Valued fenestrated tracheotomy tube having outer and inner cannulae

Abstract

An outer cannula has a first port for orienting outside the neck of a wearer, a second port for orienting within the trachea of the wearer, a first passageway coupling the first port to the second port to permit the flow of gases from the first port to the second during inhalation by the wearer and from the second port during exhalation by the wearer, and a third port between the first and second ports. An inner cannula is configured for insertion into the first passageway via the first port when the wearer desires to be able to exhale through his or her pharynx. The inner cannula includes a fourth port for orienting adjacent the first port, a fifth port for orienting adjacent the second port and a second passageway coupling the fourth port to the fifth port to permit the flow of gases from the fourth port to through the fifth during inhalation by the wearer and prevent the flow of gases from the fifth fourth port during exhalation by the wearer. A valve controls flow through the third port. The valve assumes a first orientation to permit flow from the first fourth port to the second fifth port when the first fourth port is at a higher pressure than the second fifth port, and a second orientation to permit prevent flow from the second fourth port through the third port when the second fifth port is at a higher pressure than the first fourth port.

1. In combination , an outer cannula having a first port for orienting outside the neck of a wearer, a second port for orienting within the trachea of the wearer and a first passageway coupling the first port to the second port to permit the flow of gases from the first port to the second during inhalation by the wearer and from the second port during exhalation by the wearer, a third port between the first and second ports, and an inner wearer for insertion into the first passageway via the first port when the wearer desires to be able to exhale through the wearer's pharynx, the inner cannula including a fourth port for orienting adjacent the first port, a fifth port for orienting adjacent the second port and a second passageway coupling the fourth port to the fifth port to permit the flow of gases from the fourth port to  through the fifth during inhalation by the wearer and preventing the flow of gases from the fifth  fourth port during exhalation by the wearer, a valve controlling flow through the third port, the valve assuming a first orientation to permit flow from the first  fourth port to the second  fifth port when the first  fourth port is at a higher pressure than the second  fifth port, and a second orientation to permit  prevent flow from the second  fourth port through the third port  when the second  fifth port is at a higher pressure than the first  fourth port. 
     
     
       2. The apparatus of  claim 1  wherein the valve includes a movable member and a seat, the movable member moving away from the seat to permit flow from the fourth port to the fifth port when the fourth port is at a higher pressure than the fifth port, and seating against the seat to impede flow from the fifth port through the fourth port and promote flow from the fifth port  through the third port when the fourth port is at a lower pressure than the fifth port. 
     
     
       3. The apparatus of  claim 2  wherein the seat is provided in the second passageway. 
     
     
       4. The apparatus of  claim 3  including a second seat, the movable member moving toward the second seat to impede flow from the fourth port through the third port when the fourth port is at a higher pressure than the fifth port, and moving away from the second seat to permit flow from the fifth port  through the third port when the fourth port is at a lower pressure than the fifth port. 
     
     
       5. The apparatus of  claim 4  wherein the outer cannula includes an inflatable cuff between the second and third ports and a third passageway for introducing an inflating fluid into the cuff in situ in the trachea of the wearer to impede the flow of fluids between the cuff and the trachea when the cuff is inflated. 
     
     
       6. The apparatus of  claim 3  wherein the outer cannula includes an inflatable cuff between the second and third ports and a third passageway for introducing an inflating fluid into the cuff in situ in the trachea of the wearer to impede the flow of fluids between the cuff and the trachea when the cuff is inflated. 
     
     
       7. The apparatus of  claim 2  wherein the seat is provided in the first passageway. 
     
     
       8. The apparatus of claim  4    7  including a second seat, the movable member moving toward the second seat to impede flow from the fourth port through the third port when the fourth port is at a higher pressure that  than the fifth port, and moving away from the second seat to permit flow from the fifth  second port through the third port when the fourth port is at a lower pressure than the fifth port. 
     
     
       9. The apparatus of  claim 8  wherein the outer cannula includes an inflatable cuff between the second and third ports and a third passageway for introducing an inflating fluid into the cuff in situ in the trachea of the wearer to impede the flow of fluids between the cuff and the trachea when the cuff is inflated. 
     
     
       10. The apparatus of  claim 7  wherein the outer cannula includes an inflatable cuff between the second and third ports and a third passageway for introducing an inflating fluid into the cuff in situ in the trachea of the wearer to impede the flow of fluids between the cuff and the trachea when the cuff is inflated. 
     
     
       11. The apparatus of  claim 2  including a second seat, the movable member moving toward the second seat to impede flow from the fourth port through the third port when the fourth port is at a higher pressure than the fifth port, and moving away from the second seat to permit flow from the fifth  second port through the third port when the fourth port is at a lower pressure than the fifth port. 
     
     
       12. The apparatus of  claim 11  wherein the outer cannula includes an inflatable cuff between the second and third ports and a third passageway for introducing an inflating fluid into the cuff in situ in the trachea of the wearer to impede the flow of fluids between the cuff and the trachea when the cuff is inflated. 
     
     
       13. The apparatus of  claim 2  wherein the outer cannula includes an inflatable cuff between the second and third ports and a third passageway for introducing an inflating fluid into the cuff in situ in the trachea of the wearer to impede the flow of fluids between the cuff and the trachea when the cuff is inflated. 
     
     
       14. The apparatus of  claim 1  wherein the valve includes a movable member and a seat, the movable member moving toward the seat to impede flow from the fourth port through the third port when the fourth port is at a higher pressure than the fifth port, and moving away from the seat to permit flow from the fifth port through the third port when the fourth port is at a lower pressure than the fifth port. 
     
     
       15. The apparatus of  claim 14  wherein the outer cannula includes an inflatable cuff between the second and third ports and a third passageway for introducing an inflating fluid into the cuff in situ in the trachea of the wearer to impede the flow of fluids between the cuff and the trachea when the cuff is inflated. 
     
     
       16. The apparatus of  claim 1  wherein the outer cannula includes an inflatable cuff between the second and third ports and a third passageway for introducing an inflating fluid into the cuff in situ in the trachea of the wearer to impede the flow of fluids between the cuff and the trachea when the cuff is inflated. 
     
     
       17. The apparatus of  claim 1 ,  2 ,  3 ,  4 ,  5 ,  6 ,  7 ,  8 ,  9 ,  10 ,  11 ,  12 ,  13 ,  14 ,  15  or  16  wherein the outer cannula includes a flexible member for covering the third port. 
     
     
       18. The apparatus of  claim 17  wherein the flexible member and the outer cannula including  include complementary first and second attachment members, respectively, for attaching the flexible member to the outer cannula, the second attachment member providing an attachment point located within the third port for attachment of the first attachment member to the second attachment member at the attachment point. 
     
     
       19. The apparatus of  claim 17  wherein the flexible member comprises a flexible membrane having a slit in it. 
     
     
       20. The apparatus of  claim 17  wherein the flexible member comprises a flap for covering the third port. 
     
     
       21. The apparatus of  claim 1 ,  2 ,  3 ,  4 ,  5 ,  6 ,  7 ,  8 ,  9 ,  10 ,  11 ,  12 ,  13 ,  14 ,  15  or  16  further including a member selectively movable into interfering relationship to the valve, the member preventing the valve from moving to the second orientation. 
     
     
       22. A tracheotomy cannula having a first port for orienting outside the neck of a wearer, a second port for orienting within the trachea of the wearer and a first passageway between the first port and the second port to permit the flow of gases from the first port to the second during inhalation by the wearer and from the second port during exhalation by the wearer, the cannula including a portion formed from a thermoplastic material having a first, generally curved orientation  configuration when said portion is maintained substantially below body temperature and a second, somewhat inverted L-shaped configuration when said portion is warmed substantially to body temperature. 
     
     
       23. A tracheotomy cannula having a first port for orienting outside the neck of a wearer, a second port for orienting within the trachea of the wearer and a first passageway between the first port and the second port to permit the flow of gases from the first port to the second during inhalation by the wearer and from the second port during exhalation by the wearer, the cannula including a portion formed from a first material, and a stylet formed from a second material, the first material being more flexible than the second, the stylet having a generally curved orientation  configuration, the tracheotomy cannula having a somewhat inverted L-shaped configuration when the stylet is not inserted into the first passageway and a generally curved orientation  configuration when the stylet is inserted into the first passageway.