US3860000A - Medical apparatus and method for feeding and aspirating - Google Patents
Medical apparatus and method for feeding and aspirating Download PDFInfo
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- US3860000A US3860000A US378408A US37840873A US3860000A US 3860000 A US3860000 A US 3860000A US 378408 A US378408 A US 378408A US 37840873 A US37840873 A US 37840873A US 3860000 A US3860000 A US 3860000A
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- tube
- stomach
- aspirating
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- overpressure condition
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M31/00—Devices for introducing or retaining media, e.g. remedies, in cavities of the body
Definitions
- Apparatus includes means for feeding a solution to the stomach of a patient, and sensing the pressure within the stomach to stop feeding when an overpressure condition exists. The stomach is then aspirated for a predetermined time. After aspiration, irrigation fluid is pulsed to the stomach.
- Feeding a solution intravenously is not completely satisfactory because a relatively small blood vessel is not intended to carry enough food for the entire body, and prolonged feeding into a vessel can result in partial loss of the use of an arm.
- Feeding a solution directly into the stomach of the patient eliminates the above noted objections to intravenous feeding but often results in a build up of pressure which causes rejection of the solution.
- a solution is sometimes fed to the stomach for enhancing wound healing, and a build up of pressure causing rejection of the solution results in poor wound healing.
- stomach is commonly aspirated to permit sup ply of a feeding solution.
- a feeding solution is supplied directly to the stomach of a patient, and the pressure within the stomach is sensed for interrupting the feeding cycle when an overpressure condition exists.
- stoppage of the feeding cycle due to an overpressure condition automatically starts an aspirating cycle for aspirating the stomach.
- the aspirating cycle does not commence until the overpressure condition has continuously existed for a predetermined time.
- the aspirating cycle operates for a predetermined period of time, and is followed by an irrigating cycle which pro vides irrigating liquid for a short period of time.
- the irrigating liquid cleanses the tube leading to the stomach and flushes away any mucus or particles trapped in the tube openings.
- the stomach is again checked for an overpressure condition, and if there is no overpressure condition, the feed cycle is again automatically started. If an overpressure condition does exist, as indicated, for example, by an audible signal, the aspirating cycle may be repeated.
- the apparatus may be selectively operated in a feeding, aspirating and irrigating cycle, or only in an aspirating and irrigating cycle.
- a further object is to provide an improved apparatus and method for feeding a solution to the stomach of a patient and automatically stopping the feed when the overpressure condition exists.
- An additional object is to provide an improved apparatus and method for automatically aspirating the stomach of a patient when an overpressure condition exists.
- Still another object is to provide an improved apparatus which is selectively operable to feed or aspirate the stomach of a patient.
- FIG. 1 is a schematic illustration of an improved apparatus constructed in accordance with the present invention.
- FIG. 2 is an electrical schematic of a control circuit for operating the apparatus of FIG. 1.
- FIG. 1 shows an improved apparatus constructed in accordance with the present invention.
- Flexible tube A of polyvinyl chloride or the like extends through the esophagus of a patient and has an outlet opening 42 positioned within stomach B of the patient.
- the opening in tube A positioned within stomach B may comprise a plurality of small openings in the wall of tube A.
- Tube A is connected by tee connector 44 to conduit 46 leading to a control panel C.
- Another conduit 48 is also connected to tee connector 44 and has a ball check relief valve 50 therein.
- the opposite end of conduit 48 is connected with tee connector 52.
- Flexible tubes 54 and 56 are connected with tee connector 52
- Tube 54 extends through a feeding and irrigating peristaltic pump D, and has an inlet 62 positioned in solution supply receptacle E.
- Receptacle E may contain a feeding solution of amino acids, glucose or the like.
- Tube 56 extends through peristaltic pump F and has an outlet 64 positioned in storage receptacle G.
- Pump D is operative for withdrawing feeding solution from receptacle E. and feeding it through tube A and outlet opening 42 into stomach B.
- Aspirating pump F is operative for aspirating material from stomach B through inlet opening 42 and tube A over a storage receptacle G.
- Control panel C includes a main on-off switch H.
- a selector switch S is also provided for selectively operating either pump D or pump F.
- a plurality of control knobs are provided for setting a plurality of timers. The knobs on panel C have been designated Tl through T6 to indicate the various timers which are set by the control knobs.
- Control panel C also includes an on indicator light 76; an overpressure indicator light 86; a feeding indicator light 92', an irrigating indicator light an aspirating indicator light 94', and an insufficient vacuum indicator light 96. Suitable indicia may be provided on control panel C to tell an operator what the various timer knobs and indicator lights are for.
- Conduit 46 is connected to a suitable pressure switch within the box for control panel C. This checks the pressure within tube A, and therefore in stomach B, to sense an overpressure condition for stopping operation of feed pump D.
- FIG. 2 Aschematic electrical circuit for operating the device is shown in FIG. 2.
- the circuit is adapted to be connected to a source of alternating current generally indicated by numeral 72.
- the circuit includes a plurality of relay clutch timers and solid state timing devices.
- relay clutch timers may be provided with either a standard clutchfeature or a reverse clutch feature.
- a clutch between the timer motor and timer cam is normally disengaged and is engaged upon energization of a relay.
- a reverse clutch timer a clutch between the timer motor and timer cam is normally engaged and-is disengaged upon energizatin of a relay.
- the circuit of FIG. 2 uses relay clutch timers having a reverse clutch feature.
- timers In a relay clutch timer having a reverse clutch feature, energization of the timer motor rotates a cam for the time set by the timer knob. When the timer is timed out, the cam operates a timer switch to energize a timer relay. During rotation of the cam by the timer motor, a coil spring connected with the timer cam iswound up. Energization of the relay disengages the clutch and the wound up coil spring resets the timer cam so that the timer is ready for another operation.
- the lines of the circuit in FIG. 2 are indicated by numerals 1 through 30 to the left of FIG. 2.
- the lines in which each relay has contacts are indicated to the right of FIG. 2, with numerals indicatinglines having normally closed contacts being underlined.
- Relay clutch timer Tl includes motor TMl, switch TSl and relay TRI.
- Relay TRl has normally closed contacts lTRl and 3TR1 in lines 4 and 9 respectively, and normally open. contacts 2TR1 in lines and 11 respectively.
- Relay clutch timer T2 includes motor TM2, switch TS2 andrelay TR2.
- Relay TR2 has normally closed contacts 2TR2 and 3TR2 in lines 19 and 21 respectively.
- Relay TR2 has normally open contacts lTR2 and 4TR2 in lines 18 and 22 respectively.
- Relay clutch timer T3 includes motor TM3, switch TS3 and relay TR3.
- Relay TR3 has normally closed contacts 2TR3 and 4TR3 in lines 25 and 27 respectively.
- Relay TR3 has normally open contacts lTR3, 3TR3, and STR3 in lines 24, 26 and 28 respectively.
- Relay clutch timer T4 includes motor TM4, switch TS4 and relay TR4.
- Relay TR4 includes normally closed contacts 3TR4, 5TR4 and 2TR4 in lines 4, 9 and 29 respectively.
- Relay TR4 includes normally open contacts 4TR4 and 1TR4 in lines 5 and 28 respectively.
- Solid state timing device T5 includes a variable resistance TVS in series with capacitors TC5. A unijunction transistor TTS is connected between variable resistance TVS and capacitor TC5. Solid state timing device T5 includes a relay TRS. Relay TR5 has normally open contacts ITRS and 2TR5 in line 10.
- Solid state timing device T6 includes a variable resistance TV6 in series with capacitor TC6.
- Unijunction transistor TT6 is connected between variable resistance TV6 and capacitor TC6.
- Relay TR6 is connected in series with unijunction transistor TT6.
- Relay'TR6 has normally closed contacts 1TR6 in line 10.
- Relay R7 in line 7 has normally closed contacts 1R7 and 3R7 in line 3 and 11 respectively, and normally open contacts 2R7 in line 7.
- Relay R8 in line 26 has normally closed contacts 1R8 and 3R8 in lines 18 and 21 respectively, and normally open contacts 2R8 in line 20.
- Relay R10 in line 12 has normally open contacts 1R10 and 2Rl0 in lines 14 and 15 respectively.
- Relay R11 in line 27 has normally open contacts lRll and 2Rll in-line 16 and 17 respectively.
- Selector switch S is a double-pole double-throw switch having switch arms 81 and S2 in FIG. 2.
- Switch arm S1 may be thrown for contact with either of contacts 78 or 80.
- Switch arm S2 may be thrown for contact with either of contacts 82 and 84.
- a buzzer 88 may be connected in parallel with overpressure indicator light 86 to provide an audible signal when an overpressure condition exists.
- Pump D is generally indicated in line 15
- aspirating pump F is generally indicated in line 21.
- This designation is simply for convenience of explanation, and it will be recognized that the rectangular blocks designated by numerals D and F in FIG. 2 may actually be electrical sockets into which the motors for the pumps would be plugged.
- main on-off switch H is closed to energize the circuit.
- Selector switch S may then by thrown to provide only an aspirate and irrigate cycle, or a feeding, aspirating and irrigating cycle.
- switch 8 is thrown so that arms S1 and S2 are respectively engaging contacts 78 and 82. This represents the condition of the selector switch for a feeding, aspirating and irrigating cycle.
- Solid state timing device T5 may be set anywhere between 0.1 and 10 seconds by adjusting variable resistance TV5. For purposes of explanation, it will be assumed that solid state timing device T5 is set for 10 seconds. Thus, it will take 10 seconds to charge capacitor TC5 with sufficient potential for avalanching transistor TT5 to energize relay TRS.
- Solid state timing device T6 can also be set anywhere between 0.1 and 10 seconds by adjusting variable resistance TV6. For purposes of explanation, it will be assumed that solid state timing device T6 is set to approximately 5 seconds. Thus, it will take 5 seconds for charging capacitor TC6 with sufficient potential for avalanching transistor TT6 to energize relay TR6. Capacitor TC5 has sufficient potential for continuing current flow through transistor TT5 for the entire timing period of timing device T6.
- solid state timing device T5 is energized through normally closed contact STR4 in line 9, normally closed contact 3R7 in line 11, switch arm S2, normally closed contact 3TR1 in line 9 and normally closed contact 1TR6 in line 10.
- relay TRS is energized. This closes normally open contacts lTRS and 2TR5 in line 10.
- Relay R10 is then energized to close normally open contacts 1Rl0 and 2Rl0 in lines 14 and 15. This energizes feed pump D and feed light 90.
- Solid state timing device T6 then times 5 seconds before relay TR6 is energized. Energization of relay TR6 opens normally closed contacts 1TR6 in line 10 for deenergizing solid state timing device T5.
- the pressure switch connected with conduit 46 of FIG. 1 is constantly checking the pressure within stomach B.
- An overpressure condition may be defined by any desirable pressure.
- a typical example is centimeters of water. That is, when the pressure within stomach B is greater than 15 centimeters of water, the pressure switch will operate.
- the pressure switch has normally open contacts P1 in line 4. As long as an overpressure condition does not exist, feeding will continue intermittently in the manner described. However, if an overpressure condition exists, contacts P1 will close. This will energize motor TMl of timer Tl through contacts P1, normally closed contacts 3TR4, switch arm S1, normally closed contacts 1R7 and normally closed contacts lTRl. Timer Tl defines a delay device for stopping operation of the feed cycle.
- Timer T1 may be set anywhere from 0 to 60 seconds. In a typical situation, timer T1 would be set for 15 seconds. If the overpressure condition does not exist for 15 seconds, contacts Pl will open and simply de-energize timer T1. Feeding will continue as previously described. However, if the overpressure exists for at least 15 seconds, timer Tl will time out and its cam will close switch TSl to energize relay TRl. Energization of relay TRl will open contacts lTRl in line 4 to de-energize motor TMl. Contacts 3TR1 in line 9 will also open to deenergize timers T5 and T6.
- Contacts 2TR1 in line 5 will close to provide a holding circuit through contacts STR4 in line 9 to maintain relay Trl energized when the cam re-sets and switch TSl opens. Contacts 4TR1 in line 11 will also close to provide a circuit down to the aspirating and irrigating portions of the circuit.
- relay TRl Energization of relay TRl in the manner previously described establishes a circuit through contacts STR4 in line 9, contacts 3R7 in line 11, switch arm S2, contacts 4TR2 in line 11 and contacts 1R8 in line 18 to timer T2.
- Motor TM2 is then energized through normally closed contacts 2TR2.
- Timer T2 may be set for anywhere between 0 to 60 minutes. In a typical example, timer TR2 is set for around 30 minutes.
- a circuit is also established through normally closed contacts 3TR2 and 3R8 in line 21 for operating aspirating pump F. Aspirating indicator light 94 is also lighted. Pump F will then operate to aspirate from stomach B through tube A into receptacle G.
- the pressure switch may have a normally closed contact T2 connected in series with an insufficient vacuum light 96.
- the speed of pump F may be adjusted for setting it to a desirable vacuum anywhere between 0 and I00 centimeters of water. If the pump is operating at a speed insufficient to draw the desirable vacuum, contacts P2 will remain closed and insufficient vacuum indicator light 96 will remain illuminated. Once the pump is adjusted to provide the desirable vacuum, contacts P2 will open and the insufficient vacuum light will go off.
- Relief valve 50 limits the maximum vacuum to around lOO centimeters of water.
- timer T2 When timer T2 is timed out after 30 minutes, its cam closes switch TS2 for energizing relay TR2. This opens normally closed contacts 2TR2 for de-energizing motor TM2. This also closes contacts 1TR2 for establishing a circuit to maintain relay TR2 energized. The cam of timer T2 will then automatically re-set and open switch TS2. Energization of relay TR2 opens normally closed contacts 3TR2 in line 21 for de-energizing aspirating pump F. Contacts 4TR2 in line 22will close for energizing timer T3 and relay R11 in line 27. Timer T3 may be set for anywhere between 0 and 12 seconds. In a typical example, timer T3 is set to approximately 5 second.
- Energization of relay R11 closes normally open contacts lRll and 2R11 in lines 16 and 17. This starts operation of feed pump D and illuminates feed indicator light 92.
- timer T3 times out after 5 seconds, its cam closes switch TS3 for energizing relay TR3.
- Normally closed contacts 2TR3 are then opened for de-energizing motor TM3.
- the timer clutch is then disengaged and its cam returns to its set position.
- Closing of contacts 1TR3 in line 24 provides a holding circuit to maintain relay TR3 energized.
- Energization of relay TR3 also opens normally closed contacts 4TR3 in line 27 to de-energize relay Rll. This opens contacts lRll and 2Rl1 in lines 16 and 17 for de-energizing feed pump D. Operation of feed pump D for around five seconds after aspirating for 30 minutes cleanses tube A and expels any mucus or particles trapped in the openings of tube A positioned within stomach B.
- Energization of relay TR3 closes normally open contacts 3TR3 in line 26 to energize relay R8.
- Energization of relay R8 opens normally closed contacts IRS in line 18 to completely de-energize timer T2. That is, timer relay TR2 is de-energized. Simultaneously, deenergization of relay TR2 will close contacts 3TR2 in line 21, while contacts 3R8 in line 21 are open for maintaining aspirating pump F de-energized. Deenergization of relay TR2 also opens contacts 4TR2 in line 22. Simultaneously therewith, contacts 2R8 in line 20 are closed for completing a circuit down to and past timer T3. Energization of relay TR3 also closes contacts STR3 in line 28 for energizing timer T4.
- Timer T4 may be set anywhere from 0 to 30 seconds. In a typical example, timer T4 is set to approximately 15 seconds. When timer T4 times out after 15 seconds, its cam closes switch TS4 to energize relay TR4. This opens contacts 2TR4 to de-energize motor TM4. The cam of timer T4 then returns to its set position and switch TS4 opens. Energization of relay TR4 with switch TS4 closed also closes contacts 1TR4 to establish a holding circuit for maintaining relay TR4 energized. Energization of relay TR4 opens normally closed contacts 3TR4 in line 4 and STR4 in line 9. This completely de-energizes timer T1. Contacts 4TR4 in line 5 are closed.
- contacts Pl will be closed.
- a circuit would then be established through contacts P1 and closed contacts 4TR4 to illuminate overpressure light 86 and energize audible buzzer 88.
- Relay R7 would also be energized to close contacts 2R7 in line 7 for maintaining relay R7 energized.
- contacts 4TR1 open and the lower portion of the circuit is no longer energized. The circuit then returns all of the contacts to the position shown in FIG. 2 except for contacts 2R7 which remain energized so that buzzer 88 and light 86 remain on, and relay R7 remains energized.
- timer T4 When there is no overpressure condition at the end of an aspirating and irrigating cycle, operation of timer T4 along with opening and closing of its various contacts will simply check for the overpressure condition in cooperation with contacts Pl. If there is no overpressure condition, contacts P1 will remain open and relay R7 will not be energized. If switch S1 is positioned in the aspirate and irrigate cycle, an additional aspirate and irrigate cycle will again automatically take place. If switch S is positioned in the feeding, aspirating and irrigating cycle, feeding will immediately begin when timer T4 is timed out. The feed cycle will take place in the same manner as previously described by operation of solid state timing devices T5 and T6.
- irrigation portion of the cycle irrigation takes place at a rate of 2.5 cubic centimeters per second for 5 seconds. Material is aspirated at a rate of around 2.5 cubic centimeters per second.
- the irrigation portion of the cycle may be considered somewhat of a pulse for a short time period simply to clean tube A, and its openings within stomach B, of any mucus or particles.
- an apparatus for feeding a solution to a patients stomach said apparatus including tube means having tube opening means for positioning within a patients stomach and feed means connected to said tube means for feeding a solution through said tube and tube opening means, the improvement comprising; pressure sensing means for sensing pressure within the patients stomach to signal an overpressure condition to stop said feed means, means for automatically stopping said a feed means in response to said pressure sensing means sensing such overpressure condition, and means for delaying stoppage of said feed means until said pressure sensing means senses such overpressure condition for a predetermined period of time.
- said means for delaying stoppage of said feed means comprises delay means for delaying signalling of an overpressure condition until said pressure sensing means senses such overpressure condition for a predetermined period of time.
- an apparatus for feeding a solution to a patients stomach said apparatus including tube means having tube opening means for positioning within a patients stomach and feed means connected to said tube means for feeding a solution through'said tube and tube opening means, the improvement comprising; pressure sensing means for sensing pressure within the patients stomach to signal an overpressure condition to stop said feed means, and aspirating means connected to said tube means for applying suction to aspirate pa- -tients stomach in response to said pressure sensing means sensing such overpressure condition.
- said irrigating feed means pulses a small supply of irrigating fluid for a short period of time, and pressure checking means is provided for checking pressure within a patients stomach after operation of said irrigating feed means.
- Apparatus for feeding or aspirating relative to a patients stomach comprising; tube means having tube opening means for positioning in a patients stomach, feed means connected to said tube means for feeding a feeding solution through said tube and tube opening means, aspirating means connected to said tube means for applying suction to said tube means to aspirate a patients stomach through said tube means, and pressure sensing means for sensing pressure within a patients stomach to signal an overpressure condition to stop said feed means, and selective control means for selectively connecting either said feed means or said aspirating means for operation.
- the apparatus of claim 13 further including means for automatically stopping said feed means when such overpressure condition is sensed and said selective control means is connected with said feed means, and means for automatically starting said aspirating means when such overpressure condition is sensed.
- the apparatus of claim 13 further including timing means for timing operation of said aspirating means, and irrigating means for pulsing a supply of irrigating fluid through said tube and tube opening means to clear said tube and tube opening means of any foreign material upon stoppage of said aspirating means.
- Apparatus for aspirating and irrigating a patients stomach comprising; tube means having tube opening means for positioning within a patients stomach, aspirating means connected to said tube means for aspirating a patients stomach through said tube and tube opening means, and pressure sensing means for sensing pressure within a patients stomach to signal an overpressure condition to stop said feed means, and timing means connected to said aspirating means for timing operation of said aspirating means to stop operation of said aspirating means after a predetermined period of time, and irrigating means connected to said tube means for pulsing a supply of irrigating fluid through said tube and tube opening means to clear said tube and tube opening means of any foreign material upon stoppage of said aspirating means.
- a method of supplying a solution to a patients stomach comprising; feeding a solution to a patients stomach, sensing by mechanical means the pressure within the patients stomach to signal an overpressure condition, continuing to feed such solution to the patients stomach until such overpressure condition has been sensed for a predetermined period of time, and stopping by automatic means the feeding of such solution after such predetermined period of time.
- a method of supplying a solution to a patients stomach comprising; feeding a solution to a patients stomach, and sensing by mechanical means the pressure within the patients stomach to signal an overpressure condition and stop feeding by automatic means the solution when an overpressure condition exists, and applying a suction to aspirate the patients stomach upon sensing of such overpressure condition.
- step of aspirating is carried out for a predetermined time, and is followed by the step of pulsing a small supply of irrigating fluid to the patients stomach.
- the method of claim 18 further including the step of checking pressure within the patients stomach after aspirating, and subsequently either feeding a solution or aspirating depending upon whether the sensed pressure is a normal pressure condition or an overpressure condition.
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US378408A US3860000A (en) | 1973-07-12 | 1973-07-12 | Medical apparatus and method for feeding and aspirating |
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US378408A US3860000A (en) | 1973-07-12 | 1973-07-12 | Medical apparatus and method for feeding and aspirating |
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US20090275856A1 (en) * | 2006-06-02 | 2009-11-05 | Holtech Medical | Method and system of measuring iap using a naso-enteric tube |
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US20110190719A1 (en) * | 2006-08-03 | 2011-08-04 | Aspire Bariatrics, Llc | Systems And Methods For Removing Ingested Material From A Stomach |
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