hock
between the inner core and one longitudinal reentrant
35 surface. As best shown in Figure 14, the slots are
generally perpendicular to the flat major surfaces 39
adjacent to the reentrant surface. The bite block is

~23~
- 14 -

secured to the enaotracheal tube with the reentrant
surface in contact with the tube by threading the twill
tape through one slot in the tube and one bite block
slot 38, wrapping the tape around the tube and tying
the tape.
The bite block shown in section in Figures 15
and 16 includes only one longitudinal reentrant surface.
Two apertures 40 subtend the corners of the bite block
opposite the reentrant surface. To tie the bite block to
the tube the twill tape is threaded in series through one
slot from one major surface adjacent to the reentrant
surface and threaded through the other slot from the
surface opposite the reentrant surface.
The final embodiment shown in Figures 17 and 18
is similar to the Figures 15 and 16 embodiment except
that semicircular grooves in the flat surface opposite
the longitudinal reentrant surface are substituted for
the apertures. The grooves extend from one major surface
- adjacent to the reentrant surface to the opposite major
surface adjacent to the reentrant surface. The bite
block is secured to the endotracheal tube with the neon-
tyrant surface against the tube by threading the twill tape
through a slot in the tube, wrapping the tape around the
bite block with a portion of the tape within one of the
bite block grooves and tying the twill tape.
In summary, the disadvantages of the prior art
endotracheal tube attachment mechanisms are overcome in
the present invention by eliminating the complex tube
holders which had to be secured to the tube and incur-
prorating into the tube a plurality of simple anchoring means to which a strap may be directly attached.
The present invention may be embodied in other spew
cilia forms without departing from the spirit or essential
attributes thereof and, accordingly, reference should be
made to the appended claims, rather than to the foregoing
specification, as indicating the scope of the invention.

Representative Drawing

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Administrative Status

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Administrative Status

Title Date
Forecasted Issue Date 1988-01-05
(22) Filed 1985-03-08
(45) Issued 1988-01-05
Expired 2005-03-08

Abandonment History

There is no abandonment history.

Payment History

Fee Type Anniversary Year Due Date Amount Paid Paid Date
Application Fee $0.00 1985-03-08
Owners on Record

Note: Records showing the ownership history in alphabetical order.

Current Owners on Record
ROXBURG, DWIGHT W.
MAGNUSON, LINDA M.
Past Owners on Record
None
Past Owners that do not appear in the "Owners on Record" listing will appear in other documentation within the application.
Documents

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Document
Description 
Date
(yyyy-mm-dd) 
Number of pages   Size of Image (KB) 
Drawings 1993-07-29 3 143
Claims 1993-07-29 3 134
Abstract 1993-07-29 1 21
Cover Page 1993-07-29 1 14
Description 1993-07-29 14 622