Valved Fenestrated Tracheotomy Tube Having Outer and Inner Cannulae

Abstract

A tracheotomy tube apparatus includes an outer cannula having first and second ends, and a fenestration along the length of the outer cannula between the first and second ends. The apparatus further includes a first inner cannula sized for insertion into the outer cannula. The first inner cannula has a raised region substantially to close the fenestration when the first inner cannula is inserted into the outer cannula. The apparatus further comprises a second inner cannula for insertion into the outer cannula when the first inner cannula is removed therefrom. The second inner cannula includes a resilient region which lies adjacent the fenestration when the second inner cannula is properly oriented within the outer cannula, a valve at an end thereof and a region between the resilient region and the end thereof which provides a passageway between the second inner cannula and the outer cannula when the second inner cannula is properly oriented within the outer cannula. A first coupler is provided on an outer end of the outer cannula. Second couplers are provided on outer ends of the first and second inner cannulae. The first and second couplers are provided with means for guiding the first and second inner cannulae into the predetermined orientations with respect to the outer cannula. The outer cannula further comprises an inflatable cuff formed by a sleeve including a first end, a second end, and a third region between the first and second ends. The sleeve is located around the outer cannula with at least one of the first and second ends of the sleeve between the outer cannula and the third region of the sleeve. The outer cannula further comprises a conduit extending from a first end of the outer cannula to the cuff for introducing an inflating fluid into the cuff when it is desired to inflate the cuff and removing inflating fluid from the cuff when it is desired to deflate the cuff. The first inner cannula includes a second conduit to evacuate a region of a trachea of a wearer adjacent the cuff. The second conduit includes an opening which lies adjacent the closest point in the fenestration to the cuff when the first inner cannula is in a use orientation in the outer cannula.

1 - 26 . (canceled) 
     
     
         27 . A tracheotomy tube apparatus including an outer cannula having first and second ends, a fenestration along the length of the outer cannula between the first and second ends, an inflatable cuff formed on the outer cannula between the fenestration and the second end, a first conduit extending from the first end to the cuff for introducing an inflating fluid into the cuff when it is desired to inflate the cuff and removing inflating fluid from the cuff when it is desired to deflate the cuff and a first inner cannula sized for insertion into the outer cannula, the first inner cannula including a second conduit to evacuate a region of a trachea of a wearer adjacent the cuff, the second conduit including an opening which lies adjacent the closest point in the fenestration to the cuff when the first inner cannula is in a use orientation in the outer cannula. 
     
     
         28 . The apparatus according to  claim 27  including a second inner cannula sized for insertion into the outer cannula when the first inner cannula is removed therefrom, the second inner cannula including a resilient region which lies adjacent the fenestration when the second inner cannula is properly oriented within the outer cannula, the second inner cannula further including a valve operatively associated with the second inner cannula and a region between the resilient region and the valve which provides a passageway between the second inner cannula and the outer cannula when the second inner cannula is properly oriented within the outer cannula. 
     
     
         29 . The apparatus according to  claim 28  wherein the inflatable cuff comprises a sleeve including a first end, a second end, and a third region between the first and second ends, the sleeve located around the outer cannula with at least the first end of the sleeve between the outer cannula and the third region of the sleeve. 
     
     
         30 . The apparatus according to  claim 27  wherein the inflatable cuff comprises a sleeve including a first end, a second end, and a third region between the first and second ends, the sleeve located around the outer cannula with at least the first end of the sleeve between the outer cannula and the third region of the sleeve. 
     
     
         31 . The apparatus according to  claim 30  wherein the first end of the sleeve and the second end of the sleeve are both between the outer cannula and the third region of the sleeve. 
     
     
         32 . The apparatus according to  claim 29  wherein the first end of the sleeve and the second end of the sleeve are both between the outer cannula and the third region of the sleeve. 
     
     
         33 . The apparatus according to  claim 27  further comprising a first coupler provided on an outer end of the outer cannula, a second coupler provided on an outer end of the first inner cannula, one of the first and second couplers provided with at least one surface for guiding the first inner cannula into a predetermined orientation with respect to the outer cannula when the first inner cannula is inserted into the outer cannula, the other of the first and second couplers provided with a cooperating surface for cooperating with the at least one surface for guiding the first inner cannula into the predetermined orientation with respect to the outer cannula. 
     
     
         34 . The apparatus according to  claim 28  further comprising a first coupler provided on an outer end of the outer cannula, a second coupler provided on an outer end of the first inner cannula, one of the first and second couplers provided with at least one surface for guiding the first inner cannula into a predetermined orientation with respect to the outer cannula when the first inner cannula is inserted into the outer cannula, the other of the first and second couplers provided with a cooperating surface for cooperating with the at least one surface for guiding the first inner cannula into the predetermined orientation with respect to the outer cannula. 
     
     
         35 . The apparatus according to  claim 29  further comprising a first coupler provided on an outer end of the outer cannula, a second coupler provided on an outer end of the first inner cannula, one of the first and second couplers provided with at least one surface for guiding the first inner cannula into a predetermined orientation with respect to the outer cannula when the first inner cannula is inserted into the outer cannula, the other of the first and second couplers provided with a cooperating surface for cooperating with the at least one surface for guiding the first inner cannula into the predetermined orientation with respect to the outer cannula. 
     
     
         36 . The apparatus according to  claim 30  further comprising a first coupler provided on an outer end of the outer cannula, a second coupler provided on an outer end of the first inner cannula, one of the first and second couplers provided with at least one surface for guiding the first inner cannula into a predetermined orientation with respect to the outer cannula when the first inner cannula is inserted into the outer cannula, the other of the first and second couplers provided with a cooperating surface for cooperating with the at least one surface for guiding the first inner cannula into the predetermined orientation with respect to the outer cannula. 
     
     
         37 . The apparatus according to  claim 31  further comprising a first coupler provided on an outer end of the outer cannula, a second coupler provided on an outer end of the first inner cannula, one of the first and second couplers provided with at least one surface for guiding the first inner cannula into a predetermined orientation with respect to the outer cannula when the first inner cannula is inserted into the outer cannula, the other of the first and second couplers provided with a cooperating surface for cooperating with the at least one surface for guiding the first inner cannula into the predetermined orientation with respect to the outer cannula. 
     
     
         38 . The apparatus according to  claim 32  further comprising a first coupler provided on an outer end of the outer cannula, a second coupler provided on an outer end of the first inner cannula, one of the first and second couplers provided with at least one surface for guiding the first inner cannula into a predetermined orientation with respect to the outer cannula when the first inner cannula is inserted into the outer cannula, the other of the first and second couplers provided with a cooperating surface for cooperating with the at least one surface for guiding the first inner cannula into the predetermined orientation with respect to the outer cannula. 
     
     
         39 . The apparatus according to  claim 28  further comprising a first coupler provided on an outer end of the outer cannula, a second coupler provided on an outer end of the second inner cannula, one of the first and second couplers provided with at least one surface for guiding the second inner cannula into a predetermined orientation with respect to the outer cannula when the second inner cannula is inserted into the outer cannula, the other of the first and second couplers provided with a cooperating surface for cooperating with the at least one surface for guiding the second inner cannula into the predetermined orientation with respect to the outer cannula. 
     
     
         40 . The apparatus according to  claim 29  further comprising a first coupler provided on an outer end of the outer cannula, a second coupler provided on an outer end of the second inner cannula, one of the first and second couplers provided with at least one surface for guiding the second inner cannula into a predetermined orientation with respect to the outer cannula when the second inner cannula is inserted into the outer cannula, the other of the first and second couplers provided with a cooperating surface for cooperating with the at least one surface for guiding the second inner cannula into the predetermined orientation with respect to the outer cannula. 
     
     
         41 . The apparatus according to  claim 32  further comprising a first coupler provided on an outer end of the outer cannula, a second coupler provided on an outer end of the second inner cannula, one of the first and second couplers provided with at least one surface for guiding the second inner cannula into a predetermined orientation with respect to the outer cannula when the second inner cannula is inserted into the outer cannula, the other of the first and second couplers provided with a cooperating surface for cooperating with the at least one surface for guiding the second inner cannula into the predetermined orientation with respect to the outer cannula. 
     
     
         42 . The apparatus according to  claim 34  further comprising a first coupler provided on an outer end of the outer cannula, a second coupler provided on an outer end of the second inner cannula, one of the first and second couplers provided with at least one surface for guiding the second inner cannula into a predetermined orientation with respect to the outer cannula when the second inner cannula is inserted into the outer cannula, the other of the first and second couplers provided with a cooperating surface for cooperating with the at least one surface for guiding the second inner cannula into the predetermined orientation with respect to the outer cannula. 
     
     
         43 . The apparatus according to  claim 35  further comprising a first coupler provided on an outer end of the outer cannula, a second coupler provided on an outer end of the second inner cannula, one of the first and second couplers provided with at least one surface for guiding the second inner cannula into a predetermined orientation with respect to the outer cannula when the second inner cannula is inserted into the outer cannula, the other of the first and second couplers provided with a cooperating surface for cooperating with the at least one surface for guiding the second inner cannula into the predetermined orientation with respect to the outer cannula. 
     
     
         44 . The apparatus according to  claim 27  further comprising at least one tab provided on an outer end of one of the outer cannula and the inner cannula, the at least one tab including an engaging surface, at least one coupler provided on an outer end of the other one of the outer cannula and the inner cannula for engagement by the at least one tab, the at least one coupler including a portion for cooperating with the engaging surface for orienting the inner cannula in a predetermined orientation with respect to the outer cannula. 
     
     
         45 . The apparatus according to  claim 44  wherein the at least one tab is flexibly formed or mounted to said one of the outer cannula and the inner cannula. 
     
     
         46 . The apparatus according to  claim 27  further comprising at least one tab provided on an outer end of one of the outer cannula and the inner cannula, the at least one tab including an engaging surface, at least one coupler provided on an outer end of the other one of the outer cannula and the inner cannula for engagement by the at least one tab, the at least one coupler including a portion for cooperating with the engaging surface for orienting the inner cannula in a predetermined orientation with respect to the outer cannula. 
     
     
         47 . The apparatus according to  claim 46  wherein the at least one tab is flexibly formed or mounted to said one of the outer cannula and the inner cannula. 
     
     
         48 . The apparatus according to  claim 28  further comprising at least one tab provided on an outer end of one of the outer cannula and the inner cannula, the at least one tab including an engaging surface, at least one coupler provided on an outer end of the other one of the outer cannula and the inner cannula for engagement by the at least one tab, the at least one coupler including a portion for cooperating with the engaging surface for orienting the inner cannula in a predetermined orientation with respect to the outer cannula. 
     
     
         49 . The apparatus according to  claim 48  wherein the at least one tab is flexibly formed or mounted to said one of the outer cannula and the inner cannula.