US1916658A - Pneumothorax apparatus - Google Patents

Description

July 49 1933- L. R. DAVIDSON PNEUMOTHORAX APPARATUS Filed Oct. 9, 1931 3 Sheets-Sheet 1 INVENTOR Y was Hmfmw BY M ATTORNEY July 4, 1933 l.. R. DAVlDsoN PNEUMOTHORAX APPARATUS Filed'oct. 9, 1951 5 sheets-sheet 2 .ma NV. R w m mw u S( u W July 4, 1933. L. R, DAVIDSON PNEUMOTHORAX APPARATUS Filed Oct. 9, 1951 5 Sheets-Shea?l 3 INVENTOR [was Z. azfzasan, g BY-g M ATTORNEY I Patented July 4, 1933 'uNi'rEo STATESl vLouis n. DAVIDSON, or Nnw YORK. N. Y.

* PNEUMOTGRAX ArrARA'rU'sQ i Aiyaioation inea' october 9, 193i. Se'riaijNo. 567,509;

, This invention relates to a small extremely portable pneumothorax apparatus. My improvements are directed to means, in a de! vice of this character, including a five-way valve,` whereby the pressure in the pleural cavity may be measured, whereby a measured quantity of air may bev introduced into Said cavity, and whereby air may be removed from said cavity, all by thek easy and unassisted manipulation Vof said five-way valve' for eiiecting suitable connections between the inlets and outlets thereof, with a manometer, with a pair of reservoirs,and with the operating needle.

The reservoirs are movable vertically in opposite directions and are connected at their lower ends so that the contained liquid will successively expel air therefrom and aspirate air therein, these movements of the reservoirs being controlled in and by the operation oi the valve, which operationserves to bring'k into registry the appropriate valve vents and the passages leading vtherefrom and thereto.v

Other features and advantages of my invention will hereinafter appear.

In the drawings:

Figure 1 is an elevation of they combined enclosing case and stand for my improved apparatus.

2 isa longitudinal section thereof.

Fig. 3 is a section on the line 3 3 of Fig. 2.'

Fig. 4c is a partial horizontal section showing the case employed as a stand for the ap-4 85 parat-us, taken on the line 4 4 of Fig. 5.

F ig". 5 is a front elevation of theapparatus. Fig. 6 is a side elevation. Fig. 7 is a side sectional view. l Fig. 8 is an enlarged detail view, partly in 4:0v section of the valve casing and valve.

Fig. 9 is a section on theV line 9-'9 of Fig.l

8, showing the valve turned to one setting thereof. c

Figs. 10,. 11- and 12 are similar views, re- 42'v spectivelyshowing different valve settings.vv Fig. V13 is a view of a modified form of valve, having a further vent, and bores permitting of an additional' connection with amercuryv manometer. Fig. 14 is a diagrammatic view of the reservoirs, as moved in opposite directions for the respective operations ofliquid and .air displacement. l

The vmount for my improved apparatus is in the form` of ay panel, having the face ,5 portion 1,- rearwardly extending side walls 2, 2, and langes 3, 3. Supported by the face' portion 1, near its upper end, is a five-way valve having the casing t and revolvable stem 5, which latter is provided with a han- A dle 6, having a pointer 6a, which is adapted to register with gradation marks that are placed around the valve casing in thev mannerof a dial 66. 1

The valve, stem extends through the back of the valve casingV and is there provided withv a sprocket Wheel 7, asproclet chain 8 connecting said wheel 7 with an idle sprocket wheel 9 that is journalled on a stubl shaft 10 which issecured to face portion 1 near. 70' its lower end. f

VFranies11, 11 have lugs 12 that are slidable in slots 13 formed in the Walls 2, said lugs engaging the chain 8 respectively at opposite sides thereof, said frames 11, 11, re- ;k spectively supporting the reservoirs 14, 15, which may b e composed of glass, and are provided with suitable calibrations.

Four of the vents in the valve casing 4 are in the same transverse plane, vent 16k being 80 at the top, 17' at the bottom, 18 at the left side and 19' lat the right side. A fifth vent, 20, is provided at the bottom, forward of thek vent 1'?.v These vents are respectivelypro'- vided with `the rigid tubes 16a,i17a, 18a, 19a 85 and 20a.- Y Thevalvestem` or male element 5 has grooves 21,'22formed therein whichper-Q mit the formation of passagewaysbetween pairs ofy vents in the casing, according tothe settings of thevalve stem to suit the various' 90A purposes of the apparatus. Also the valve stem has an angular bore 21o therethrough .which in al given'valve setting connects thevent 16, by way of groove 21a, with vent 20.

At another setting groove 2lb-.connects vent 95A 17 with vent 20. f

The" vent tube 20a is connected bya rubber tube2'3 toa'U-shapedv water manomet'er 24,-

which is here-shown' as mounted on the face portion 1 of the panel, the limbs of said 10o manometer having' a glass stop cock at each upper end.

In practice I have provided this manometer with a working distance of 22 cm., its bore, like the bore in the valve casing is 3l/g -I- mm., and the same calibre of bore exists in the glass stop cocks, thus eliminating eddying effects. Y

The rubber tubing throughout has a workinv diameter of 4 mm.

P lhe vent tubes 18a and 19a are respectively connected by rubber tubing 25, 26, to the upper ends of the reservoirs 14, 15. These reservoirs each have a capacity of 100 cc., and contain a five percent phenol solution. Said reservoirs, which each have a lower opening, are connected thereby with a rubber tube 27, so that liquid may flow from one reservoir to the other, dependent upon the relative positions of the reservoirs.

The lower vent tube 17a is connected by a rubber tube 27a, with a calcium tube 28, which holds sterilized cotton Wool, and which is firmly fastened to the panel as by clip 29.

In Fig. 5 there is shown a rubber tube 30 as connected with the vent tube 16a, said tube 30 being interrupted by a calcium tube 31, which contains sterilized cotton wool, the tube 30 being adapted to carry the usual form of hollow needle (not shown) for inser- 'tion into the pleural cavity.

i inthe right limb of the manometer, the point'- diametrically movable In brief then the apparatus is constituted by connecting a five-way valve to a manometer and by the use of two vertically and reservoirs whose movements are controlled by a sprocket chain, which chain is operated by turning the valve stem. It is apparent that the respective positions of the reservoirs and the valve are lsynchronized in the movements of the valve stem handle.

In the employment of the apparatus, when set up, the cut off clamps 32 being released, and the stop cocks 33 being opened by turn- ,ing them to the vertical position, first the pointer 6a` of the valve stem handle is turned to A on the dial, bringing the valve stem to the position shown in Fig. 11, also elevating reservoir 15 and lowering reservoir 14, as

Jshown in Fig.. 14. Assuming the dial to be calibrated like a clock face the point A will represent 10 8O oclock. This permits reser= voir 15 to be all but completely emptied. With the liquid in the reservoirs leveled the connecting vents 16 and 20 by Way of bore 21a, and the pneumothorax needle is inserted in the pleural cavity. I-Iaving obtained the proper reading after noting the fluctuations er is again turned to A, 10: 30 oclock, and the air contained in the reservoir (7 5 cc.) is aspirated into the pleural cavity. This is the primary procedure in an initial lling.

When the level of the liquid in reservoir 15 ascends a definite distance, thereby indicating that air has entered the pleural cavity,

the fear of embolism is lost. The following procedures are then instituted as for refills.

The pointer is turned to the open position, at 7:80 oclock, whereby liquid flows from reservoir 15 to reservoir 14, the latter becoming filled with phenoled water and the former charged with filtered atmospheric air. Then the handle (i is turned to bring the pointer to 12: O() oclock and if this is a refill the needle is inserted into the pleural cavity through an intercostal space. Ihen the proper reading has been obtained the handle is smartly turned clockwise through 185 degrees, to 4: 30 oclock.- Liquid now runs from reservoir 14 to reservoir 15, displacing the air in the latter, which displaced air is thereby forced into the pleural cavity. IN hen all this air cc.) is expelled by the liquid the handle is again smartly turned, this time counter-clockwise, through 270 degrees, t0 7: 30 oclock.

In the previous position, while the air was leaving the reservoir 15, and the liquid was position and filteredfair is again displaced from the respective reservoir, which is calibrated, into the pleural cavity. It is apparent that by continuously turning the handle clockwise and counter-clockwise a limitless amount of air can be introduced. Utilizing this manoeuvre a positive pressure of 16 cm. of water can be'obtained. However, if greater pressures are wanted, particularly by those who desire to stretch adhesions, the following' procedure is adopted:

TWhen the manometer indicatesa positive pressure of about 14 om., a small rubber bulb, such as is customarily used with a nasal atomizer, is slipped over the `tube 28. When this bulb is slowly squeezed filtered air` exerts pressure upon the surface of liquid in one reservoir, thereby7 forcing air from the other reservoir into the pleural cavity, and, if considerable air under pressure is necessary, and this I sincerely doubt, and the air in one reservoir is completely emptied, the handle is again reversed through 270 degrees and the pressure bulb is again slowly squeezed. Frequentmanometric readings should Ybe taken when creating high pressures.

By removing the distal rubber tubing from filter tube 30, and connecting it to filter tube 28, then performing the procedures as Also upon reversing the positions of the resfor refills, air is removed from the pleural cavity. However, manometric readings in this instance are not available unless appropriate connections are made by turning the pointer to 9: 00 oclock. For the purpose of vithdrawing air from the pleural cavity, the pointer for the valve stem is turned to 7 30 ocloclr, as for introducing air into the pleural cavity. The partial vacuum created in reservoir 15 will draw air from the pleural cavity.

ervoirs the air withdrawal will be effected by the partial vacuum in reservoir 14.

The valve shown in Fig. 13 is like the valve shown in the other figures, excepting that in Fig. 13 there is an additional vent 220, having a tube 22d. The purpose of the additional vent is for a. double reading, where higher pressures are met wit-h, and in this instance vent 220 is in communication with a mercury manometer (not shown), vent 220 connecting with vent 16 through a bore 22a provided for the purpose. Vhen relieving pleural pressures, in order to effect the reading through vent 17, the groove 22?) is provided in the stem ot the valve shown in Fig. 3, and establishes communication between vent 17 and vent 22o.

For convenience in transporting the apparatus l have provided the box illustrated in Fig. 1, which is provided with grooves 'for the secure lodgement of the apparatus therein; and also said box, when the apparatus has been removed therefrom, serves the purpose of a stand for supporting the appa.- ratus in a vertical position, for service.

Variations within the spirit and scope of my invention are equally comprehended by the foregoing disclosure. y

I claim:

1. The combination, in a pneumothorax apparatus, having reservoirs that are vertically movable in opposite directions, and are in communication at their lower portions, of aiive-way valve having a casing and a stem revolvable therein, said casing provided with iive vents and said stem having passageways that selectively connect certain of said vents, respective means of communication between the upper portions of said reservoirs and said valve, a manometer, means of communication between said valve and manometer under the direct control of said valve, and .means actuated by the operation of said valve stem to ated by the operation of said valve stem toy move said reservoirs oppositely.

3. The combination.v in a pneumothorax apparatus, having reservoirs that are vertically movable in opposite directions, and are in communication at their lower portions, ofa valve having a casing and a stem revolvable therein, said casing provided with a plurality of vents and said stem having passageways that selectively connect certain of said vents, respective means of communication between the upper portions of said reservoirs and said valve, a water manometer, respective means of communication between said valve, water manometer and a pneumothorax needle, also between said valve and a mercury manometer, and means actuated by the operation of said valve stem to move said reservoirs oppositely.

4. In a pneumothorax apparatus, reservoirs vertically movable in opposite directions and being interconnected at their lower portions, a manometer, a calcium tube, a pneumothorax needle, a live-way valve including a casing having four vents connected to said reservoirs, said manometer and said needle, respectively, and also having a vent in communication with said calcium tube, a revoluble valve stem having a pair of grooves to permit the formation of passageways between a selected reservoir and the needle and calcium tube,and further presenting an annularl bore adapted to connect said needle to said manometer and also having a groove to connect said calcium tube to said manometer, and means actuated by the operation of said valve stem to move said reservoirs oppositely.

LOUIS R. DAVIDSON.

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