WO1988000021A1

WO1988000021A1 - Laryngoscope

Info

Publication number: WO1988000021A1
Application number: PCT/EP1987/000337
Authority: WO
Inventors: Steven Marc Yentis
Original assignee: Boc Health Care
Priority date: 1986-06-30
Filing date: 1987-06-25
Publication date: 1988-01-14
Also published as: GB8715068D0; GB8615884D0; GB2191949B; GB2191949A

Abstract

A laryngoscope (1) comprises a detachable blade (12) mounted on a handle (10), whereby the handle can be pivoted about an axis substantially parallel with that of the axis of the blade (12) between a first position in which the handle (10) is in normal use to a second position in which insertion of the blade into the mouth of a patient is facilitated. In one embodiment of the invention an adaptor (14) in the form of a universal joint is provided, which can be fitted between the blade (12) and the handle (10) of a traditional laryngoscope to enable the user to benefit from the invention without having to replace an existing laryngoscope or the stock of blades which usually accompanies it.

Description

Laryngoscope

The present invention relates to medical instruments and in particular to laryngoscopes.

The traditional laryngoscope comprises a stainless steel blade, a so-called Macintosh blade, mounted on a tubular handle. The blade, which is shaped like the bill of a curlew, can, when not in use, either be pivoted about the top of the handle to fold flat with the handle in the case of older versions or be uncoupled in the case of later versions.

When in use, the handle is substantially perpendicular to the blade and, with certain patients, insertion of the blade into the mouth can be difficult owing to the handle being obstructed by the patient's chest, medical equipment attached to the patient or any other similar obstruction. One solution devised many years ago when polio patients were treated in an iron lung was to design a special blade which was almost in line with the axis of the handle, the so-called Macintosh polio blade.

Although the polio blade is still widely used in situations where the handle is obstructed by the patient's chest, it is by no means satisfactory as it is more difficult to apply the necessary degree of pressure during intubation and the handle tends to obstruct the Doctor's view of the throat of the patient.

In 1984 Jellicoe and Harris described a compromise solution to the problem whereby an adaptor was inserted between the blade and the handle in order to make an obtuse angle between the blade and the handle of approximately 120 degrees. At best, this provided an improvement, but failed to solve the problem completely.

It is an aim of the present invention to provide a laryngoscope with means for allowing the handle to be pivoted about an axis substantially parallel with that of the blade between a first operative position and a second position in which the handle is unlikely to be obstructed by the patient, any medical equipment attached to the patient or any other similar obstruction.

It is a further aim of the invention to provide an adaptor in the form of a universal joint which can be used with existing laryngoscopes to permit the handle of the laryngoscope to pivot about an axis substantially parallel with that of the blade between a first operative position and a second position at which the handle is unlikely to be obstructed by the patient, any medical equipment attached to the patient, or any other similar obstruction.

According to a first aspect of the present invention a laryngoscope comprises a detachable blade mounted on a handle and means enabling the handle to pivot relative to the blade about an axis substantially parallel with the blade between a first operative position and a second position in which the handle is unlikely to be obstructed by the patient, any medical equipment attached to a patient or any other similar obstruction.

According to a further aspect of the present invention, an adaptor for use with a laryngoscope having a blade releasably attachable to a handle is in the form of a universal joint having two perpendicular axis such that the blade can be releasably pivotally mounted about one axis whilst the handle can be releasably pivotally mounted about the other axis.

Embodiments of the invention will now be described, by way of example, reference being made to the Figures of the accompanying diagrammatic drawings in which :-

Figure 1 is a perspective view of a laryngoscope with an adaptor interposed between the blade and the handle of the laryngoscope;

Figure 2 is a perspective view of the adaptor for use with the laryngoscope of Figure 1; Figure 3 is a further perspective view of the adaptor of Figure 2;

Figure 4 is a perspective view of a further adaptor; and

Figure 5 is a further perspective view of the adaptor of Figure 4.

As shown in Figure 1, a laryngoscope 1 comprises a blade 12, a handle 10 and an adaptor 14. Referring also to Figures 2 and 3 the blade 12 is located on the upper (as shown) end of the adaptor 14 by means of a lug 16 extending downwardly (as shown) from a base 22 which lug 16 engages within a slot 18 formed in said upper end of the adaptor. The lug 16 has a through hole (not shown) which when the lug 16 is operatively inserted in the slot 18, is aligned with holes 24, 24' formed in opposite side walls of the slot 18. The lug 16 is retained in the slot 18 by a pivot member in the form of a screw 20 which passes through hole 24, the hole in the lug 16 and finally screws into the hole 24'. The blade 12 can thus pivot about the screw 20 from its operative position shown in Figure 1 to a position almost flat against the handle 10 when not in use.

In use, the blade 12 is releasably secured in the operative position shown in Figure 1 by a spring clip 26 mounted on the base 22 which co-operates with an indentation 28 formed in the adaptor 14.

Extending downwardly (as shown) from the adaptor 14 is a lug 13 having a through hole 32. Lug 13 is located in a channel formed in the upper (as shown) end of the handle 10 such that the hole 32 is aligned with holes (not shown) formed in side walls defining the channel. A pivot member in the form of a screw 30 passes through one hole in a side wall of the channel, through the hole 32 and screws into the hole in the opposite side wall of the channel. It will be apparent, that the handle 10 can be pivoted about the screw 30 between a first operative position (shown in broken lines) to a second position (shown in full lines) where the handle 10 is unlikely to be obstructed by the patient, any medical equipment attached to the patient, or any other similar.obstruction, for example a hand of an assistant.

A spring clip 34 is mounted on the adaptor 14 to releasably secure the handle 10 in the first operative position. The end 36 of the lug is rounded slightly to facilitate the lug 13 pivoting freely in its co-operating channel.

A laryngoscope as described above has the advantage that it is simple to insert into the mouth of a patient because during insertion the handle 10 is swung out of the way of the patient's chest to its second position. However, once the blade 12 has entered the patient's mouth the handle can be swung back and snapped into its normal first operative position to provide the necessary leverage for intubation.

A feature of the standard laryngoscope is a small light source 38 positioned towards the distal end of the blade 12. This may either be provided by means of optical fibres or by a bulb as in the laryngoscope illustrated in Figure 1. The bulb is powered by batteries enclosed in the handle 10. The body of the laryngoscope is used as one pole whilst the other is carried by an insulated electrical connector 40 running through the adaptor 14 and making electrical contact when the handle 10 is in its first operative position.

It will be apparent, that the laryngoscope may be carried or stored with the blade 12 folded about the first screw 20 to lie along handle 10 when said handle 10 is in its first position. In order to insert the blade 12 into a patient's mouth the blade 12 is moved to the position as shown in Figure 1 and the handle 10 is then rotated about the screw 30 into the second position shown in full lines in Figure 1. In this way the handle 10 is most unlikely to be obstructed by the patient or by any equipment attached to the patient. Once the blade 12 is inserted into the patient's mouth the handle 10 is pivoted about the screw 30 to the position shown in broken lines i.e. its normal operative position.

The adaptor 14 described above is in the form of a universal joint having two perpendicular axes which enable existing handles and blades to be used without further modification. The adaptor 14 allows full pressure to be exerted on the blade 12 via the handle 10 when in its operative position and does not reduce visibility when in use.

The adaptor 14 as described is suitable for use with the most common types of laryngoscope in use today. However, for other laryngoscopes in which the handle is provided with a pivot member in the form of a pin extending between opposed side-walls of a channel and the blade has a lug for location within the channel which lug is formed with a hoo -like recess which releasably receives the pin, then the adaptor illustrated in Figures 4 and 5 can be used.

The adaptor 50 which again is in the form of a universal joint is formed with a channel 52 on its upper (as shown in Figure 4) end across which extends a pivot member in the form of a pin 54. The side walls 55 defining the channel 52 are formed with detents 57 (only one shown) . On the base 56 of the channel 52 is an insulated electrical connector in the form of a spring loaded ball 58.

The channel 52 receives a lug on the blade of the laryngoscope and a hook-like recess formed in the lug receives in a releasable manner the pin 54. Spring loaded balls in the lug of the blade engage the detents 57 to releasably hold the blade in its operative position. However, the blade can be pivoted about the pin 54 relative to the adaptor 50. Extending downwardly (as shown in Figure 4) from the adaptor 50 is a lug 60 which is formed with a hook like recess 62. Spring loaded balls 64 (only one shown) extend from opposite sides of the lugs 60. The lug 60 is dimensioned to be received in a channel formed in the handle of the laryngoscope with the recess 62 releasably receiving a pin extending across the channel formed in the handle. The balls 64 co-operate with detents formed in the channel to releasably retain the lug in the channel. The handle can be pivoted relative to the adaptor between an operative position and a second position in which the handle is unlikely to be obstructed by the patient or any medical equipment attached to the patient. An insulated electrical connector in the form of a spring loaded ball 68 extends from the base of the lug 60 and this mades electrical contact with batteries enclosed in the handle. The ball 68 is in electrical contact with ball 58 and acts as an electrical connector between the batteries in the handle and a bulb in the blade as explained previously.

The use of the adaptor as illustrated in Figures 4 and 5 offers the same advantages as the adaptor illustrated in Figures 2 and 3 in that it permits the blade of a laryngoscope to be placed in a patient's mouth whilst the handle is rotated towards its second position where it is unlikely to be obstructed by the patient or by any equipment attached to the patient.

It will be appreciated that although in the above described embodiments independent adaptors 14, 50 have been described the benefits of the invention can be achieved by permanently attaching an adaptor to either the handle or the blade of a laryngoscope.

The laryngoscope described above has the advantage that it is simple to insert the blade into the mouth of a patient since during insertion the handle is pivoted out of the way of the patient's chest. Once the blade is in the patient's mouth the handle can be pivoted back and snapped into its operative position to provide the necessary leverage for intubation.

The handle of the laryngoscope may be designed to pivot in either a clockwise or anticlockwise sense with respect to the blade.

Claims

1. A laryngoscope comprising a detachable blade mounted on a handle and means enabling the handle to pivot relative to the blade about an axis substantially parallel with the blade between a first operative position and a second position in which the handle is unlikely to be obstructed by the patient, any medical equipment attached to the patient or any other similar obstruction during insertion of the blade into the mouth of a patient.

2. A laryngoscope as claimed in claim 1, in which the means comprises an adaptor in the form of a universal joint having two perpendicular axes, one about which the blade is pivotally mounted and the other about which the handle is pivotally mounted,

3. A laryngoscope as claimed in claim 2, in which the adaptor is releasably mounted on the handle.

4. A laryngoscope as claimed in claim 2, in which the adaptor is permanently mounted on the handle.

5. An adaptor for use with a laryngoscope comprising a blade and a handle, the adaptor being in the form of a universal joint having two perpendicular axes, one about which the blade can be pivotally mounted and the other about which the handle can be pivotally mounted.

6. An adaptor as claimed in claim 5, in which an axial insulated electrical connection is provided for making an electrical contact between the handle and the blade.

7. A method of using a laryngoscope substantially as hereinbefore described.

8. A laryngoscope constructed, arranged and adapted to operate substantially as hereinbefore described with reference to and as illustrated in the Figures of the accompanying drawings.

9. An adaptor substantially as hereinbefore described with reference to and as illustrated in Figures 1, 2 and 3 or Figures 4 and 5 of the accompanying drawings.