Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
The invention relates to devices for the administration
of gases, and in particular to a gas administration valve
having a multi-purpose function.
_ACKGROUND OF' THE INVENTION
Administration o~ gaseS ~nd gas m:ixtures to patients
may be required in a variety of circumstances. Where a
patient has ceased breathing, or is breathing with diffi-
culty and requires assistance, some form of resusci-tation
treatment by a medical assistant may be required. This may
take the form of the administration of a gas m:ixture wi-th
or withou-t manual asistance, or with or withou~ a form of
mouth-to-mouth resuscitation, depending upon the condition
of the patient and the circumstances, and even upon the
equipment available and the location. In addition, the
type of resuscitation effort applied may depend upon -the
age of the patient. For example, infan-ts require a more
gentle form of treatmen-t than can be applied to adults.
Another circumstance where gas administration may
be required, is for analgesic purposes or for anaesthetic
purposes. Where, for example, a pa-tient is in pain, due,
for example, to an injury or an accident, gas mixtures may
be administered for the relief of pain. Where such a
patient is involved in an accident, and is, for example,
pinned by some s-tructure or article, such gas mixtures may
have to be self-administered in order to produce -temporary
unconsciousness so as to enable rescue workers to free the
victim.
In other circums-tances, a vic-tim may be suffering
from partial disability due -to inhalation of noxious gases,
and may simply require self-administered gas mixtures for
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breathing purposes in order to overcome the effects of the
incident.
These are merely examples of various different
situations in which the administration of gases may be
required. It will be appreciated that such gases may be
administered in different ways, other -than those suggested
herein. In addition, reference to administration of
"gases" is deemed to include any gas or mix-ture of gases
which may be administered for breathing purposes, or for any
treatment of any condition, or for relief of pain, or for
anaesthetic purposes, and includes the administration of
fresh air.
Different problems occur when gases are administere~
in such a wide variety of. circumstances.
For example, mouth-to-mouth resuscitation is
known to produce possible undesirable results. Where direct
mouth-to-mouth resuscitation is applied, simply by
placing the mouth over the mouth of the patient, it is
possible for the medical assistant to receive infection from
the patient. Instances are well known, where, for example,
paramedical personnel have become infected as a result
of giving emergency mouth-to-mouth resuscitation.
In an attempt to overcome -this problem, it is well
known to provide some form of mouth piece and mask, by means
of which mouth-to-mouth resuscitation may be given through a
mask and tube. Even in this case, however, it is possible
for -the assistant to receive exhaled breath from the patient.
A further and more fundamental disadvantage is
the fact that the medical assistant will be administering
his own exhaled air. Normally, exhaled air contains
approximately 15~ free oxygen. This percentage is, of course,
reduced in relation to normal fresh air and is generally
speaking not suf~icient to support life over a continuous
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period.
It is, therefore, highly desirable to supply some
form of gas mixture or oxygen supplement when applying
resuscitation.
A wide variety of different systems are available on
the market for resuscitation by administering oxygen or
mixtures of air and oxygen, through various forms of masks'
valves and bellows-type devices or bags.
These systems do, however, involve a certain cash
investment, and are often not available at the scene of the
emergency. In addition, however, they do require a certain
degree of training in their use. Operators of such equip-
ment require to develop a sensitive "feel" on the pressure in
the bellows or bag, so as to avoid overpressuring the lungs
of the patient. If the airway is obstructed, then it is
dangerous to overpressure the bag since it will increase
the obstruction, and operators must be carefully trained
to sense resistance.
When giving straightforward mouth-to-mouth
resuscitation, however, the presence of an obstruction
is more easily sensed. Resistance to air flow is im~ediately
apparent to anyone attempting to blow into the mouth of a
victim. -
Accordingly, a system whereby mouth-to-mouth
resuscitation could be applied, while at the same time
applying supplemental free oxygen or gas mixture would
be highly advantageous both from the viewpoint of initial
cost and also from the viewpoint of operator sensitivity.
When gases are administered in other situations,
and even self-administered, for example, for pain relief,
anaesthetic purposes, or for simply recovering from smoke
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inhalation or the like, the existing s~stems currently in
use provide a simple form of "demand" valve~ which is
connected to a pressurized souxce of gas. Such a demand
valve incorpoxates an on/off valve controlling the supply
of gas, and a flexible diaphragm, which senses the
inhalation effort of the victim, and operates the on/off
valve so that gas is supplied during inhalation. As soon
as the victim exhales, the diaphragm moves in the reverse
direction, and the on/off switch closes, and gas supply is
halted.
Such demand valves are in wide usage.
There are, however, certain disadvantages
associated with their use. If supply of the gas under
pressure becomes exhausted, or if the supply tube is
blocked, or bent, then the vic-tim will be unable to breathe
through the mask. If he is conscious he will, of course,
immediately remove the mask. If, however, he is unconscious
he may suffocate.
Demand valves of this kind may also be used for
emergency administration of gases by medical personnel.
Again, the assistant must be alert at all times to the
possibility of blockage in the gas supply, so that he may
immediately remove the mask in the event of failure.
Clearly, therefore, it is desirable to incorporate
in such a demand valve an additional valving system whereby
the victim or patient may be enabled to breathe atmospheric
air, in the event of failure of the gas supply to the
demand valve.
BRIE~ SUMMARY OF THE I~VENTION
The invention is directed to overcoming these
various different problems, by providing a multi-function
valve for the administration of gases comprising wall means
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defining a valve chambe~ having a gas administ~ation
opening, for deli~ery of gases to a patientl connectible
with a sui-table gas administration attachment, a pressurized
gas inlet in the wall means, an inlet valve for said gas
inlet, operating arm means associabed with said inlet
valve for opera-ting s~id inlet valve, said operating arm
means extending into the interior of said chamber, a wall
portion of said chamber having resuscitation fluid inlet
means, connectible to a resuscitation inlet supply, a
diaphragm in said chamber, dividing the same in-to upstream
and downstream chamber portion, with said resuscitation
inlet means on one side of said diaphragm, and said gas
administration opening and said gas supply inlet on the
opposite side of said diaphragm, and contact means on said
diaphragm movable into and out of contact with said valve
operating means, and fluid flow opening means in said
diaphragm, for fluid flow from one side of said chamber to
the other.
More particularly, the invention provides such a
multi-function valve wherein the diaphragm incorporates a
central rigid contact member for contacting said valve
operating member, and an annular flexible portion,
permit-ting said diaphragm to move toward and away from said
operating member.
More particularly, the inven-tion comprises a valve
having the foregoing advantages wherein the fluid flow
opening through the diaphragm is dimensioned so as to
cause said diaphragm to flex, in response to a moderate
inhalation effort by the victim, while being sufficien-t to
permit flow of air therethrough in response to a more
vigorous inhalation effort by the victim.
More particularly, the invention comprises a
valve havi.ng the foreyoing advantages wherein such fluid
flow openi.ng in such diaphragm is dimensioned so as to
permit resuscitation by mouth-to-mouth or manual means, by
supply of fluid from said resuscitation inlet means and
then through said fluid flow opening.
The various features of novelty which charac-terize
the invention are pointed out with particularity in the
claims annexed to and forming a part of this disclosure.
For a be-tter unders-tanding of the inventi~on, its operating
advantages and specific objects attained by its use,
reference should be had to the accompanying drawings and
descriptive matter in which there are illustrated and
described preferred embodiments of the invention.
IN THE DRAWINGS
_ _
Figure 1 is a section through a multi-function
valve according -to the inven-tion, showing the diaphragm in
its normal at res-t position;
Figure 2 is a top plan view of the diaphragm;
Figure 3 is a partial section corresponding to
Figure 1I but showing the diaphragm in its inhalation or
resusci-tation position, and,
Figure ~ is a partial sec-tion corresponding to
Figure 3, showing the diaphragm in its exhalation position.
Referring Eirst of all to Figure 1, it will be
seen that the invention generally comprises a multi-
function valve having a generally cylindrical shape in this
embodiment, the section bei.ny taken down the central axis
along the diameter o~ such cylindrical shape.
It will, however, be appreciated that the
invention is no-t solely restricted to such a shape, the
shape being illus-trated merely being one which c~n be most
conveniently and economically formed in various fabricating
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techni~ues.
~ eferring now to F'igure 1, it will be seen that
the inven-tion is illustrated there in the particular form
of a generally circular shaped structure, having upper and
lower ends and a hollow interior, which will be deseribed
in more detail below.
It will, however, be appreciated -that the
invention is not restrieted to sueh shape, but that i-t may
be construc-ted in other shapes and forms, without well
defined upper and lower ends, and may be constructed of a
variety of materials sueh as machined metals, castings,
thermoplastics and the like.
As illus-trated in this embodiment, the valve
chamber which is indicated generally as 10 comprises a
generally annular or cylindrical shaped sidewall 12, and a
frusto-conical wall portion 14. A generally annular ledge
portion 16 extends inwardly into the interior of chamber
10, at approximately the level of the transition between
wall portion 12 and wall portion 14, and the wall portion
14 is of substantially greater thickness than the wall
portion 12.
The upper end oE the cylindrical wall portion 12
is open, and is closed by means of a closure plate member
18, having a downwardly dependent skirt 20 r ex-tending
; downwardly within wall portion 12. A resusci-tation fluid
inle-t opening 22 is located centrally of member 18, and has
a typical frictional coupling 24 extending upwardly.
Coupling 24 is typically sized -to make a friction fit with
the resuscita-tion mouthpiece, or any o-ther form of
resuscitation gas supply, indicated in phan-tom as S, the
details of which are omitted for the sake of clarity.
At the lower end of wall por-tion 14, there is
provided a gas administrat:ion opening 26, connecting with
a suitable gas administrati,on coupling 28. Coupling 28 is
of a standard shape, designed to make a good friction fit
with a typical gas administration device such as a face
mask, or other breathing device such as a tube or the like,
indicated generally as D. Typically, a wire or plastic
mesh screen 30 will be located across outlet 26 to prevent
passage of solid material in either direction.
A pressurized gas inlet opening 32 extends through
wall 14, being located at an angle relative to the central
axis of the chamber 10. A pressurized gas conduit 34 is
threadedly engaged within suitable threaded means in
opening 32.
The supply of pressurized gas is controlled by any
suitable on/o:Ef control valve indicated as 36, of any
suitable type such as is well known in ~he art. The valve
member 36 will be secured typically by threaded means within
the interior of the pressurized gas supply conduit 34.
Valve 36 will typically be operated by an operating
arm 38. Arm 38 may be swung downwardly in-to the position
shown in phantom, so as to allow flow of pressurized gas,
and upon release of arm 38, it will spring back upwardly
into the solid line positionl thereby closing off supply of
gas.
In order to cause operation of the arm 38, in
response to an inspirationary effort by a patient or victim,
a flexible diaphragm 40 is provided within chamber 10.
Diaphragm 40 comprises an outer annular sealing rim 42,
an outer flexible portion 44, an intermediate annular semi-
circular channel portion 46l and an inner flexible portion
48. ~ central rigid contact disc 50 is connected to the
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inner extremity of flexible portion 48, and has gas passage-
way means, which in this case comprise a pair of openings
54 extending therethrough.
The rigid contact member 50 is of a shallow
~aucer~lik~ ~hap~ in ~ct~on, an~ is adap~d to ~xt~nd
downwardly into contact with the tip of arm 48.
The interior of wall portion 14 is machined out
to define a reduced diameter cavity wall 54, the lower of
which communicates with opening 26. At the upper end of
cavity will 54, there is machined an angled valve seat 56.
Valve seat 56 is intended to make sealing engagement with
the annular channel portion 46 of diaphragm 40.
In order to provide a passageway for exhaled
gases, a plurality of conduit drillings 58 are formed
through the body of wall portion 14, and the upper ends
of passageways 58 are normally closed off by the outer
flexible portion 44 of diaphragm 40.
Various different modes of operation are possible
with the valve according to the invention.
A. DEMAND VALVE
When in use as a simple demand valve, gases are
normally being self-administered, or may administered in
circumstances where a resuscitation treatment is impossible
for example, in the case of an accident victim or the like.
In this case, the resusci-tation valve supply S
would not, of course, be connected to the coupling 24. In
this type of operation, a breathing mask device will be
represented as D, connected to coupling 28. The gas under
pressure, typically oxygen, will be supplieq through
pressure gas supply condui-t 34~
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In -these circumstances it is assumed that the
victim is making a breathing effort, al-though this may
or may not be a reduced effort depending upon the condition
of the victim. In this case, the victim makes an inspiratory
effort. This produces a reduced pressure in the cavity wall
portion 54 of chamber 10. Diaphragm 40, through its
flexible portion 48,will flex downwardly in an at-tempt
to equalize this pressure. Contact member 50 will then
contact the tip of arm 38 and depress it downwardly as
shown in phantom. This will open up valve 36, thereby
allowing supply of pressurized gas to flow into the cavity
portion 54, and into the lungs of -the victim.
When the victim exhales, the pressure in cavity
54 becomes momentarily positive. This will immediately
cause diaphragm 40 to rise, thereby releasing arm 38
and shutting off valve 36. At the same time, the flexible
portion 34 of diaphragm 48, due to the positive pressure,
will lift off drillings 58, thereby allowing the exhaled
air and gas to pass outwardly.
In the event of malfunction in the supply of
pressurized gas, if this were a typical prior art demand
valve, there would then be no gas supply within cavity
54 for the patient or victim to breathe.
However, in the case of the present embodiment,
where the pressurized gas supply failed either through
exhaustion, or through a kink in the pipe, for example,
then the patient can inhale fresh air directly through gas
passageways 52 in the contact portion 50. It will, of
course, be understood that the gas passageways 52 will be
of such a size and shape that they will permit air to flow
into the cavity portion 54 in the lower region of the
chamber 10 where the patient inhales, but are not so
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large that they will overcome the tendency of the diaphragm
40 to move downwardly in response -to negative pressure
produced by such an inhalation.
In practice, the sizing and shaping of such
openings 52 can readily be arrived at by experimentation.
In this first mode of operation, it will thus
be appreciated that a patient or victim may use the
invention as a simple demand valve, for a variety of
different treatment situations, with or without the assis-
tance of a medical aid. In particular, where a medical
aid is not present, or where he fails to notice -the failure
in the gas supply, the patient will be able to continue
breathing, until the condition is rectified.
B. RESUSCITATION MODE
In this mode of operation, some form of resusci-
tation gas supply indicated generally as S will be
connected to the upper coupling 2~, and a typical mask
device or other gas administration attachment D will
be connected as before to coupling 28.
In this case it is assumed that the patient is
, temporarily unable to breathe, or is breathing only with
great difficulty.
In this case, after the medical assistant
makes the usual examination, of the mouth and air way and
general condi-tion of the victim, the gas administration
device D is placed over -the mouth, or down the throat
of the victim. The medical assistant will place his mouth
over the mouthpiece of the resuscitation supply S, and will
then apply a resuscitation exhalation into the supply
device S. This will then flow through opening 22 into the
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upper cylindrical portion of chamber 12 within skirt 20,
and wall 12 This w.ill cause a slight positive pressure
in the upper chamber por-tion. This will cause the
diaphragm 40 to be depressed downwardly, thereby
contacting arm 38, and opening valve 36~
As the medical assistan-t continues to blow into
the supply device S, exhaled air from the assistant will
flow through the opening 22, and thxough the openings 52 in
the diaphragm 40, and out through the opening 26 in-to the
breathing passages of -the victim. However, unlike
conventional resuscitation, this resuscitation air will be
enriched by the supply of pressurized yas such as oxygen,
or oxygen and other gases, :10wing inwardly to the lower
chamber portion through the gas supply 34.
As soon as the medlcal assistan-t stops -the
resusci-tation breath.ing eEEort, the natural resilience of
the lungs oE the patient will cause exhalation from the
patient. This will reverse the pressures within the
chamber 10, so that the pressure in the upper portion of
the chamber 10 goes to atmospheric, and the pressure in
the lower portion of the chamber 10 goes positive. This,
then, will cause the diaphragm 40 to flex upwardly, thereby
shutting off the valve 36, and at the same time opening up
the exhalation passageways 10 to permit outflow of exhaled
air.
The two openings 52 in the diaphragm have a
relatively small open area, and the plurality of conduits
58 have a relatively larger open area. Consequently the
air exhaled by the patient does no-t re-turn through the
openings 52 and into the mouth of the medical assistan-t,
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bu-t merely escapes to the atmosphe~:e -through the openings
58.
The medical assistant .is thus avoiding any direct
contact with the person or exhaled breath of the victim or
patient, and is thus free from any danger of infection.
In the event that the airway of the patien-t is
blocked, the medical assistant will immediately sense the
presence of the blockage. He will immediately sense that
; his breathing effort into the device S is being resisted
by some abnormality, and will then discontinue resuscitation
while he again checks the pa-tient's airway for an obstruc-tion.
C. ~ANUAL BAG RESUSCITATION
In this case, the device S represents a manual
air bag such as is used for resuscitation by more skilled
and experienced medical assistants. In this case, the
resuscitation effort is applied by squeezing the bag,
thereby causing flow oE fresh air from the bag, which may
in some cases be further enriched with other gases, such
gases flowing through the opening 2~ into the upper portion
of chamber 10.
Resuscitation and exhalation then continue as
before.
In this case, however, if there is an obstruction,
the medical assistant will require considerably more
experience to detect it, due to increased resis-tance in the
bag itself.
The foregoing is a description of a preferred
embodiment of the invention which is given here by way of
example only. The invention is no-t to be taken as limi-ted
to any oE the specific features as described, but comprehends
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all such variations thereoE as come with.in -the s.cope of
the appended claims.
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