US2407221A - Multiple purpose gas unit - Google Patents

Description

1 p I J. 1.; BLOOMHEART 0 MULTIPLE PURPOSE GAS 6N1 Filed March 20, 1944 4 Sheets-Sheet 1 Sept. 10, 1946.

J. L. BLOOMHEART MULTIPLE PURPOSE GAS UNIT 4 Shee ts-Sheet 2 37 C ll 36 E 3 E 3 C T t 3 c I a 2 20 V 26 9 E345 Z7 Z I J (I) 46 g /5' Fla 2 JauA/Lfiiawusngz;

Sept. 10, 1946. J. L. BLOOMHEART MULTIPLE PURPQSE'GAS UNIT Filed March 20, 1 944 4 Sheets-Sheet s Fla/ll .Sept. 10, 1946.

J. BLOOMHEART MULTIPLE PURPOSE GAS UNIT Filed March 20, 1944 4 S heets-Sheet 4 EX PflNS/BLE BELLOU/J 21 Jafml Embed/f valve body;

Patented Sept. 10, 1946 UNITED STATE MULTIPLE PURPOSE GAS UNIT John L. Bloomheart, Toledo, Ohio, assignor to Martha F. McKesson Application March 20, 1944, Serial No. 527,249

This invention relates to predetermining the selection of a gas or. gases in a respectiveratio or quantity, with range for maintaining or varying the control thereof, more particularly in the administration uses foranalgesia and anaesthesia, as well as for resuscitation.

This invention has utility when incorporated to respond to varying inhalation demands, with possible definite modulation therebetween. The disclosed equipment therefor conducts the gas or gases prescribed to respond to volume measurement, with rate indication. Efficient and economical handling may be readily adopted, involving treatment of exhalation gases and return or re-use of the exhaled gases according to adesired program. The manifold-carrying head with the closely adjacent diverse passage controlling valve body set up a panel-approximating instrument-board-like grouping of the indicating devices with the manually operable valves directly adjacent to forthwith disclose performance.

Referring to the drawings:

Fig. 1 is a general side-elevation of the comprehensive unit embodiment, with parts broken away; the set-up being of a portable apparatus for anaesthesia administration in hospitals or even in emergency at the location where the patient requires. service;

.Fig. 2 is a plan view of. the unit of Fig. 1, partially in section, of the post-carried head and Fig. 3 is a somewhat diagrammatic showing of the gas routing or travel thru a flow gage as carried on the head, the diagram of the layout forv the flow having top and bottom plans in appropriate register with the intermediate portion, the sequence being illustrated in the three sections at the upper portion of Fig. 2.

Fig. 4 is a view looking down into the absorbervaporizer control valve body, with the top wall removed; and even to a slight extent in portions therebelow, to show the flow-interrelation valve chambers, not only for fresh gas supply, but of exhalation gas modifying control for absorber handling for carbon dioxide removal, with possible supplemental substance supplied by th vaporizer, such as ether; i Fig. 5 is a fragmentary detail view in vertical section of the absorber valve in the valve body, approximately on'the region medially of the ports 16, 64 at the upperright quarter of Fig. .4;

Fig. 6 is also a section from the valve body, approximately in the direction of the line I34 extended upwardly to the left across th port Hill, Fig. 4, showing parts of th vaporizer valve; and

4 Claims. (01. 128188) Fig. 7 is a diagrammatic showing of the valves at the supply region on the manifold, with the flow lines indicated therefrom to the various control valves at the valve chamber body.

Pedestal and gas supplies thereto depending tubular portion 4 mounts .a head 5' atop the column or post 3. The head 5 is a primary section or supply manifold carrier for the apparatus.

The major volume gas of supplies whether vitreous oxid or oxygen may be each a compressed gasof' tank or cylinder 5 having a head valve 1 adapted to be connected thru a reducing valve 8 to a flexible duct 9 with a connection or fitting Ill to the under side of the after portion of the head 5. With a, fitting, [0 for each gas supply, these mayconstitute a row across the back underside of the head 5. In providing for having several gases available; there is rendered readily accessible awide range for adaptations for use. An instance consistent with the set-up herein disclosed may be for supply of nitrous oxid at the left (Fig, 2) and oxygen at the right. In intermediate these two supplies there may be cyclopropane, ethylene, carbon dioxid and helium.

Direct nitrous oxid and oxygen The nitrous oxid, from its receiving fitting II] at the head 5, has a duct II to a T or branch fitting l2, with a way It on to a manually operable direct flow nitrous oxid control valve It. This valve 14 as manually opened, say for emergency, or to bring the patient quickly to the desired response, is connected by a duct [5 to a valve body It, there to be delivered into a chamber I! (Fig. 4) to pass on therefrom by way of inhalation duct 18 to a fitting I9 (Fig. l) The Y-fittin .19 has a manually adjustable valve 20. At one position for the valve 20, the inhalation and exhalationof a patient at a mask 2| is thru the valve 29 from and to the atmosphere. At another position of the valve 20, the patients breathing is not independent of the gas administration unit, but is now connected up to receive gas supply from the-duct IS. The exhalation by the patient at the mask 2| may then be byway of the fitting is into an exhalation duct 22.

This handling -of nitrous oxid is usually to establish the desired stage of analgesia or anaesthesia. For resuscitation, or bringing back, at the oppositeside of the head 5, a manuall operable valve 23 may connect an oxygen supply tank for direct oxygen flow by a duct 24 to the body 16. The fresh oxygen gas supply is now in the valve body chamber IT for ready flow by way of the inhalation duct I8 and the fitting I3 and the mask 2| to the patient requiring attention.

Flow gages The branch fitting I2 (Fig. 1) for the nitrous oxid supply, as is the case for the oxygen supply, has, as its upwardly extending branch, a duct 25 to a valve housing 26 in which is located a manually adjustable valve 21 at the base of a flow-gage or indicator housing 28. The housing 28 has a front window 29 thru which may be noted rising float positions as to gage markings or graduations along (Fig. 2) a minor scale 33 and a major scale 3I. The minor scale 33 may be for smaller readings, as decimal parts of a liter. The major scale 3|, even tho of similar overall length, may be hereunder for a plurality of full volume units, as say up to ten liters.

The flow directions of travel in this indicating instrument, one for each of the respective gases, as passing the manually adjustable valve 27, is by a passage 32 (Fig. 3) to the lower portion of an upwardly extending tapering, and in this instance slightly inclined at the top rearwardly, way 33. The broken away portions of the housings 28 (Fig. 2) have placements for the passages diagrammatically set forth (Fig. 3). The indicating means are floats, or light weight objects which may be poised and shifted according to the impetus from the moving gas. A float herein is shown as comprising a base convex portion 34 connected to an upper disk by an intermediate narrowed or neck portion 36.

The taper for the upward way 33 is for a uniform slight enlargement in the cross-sectional areav of the passage. Furthermore, with the top or upper portion tilted back or rearwardly, say in the range of 5, such is sufiicient to cause the convex portion 34 of the float to ride along the underside wall and the disk 35 to slide along the upper side wall. The gas flow thrust as inclined upwardly is opposed by the vertical gravity force component in the resultant balance. The experience is that, notwithstanding the gradual enlargement of the crescent clearance about the disk 35 as it ascends, and the converse crescent enin gage measurements for a low flow rate, while i there is available a higher flow rate. The larger flow rate indicator 34, 35, 36 is in the passage 33.

The upper end of the passage 33 has a crossover 36' therefrom to a down duct 31, a bottom cross-over 33, thence to a riser upwardly tapering way 39 parallel to but of less diameter than the way 33. The taper proportioning for the graduations 30, in tenths of a liter, are for a float 40 in the way 39; and the graduations 3| along the way 33, in liters, for the float 35, 36, 34. The float 40 is of a general similar contour to th float 34, 36, 35, and may be more buoyant as well as of less diameter. As the float 40 is lifted, say to full liter height and so poised, it does not close notched exit from way 39. ate the float 40 is at just slightly lifting or poising of the float 35, 35. 34, near the lower end of the way 33. The further gas flow increase, after the float 43 has fully ascended, now causes the float 35, 35, 34, to rise along the scale 3|.

This gas flow to oper- Th gas from the passage 39 has a top crossover way 4| to a down flow wa 42, to a bottom cross-over 43, thence to a midback short riser 44, thru a float gage housing mounting flow-off passage 45 to a manifold 46 (Fig. 1) having a hollow post 41 to mount it upon the head 5 for a flow connection with a way 48 in the housing 5. The way 48, as under the upper forward edges of the head 5, extends to a delivery fitting 49 having mounting connection for the valve body l6, and is there in communication with' the chamber l1.

Mixed gas flow cut-017 On the body I6 is a manually operable cut-01f valve 50 (Figs. 1, 2, 4) having an open or on position 5|, and, at half turn in the selected direction therefrom, a closed or off position 52. The valve member 50 extends into the chamber I! of the body I6 and there has fixed therewith an eccentric 53 adapted to pull a valve disk 54 against the resistance of a compression spring 55, for thereby positioning the valve disk 54 away from a seat 56. The valve, as thus normally open, allows gas flow 51 from the head 5 into the chamber I! in the body I6.

Exhalation The gas flow 57, with or independent of nitrous oxid direct flow I5 or oxygen direct flow 24, may be from the chamber H by way of the inhalation duct I8 to the mask 2| and from thenc by way of the exhalation duct 22 back to the housing I5. The duct 22 to the body I6 has its flow into a chamber 58 (shown at the lower right of Fig. 4), and thence by an under passage or valve chamber way 59 in the lower portion of the body I6 to the underside of a flutter check valve 60, visible thru a window GI (Fig. 2). The up flow as lifting the check valve 60 is to an upper chamber way 62 (Fig. i), from which there is fiow1aterally and down (shown at the middle right of Fig. 4) thru a passage 63 to the underside of a valve disk 54 (Fig. 5). The valve disk 6-3 may be more or less open for flow control into a carbon dioxid absorber or fragment-carrying canister 65, say of soda lime.

Absorber Conservative practice is for carbon dioxid to contribute to some extent in promoting conditions desired to prevail in anaesthesia. In some proportions, carbon dioxid is an excitant for respiration. In other proportions, it may contribute to the desired stage of analgesia or anaesthesia. It thus is within the control of the operator to remove all or only a portion of the carbon dioxid from the exhaled gas.

The absorber usually has at least some slight heat from exothermic reaction in removing the carbon dioxid from the gas exhaled by the patient. Additionally there may be some moisture. Should the moisture carry thru, gas outflow from the canister 65 b way of its perforate bottom 56 may at once expand into rebreathing bag 6?, as a condensing chamber for a more complete removal of moisture, due to the extended outer surface. However, a compact assembly is for the bag 61 to envelop the canister 65. Inasmuch as the ba is readily removable, there is convenient access for canister replacement as such degenerates from a period of use. A minimizing of condensation or moisture in the equipment is an important factor for retaining accuracy in valve performance and the resultant gas supplies.

. The positioning of the valve disk 64 away from a lower valve seat 68 is to open the absorber, and

'5 toward a valve seat '69 is to check flow of gas ex halation from bypassing th absorber. This manual adjustment is eifected thru a knob or head I (Figs. 2,

With the knob in register with a position H, such may be for full on for the absorber, that is, for the full volume of the exhalation from th mask 2|, duct 22, to the body I6, chamber 58, up thru the flutter valve 60 as shown thru the window 6|, thence to pass into the chamber 62, down to the chamber 63, and as the valve 64 is now in its fully liftedposition (Fig. 5), the seat 69 is fully closed and the seat 68'therebelow is fully open. The total exhalation flow is accordingly down into the canister 65 for the CO2 to be re: moved from the exhalation by the soda lime charge therein. The CO2 extraction has the residual gas therefrom pass out thru the perforate bottom 66 into the rebreathing bag 61. "With clockwise turning, therefrom to a scale I2 for fractional stages to a closed or off position 13 (shown in Fig. 2). A still further turning and also clockwise to a position I4 is effective thru a lever I5 (Fig. 5) to move a valve disk I6 against the resistance of a compression helical spring 11 to close a seat I8 and thereby shut off or cut out the rebreathing bag 61. At this fully down position, the valve disk 64 is on the seat 68 and the gas flow from the way 63 is bypassing the absorber and going past the seat 69 into a chamber I9.

Vaporizer A valve disk 60 (Fig. 6) clear of a seat 8I,,allows gas flow into a wick-carrying perforate cylinder 82 of an ether vaporizer. The cylinder 82 is in a glass jar or container 83 having a mounting ring 84 to connect the jar with the underside of the valve body I6. Along an exposed vertical side of the jar 83 is a scale of graduations 85 (Fig. 1) which may permit direct reading of the quantity of liquid, as ether, in the jar 83 up to a graduation line. Between the cylinder 82 and the jar 83 is a chamber 89 into which the vapor laden gas from the cylinder 82 may pass, and by a passage 89 in the body I6 to an upper chamber 90 (Figs. 4, 6).

A knurled head 9| (Fig. 2) has a position 93 for full on, with adjacent clockwise scale 94 therefrom for ether proportion reduction to an off position 95. With the handle or head 9| at the position 95, a manual valve 91 at a pouring funnel 98, may be opened, for volatilizable me dium, as ether, to be supplied to the jar 83, there to be absorbed by the wick in the cylinder 82.

The weight of the respective knobs I0, 9| is carried by compression helical springs 86. Each knob has a depending internall threaded sleeve or nut 81. For the knob I0, the sleeve 81 lifts and lowers externally threaded stem 81. The knob 9| operates to lift and lower an externally threaded stem 92. i

As the disk 80 (Fig. 6) moves clear of closing the seat 8I, it shifts toward closing a valve seat 99. The head 9| operates not only the disk 80, but also a disk I00, which has key against turning or for}; engaging stem NH. The holding of the valve devices at the knob I0 from rotation with the knob 10 is efiected by the lever I5.

With the disk 80 at the seat iii to close the vaporizer intake flow, the disk I00, is at a seat I02, to cut off the chamber 90 outflow from the ether vaporizer, from a chamber I03, whereby the gas flow from, or as bypassing the absorber, may likewise fully bypass the ether vaporizer to go to theunderside of a flutter check valve I01, visible thru a window I05 (Fig. 2).

' .With the valve 50 closed, whether or not the knurled head pieces or knobs I0, 9I be in position to shut off the absorber and rebreathing bag, and also the vaporizer, there may be exhalation relief by manually opening a valve I06 in the body I6 (Figs. 1, 2).

The extent to which the absorber is used may be recorded, say as to time intervals of fifteen minutes each, at a scale I01, by a handle I08, at the top of the valve body I6 (Fig. 2) at the other side from that for the valve I06.

, Bellows 0n the head 5 is a handle or knob I09, adapted as freely turned to carry therewith a pointer I I0 over a scale I I I, say in liters (Figs. 1, 2) Rotation of the knob I09'is effective thru a toothed disk H2 in mesh with a toothed disk H3 at an angle thereto, thereby to Wind a cable H4 having a, Wrap about the hub of the disk H3. One end of the cable H4 is connected to a tension helical spring II 5 fixed with the head 5. other end of the cable II4 has a wrap at an enlargement I I6 fixed with a shaft I I! having exterior Of the housing or head 5 an upstanding arm II8 extending to bellows back section II9. Opposite thereto is a fixed bellows front section I20 having a duct way I2I therefrom in the housing 5 to the way 48. To counterbalance the bellows, is a spring I2 I The rebreathing bag 61 may be shut off, in the event such be not a rigid envelop for the absorber, anda definitely disclosed rebreathin checked at the scale ill for the full rebreathing to take place in the bellows. The knob 109 may be turned to locate the pointer, say at zero,'in an adjusted capacity for the bellows. As the variation be plus or minus, the operator may thereby determine gas reduction or replenishment.

For a minor cylinder or gas supply, as for cyclopropane, there may be a ring I22 on the post 3 below the boss or tubular portion 4 (Fig. 1). Fromthis ring I22, an arm I23 may have a, clamp I24 to engage a valve head I25 of a cylinder I26, thereby to be sustained from the post 3 of the portable unit. From the cylinder I26 there may thus be "controlled gas flow to the arm I23 and therefrom by a, duct I21 lined up in approximateparallelism to the ducts 9 for similar fittings I0 to connect at the rear under portion of the head 5. y

In the instance of some administration gases, condensation may occur. To promote accuracy in anaesthesia control, advantage arises in precluding such liquid disturbance factors from further travel. into the valve regions of the equipment. To this end, the valve housing 26, below the flow gage main housing 28, say for cyclopropane, may have a drip tube I20 protruding from a'hollow depending boss I29 at which is detachably mounted a glass receiver or cup I30. As condensation is noted to collect therein, the cup I30 may be removed, emptied and then replaced.

Use

The unit as herein disclosed is one which may be connected up for the desired gas or gases at the head 5. With the valve body I6 mounted on the head 5, and the mask 2I connected by the ducts I8, 22, the assembly is complete for handling'a patient. Exhalation-inhalation cycle is disclosed by the flutter valves 60, I04, t0 be seen The thru the windows GI, I05, in the top of the valve body It. The cutoff valve 50 may be to clear of the dosage gases, or to leave the way clear for direct oxygen supply thru the valve 23, for a quick come back or resuscitation. In an emergency to anaesthetize the patient, the nitrous oxid direct flow valve I 4 could be operated.

The normal operation of the equipment is with the valve 59 open. The operator may set the pointer H at upper mid position when the gas administration has started. Whenever the pointer I I0 shows change, the dosage gases and their flow rate quantity may be reset thru the valves 21. There may be total bypassing of the vaporizer. For administration gas economy in recirculation, the extent of absorber operation may be adjusted.

There is an important factor available to the operator in the matter of changing of the cycle or swing of the pointer H0 in response to the rebreathing functioning of the bellows. For the full exhalation to come back thru the absorber to the bellows, the gradual decrease in the bellows maximum capacity position as shown by the pointer H6, is a check on the oxygen consumption should the apparatus be manipulated with such end in view. Should the patient be in some stage of analgesia or anaesthesia which it bedesired to maintain, the drop in capacity maximum as indicated by the rebreathing bellows, may be a clue to hold the patient against shifting from the condition established and which it be desired to maintain, that the deficiency should be made up by the supply of additional oxygen. In conducting this replenishment, it is in order to avoid introducing such quantity in excess, but to bring the operation up to swinging the pointer IIIl just to the mid position. In the event the needle or pointer I II] gets to swinging too far, or to show a capacity in excess, then it is in order to reduce or out oif the oxygen supply, to bring the pointer 'I II] in its cycle back to the selected limit. Also, the gradual supply of oxygen, even at an increasing rate, may be adopted for changing from anaesthesia to analgesia, or fully back; altho for quick response the valve 23 is available.

The quantity or pro-portion of the treatment or anaesthestizin gas or gases may be established to the satisfaction of the operator with the bringing of the pointer I II) to the upper midposition. This turning of the knob I09 is against the frictional resistance of the cable H4 at the hub of the gear I I3 and is not to operate the bellows. However, as the knob is released, the operation of the bellows is effective to shift the pointer IIG. In the event the absorber be not removing the carbon dioxid, this may be detected by the gradual increase in the capacity disclosed for the rebreathing bellows by the pointer I III. Effort should be made to have such overcome by the absorber. Here as with oxygen consumption, the safeguardin course is by resort to oxygen supply.

The counterbalance spring I2 I renders the bellows sensitive to rebreathing operation. Such incoming supply of gas or gases as may be determined at the manifold on the head 5, may pass therefrom to the plural or multiple chamber valve II, as indicated by an arrow I31 (Fig. 4).

The integral unit or single body It has appended thereto a plurality of gas treatment means. The absorber 65, 61, is subtractive, in that it is designed to eflect the reduction in the closed circuit of the carbon dioxid in the exhaled breath before such be returned for inhalation. The additive treatment means 82, 83, of the vaporizer, to the extent used, may be a further supplemental supply of a relevant substance, as ether.

The control of the apparatus may be set for fully cutting out the absorber. This is accomplished by locating the valve disk 64 (Fig. 5) on the seat 68 and the valve disk 15 on the seat I8. The result is that the direct or bypassing gas flow from the chamber 63 is to the chamber 19, as indicated by an arrow I32 (Fig. 4)

The control may go still further with the treatment means at the body I6. Whether or not the absorber be wholly, partly, or not at all bypassed, a somewhat similar range of control is available atthe vaporizer 82, 83. As there may be a total shutting off of the absorber, as to intake and outlet, such steps may be taken at the vaporizer (Fig. 6). With the disk on the valve seat 8|, the inlet port is closed. With the valve disk I00 against the seat I02, outflow from the vaporizer into the stream for inhalation is shut off. That is, the incoming gas fiow from the chamber I9 is now to a chamber I33 above the valve disk 80, with the way open therefrom thru the open valve seat 99 for free communication with the chamber IE3. This bypassing of the vaporizer is indicated by an arrow I 34 (Fig. 4) for the flow to the underside of th check valve disk I04. The rising gas, opening the check valve I04, is now in the chamber IT, to the extent treated or untreated from exhalation, and is now ready to fiow from the body I6 by the inhalation duct I8.

What is claimed and it is desired to secure by Letters Patent is:

1. Respiration equipment comprising a head, a manifold unit mounted on the head having a line of parallel intakes thereto, a common discharge therefrom with an intermediate chamber, a panel provided with individually adjustable controls for gas supplies to the respective intakes for the manifold, a variable capacity gas receiver mounted with the head and in open communication at all times with the manifold chamber, an additional flow control body medially forward from the panel in the extent of the panel transversely of the head, said body being in communication with the manifold chamber by way of a passage thru the head, said body including a plurality of valve chambers, an absorber unit, and laterally therefrom, a vaporizer unit, each unit directly and independently upwardly connected to different chambers from the underside of the body to be there supported by the body, relatively movable valves in the body for the absorber and vaporizer units, a mask, and in addition to said relatively movable valves, a manually operable ingle way valve in the passage from the head to the body for restricting gas flow from the head to the body, and duct means extending from the said flow control body to the mask.

2. Respiration equipment comprising a head, a manifold unit providing a chamber having a tubular discharge post to mount the unit on the head, said manifold having a line of parallel intakes to the chamber, in alignment a panel-like grouping of individually adjustable gas supply fiow controls to said intakes, a variable capacity gas receiver mounted back of the intakes adjacent the controls and in open communication at all times with the manifold chamber, an assembly of indicators on the head for the respective controls, each indicator with its control and intake forming an element of the grouping arranged symmetrically side by side for the extent of the panel unit, a manually adjustable indicator for disclosing receiver fluctuation from a preset indication position therefor, a valve body, there being a passage from the manifold chamber thru the head and providing mounting for the body with the head, exhalation and inhalation passage mean to and. from the body, and independently relatively movable valve means at the body determining gas flow thru the body and independent of the head.

3. Respiration equipment comprising a head, administration gas supply connections independently thereto, said head having a chamber isolated from said connections, a manifold having a chamber provided with a tubular post mounting connection providing communication between the head and manifold chamber, an adjustable receiver in open communication at all times with the manifold chamber, valve means from the respective supply connections including gage disclosing duct means from the different valve means each into the manifold chamber, gas flow way means from the head chamber, flow controlling valve means along said way including a housing having partitions therein forming assages in said housing, said partitions being provided with a pair of aligned ports and a third port, a common control valve element reciprocable intermediate the aligned ports, an additional valve element for the third port reciprocable in parallel with the other element, and an inter-connected single control in said housing for moving the elements into and out of port closing positions.

4. For respiration equipment, a controllable gas supply including flow gage means embodying in a gas flow circuit, duct means providing a plurality of successive passage-forming sections in a single connected series, sequential calibration disclosing means in distinctive sets along the respective sections and indicators adapted to have different ranges of location in the duct means in successive response to common gas stream flow through the sections.

JOHN L. BLOOMHEAR'I'.

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