Патент USA US2119446код для вставки
May 31,‘ 1938. . > J. IGJSHOLES - ' 2,119,446‘ SELF ADMINISTRATION OF GASEOUS ANESTHETICS ' Filed Dec. 11, 1936 2 ‘Sheets-She'et 1 ATTORNEYS May 31, 1938- . J. G. SHOLES - 2,119,446 SELF ADMINISTRATION OF GASEOUS ANESTHETICS Filed Dec. 11, 1936 2 Sheets-Sheet 2 55 g‘ ?t INVENTOR ATTORNEY§ 2,119,446 Patented May 31, 1938 ‘ UNITED STATES PATENT OFFICE 2,119,446 ‘SELF ADMINISTRATION OF GASEOUS ANESTHETICS Justin G. Sholes, Cleveland, Ohio, assignor to The Ohio Chemical and Manufacturing Company, Cleveland, Ohio, a corporation of Ohio Application December 11, 1936, Serial No. 115,327 9 Claims. (01. 128-403). [In many cases arising in the practice of medi cine, surgery and dentistry, in which analgesia, that is relief from pain, is wanted rather than anesthesia, it is sometimes desirable to have the gas (or vapor)‘ administered by the patient. Thus in parturition the patient knows best when the pain becomes too severe, and it is therefore of advantage to have the administration of the gas'under her control. Self-administration may 10 also be advantageous in minor surgery such as the lancing of a boil or abscess, the cleaning and dressing of a wound or a burn, the setting of a fractured bone, or, in dentistry, the preparation of a tooth for ?lling. It is accordingly an object of the present in vention to provide a simple and convenient ap paratus for the self-administration of a gaseous anesthetic, using this term hereinafter to in clude vapors as well as gases. Another object 20 is to provide an apparatus in which the delivery of the anesthetic to the patient requires a pur poseful e?ort on the latter’s part, so that if by taking too much he or she should become uncon scious or semi-conscious the supply of anesthetic 25 will cease or will fall to so low a rate that he will speedily regain consciousness. A further object is to provide an apparatus in which the maxi mum amount of the anesthetic delivered by an actuation of the apparatus can be determined by the physician. Still another object is to provide simple and convenient apparatus which may be operated by the doctor to produce anesthesia, for example for the brief period needed in minor op eraticns such as the lancing of a boil or abscess, setting a fracture or reducing a dislocation, prob ing a wound, removing skin blemishes, cleaning and dressing painful wounds and burns, etc., an esthesia for such purposes being particularly de sirable in the .case of children. To these and 40 other ends the invention comprises the novel fea tures and combinations hereinafter, described. In its broader aspects the invention comprises the connection with a suitable source of the anes thetic and with an inhaling “mask” of con venient shape to ?t over the nose or mouth or over the nose and mouth of the patient. Con nected with the mask I provide a chamber or 5 reservoir, preferably composed in part of a ?ex iblc corrugated tube of suitable length, into one end of which air may be drawn at each inhala tion and at the other end of which the pump is connected so- that the patient inhales a mixture 10 of air and anesthetic. ' Referring to the annexed drawings: Fig. 1 illustrates one form of the invention, comprising a pump operated'by the patient, a mask, and a source of anesthetic; the source of 15 the latter in the present instance being a rubber bag to hold a supply of the anesthetic inhalant. Fig. 2 is a sectional view, on a larger scale, of a suitable pump, actuated pneumatically by the patient. 20 Fig. 3 is a part-sectional view illustrating on a larger scale than that of Fig. 1 the preferred air-gas reservoir. ' Fig. 4 is a detail cross-sectional view of a sim ple form of check valve which may be used at the 2 air inlet of the/air-‘gas reservoir and at the mask. Fig. 5 is a detailed sectional view showing the connection between the pump and the inhaling mask. The bag I0, for holding a supply of the anes thetic inhalant, is connected to a head by which it may be connected with an ampule or cylinder or bottle containing the gas. ,The head shown at H is provided with a corrugated nipple l_2.over which a rubber tube, not shown, may be ?tted, for temporary connection with a cylinder or bot tle. The nipple may have a valve l3, which, when closed, will prevent escape of anesthetic into the air. A valve may also be provided, in dicated at M, to control, and shut off entirely 40 when desired, the out?ow of anesthetic to the pump. A. nipple I5 is shown for connection of combination of a source of anesthetic gas or va por; an inhaling mask adapted to ?t over the pa tient‘s nose or over both mouth and nose, and the head II with the pump I6 by means of a rubber tube H. The pump is connected by a in communication with the atmosphere so that at each inhalation air may be taken into the patient’s lungs; and between the mask and said source, control means to be operated by the pa be of any suitable form and construction. The pump is actuated by a rubber bulb 20 which the rubber tube. It! to the mask 19, which latter may patient can compress by hand. The bulb (pref erably of the type commonly employed for spray tient, such means requiring positive, and prefer ably intermittent, operation by the patient, to 'ing'a liquid from an atomizer nozzle) is shown 50 deliver the anesthetic gas to the mask. In the preferred form of the invention I pro The tubes ll, 18, 2| are preferably rather long so as to permit placing of the pump and bag at vide a “pump” operated pneumatically by the patient, say by his hand or foot, and adapted for from the patient. as connected to the pump by a rubber tube 2|. any convenient point or points, near or remote It is desirable to have the 55 n 2 _ 2,119,446 bag or reservoir In large enough to hold sufficient anesthetic for a considerable range of operations on patients widely different in their susceptibility stem 33 to which it is connected. For the pur pose of adjustment the stem is threaded in a disk to the gas, but it will of course be understood that the doctor can put into the bag no more gas than suitable distance from the septum 23. his experience and judgment tell him will be needed. If the operation is to be performed at the patient’s home, for example, the doctor can take with him a small bottle or several ampules 10 of the gas for replenishment of the supply in the bag as may be necessary. It is also desirable to or‘ plate 34 threaded to the pump body 22 at a At its top the stem is rigidly attached to a rotatable mem 5 ber 35, so that by turning the latter the stem‘ and the disk 3| can be adjusted toward or from the diaphragm. The member 35 may be in the form of a cup or cap, as shown, with its skirt or ?ange 36 extending down over the pump body and ?tting ‘the same closely enough to aid the have the bag as light as possible, so that even - stem 33 'to resist breakage or bending by drop- , when it is well ?lled the gas therein will be under ping on the ?oor or other rough usage. A rather but slight pressure, but little above atmospheric close ?t will also give the cap su?icient frictional 15 at the most. ’ The pump, shown in detail in Fig. 2, comprises a hollow body portion or casing 22 divided into two chambers or parts by a transverse partition 23. Below the latter the casing has a nipple 24 20 for the tube l1 and a nipple 25 for tube I8, and may have check valves 26, 21, to permit ?ow of gas in the direction of the arrows only. These‘ . valves may be of any suitable construction, pref erably with provision for adjustment to deter 25 mine the pressure required to open them, and since check valves of‘ such type are well known it is unnecessary to illustrate the construction of the same here. ' , The lower chamber of the valve body 22 is 30 spanned by an elastic rubber diaphragm 28, held hermetically in place by a screw cap 29 equipped with a nipple 30 for the tube 2| leading to the hand bulb 20. Above the diaphragm is a plate or disk 3| carried by an adjustable stem extend 35 ing through an opening in the septum 23. From the foregoing it will be seen that if the ' bulb is compressed the air forced thereby through the tube 20 will expand the diaphragm '28, say to the position indicated by the dotted lines in Fig. 2, thus expelling gas and. any air present from the lower pump-chamber through check valve 21, the valve 26 preventing back-?ow into tube l1. When the patient relaxes his hand the bulb expands, thus allowing the diaphragm 28 to resistance to rotation to prevent unintentional alteration of the setting of the gas-volume plate or disk 3 |. If desired, the pump body may carry graduations, as indicated in Fig. 1, for example, to show, by the position of the edge of ?ange 36 as an index, the position of the volume-control 20 disk 3|. The edge of the ?ange may be beveled for convenient reading. The graduations may be spaced to be read in any suitable units, as for example cubic centimeters or cubic inches. It will be seen that the pump serves not only to 25 supply the anesthetic to the patient but also measures the amount so supplied as the bulb is compressed and that the amount can be varied as desired by the physician by a simple adjust ment. ' 30 v To prevent leakage of gas along the stem 33 a yielding gasket- 31 may be ‘provided, to be pressed against the stem by a neck 38, projecting from the disk or closure 34. I The volume-control disk shown at 3| is formed 35 to give free communication between the spaces above and below it. This may be done in various ways, as by making it smaller than the internal cross section of the pump chamber, or notching its edge at one or more points, or by perforating 40 it, as indicated in Fig. 2. > By preference the tube |8,- leading from the pump I6, is not connected to discharge, directly into the mask but is connected to an air and gas collapse. As this occurs the check valve 21 closes ' reservoir which is itself connected to the mask, through which reservoir the patient receives air and the suction opens valve 26, thus causing more gas to enter the pump chamber from the gas bag I" until the pressure in the former is su?i cient to permit valve 26 to close, this pressure being insufficient to open valve 21. A small vent may be provided, say in the nipple 30 as shown at 32. Then it the patient, having compressed the bulb, does not at once relax his grip the outflow of air through the vent will \_ reservoir may comprise a simple tube 4| of the corrugated non-collapsible type, and a tubular 50 elbow 40 by which it is connected to the mask permit the diaphragm to collapse notwithstand 4| being open to the atmosphere. Or the reser 55 voir may include a light, easily 'expansible rubber ing, and draw in a fresh supply of gas. How ever, to ‘deliver more gas to the mask the patient must relax his pressure on the bulb and wait until it has expanded, more or less, by in?ow of 60 air through the vent or through the check valve (not shown) with which an atomizer» bulb is usually provided. This has the advantage that i if his continued pressure on the bulb had been ' of a convulsive nature,‘due to his becoming un conscious or semi-conscious, he will not need more gas until he has regained consciousness far enough to feel the need and will then be su?‘l ciently awake to remember to’ release the bulb. The amount of gas that can be drawn into the pump chamber by collapse of "the diaphragm for breathing, so that the gas which he takes into his lungs is admixed with air. The air and gas and to which the tube I8 is connected so that gas delivered to tube l8 by the pump will be dis- . charged into the elbow; the other end of tube bag 4|a enclosing the tube 4|, the latter having openings, as 4|b, for communication with the interior of the bag. At the discharge end of the elbow 40 is an inhaling check valve 42 and the 60 mask is equipped with an exhaling check valve 43, so that 42 opens and 43 closes when the pa tient inhales, andvice versa when he exhales. If desired the outer end of tube 4| may be pro vided with a check valve to permit free in?ow of air but prevent loss of the anesthetic gas from '65 the air-gas reservoir through such end of the tube. A suitable valve for the purpose is shown in Fig. 4, comprising a septum 44 having an an nular series of openings 45, and a thin rubber disk 70 28, and the amount that can be delivered to the , 46 fastened at its'center to the septum or plate mask I!) by the expansion of the diaphragm, is by a screw 41 so that at inhalation the disk will ordinarily determined with all necessary accu ?ex away from the openings 45 and thus admit racy or closeness by the position of_ the plate or air. The inhaling valve 42 at the elbow 40 may disk 3|, adjustable in position by means of. the have a slightly higher tension than valve 46. 75 . 2,1 19,446 Then by continued pumping, more or less gas can be accumulated in the bag Ma without loss of gas through either valve, and this accumulation can be drawn upon by deep or vigorous inhalation. On the other hand, if the patient, getting more gas than necessary, becomes unconscious, or partly so, and ceases to pump, his continued breathing, even though light, exhausts the stored gas in the reservoir and thereafter he breathes 10 air with no gas, or very little, until he begins pumping again. Either valve may be omitted but it is preferred to have at least one, and in some cases both are desirable. ‘ It will be observed that what the patient takes into his lungs by inhalation when be squeezes the bulb is a mixture of air from the reservoir M-?la and gas from tube i8 leading from the pump l6, and that the maximum amount of gas in the mixture which can be so taken into the lungs is 20 determined by the setting of an adjustable part or parts of the pump. It will also be observed that the patient can not draw gas from the elbow 40 without drawing air therefrom also, and that the cross section of elbow 40 and chamber 25 4| is large in comparison with the size of the gas inlet on the elbow. Hence the suction of a sud den and powerful inhalation by the patient will, in general, be expanded chie?y upon the atmos phere through the reservoir 40—4l—4l a, leaving 30 but slight suction, if any, to be exerted on the check valve 21; so that by proper tensioning of the latter, or of valve 25, or both, the possibility of the patient drawing gas from the pump by inhalation alone can be eliminated, but still leav 35 ing itsuf?ciently easy for gas to be delivered through the supply tube i 8 by manual actuation of the pump. ‘The air and gas reservoir M, Ma, Mb, with its associated apparatus, as described above, is a part of my invention, and is believed to be novel and patentable per se; it is claimed in my co pending application Serial Number 151,569, ?led July 2, 1937, for “Apparatus for self-administra tion of anesthetics”. It is to be understood that the invention is not con?ned to the construction herein speci?cally described but can beembodied in other forms without departure from its spirit as de?ned by the following claims. 50 I claim— 1. Apparatus for the administration of an an esthetic, comprising, in combination, a source of anesthetic gas, a gas pump adapted to be oper ated by the patient and connected with said source for intermittent operation to receive gas therefrom, an inhaling mask for the patient, a reservoir connected with the mask and adapted to receive air from the atmosphere and deliver the same to the mask when the patient inhales, 60 and a connection between the pump.and said reservoir for conveying gas to the latter‘ when the pump is actuated whereby the patient when in haling receives a mixture of air from the atmos phere and gas from the pump. 65 . 2. Apparatus for the administration of an an esthetic, comprising, in combination, a source of anesthetic gas, a gas pump connected with said source for intermittent operation to receive gas therefrom, pneumatic means adapted to be oper ated by the patient for actuating the pump, an inhaling mask for the patient, a reservoir con nected with the mask and adapted to receive air directly from the atmosphere and deliver the same .to the mask when the patient inhales, and a connection between the pump and said reser 3 voir for delivery of gas to the latter when the pump is actuated whereby the patient when in haling receives a mixture of air from the atmos phere and gas from the pump. 3. Apparatus for the administration of an an esthetic, comprising, in combination, a source of anesthetic gas; an expansible pneumatic bulb adapted to be compressed by the patient for ex pulsion of air; a gas pump connected with said source and said bulb and having means_for ex 10 pelling gas when the bulb is compressed and drawing gas from said source when the bulb ex‘— pands; an inhaling mask for the patient; a reser voir connected with the mask and adapted to receive air from the atmosphere and deliver the same to the mask when the patient inhales; and a connection between the pump and said reservoir for delivery of gas to the latter when the bulb is compressed whereby the patient when inhaling receives a mixture of air from the ,atmosphere 20 and gas from the pump. 4. Apparatus for the administration of an an~ esthetic, comprising, in combination, a source of anesthetic gas; an inhaling mask for the patient; a reservoir connected with the mask and adapted ‘ to receive air from the atmosphere and deliver the same to the mask when the patient inhales; a gas pump connected with the source of gas and with the reservoir for supplying gas from the former to the latter, the pump having a pneu matically actuated member movable in one di rection to force gas to the reservoir and in the other direction to draw gas from said source; means for. predetermining the maximum amount of gas drawn from the source per actuation of 35 said movable means; and a compressible and expansible pneumatic bulb connected with the pump to actuate said movable means by alternate compression and expansion of the bulb. 5. Apparatus for the administration of an an 40 esthetic, comprising, in combination, a source of anesthetic gas; an inhaling mask adapted to be applied to the face of the patient; a reservoir connected with the mask and communicating with the atmosphere whereby air is'supplied to 45 the mask for inhalation by the patient, said res ervoir comprising a perforated non-collapsible tube in communication with'the atmosphere at one end and having its other end connected with the mask, and an expansible rubber bag sur rounding the tube and communicating with the latter through the perforations therein; and a pump adapted to be operated by the patient, the pump being connected with the said source to receive anesthetic gas therefrom and with said reservoir to deliver gas thereto for admixture with air from the atmosphere to provide a mix ture of gas and air for inhalation by the patient. 6. Apparatus for the administration of an- an esthetic, comprising, in combination, a source of 60 anesthetic gas; an inhaling mask adapted to be applied to the face of the patient; a reservoir connected with the mask and communicating with the atmosphere whereby air is supplied to. the mask for inhalation by the patient, said res 65 ervoir comprising .a perforated non-collapsible tube in communication with the atmosphere at one end and having its other end connected with the mask, and an expansible rubber bag sur rounding the tube and communicating with the 70 latter through the perforations therein; and a pump adapted to be operated by the patient, the pump being connected with the said source to receive anesthetic gas therefrom and with said reservoir to deliver gas thereto for admixture 75 4 2,119,446 with air from the atmosphere to provide a mix ture of gas and air for inhalation by the patient, the pump comprising a member movable in one direction ‘by the patient to receive into the pump a predetermined volume of gas from said source and in another direction by the patient to de liver gas to said reservoir._ 7. Apparatus for the administration of an an esthetic, comprising, in combination, a source of 10 anesthetic gas; an inhaling mask adapted to be applied to the face of the patient; a reservoir connected with the mask and communicating with the atmosphere whereby air is supplied to the mask for inhalation by the patient, said res ervoir comprising a non-collapsible tube in- com munication with the atmosphere at one end and having its other end connected with the mask; and a pump adapted ‘to be operated by the pa tient, the pump being connected with the said source to receive anesthetic gas therefrom and with said reservoir to deliver gas thereto for ad 10 mixture with air from the atmosphere to pro , connected with the mask and communicating - vide a mixture of gas and air for inhalation by with the atmosphere whereby air is supplied to the mask for inhalation by the patient; a pump 15 comprising a hollow body, an expansible and con tractible elastic diaphragm spanning the interior of ‘said hollow body, said body being connected on one side of the diaphragm with the source of anesthetic gas and with said reservoir; check 20 valves for preventing-?ow of gas from the pump to the source of gas and from the reservoir to the pump; and a compressible and .expansible pneumatic bulb connected with the pump body on the other'side of the diaphragm therein for actu ation by the patient to expand and contract the diaphragm. 8. Apparatus for the administration of an an esthetic, comprising, in combination, a source of anesthetic gas; an inhaling mask adapted to be 30 applied to the face of the patient and having in haling and exhaling check valves; a reservoir the ‘patient. 9. Apparatus for the administration of an an esthetic, comprisingain combination, a source of 15 anesthetic gas, an inhaling mask in communica tion with the atmosphere whereby to- supply air. therefrom to the patient, a pump comprising a chamber connected with said source and 'said \ mask, and a member movable in one direction 20 therein- to draw gas from the source into the chamber and ‘in the other direction to‘ expel gas from the chamber to the mask, said pump being connected with said source and the mask and op erable by the patient to inject gas from said‘ source into the air taken from the atmosphere into the mask, and means operable to predeter-i mine the maximum amount of gas so injected when the'pump is actuated. _ ‘ JUSTIN G. SHOLES.