Field of Search:
128/133,136-137,147,206,208,283,347-351,DIG.6,DIG.16,DIG.26 248/56,74PB,25A 24/73SH,81HS,DIG.11,DIG.18
Claims:
I claim
1. An endotracheal tube holder for holding an endotracheal tube in a patient's mouth during surgery comprising an adhesive-backed strip adapted to be adhesively secured over the mouth of the patient, the strip having an opening therethrough adapted to receive an endotracheal tube, and holding means mounted on the strip adjacent the opening for holding the endotracheal tube as it extends through the opening, the holding means including a strap having self-adhering ends and a strap support secured to the adhesive-backed strip adjacent the opening, the strap support having a portion extending from the strip generally parallel to the axis of the opening, the strap extending generally perpendicularly to said strap support portion and having a length sufficient to permit the strap to be wrapped around the tube with the ends of the strap means in overlapping adhering relationship whereby the strap can be wrapped around the tube in a plane extending generally perpendicularly to the axis of the opening and the tube can be held in a position generally parallel with the axis of the opening.
2. The tube holder of claim 1 in which the self-adhering ends of the strap include interengageable hook-and-loop fastening means.
3. The tube holder of claim 1 in which the adhesive-backed strip includes a release strip covering the adhesive, the release strip being removable from the adhesive-backed strip when the tube holder is to be secured to the patient's mouth.
4. The tube holder of claim 1 in which the adhesive-backed strip is formed of flexible material to permit the strip to conform to the contour of the patient's face.
Description:
BACKGROUND AND SUMMARY
This invention relates to an endotracheal tube holder for use during surgery. During most major surgical cases involving general anesthesia, a tube is inserted through the patient's mouth into the trachea to ensure an open airway. The tube is desirably held in a fixed position, and a common practice is to use a considerable amount of adhesive tape. Many physicians have their own favorite technique for securing the tube. Other means for holding endotracheal tubes are shown, for example, in U.S. Pat. Nos. 2,908,269, 3,602,227, and 3,713,448.
However, past techniques have not been entirely satisfactory. For example, the lack of standardization in the taping techniques might introduce inconsistencies in the method of securing the tube from one operation to another; the procedure might be too time-consuming; and the tape might not anchor the tube in a fixed position.
The invention provides a standardized method and means for holding an endotracheal tube which can be quickly applied and which securely holds the tube in the desired position. The tube holder includes an adhesive-backed plastery with a central opening. When the tube is positioned properly, the tube holder is slipped over the exterior end of the tube, the release strip on the adhesive is pulled off, and the plastery is adhered over the mouth. A strap having self-adhering ends which is mounted on the plastery is then wrapped around the tube and adhered to itself to anchor the tube in place. The tube can be removed if desired without removing the plastery merely by detaching the ends of the strap and withdrawing the tube. The tube holder can be removed from the the patient merely by stripping the single adhesive strip from the patient's face.
DESCRIPTION OF THE DRAWING
The invention will be explained in conjunction with an illustrative embodiment shown in the accompanying drawing, in which
FIG. 1 is a fragmentary side view of an endotracheal tube holder formed in accordance with the invention which is applied to a patient and which is holding an endotracheal tube;
FIG. 2 is a front elevational view of the tube holder, which also illustrates in phantom an endotracheal tube and the tube holding strap in a tube-holding position; and
FIG. 3 is a top plan view of the tube holder taken along the line 3--3 of FIG. 2.
DESCRIPTION OF SPECIFIC EMBODIMENT
Referring now to the drawing, the numeral 10 designates generally an endotracheal tube holder which includes an adhesive-backed strip or plastery 11 and a tube-holding strap 12. The strip 11 is relatively elongated and is adapted to fit lengthwise over the mouth below the nose. A central opening 13 is provided through the strip, and the adhesive backing extends from lines 14 and 15 laterally outwardly of the opening to the ends 16 and 17 of the strip. Release strips 17 and 18 cover the adhesive areas before the tube holder is used, and each release strip includes a free end portion 17a and 18a, respectively, which extends over the central non-adhesive-backed portion 19 of the strip to facilitate removal of the release strips.
The tube-holding strap 12 is secured to the central portion of the strip 11 immediately above the tube opening 13 by a support strap 20. The support strap is suitably secured to both the strip 11 and the tube-holding strap 12, as by adhesive or the like, and the support strap is seen to be generally L-shaped, having a portion 20a which is secured to the strip 11 and which extends generally perpendicularly to the axis of the opening 13 and a portion 20b which is attached to the tube-attaching strap 12 and which extends generally parallel to the axis of the opening 13.
The tube-attaching strap 12 is relatively elongated and includes a pair of end portions 22 and 23 which are adapted to be self-adhering when they are wrapped around the endotracheal tube and pressed together. In the particular embodiment illustrated, the adhering means comprises hook-and-loop fastening means which are sold under the name Velcro. The end portion 22 comprises a pad having a plurality of felt-like hooks on the upper surface thereof as viewed in FIG. 2, and the end portion 23 comprises a pad having a plurality of loops on the lower surface thereof as viewed in FIG. 2 which are interengageable with the hooks on the end portion 22. Since this type of fastening means is well-known, a detailed description thereof is unnecessary. It will be understood that many other self-adhering means can be used. For example, one or both ends of the strap can be provided with a pressure-sensitive adhesive.
Referring now to FIG. 1, an endotracheal tube 24 is shown inserted through the mouth of a patient P into the patient's trachea. After the tube is properly positioned, the tube holder is slipped over the exterior end (not shown) of the endotracheal tube by passing the end of the tube through the opening 13. The tube holder is then slipped along the tube toward the patient's mouth, and the release strips 17 and 18 are removed to expose the adhesive. The strip 11 is then secured over the mouth of the patient below the patient's nose by pressing the adhesive against the cheeks. The strip 11 is advantageously formed of flexible material, such as thin plastic or the like so that the strip can readily conform to the contour of the patient's face. The tube-holding strap 12 is then wrapped around the tube and the end portions 22 and 23 are secured together to anchor the tube in place. The tube is illustrated in phantom in FIG. 2 at 24', and the adhered end portions of the strap are indicated at 22' and 23'.
The portion 20b of the support strap 20 which is secured to the tube-holding strap 12 extends outwardly from the mouth generally parallel to the axis of the opening 13, and the tube-holding strap can therefore be wrapped around the tube in a plane which extends generally perpendicularly to the axis of the opening. Accordingly, the tube 24 can be held in a position in which it extends generally parallel to the axis of the opening.
The endotracheal tube can be withdrawn from the patient without removing the tube holder merely by detaching the adhered ends of the tube-holding strap 12 and withdrawing the tube. If the tube is to be reinserted, the tube can be inserted through the opening 13 and re-secured by the tube-holding strap. When the tube holder is to be removed from the patient, the adhesive-backed portions of the strip can merely be peeled away from the face.
Although the tube holder anchors the tube securely, it is relatively inexpensive, and it is disposable after a single use.
While I have described the tube-holding means as being a strap having self-adhering ends, the strap can also be equipped with means for securing the strap directly to the tube rather than to itself. For example, the strap can be provided with pressure-sensitive adhesive so that the strap can be secured around the tube.
The support strap 20 desirably assumes an L-shape in use so that the tube will be held in a position in which it extends parallel with the axis of the opening in the flexible strip. This support strap can be either flexible or inflexible, and I have found it advantageous to make the strap of flexible material to permit packaging the tube holder in a flat package.
While in the foregoing specification a detailed description of a specific embodiment was set forth for the purpose of illustration, it is to be understood that many of the details herein given may be varied considerably by those skilled in the art without departing from the spirit and scope of the invention.