TRACHEAL SUCTION CATHETER

CATHETER POUR SUCCION TRACHEALE

English Abstract

A suction catheter has a distal end portion
with an opening for insertion into a patient's airway.
The proximal end portion is attached to a resilient
tubular member on which an external valve mechanism
can operate to prevent fluid flow through the member.
The valve mechanism is biased to a normally closed
condition, will open the tubular member when depressed,
and will return to its normally closed condition when
not depressed. A downstream connector can be attached
to a source of suction. The invention is more
comfortable for the patient, uses fewer components and
is less expensive than prior art suction catheters.

French Abstract

Un cathéter à succion, destiné à être inséré dans les voies respiratoires d'un patient, comporte une terminaison distale munie d'une ouverture. Sa partie proximale est jointe à un tube élastique relié à une valve permettant de contrôler l'écoulement d'un fluide dans ce tube. Dans son mode de fonctionnement habituel, la valve maintient le tube fermé, l'ouvre lorsqu'elle est actionnée et le referme lorsque l'action est interrompue. Un appareil de succion peut être couplé au système par le biais d'une connexion située en aval. L'invention compte moins de composantes, elle est moins coûteuse à réaliser que les cathéters à succion de l'art antérieur et son utilisation présente moins d'inconfort pour le patient.

Claims

THE EMBODIMENTS OF THE INVENTION IN WHICH AN EXCLUSIVE PROPERTY OR
PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. A suction device for removing material from the trachea of a patient
during ventilation comprising, a catheter having an internal lumen and opposed front and
rear ends with the front end including a suction opening, front and rear couplings
supporting said catheter and a protective sleeve normally enclosing said catheter and in
turn connected to said front and rear couplings, said catheter fixedly connected at its rear
end to said rear coupling, said front coupling including an internal seal for slidable receipt
of the outer surface of said catheter whereby said catheter front end may be inserted into
and withdrawn from the trachea of said patient, and said rear coupling including an
irrigation port in turn communicating with said catheter lumen whereby lavage fluid may
be injected into said port so as to wash said lumen and to directly irrigate the patient's
trachea through said suction opening.
2. The device of claim 1, said sleeve is in the form of an expandable,
collapsible plastic sheath normally enclosing said catheter and having opposed front and
rear ends respectively sealingly attached to said front and rear couplings, said rear
coupling movable towards said front coupling when said catheter is forwardly advanced
with accompanying collapse of said sleeve as when the catheter front end is inserted into
the patient's trachea.
3. The device of claim 1, said irrigation port having closure means.
4. The device of claim 1, including means connected to said rear coupling
for applying suction to said catheter.
5. The device of claim 4, said suction applying means including a tubular
member connectable at one end to a suction source and connected to said rear coupling

at the other end thereof and a valve member for effectively biasing said tubular member
in a normally closed position.
6. The device of claim 5, said rear coupling including a passageway
operationally connecting said catheter lumen with said tubular member and to said suction
source when said valve member is opened.
7. The device of claim 1, said irrigation port is connected to said rear
coupling passageway.
8. The device of claim 6, said rear coupling including a front portion
attached to said sleeve and a rearwardly disposed flange in turn supporting the base of
a leaf clamp comprising said valve member, said rear coupling further including a stem
rearwardly extending from said flange for receipt of said tubular member.
9. The device of claim 1, said device further including an adapter capable
of attachment to a tracheal tube connected to said front coupling, said adapter having a
ventilator side port adapted for connection to a ventilator and wherein said internal seal
through which said catheter tube is slidably received prevents inflation of said sleeve
during operation of the ventilator when the adapter is connected to the patient.
10. The device of claim 4, said means for applying suction to said catheter
and said irrigation port being separate and independent of each other such that the patient
may be simultaneously suctioned and lavaged.
11. A suction device for removing material from the trachea of a patient
during ventilation comprising a catheter having an internal lumen and opposed front and
rear ends with the front end including a suction opening, front and rear couplings
supporting said catheter and a protective sleeve normally enclosing said catheter and in

turn connected with said front and rear couplings, said catheter fixedly connected at its
rear end to said rear coupling, said front coupling including an internal seal for slidable
receipt of the outer surface of said catheter whereby said catheter front end may be
inserted into and withdrawn from the trachea of said patient, and said rear coupling
including an irrigation port in turn communicating with said catheter lumen at said rear
coupling whereby lavage fluid may be injected into said port so as to directly wash said
lumen in a rear to front catheter flow direction and to directly irrigate the patient's trachea
by passing out of the catheter through said suction opening.
12. The device of claim 11, said sleeve is in the form of an expandable,
collapsible plastic sheath normally enclosing said catheter and having opposed front and
rear ends respectively sealingly attached to said front and rear couplings, said rear
coupling movable towards said front coupling when said catheter is forwardly advanced
with accompanying collapse of said sleeve as when the catheter front end is inserted into
the patient's trachea.
13. The device of claim 11, said irrigation port having closure means.
14. The device of claim 11, including means connected to said rear
coupling for applying suction to said catheter.
15. The device of claim 14, said suction applying means including a tubular
member connectable at one end to a suction source and connected to said rear coupling
at the other end thereof and a valve member for effectively biasing said tubular member
in a normally closed position.
16. The device of claim 15, said rear coupling including a passageway
operationally connecting said catheter lumen with said tubular member and to said suction
source when said valve member is opened.

17. The device of claim 11, said irrigation port is connected to said rear
coupling passageway.
18. The device of claim 16, said rear coupling including a front portion
attached to said sleeve and a rearwardly disposed flange in turn supporting the base of
a leaf clamp comprising said valve member, said rear coupling further including a stem
rearwardly extending from said flange for receipt of said tubular member.
19. The device of claim 11, said device further including an adapter
capable of attachment to a tracheal tube connected to said front coupling, said adapter
having a ventilator side port adapted for connection to a ventilator and wherein said
internal seal through which said catheter tube is slidably received prevents inflation of said
sleeve during operation of the ventilator when the adapter is connected to the patient.
20. The device of claim 14, said means for applying suction to said
catheter and said irrigation port being separater and independent of each other such that
the patient may be simultaneously suctioned and lavaged.
21. A suction device for removing material from the trachea of a patient
during ventilation comprising a catheter having a single internal lumen and opposed front
and rear ends with the front end including a suction opening, front and rear couplings
supporting said catheter and a protective sleeve normally enclosing said catheter and in
turn connected to said front and rear couplings, said catheter fixedly connected at its rear
end to said rear coupling, said front coupling including an internal seal for slidable receipt
of the outer surface of said catheter whereby said catheter front end may be inserted into
and withdrawn from the trachea of said patient, and said rear coupling including an
irrigation port in turn communicating directly with said catheter lumen at said rear coupling
whereby lavage fluid may be injected into said port so as to directly wash said lumen in

a rear to front catheter flow direction and to directly irrigate the patient's trachea by
passing out of the catheter through said suction opening.
22. The device of claim 21, said sleeve is in the form of an expandable,
collapsible plastic sheath normally enclosing said catheter and having opposed front and
rear ends respectively sealingly attached to said front and rear couplings, said rear
coupling movable towards said front coupling when said catheter is forwardly advanced
with accompanying collapse of said sleeve as when the catheter front end is inserted into
the patient's trachea.
23. The device of claim 21, said irrigation port having closure means.
24. The device of claim 21, including means connected to said rear
coupling for applying suction to said catheter.
25. The device of claim 24, said suction applying means including a tubular
member connectable at one end to a suction source and connected to said rear coupling
at the other end thereof and a valve member for effectively biasing said tubular member
in a normally closed position.
26. The device of claim 25, said rear coupling including a passageway
operationally connecting said catheter lumen with said tubular member and to said suction
source when said valve member is opened.
27. The device of claim 21, said irrigation port is connected to said rear
coupling passageway.
28. The device of claim 25, said rear coupling including a front portion
attached to said sleeve and a rearwardly disposed flange in turn supporting the base of

a leaf clamp comprising said valve member, said rear coupling further including a stem
rearwardly extending from said flange for receipt of said tubular member.
29. The device of claim 21, said device further including an adapter
capable of attachment to a tracheal tube connected to said front coupling, said adapter
having a ventilator side port adapted for connection to a ventilator and wherein said
internal seal through which said catheter tube is slidably received prevents inflation of said
sleeve during operation of the ventilator when the adapter is connected to the patient.
30. The device of claim 24, said means for applying suction to said
catheter and said irrigation port being separate and independent of each other such that
the patient may be simultaneously suctioned and lavaged.
31. A suction device for removing material from the trachea of a patient
during ventilation comprising, a catheter having an internal lumen and opposed front and
rear ends with the front end including a suction opening, front and rear couplings
supporting said catheter and a protective sleeve normally enclosing said catheter and in
turn operatively associated with said front and rear couplings, said catheter connected at
its rear end to said rear coupling, said front coupling including an internal seal for slidable
receipt of the outer surface of said catheter whereby said catheter front end may be
inserted into and withdrawn from the trachea of said patient, including suction control
means connected to said rear coupling for applying and controlling suction to said
catheter, said control means including a longitudinally oriented resilient tubular member
having a straight through, normally unobstructed internal lumen, compression means
associated with said tubular member for sealing off said internal lumen in a normally
closed position, said compression member also operable solely by external operator
applied manual depression to open up said tubular member internal lumen so as to apply
suction to said catheter internal lumen, said compression means being continually urged

to a closed position and normally in a completely closed position when not being manually
activated.
32. The device of claim 31, said rear coupling including a passageway
operationally connecting said catheter lumen with said tubular member and to said suction
source when said valve member is opened.
33. The device of claim 31, said rear coupling including a front portion
attached to said sleeve and a rearwardly disposed flange in turn supporting the base of
a leaf clamp comprising said valve member, said rear coupling further including a stem
rearwardly extending from said flange for receipt of said tubular member.
34. The device of claim 31, said device further including an adapter
capable of attachment to a tracheal tube connected to said front coupling, said adapter
having a ventilator side port adapted for connection to a ventilator and wherein said
internal seal through which said catheter tube is slidably received prevents inflation of said
sleeve during operation of the ventilator when the adapter is connected to the patient.
35. The device of claim 31, said sleeve in the form of an expandable,
collapsible plastic sheath normally enclosing said catheter and having opposed front and
rear ends respectively sealingly attached to said front and rear couplings, said rear
coupling movable towards said front coupling when said catheter is forwardly advanced
with accompanying collapse of said sleeve as when the catheter front end is inserted into
the patient's trachea.
36. The device of claim 31, said valve member positioned to act externally
on opposed wall portions of said tubular member so as to collapse said tubular member
so as to effectively shut off fluid therethrough.

37. The device of claim 31, including means external of said valve for
preventing the accidental operation of said valve member.
38. The device of claim 33, including external prevention means for
preventing the accidental operation of said valve member, said prevention means including
said front portion of said rear coupling, said front portion upwardly extending at least a
major portion of the upward extent of said leaf clamp such that a patient laying an arm
across the valve member will contact said front portion and thus reduce contact with said
leaf clamp.
39. A suction device comprising a catheter having an internal lumen and
front and rear ends with the front end including a suction opening for insertion into and
withdrawal from the trachea of a patient, a resilient tubular member having a straight
through, normally unobstructed internal lumen and further opposed ends and adapted to
move between open and closed positions, said catheter end in turn operatively connected
to one end of said tubular member and the other end of said tubular member operatively
connected to suction means such that when said tubular member is in its open position
suction is operationally applied to said catheter and valve means for continually urging and
thus effectively biasing said tubular member to a normally closed position said valve
means in turn operable to its fully open position from its fully closed position solely by
external manual depression.
40. The device of claim 39, said valve means acting externally on said
tubular member such that the opposed walls thereof are effectively flattened thereby to
said normally closed position.
41. The device of claim 40, said valve means including a depression
mechanism whereby an operator can depress such so as to allow the tubular member to
return to its open position against the closing action of the valve means.

42. The device of claim 41, said valve depression mechanism adapted to
immediately shut off the fluid path of said tubular member and immediately return it to its
normally closed position when the mechanism is released after actuation.
43. The device of claim 39, including means external of said valve for
preventing the accidental operation of said valve means.

Description

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Background of the Invention
The use of a suction catheter to remove accumulated mucous from
a patient's airway is widely used and known. Sterile handling of the catheter and
connection to the ventilating machine have also been proposed and discovered.
Dryden, in Pat No. 3,902,500, first disclosed a catheter with a sleeve and a
device which first addressed the sterile technique and ventilator problems.
One of the main problems with Dryden was the fact that when it was
connected to the ventilating machine that oxygen being delivered to the patient
would inflate the protective sleeve and oxygen was lost through the open valve.
To solve these problems, Radford, Pat No. 3,991,762, proposed a
frontal seal which prevented the sleeve or envelope from inflating and a rear valve
mechanism which prevented oxygen from escaping into the atmosphere.
Most recently, Palmer, Pat No. 4,696,296, disclosed an
Aspirating/Ventilating Apparatus and Method with a protective catheter sleeve, afront catheter seal, an irrigation port located frontally and a rather complex
normally closed proximal valve mechanism.
The prior art is discussed in considerable detail in all these patents.
To my knowledge, the device of Palmer is the only one which is
commercially available although it is very expensive (approximately $ 12.00 each)
versus a regular suction catheter without the Palmer features of around $.50 each.
In spite of the expense of Palmer many hospitals have begun using the
Palmer device since its catheter sleeve offers contamination protection to the user
and the device once attached to the ventilator can be reused to suction the
patient.
Protection to the healthcare worker from coming in contact with body
secretions is very important because of possible Hepatitis or HIV infection fromcontact with body fluids.
The device of Palmer does offer that protection to the user and has
proven successful in spite of the expense to the healthcare system.
Brief Summary and Objects of the Invention
With the foregoing in mind, the present invention offers all the
advantages of the prior art with additional features and at lower hospital cost.

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The present invention among other things, is unitized to prevent
separation and the danger of aspiration of loose components, is less expensive,
more comfortable for the patient, provides more effective and rapid suction, less
clogging of the device, and more thorough flushing of the inside of the catheterto prevent the growth of potentially harmful organisms.
Accordingly, it is a primary object to provide a device which is safer,
more convenient to use, less expensive, and yet provides protection to the user
from body fluid contact.
An objective of the invention is to provide a ventilator adapter which
will swivel in response to the user for greater patient comfort.
Another objective is to provide a completely unitized assembly to
eliminate any separation of any component.
Another objective is to provide a much less expensive and more
effective normally closed suction control device.
A further objective to the suction control device is to be external to
the fluid flow path to prevent internal blockages and clogging.
Another object is to provide a catheter flushing element which directly
accesses the inside of the catheter to thoroughly flush the catheter to prevent
blockage and eliminate organism contamination from residual mucous.
Another important objective is to provide a completely closed suction
catheter system which prevents user contact with body fluids.
Another objective is to provide a device which is positioned
comfortably on the patient when not in use.
Detailed Description of the Illustrated Embodiment
Fig. 1 is a side view of the catheter assembly.
Fig. 2 is an enlarged sectional view of the lavage port.
Fig. 3 is a side view showing the catheter advanced and lavage at
catheter tip.
Fig. 1 is a side view showing flexible catheter 1 typically extruded
from PVC plastic. The distal tip of the catheter 2 is rounded smooth with a sidevent hole 3.

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The catheter is graduated 4 with centimeter markings to show the
depth of insertion into the trachea. Injection molded coupling 5 is made from rigid
PVC. Catheter 1 is solvent bonded into coupling 5 at joint 6. A side port 7
accesses internal lumen 22 on the coupling. Port seven is extruded from flexiblePVC. Solvent bonded onto 7 is an injection molded PVC connector 8 which will
accept any luer tip syringe. Closer cap 9 is normally closed on connector 8.
A collar or flange 10 having a recess 10a is provided on coupling 5 to
prevent inadvertent activation of a spring steel external clamp 11 having clamp
leafs 24 and 25. The clamp 11 includes a base 21a in turn having an opening 22
through which rubber or silicone tubing 14 passes. Tubing 14 is press fit onto
coupling over stem 15. Thus, the stem 15 and the tubing 14 thereover frictionally
position the clamp 11 as shown. The leafs in turn have inwardly extending fingers
21 b in turn each provided with an opening 23. The fingers 21 b in turn include a
forwardly extending integral tab at the inner periphery of the openings 23. These
tabs 12 and 13 are normally closed, that is, biased to contact each other so when
the tubing 14 is inserted through openings 23, the tabs 12 and 13 press down on
the tubing to completely close off the fluid path.
Note clamp 11 acts externally on tubing 14 such that when clamp
leafs 24 and 25 are pressed down by the user that resilient tubing 14 opens up
to permit fluid flow through the tubing. The clamp can be made in one piece of
spring steel.
The rear of tubing 14 is press fit onto suction connector 17 at joint
16. The connector is injection molded of rigid polypropylene. An integral strap
18 attaches to closer cap 19 to close off connector 17.
Strap extension 20 has a molded in hole 21 through which a simple
safety pin can pass through. The safety pin can attach to the patient's gown to
hold the device in place when not in use.
Fig. 2 depicts a complete closed tracheal suction system. An
extruded polyethylene envelope 25 is attached to coupling 5 using ultrasonic
welding.
Envelope 25 is attached at its distal portion to swivel adapter 30 at
joint 27 which also ultrasonically welds the envelope to the swivel adapter.

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The adapter is molded from clear rigid PVC with front swivel 31 which
directly attaches to the tracheal tube.
Side swivel 32 attaches to the ventilator tubing. Press fit into the
adapter is neoprene "O" ring 29 through which the front portion of the catheter
1 is inserted.
The O ring forms a seal around the catheter to prevent oxygen from
the ventilator inflating envelope 25.
Further since rear clamp 11 is normally closed no oxygen can escape
to atmosphere, e.g. via opening 3.
During use the device of Fig. 2 is attached to the patient at front
swivel 31.
The catheter can be advanced into the front swivel down into the
patient's trachea and the patient suctioned as often as desired without
disconnecting the ventilator from side swivel 32.
Black line 33 is an indicator line which indicates to the user that the
catheter is fully retracted and not inside the patient.
When suction connector 17 is connected to a source of suction no
suction is applied to the catheter tip until clamp 11 if fully depressed open.
The passageway of silicone tubing 14 and connector 17 is larger than
the catheter internal diameter such that any thick mucous plugs which pass
through the catheter will easily flow through the passageway of the tubing and
connector and will not clog the device.
Most importantly the silicone tubing 14 has a smooth uninterrupted
passageway wherein suctioned mucous will not become clogged.
The prior art of Palmer has a very complex internal mechanism which
readily becomes clogged with thick secretions making the entire system non-
functional .
Further, all the prior art of enveloped catheters have an irrigation port
located in a front coupling which accesses only the outside of the catheter.
Mucous plugs can become lodged in the inside of the catheter or in
the valve mechanism of the prior art with no means of internal flushing of the
catheter and the inside of the valve.

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The present invention shows flushing port 7 located in the rear
coupling 5 to effectively flush both the inside of the catheter and the entire
internal passageways of the device.
Cap 9 is readily opened and 5 to 8 cc's of water or saline will
effectively flush the device.
Encrusted and lodged mucous in the prior art catheters and valve
mechanism can breed viruses and bacteria which can be reintroduced at the next
suctioning procedure.
With the present invention instantaneous flushing of the entire
passageway takes place during flushing to prevent organism build-up.
All the normally closed valves of the prior art closed systems are
internal valve devices which are difficult to manufacture, expensive and block the
fluid flow of thick secretions often becoming clogged. This is why the Palmer
device must be disassembled wherein the present invention is unitized.
As can be seen the device is simpler, easier to use, and provides for
more effective suctioning and flushing of the device at less expense to the
institution .
Appropriate instructions for the use of the present closed track suction
system are as follows:
SET UP
1. Attach suction connection to wall suction.
2. Turn on wall suction before attaching the system to the patient,
depress suction control clamp while setting suction to desired level.
3. Attach ventilation circuit to side swivel opening.
4. Connect front 15 mm l.D. end to patient trach tube.
5. Insure irrigation port is closed.
6. Attach a safety pin to cap hole, if desired.
TO SUCTION PATIENT
1. Hold onto swivel adapter with one hand and advance catheter with
opposite hand through the sleeve.
2. Apply intermittent suction by depressing suction control clamp.

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3. Upon completion, fully retract the catheter until black line on catheter
is visible.
4. Flush catheter by introducing solution into the irrigation port (5 to 8
MLs)
Depress suction control clamp after instilling solution.
6. Turn off wall suction, cap, and pin to patient's gown.

Representative Drawing