US-12623039-B2 - Medico-surgical apparatus

US12623039B2US 12623039 B2US12623039 B2US 12623039B2US-12623039-B2

Abstract

Apparatus ( 20 ) for fitting to the machine end of a tracheostomy tube ( 10 ) includes both an HME and a speaking valve ( 30 ). The HME includes two exchange elements ( 28, 29 ) at opposite ends of a housing ( 23 ) extending laterally of a coupling ( 25 ) for fitting on the tube. The speaking valve has a cylindrical sleeve ( 31 ) extending across the housing midway along its length and in line with the tube. The sleeve is rotatable about its axis and has two openings ( 36 ) on opposite sides that can be aligned with the exchange elements of the HME to allow gas to flow from the tube through the exchange elements, bypassing the speaking valve. When the patient wishes to speak, he twists and rotates the speaking valve to block flow to the exchange elements and instead to allow air to be inhaled via the valve.

Inventors

Steven Mark Tupper
Jamie Daniel Perkins
Steven James Field

Assignees

SMITHS MEDICAL INTERNATIONAL LIMITED

Dates

Publication Date: 20260512
Application Date: 20210528
Priority Date: 20200603

Claims (8)

1 . Medico-surgical apparatus adapted for fitting with a machine end of a tracheostomy tube, characterised in that the apparatus includes a housing having both a one-way speaking valve and at least one HME element, that the apparatus is arranged such that in one state flow through the at least one HME element is enabled preferentially to flow through the speaking valve and in another state inhalation flow through the speaking valve is enabled preferentially to flow through the at least one HME element, that the speaking valve has a portion arranged to block a passage through the HME element in the other state, that the portion of the speaking valve is a cylindrical sleeve angularly displaceable within the housing, and that the sleeve has an opening that aligns with the at least one HME element in the one state.
2 . The medico-surgical apparatus according to claim 1 , characterised in that the speaking valve is fitted with the housing in a manner that enables the speaking valve to be displaced out of the housing by an excessive expiratory force.
3 . The medico-surgical apparatus according to claim 1 , characterised in that the apparatus has a coupling adapted for fitting with the machine end of the tracheostomy tube, a body portion extending transversely of the coupling, the at least one HME element and an other HME element at opposite ends of the body portion and a cavity aligned with the coupling in which the speaking valve is angularly displaceably received for displacement between the one and other states.
4 . The medico-surgical apparatus according to claim 1 , characterised in that the apparatus includes occlusion means operable separately of the speaking valve to prevent or enable flow through the or each HME element.
5 . The medico-surgical apparatus according to claim 4 , characterised in that the occlusion means is pneumatically operable, and that the apparatus includes a pneumatic actuator.
6 . The medico-surgical apparatus according to claim 4 , characterised in that the occlusion means includes a bellows expansible to block flow through the or each HME element.
7 . The medico-surgical apparatus according to claim 5 , characterised in that the occlusion means includes a bellows expansible to block flow through the or each HME element.
8 . An assembly of a tracheostomy tube and medico-surgical apparatus according to claim 1 , wherein the medico-surgical apparatus is fitted with the machine end of the tracheostomy tube.

Description

This invention relates to medico-surgical apparatus adapted for fitting with the machine end of a tracheostomy tube. The invention is more particularly concerned with apparatus in the form of combined HME and speaking valve. Where a patient breathes through a tube inserted in the trachea, such as a tracheostomy or endotracheal tube, gas flow to the bronchi is not warmed and moistened by passage through the nose. Unless the gas is warmed and moistened in some way it can cause damage and discomfort in the patient's throat. The gas can be conditioned by a humidifier in the ventilation circuit but, most conveniently, a heat and moisture exchange device (HME) is used. HMEs are small, lightweight devices including one or more HME exchange elements. When the patient exhales, gas passes through the exchange element and gives up a major part of its heat and moisture to the element. When the patient inhales, gas passes through the exchange element in the opposite direction and takes up a major part of the heat and moisture in the exchange element so that the gas inhaled by the patient is warmed and moistened. HME devices also help protect the patient from airborne contaminants like dust and bacteria. These HMEs are low cost and are disposable after a single use. They can be connected in a breathing circuit or simply connected to the machine end of a tracheal tube and left open to atmosphere where the patient is breathing spontaneously. HMEs can be used with other breathing devices such as face masks. HMEs are sold by Smiths Medical under the Thermovent® mark (Thermovent is a registered trade mark of Smiths Medical) and by other medical device companies. Patients with a tracheostomy may be conscious and can be enabled to speak while the tube is inserted by means of a speaking valve connected to the external, machine end of the tracheostomy tube. Such speaking valves have a one-way mechanism that allows air to be inhaled through the valve by the patient but closes to prevent air being exhaled through the speaking valve. Instead, when the patient exhales, the air from the lungs by-passes the tube and flows up through the patient's vocal folds. Where the tracheostomy tube has a sealing cuff towards its patient end this is either deflated when speech is required or the wall of the tube is formed with fenestrations on the machine side of the seal so that air can flow out through the fenestrations above the cuff. Speaking valves are sold by Smiths Medical under the Orator® trade mark (Orator is a registered trade mark of Smiths Medical) and by other medical device companies. Up to now it has only been possible for a patient to benefit from either a speaking valve or an HME but not to have both fitted at the same time. So, if a patient needs to speak, he must first disconnect the HME and then connect the speaking valve. Once the need for speech has passed the patient must remove the speaking valve and reconnect the HME. This repeated connection and disconnection to the tracheostomy tube can cause discomfort to the patient. It is an object of the present invention to provide alternative medico-surgical apparatus. According to one aspect of the present invention there is provided medico-surgical apparatus of the above-specified kind, characterised in that the apparatus includes a housing having both a one-way speaking valve and at least one HME element, and that the apparatus is arranged such that in one state flow through the HME element is enabled preferentially to flow through the speaking valve and in another state inhalation flow through the speaking valve is enabled preferentially to flow through the HME element. The speaking valve preferably has a portion arranged to block a passage through the HME element in the other state. The portion of the speaking valve is preferably a cylindrical sleeve angularly displaceable within the housing, the sleeve having an opening that aligns with an HME element in the one state. The speaking valve may be fitted with the housing in a manner that enables the valve to be displaced out of the housing by an excessive expiratory force. The apparatus preferably has a coupling adapted for fitting with the machine end of the tracheostomy tube, a body portion extending transversely of the coupling, an HME element at opposite ends of the body portion and a cavity aligned with the coupling in which the speaking valve is angularly displaceably received for displacement between the one and other states. Alternatively, the apparatus may include occlusion means operable separately of the speaking valve to prevent or enable flow through the or each HME element. The occlusion means may be pneumatically operable, and the apparatus may include a pneumatic actuator. The occlusion means may include a bellows expansible to block flow through the or each HME element. According to another aspect of the present invention there is provided an assembly of a tracheostomy tube and apparatus according to the above o