Manually articulated intubation stylet, intubation device and intubation method

Abstract

Apparatuses useful in and methods for positioning of an endotracheal tube within an airway by allowing manual articulation of the endotracheal tube while a patient is being intubated. The apparatuses and methods are of particular use in intubating patients with unique anatomical conditions that make standard stylets inadequate for intubation. In one embodiment, an apparatus may comprise a stylet having a first end and a second end, with the second end of the stylet being insertable within a lumen of the endotracheal tube. First and second articulatable portions of the stylet may be independently articulated into respective primary and secondary arcuations to bend the endotracheal tube in conformance therewith as desired during the intubation procedure.

1 . An apparatus useful in the positioning of an endotracheal tube within an airway, said apparatus comprising:
 a stylet having a first end and a second end, said second end being insertable within a lumen of the endotracheal tube such that at least a portion of a longitudinal extent of said stylet is received within the lumen of the endotracheal tube;   a first filament extending substantially parallel with a longitudinal axis of said stylet, said first filament being connected to said stylet at a first location between said first and second ends;   a second filament extending substantially parallel with a longitudinal axis of said stylet, said second filament being connected to said stylet at a second location farther from said first end than said first location;   a first tensioning mechanism operable to put said first filament under tension to articulate said stylet into a primary arcuation extending from said first location toward said first end; and   a second tensioning mechanism operable to put said second filament under tension to articulate said stylet into a secondary arcuation extending from said second location toward said first location.   
     
     
         2 . The apparatus of  claim 1  wherein said second location coincides with said second end. 
     
     
         3 . The apparatus of  claim 1  wherein said second location is between said first location and said second end. 
     
     
         4 . The apparatus of  claim 1  wherein said primary arcuation and said secondary arcuation are oriented in opposing directions. 
     
     
         5 . The apparatus of  claim 1  wherein said primary arcuation and said secondary arcuation are substantially co-planar. 
     
     
         6 . The apparatus of  claim 1  further comprising:
 an internal passageway extending longitudinally within said stylet from said first end to said second location, wherein both of said first and second filaments are receivable in said internal passageway. 
 
     
     
         7 . The apparatus of  claim 1  further comprising:
 a first internal passageway extending longitudinally within said stylet from said first end to said first location, wherein said first filament is receivable in said first internal passageway; and 
 a second internal passageway extending longitudinally within said stylet from said first end to said second location, wherein said second filament is receivable in said second internal passageway. 
 
     
     
         8 . The apparatus of  claim 7  wherein said first internal passageway is proximal to an outer surface of said stylet at a first radial location relative to said longitudinal axis of said stylet, and wherein said second internal passageway is proximal to an outer surface of said stylet at a second radial location relative to said longitudinal axis of said stylet. 
     
     
         9 . The apparatus of  claim 8  wherein said first and second radial locations are separated by about 180 degrees. 
     
     
         10 . The apparatus of  claim 1  wherein said first tensioning mechanism and said second tensioning mechanism are independently operable from one another. 
     
     
         11 - 15 . (canceled) 
     
     
         16 . The apparatus of  claim 1  wherein said stylet comprises a plurality of individual beads. 
     
     
         17 . The apparatus of  claim 16  wherein said plurality of individual beads includes a primary series of beads and a secondary series of beads, wherein said primary series of beads corresponds with said primary arcuation and wherein said secondary series of beads corresponds with said secondary arcuation. 
     
     
         18 . The apparatus of  claim 17  wherein at least one of said beads comprising said primary series of beads includes at least one beveled end surface, and wherein at least one of said beads comprising said secondary series of beads includes at least one beveled end surface. 
     
     
         19 . The apparatus of  claim 1  wherein said stylet includes a plurality of individual notches formed therein. 
     
     
         20 . The apparatus of  claim 19  wherein said plurality of individual notches includes a primary series of notches and a secondary series of notches, wherein said primary series of notches are formed in a portion of a lengthwise extent of said stylet corresponding with said primary arcuation and wherein said secondary series of notches are formed in a portion of a lengthwise extent of said stylet corresponding with said secondary arcuation. 
     
     
         21 . An apparatus useful in the positioning of an endotracheal tube within an airway, said apparatus comprising:
 a stylet having a first end and a second end, said second end being insertable within a lumen of the endotracheal tube such that at least a portion of a longitudinal extent of said stylet is received within the lumen of the endotracheal tube;   said stylet comprising at least a first articulatable portion extending toward said first end from a first location along a longitudinal extent of said stylet and a second articulatable portion extending toward said first location from a second location along the longitudinal extent of the stylet farther from said first end than said first location, said first articulatable portion of said stylet being articulatable into a primary arcuation and said second articulatable portion of said stylet being articulatable into a secondary arcuation, said first and second articulatable portions of said stylet being independently articulatable into respective said primary and secondary arcuations.   
     
     
         22 - 39 . (canceled) 
     
     
         40 . A method for positioning an endotracheal tube within an airway, said method comprising:
 coupling a first end of a stylet with a handle body including first and second articulating mechanisms, wherein the stylet includes a first articulatable portion extending toward the first end from a first location along a longitudinal extent of the stylet and a second articulatable portion extending toward the first location from a second location along the longitudinal extent of the stylet farther from the first end than the first location, and wherein the first and second articulating mechanisms are independently operable;   inserting a second end of the stylet within a lumen of the endotracheal tube such that at least a portion of the longitudinal extent of the stylet is received within the lumen of the endotracheal tube; and   concurrent with positioning the endotracheal tube within the airway, performing at least one of:
 operating the first articulating mechanism to articulate the first portion of the stylet into a primary arcuation; and 
 operating the second articulating mechanism to articulate the second portion of the stylet into a secondary arcuation. 
   
     
     
         41 . The method of  claim 40  wherein said performing at least one of operating the first articulating mechanism to articulate the first portion and operating the second articulating mechanism to articulate the second portion comprises at least one of:
 pivoting a first lever about a fulcrum to increase tension in a first filament connected to the first lever and extending substantially parallel with a longitudinal axis of the stylet, the first filament being connected to the stylet at the first location; and 
 pivoting a second lever about a fulcrum to increase tension in a second filament connected to the second lever and extending substantially parallel with the longitudinal axis of the stylet, the second filament being connected to the stylet at the second location. 
 
     
     
         42 . The method of  claim 40  further comprising:
 withdrawing the stylet from the lumen of the endotracheal tube. 
 
     
     
         43 . The method of  claim 42  further comprising:
 concurrent with said withdrawing the stylet from the lumen of the endotracheal tube, performing at least one of:
 operating the first articulating mechanism to release the primary arcuation from the first portion of the stylet; and 
 operating the second articulating mechanism to release the secondary arcuation from the second portion of the stylet. 
 
 
     
     
         44 - 48 . (canceled)