Oxygenation device for a patient.

Warmblüterzellen rely on continuous and adequate, on-demand supply of oxygen, so that even short interruptions of the oxygen supply can cause irreparable damage in and around the cells, particularly the central nervous system and the cardiovascular system.

Lack of oxygen, hypoxia, can be caused by inadequate supply, disturbances in lung function, disturbances of transport in the blood or lack of hemoglobin, as well as disorders of the cardiovascular system in principle. In emergency medicine, as well as in-hospital care, it is therefore standard, a patient to supply oxygen. As part of the so-called pre-oxygenation, especially before each intubation, it is imperative to meet the oxygen needs of the patient in the dangerous period until the end of intubation or in the event of Intubationskomplikationen.

In these and other cases, it is essential to enrich the memory space of the lungs with pure oxygen and at the same time also ensure that other gases in the body or in inhaled located, especially nitrogen, are as completely removed. This is achieved mostly no or only very inadequately by conventional Präoxygenierungsmethoden. Known devices for oxygenation are masks, throat tubes and nasopharyngeal tubes, so-called tubes.

The disadvantages of these devices, described in the literature (eg BRG Sandersen. [Ed.]: The Cardiac Patient, Philadelphia, WB Saunders, 1972, p 310), are especially<ul><li>lack of humidifying and heating the gas,</li><li>Oxygen concentration never 100%,</li><li>Rebreathing of exhaled air (CO ₂ and N₂ enrichment)</li><li>Leak in the system (Low N₂) and</li><li>very large oxygen flow.</li></ul>

The the object underlying the invention therefore was to obtain an apparatus for providing a patient with oxygen (oxygenation), are removed by means of which simultaneously with undesirable oxygenation other gases as completely as possible from the lung area.

In addition, the above-mentioned drawbacks of known devices should be eliminated.

According to the invention, this device for oxygenation of a patient is characterized with a Sauerstoffapplikator for the supply of oxygen over the nose, characterized in that the Sauerstoffapplikator is so designed that it supplies pure oxygen in directional flow (nasoral) exclusively through the nose (nasal), and that the device additionally into the mouth (oral) of the patient essentially sealing applicable one-way valve comprises at least that opens only when gas effluent and otherwise closes and excess oxygen and exhaled air can escape only through the mouth.

In principle, can be achieved with this device is that on the one hand<ul><li>a directed flow, namely the separation of inhalation (100% O₂ through the nose) and exhalation (excess O₂, N₂ and CO₂ via the mouth valve, ie "nas-oral" is enforced,</li></ul> on the other hand<ul><li>a physiological flow, namely humidification and heating above the nose, without increasing the dead space and avoiding einr rebreathing, is respected.</li></ul>

With this device, it is ensured that at existing or sistierender breathing (apnea) the patient only pure oxygen (warmed and humidified) can get into the respiratory tract and lungs, and all to be eliminated gases (nitrogen, nitrous oxide, carbon dioxide) completely (N₂, N₂O) or physiologically (CO₂) are delivered through the valve mouth.

The patient can with this device even in the absence of intrinsic respiration (so-called oxygenation apnoeic) "inhale" only pure oxygen, because the one-way valve prevents the uncontrolled and undesired penetration of outside air, and thus large quantities of nitrogen. This works indefinitely. Once an apnea has occurred, desirable (for intubation) or undesirable (emergency), the mouth valve can be removed if it is ensured that excess oxygen escapes through the mouth. In this state, therapeutic measures can now be made via the mouth (z. B. suctioning, intubation, haemostasis), but also diagnostic measures are possible (eg. As bronchoscopy, laryngoscopy). Doctor, nurse or paramedic both hands have additional dates may be necessary for routine or acute measures such. As the Covering of instruments for artificial respiration and the appropriate medication or even placing a peripheral venous access for administering lifesaving or anaesthesiological emergency absolutely necessary medication or blood or blood substitutes. Also doctor, bystanders or paramedics have both hands free for extrathoracic measures of revival, such. As CPR, defibrillation, injections or infusions. Another advantage of the device is that it is even allowed the laity, significantly and without risk to increase the existing minimum even under normal conditions, oxygen supply, which is the entire range of outpatient and in-hospital patient care for daily routine application of great benefit. A Use of the patient is not required. The device can be used with advantage for various causes hypoxia or pre-oxygenation prior to intubation. In this device a priori invention reduces the overall risk, which in particular through possible Intubationshindernisse.

The same device can be used universally, namely both in emergency medicine (awake or unconscious patient, existing or sistierende breathing) as well as in anesthesiology (preoperative: preoxygenation postoperatively: recovery room), in the intensive care unit (respirator weaning), in the neck -Nasen-Laryngology (laryngoscopy), in pulmonology (bronchoscopy) and in dental, oral and maxillofacial medicine (Oral surgery).

Much of the inventive device is that the introduction of oxygen is only possible via the nose. The oxygen overflow and exhalation going through the mouth, which is prevented by the one-way valve at the inhalation.

The Sauerstoffapplikator may be designed differently and be in his feeding part for example in the form of a nasal catheter. but is advantageous to use a Sauerstoffapplikator in the form of a mask that covers only the nose. Preferably, this mask is designed so that it is sealingly engageable with the nose substantially.

The Sauerstoffapplikator may be connected in a conventional manner with an oxygen bag, which is interposed between the oxygen source and the Sauerstoffapplikator and can visually observe the inhalation process. In addition or in place of the oxygen bag an acoustic or optical signal can at the Sauerstoffapplikator and / or at the one-way valve may be affixed, is triggered when the desired inhalation or exhalation takes or at Gaseinstrom or outgas.

For easy and universal (intra-clinically as außerklnisch) handling of the oxygen bag following arrangement is recommended: The oxygen bag to the oxygen tubing 2 of Sauerstoffapplikators 1 has a connector on the diameter of 22 mm (DIN ISO 5356 Part I), wherein both the Sauerstoffapplikator 1 and can be directly connected to an intubation tube, additionally via a connector on the diameter of 15 mm (DIN ISO 7228), both with the permanently connected to the central oxygen supply ventilation system as well as via the built in this connection connector according to ISO 594/1 with a oxygen bottle.

This arrangement makes it possible, after endotracheal intubation (one-way valve 3 removed), oxygenation or denitrogenation of patients maintain (transport from anesthesia induction room to the operating theater or the surgical recovery room or to the intensive care unit, storage or rearrangement measures) after the oxygen bag sealed with a clamp and dekonnektiert from oxygen tube 2 was (mobile oxygenation).

As stated above, the Einwegentil is formed so that it is sealingly insertable into the mouth of the patient substantially. To this end, the one-way valve is suitably provided with an elastic sealing plate is inserted to the patient prior to the upper and lower jaw between them and the lips. Particularly expedient joins this sealing plate a pipe connection on which projects into the oral cavity and on which the patient bites expedient to hold the seal plate in sealing position.

The seal of the one-way valve can but of course also in other ways, such as through an optionally inflatable rubber balloon, the sealing places in the mouth during inflation.

The two members of the apparatus of the invention means, Sauerstoffapplikator and one-way valve may be separate from each other as a device set. Suitably but they are interconnected, so that the user, the doctor, the nurse or paramedic, both devices has always be on hand together.

In the drawing, an embodiment of the apparatus is shown according to the invention schematically in vertical section.

The device consists of the Sauerstoffapplikator 1 and the one-way valve 3. The Sauerstoffapplikator device 1 is in the form of a mask with two sealing lips 7 and 8, above and below the nose to create and allow oxygen supply only through the nose. The Sauerstoffapplikator 1 is connected to an oxygen tube 2, which optionally communicates with an oxygen cylinder in connection via an oxygen bag.

The one-way valve 3 has an elastic sealing plate 5 between the lips and pines (teeth) of the patient is sealingly insertable substantially. At this sealing plate 5, a pipe connection 6 connects to which the patient bites. In the extended front part of the one-way valve, which is located outside the mouth, the flaps are 4 that are formed so as to spread apart during exhalation or at the gas effluent, while otherwise (z. B. the inhalation process) against one another in a sealing and prevent the ingress of outside air.

Under clinical conditions, both the denitrogenation and the ventilation of a patient can be controlled by end-tidal gas samples, by means of mass spectroscopy (O₂, CO₂, N₂) or capnography (O₂, CO₂): For this purpose can be found on the one-way valve 3, a special, lockable gas discharge pipe 9 for connecting corresponding measuring systems (ISO 594/1) and for continuous gas sampling (side stream principle).