Background of the Invention
It has heretofore been proposed to provide oxygen masks which form a cup like, enclosure over the nose of the patient so that apertures in an oxygen supply tube will discharge oxygen into the enclosed chamber of the mask for inhaling by the patient.
Exemplary of such devices are the masks disclosed in the following patents:
U.S. Pat. No. 1,288,647, Miller; Dec. 21, 1918
U.S. Pat. No. 1,632,449, McKesson; June 14, 1927
U.S. Pat. No. 2,843,121, Hudson; July 15, 1958
U.S. Pat. No. 2,843,122, Hudson; July 15, 1958
U.S. Pat. No. 2,859,748, Hudson; Nov. 11, 1958
U.S. Pat. No. 3,889,671, Baker; June 17, 1975
U.S. Pat. No. 4,354,488, Bartos; Oct. 19, 1982
The enclosed chambers of these masks, usually have one way air outlet valves in a side, or bottom wall but they tend to build up heat, fear of asphyxiation and possibly can cause suffocation due to vomitting.
In U.S. Pat. No. 4,263,908 to Mizerak of Apr. 28, 1981 a nasal cannula mask is disclosed which has an enclosed chamber fitting over the mouth and is supported on the chin of the wearer.
Another known device for administering oxygen is marketed as "The Face Shield" by Hudson Oxygen Therapy Sales Co. of Temecula, Calif. It does not have an enclosed cup-like chamber, but instead is an open bottom skirt which extends from the bridge of the nose down to the level of the bottom of the chin with apertures in the front wall facing upwardly and rearwardly from the level of the lower lip toward the nostrils. This device is of such large area that fixation without leakage to the eyes presents problems, especially if the patient rolls over, or the lower tip of the mask is inadvertently struck. Fixation is by elastic straps over the ears and a strip of moldable metal which is intended to be molded by the fingers to fit over the bridge of the nose.
The Bartos nose mask of U.S. Pat. No. 4,354,488, discloses a shell with a gas delivery tube having gas delivery openings within the shell directed in any of a variety of directions usually toward the mouth or nose. It also teaches that the gas delivery tube should be below the tip of the wearers nose, and not under the nostrils, so that the area under the nose is completely open.
Summary of This Invention
In this invention there is no cup shaped mask with enclosed chamber fitting over the nose and no air outlet holes or valves, but instead the device is what we call a hood, shroud or dome forming an open-bottom chamber, the dome projecting outwardly, from upper lip level, for a spaced distance to mix incoming oxygen with moist exhaled breath in a whirlpool, or vertical circulation, turbulent manner. Because the dome and its open bottom chamber are at nostril and upper lip level they do not interfere with eating, drinking, talking, or breathing through the mouth nor do they build up heat or collect vomit issued from mouth or nostrils.
The oxygen supply manifold within the chamber, is connected to a supply of oxygen, and extends across the open bottom chamber from side wall to opposite side wall, resting along the upper lip with the pair of oxygen discharge ports, or nozzles directed outwardly and upwardly against the inside face of the front wall of the dome-like shell. This creates the whirlpool vortex circulation which mixes the oxygen with moist exhaled air and fills the chamber as well as circulating through the open bottom down to in front of the mouth for inhalation through the mouth.
Three point fixation is obtained by a central recess in the upper central portion of the dome which seats on the bridge of the nose, by a narrow strap, or by the manifold of the tube, resting along the upper lip and by a pair of rearwardly and upwardly extending wings, integral with the shell and each extending along one of the opposite cheek bones for attachment by an elastic band around the rear of the head.
The continuous, whirlpool vortical path of moist oxygen within the open bottom chamber of the dome of the shell of the hood of the invention creates a globular path part of which is always in front of the mouth and is much preferred to what might be called an anatomical chamber covering both nose and mouth and in which the oxygen is trapped. Non-humidified oxygen jetted into the nostrils may dry and burn the sensitive nasal mucous and causes patient discomfort at high flow rates due to the jet stream.
In addition, the points of stabilization being the cheek bones, upper lip and bridge of the nose, there is virtually no possibility of nasal and/or septal necrosis occasionally seen when prongs into the nostrils are used to stabilize the cannula.
Brief Description of the Drawings
FIG. 1 is a side elevation of a human head with the nasal hood of the invention in place and in half section,
FIG. 2 is a bottom plan view of the hood,
FIG. 3 is a side elevation of the hood,
FIG. 3A is a close-up view of the hood in half section,
FIG. 4 is a perspective view of the hood looking up into the mixing chamber,
FIG. 5 is a top plan view of the hood and
FIG. 6 is an enlarged, perspective rear view showing the inside of the mixing chamber and the oxygen discharge nozzles and manifold.
Description of a Preferred Embodiment
As shown in the drawings, the nasal hood 20 of the invention is not a face shield covering the face and is not a cup shaped mask edge sealed against the face of a patient 21. Nasal hood 20 could be described as a shroud, cover, or roof, at the level of the nose 22, upper lip 23 and cheek bones 24 of the patient.
Thus it does not interfere with eating, drinking talking or breathing through the mouth 25 and does not interfere with sight through the eyes 26.
Nasal hood 20 is preferably formed of soft, pliable, gas impermeable material 27, which may be plastic and translucent and such that it may be sterilized for reuse. The plastic material 27 is relatively thin, flexible and resilient so as to conform to the configuration of the face 28 of a patient and is non-toxic, light in weight, and preferably polyethylene, or the like.
Nasal hood 20 comprises a shell 29, having a dome 31, in the central portion 32, the dome having a top wall 33, front wall 34, side walls 35 and 36, a rear opening 37 and a bottom opening 38.
The upper edge 39 of top wall 33 is thin, soft, resilient and pliable to conform to the configuration of the face of the patient 21 and seal the edge against leakage of oxygen out of dome 31 into the eyes 26 to cause irritation, or other eye damage. A recess 40 is formed in the central portion of top wall 33 to fit over the bridge 41 of nose 22 and conform to the shape thereof while acting as a seal.
Each opposite side wall 35 or 36 includes an integral, elongated side wing, or flap, 42 or 43 which extends along the cheek bones, such as 24, of the head 44 of the patient. An elastic band 45 connects the ends of the wings 42 and 43 around the back of the head 50 of the patient.
The front wall 34 is provided with a slightly inturned, curved, lower edge 46, which defines part of the rim of the bottom opening 38 of the mixing chamber 47 formed within the dome 31 of shell 29. It will be seen that the open bottom dome 31 and the open bottom mixing chamber 47 are located at the level of the nostrils 48 and upper lip 23 of the patient 21 with no part extending down to the level of mouth 25 or chin 49 to interfere with eating, drinking, breathing or talking through the mouth. The dome 31 extends outwardly away from upper lip 23 and nostrils 48 to position mixing chamber 47 just above the level of the mouth.
Oxygen, or other gas supply means 51 includes a source 52 connected to an oxygen tube 53 which may run along one of the wings 42 or 43 and into the mixing chamber 47, there being oxygen discharge apertures 54 within the mixing chamber. Preferably, however, tube 53 is divided at a coupling 55 into two branch supply tubes 56 and 57, each extending along a wing 42 or 43 and each having a terminal end 58 or 59 sleeved into one of the opposite ends of a manifold tube 61.
The manifold tube 61, preferably includes a pair of spaced nozzles 62 each at an each aperture 54, the nozzles or apertures being located along the bottom of the rear opening 37 and directed toward the inside face 63 of the front wall 34 of open bottom dome 31. Thus, the oxygen does not directly jet into the nostrils 48 to possibly burn and dry the nasal mucous, or to cause nasal and septal necrosis.
Instead, the incoming oxygen is mixed with moist air being exhaled by the patient while its direction of flow within the open bottom mixing chamber 47 creates a vortical circulation, or whirlpool effect for thorough mixing before being inhaled as moist oxygen. The swirling turbulence of moist oxygen in the mixing chamber also enables a portion of the moist oxygen to escape through the open bottom down to the mouth area for inhalation through the mouth of humidified oxygen.
The manifold 61, or the apertured part of tube 53, preferably extends along, and rests against the upper lip portion of the patient's face for additional stabilization and fixation or it may be accompanied by a narrow strap 64 which extends across the bottom of the rear opening 37 from one side wall 35 to the other side wall 36 to support the shell 29 thereon.
Thus the nasal hood of the invention has three point fixation, namely the strap 64, tube 53 or manifold 61 along the upper lip, the recess 40 in the upper edge 39 of the shell and the wings or flaps 43 and 44 extending along the cheek bones for attachment behind the head 44 of the patient 21.
Preferably oxygen is introduced into the open bottom dome 31 of hood 20, from nozzles 62 at a rate of about six to eight liters per minute but because directed outwardly against inner wall 63 rather than jetted at the nostrils, the whirlpool effect prevents any damage, or discomfort, to the patient.
As best shown in FIG. 3a, it may be desirable to aim the nozzles 62 at the top 65 of the inside face 63, of the front wall 34 of the dome 31, to achieve a turbulence within the dome without directly jetting at the nostrils and still enable moist oxygen to readily reach the mouth 25. The inturned, curved lower edge 46 and the integral side wings, or flaps, 42 and 43 may also be reduced in size, or eliminated, but it is preferred that they be provided as shown in the other figures of the drawings.