Method and apparatus for determining optimal endotracheal tube size
A method and apparatus for determining the optimal endotracheal tube size for the intubation of a patient based upon both optimal tube length and optimal tube diameter which are determined by using either direct or indirect measurement devices or techniques to measure the patient's glottis aperture and tracheal length. The apparatus may include a maneuverable arm, a fiber optic video guidance system and an introducer guide to maneuver an end of the apparatus around obstructions in a patient who has a difficult airway to facilitate insertion of either an optimally sized endotracheal tube or a standard endotracheal tube into the patient's airway.
1. An apparatus for intubating a patient with an endotracheal tube, the endotracheal tube being adapted to be inserted in a trachea of a patient requiring intubation, the patient having a head, a face, a mouth, an oral cavity, a thoracic area, a trachea having a length and forming an airway in the patient, vocal cords, a cricoid arch cooperating with the patient's vocal cords in forming a glottic aperture, and a carina defining a point at which the trachea separates into a left and a right bronchial tube, the apparatus comprising:
a hand-held intubating laryngoscope operatively connected to a handle and a detachable sterile cartridge, the laryngoscope including a curvilinear blade adapted to be inserted into the patient's oral cavity, the handle having a plurality of controls positioned thereon; the detachable sterile cartridge operatively connected to the handle, the detachable sterile cartridge being adapted to store a semi-flexible, hollow guide tube or introducer, wherein the curvilinear blade contains an extendable flexible intubation arm therein; the extendable flexible intubation arm including a hollow core extending coaxially along a length thereof, the extendable flexible intubation arm comprising a plurality of sections, each one of the plurality of sections being sequentially connected to an adjacent one of the plurality of sections by one of a plurality of extensible, rotatable joints, and a tip; and
a fiber optic video and ultrasound bundle having a fiber optic video portion and an ultrasound portion, wherein the fiber optic video portion of the bundle is adapted to aid in visually guiding the flexible extendable intubation arm into the patient's oral cavity; and wherein the ultrasound portion of the bundle is adapted to measure the length of the patient's trachea, wherein the fiber optic video and ultrasound bundle positioned within the extendable flexible intubation arm; and
the semi-flexible, hollow guide tube or introducer having measuring capabilites and being adapted to be deployed into the patient's trachea by sliding through a channel of the extendable flexible intubation arm and configured to be removed from the extendable flexible intubation arm, the curvilinear blade, and the handle to facilitate intubation of the patient with an endotracheal tube by guiding the endotracheal tube into the patient by passing the endotracheal tube over the introducer.
2. The apparatus of claim 1 , wherein the apparatus further includes a device for measuring a diameter of the glottic aperture.
3. The apparatus of claim 2 , wherein the device for measuring the diameter of the glottic aperture comprises a ring mandrel.
4. The apparatus of claim 2 , wherein the device for measuring the diameter of the glottic aperture comprises an optical scanning device.
5. The apparatus of claim 2 , wherein the device for measuring the diameter of the glottic aperture comprises an ultrasound scanning device.
6. The apparatus of claim 1 , wherein the endotracheal tube includes a cuff which is adjustably inflatable to a preselected pressure.