LARYNGOSCOPE GUIDE AND RELATED METHOD OF USE
A laryngoscope guide including a guide conduit for advancing an introducer. The guide can house an imaging system having a field of view and an optical axis. The guide can include a distal tip and a first blade plane that bisects the distal tip and/or the blade. The guide conduit can define an advancement axis projecting into the field of view, the advancement axis aligned to traverse and/or intersect at least one of the first blade plane and the optical axis. The orientation of the advancement axis relative to the first blade plane and/or optical axis can assist in viewing, aligning and optionally steering the introducer with the guide into a preselected location in a subject, such as a glottis or a trachea, to optionally establish an airway. The guide is suitable for use where neck mobility is an issue, an airway is difficult, or a subject is obese.
1 . A laryngoscope system comprising:
a portable, hand held laryngoscope including a handle and an imaging system adapted to communicate image data to a monitor, the imaging system having a field of view within which an optical axis projects, and
a laryngoscope guide joined with the laryngoscope, the laryngoscope guide including a blade having a distal tip and a laryngoscope guide element in the form of a conduit, the conduit including internal contours and extending between an entrance and an exit, the conduit including a lateral portion extending between the entrance and exit, the exit being proximal to the distal tip, the conduit defining an advancement axis that projects into the field of view, the advancement axis disposed at a first angle relative to the optical axis and oriented to traverse the optical axis,
wherein the conduit is configured to slidingly receive a flexible introducer at least partially through the conduit, the flexible introducer including a primary portion and a distal end, the internal contours of the conduit engaging the flexible introducer when the introducer and conduit slide relative to one another,
wherein the conduit is configured to establish at least a portion of a trajectory of the flexible introducer distal end and at least partially guide the flexible introducer so that the flexible introducer distal end travels toward the optical axis so that the distal end can be viewed and aligned with a preselected location of a subject in which the guide is inserted,
wherein the conduit is configured to surround the introducer so that the introducer is removable from the conduit through at least one of the entrance and the exit and so that the introducer is incapable of being removed laterally from the conduit through the lateral portion in a laryngoscopic procedure.
2 . The laryngoscope system of claim 1 wherein the internal contours are formed by an internal bore extending through the conduit, the internal bore opening to the environment only at the entrance and the exit, the entrance and the exit being located at opposite ends of the conduit.
3 . The laryngoscope system of claim 1 wherein the entrance is located adjacent the handle, wherein the exit is located at the opposite end of the conduit, and wherein the introducer is removable from the conduit only through at least one of the entrance and the exit.
4 . The laryngoscope system of claim 1 comprising a first blade plane that is perpendicular to and bisects at least one of the blade and the distal tip of the laryngoscope guide, wherein the advancement axis intersects the first blade plane at a first angle.
5 . The laryngoscope system of claim 4 wherein the blade includes a superior portion forward of the imaging system, wherein the superior portion defines a second blade plane that is perpendicular to the first blade plane, wherein the advancement axis diverges at a second angle away from the second blade plane.
6 . The laryngoscope system of claim 5 wherein the second angle is preselected so that the advancement axis is aligned with a laryngeal axis of the subject when the blade is engaged against tissue in an airway of the subject.
7 . The laryngoscope system of claim 5 wherein the first angle is between 1° and 25° and wherein the second angle is between 1° and 35°.
8 . The laryngoscope system of claim 1 wherein the conduit includes a major portion and a minor portion, the minor portion disposed at a third angle offset relative to the major portion.
9 . The laryngoscope system of claim 1 wherein the conduit surrounds the introducer to restrain movement of the introducer so that the introducer and conduit substantially only coaxially slide relative to one another in the laryngoscopic procedure.
10 . A laryngoscope system comprising:
a portable, hand held laryngoscope including a handle, a monitor joined with and moveable with the handle, and a guide attachment end, the guide attachment end including an imaging system and a light source, the imaging system adapted to communicate image data to the monitor, the imaging system having a field of view within which an optical axis projects; and
a disposable laryngoscope guide including a laryngoscope attachment end that is adapted to removably join the laryngoscope guide and the laryngoscope, the laryngoscope guide including a blade having a superior portion and an inferior portion opposite the superior portion, the superior portion and inferior portion joining at a distal tip of the blade, the blade defining a lateral portion and a medial portion with a first blade plane being generally vertical relative to the superior portion and being defined midway between the lateral portion and the medial portion, the laryngoscope guide including a viewing window adjacent the superior portion, the laryngoscope guide including a laryngoscope guide element in the form of a conduit extending from the laryngoscope attachment end toward the field of view, the conduit terminating at an exit and defining an advancement axis, the advancement axis projecting outwardly from the exit and intersecting the first blade plane forward of the viewing window, the disposable laryngoscope guide being joined with the portable, hand held laryngoscope at the guide attachment end, with the imaging system positioned so the optical axis projects through the viewing window and the field of view encompasses an area forward of the viewing window,
wherein at least one of the superior portion and the inferior portion of the blade are configured to engage tissue within a subject to move the tissue and establish a viewing volume, a glottis of a subject being within the field of view,
wherein the conduit is configured to slidingly receive a flexible introducer at least partially through the conduit, the flexible introducer including a primary portion and a distal end, the internal contours of the conduit engaging the flexible introducer to bend the flexible introducer when the introducer and conduit slide relative to one another,
wherein the laryngoscope guide is operable in a first mode in which the introducer is guided by the conduit so that the flexible introducer intersects the first blade plane and so that the distal end of the flexible introducer enters a glottis of the subject,
wherein the laryngoscope guide is operable in a second mode in which the laryngoscope guide is removed from the subject, with the distal end of the flexible introducer remaining in the glottis, and with the primary portion and conduit sliding coaxially relative to one another as the laryngoscope guide is removed,
whereby an endotracheal tube can be guided by flexible introducer toward the distal end so that a tube end of the endotracheal tube enters the glottis of the subject, whereby the flexible introducer is removable from the glottis while leaving the endotracheal tube in position with the tube end in the glottis of the subject to intubate the subject.
11 . The laryngoscope system of claim 10 wherein the advancement axis intersects the first blade plane at a first angle between 1° and 25°.
12 . The laryngoscope system of claim 11 wherein the advancement axis diverges at a second angle away from the superior portion of the blade so that as the flexible introducer is advanced, the flexible introducer diverges at the second angle away from the superior portion of the blade.
13 . The laryngoscope system of claim 10 wherein the advancement axis intersects the first blade plane forward of the distal tip of the blade.
14 . The laryngoscope system of claim 10 wherein the blade defines a second blade plane being generally horizontal and extending between the lateral portion and medial portion of the blade, wherein the conduit is positioned so that the exit is located a preselected distance above the second blade plane, wherein the advancement axis is oriented so as to diverge away from the second blade plane, whereby the introducer aligns with a laryngeal axis of the subject.
15 . A laryngoscope system comprising:
a laryngoscope guide at least partially housing an imaging system having a field of view and an optical axis, the laryngoscope guide including a blade having a superior portion and an inferior portion located opposite the superior portion, the laryngoscope guide including a distal tip and a first blade plane that generally bisects at least one of the distal tip and the blade, the laryngoscope guide including a conduit defining an advancement axis that projects into the field of view, the advancement axis aligned to traverse at least one of the first blade plane and the optical axis,
wherein at least one of the superior portion and the inferior portion of the blade are configured to engage tissue within a subject to move the tissue and establish a viewing volume, a preselected location of a subject being within the field of view,
wherein the laryngoscope guide is operable in a first mode in which the conduit establishes at least a portion of a trajectory of a flexible introducer and at least partially guides the flexible introducer so that the flexible introducer can be viewed and aligned with the preselected location,
wherein the laryngoscope guide is operable in a second mode in which the laryngoscope guide is removed from the subject, with at least a portion of the flexible introducer remaining in the preselected location, and with the introducer and conduit sliding coaxially relative to one another as the laryngoscope guide is removed,
whereby a tube can be guided by flexible introducer to the preselected location, the flexible introducer being removable from the preselected location while leaving the tube at least partially in the preselected location.
16 . The laryngoscope system of claim 15 wherein the advancement axis intersects at least one of the first blade plane and the optical axis at a first angle between 1° and 25°.
17 . The laryngoscope system of claim 15 wherein the blade includes a lateral portion and a medial portion, wherein the conduit defines an exit, wherein the blade defines a second blade plane being generally horizontal and extending between the lateral portion and the medial portion of the blade, wherein the conduit is positioned so that the exit is located a preselected distance above the second blade plane, wherein the advancement axis is oriented so as to diverge away from the second blade plane, whereby the introducer is adapted to align with a laryngeal axis of the subject in use.
18 . The laryngoscope system of claim 15 wherein the conduit defines an exit, wherein the exit is positioned a preselected distance forward of the imaging system, with the exit being closer to the distal tip than the imaging system.
19 . The laryngoscope system of claim 15 wherein the conduit defines an entrance and an exit and wherein the conduit is configured to surround the introducer so that the introducer is removable from the conduit through at least one of the entrance and the exit and so that the introducer is incapable of being removed laterally from the conduit in a laryngoscopic procedure.
20 . The laryngoscope system of claim 19 wherein the conduit is configured to surround the introducer to restrain movement of the introducer so that the introducer and conduit substantially only coaxially slide relative to one another in the laryngoscopic procedure.