Not Applicable
A cannula 20 is typically used for administering fluid via a subcutaneous blood vessel V. Typically, cannula 20 is inserted through skin S at a cannulation or cannula insertion site N and punctures the blood vessel V, for example, the cephalic vein, basilica vein, median cubital vein, or any suitable vein for an intravenous infusion. Similarly, any suitable artery may be used for an intra-arterial infusion.
Cannula 20 typically is in fluid communication with a fluid source 22. Typically, cannula 20 includes an extracorporeal connector, e.g., a hub 20a, and a transcutaneous sleeve 20b. Fluid source 22 typically includes one or more sterile containers that hold the fluid(s) to be administered. Examples of typical sterile containers include plastic bags, glass bottles or plastic bottles.
An administration set 30 typically provides a sterile conduit for fluid to flow from fluid source 22 to cannula 20. Typically, administration set 30 includes tubing 32, a drip chamber 34, a flow control device 36, and a cannula connector 38. Tubing 32 preferably extends along a longitudinal axis of administration set 30 from an inlet 30a to an outlet 30b and is typically made of polypropylene, nylon, or another flexible, strong and inert material. Preferably, inlet 30a is coupled at fluid source 22 and outlet 30b is coupled at hub 20a. Drip chamber 34 typically permits the fluid to flow one drop at a time for reducing air bubbles in the flow. Tubing 32 and drip chamber 34 are typically transparent or translucent to provide a visual indication of the flow. Typically, flow control device 36 is positioned upstream from drip chamber 34 for controlling fluid flow in tubing 32. Roller clamps and Dial-A-Flo®, manufactured by Hospira, Inc. (Lake Forest, Ill., US), are examples of typical flow control devices. Typically, cannula connector 38 and hub 20a provide a leak-proof coupling through which the fluid may flow. Luer-Lok™, manufactured by Becton, Dickinson and Company (Franklin Lakes, N.J., US), is an example of a typical leak-proof coupling.
Administration set 30 may also include at least one of a clamp 40, an injection port 42, a filter 44, an extension set 46, or other devices. Typically, clamp 40 pinches tubing 32 to cut-off fluid flow. Injection port 42 typically provides an access port for administering medicine or another fluid via cannula 20. Filter 44 typically purifies and/or treats the fluid flowing through administration set 30. For example, filter 44 may strain contaminants from the fluid. Typically, extension set 46 is a portion of tubing 32 that is coupled between cannula connector 38 and hub 20a. Extension 46 may have a reduced diameter bore for neonates or pediatric patients.
An infusion pump 50 may be coupled with administration set 30 for controlling the quantity or the rate of fluid flow to cannula 20. The Alaris® System manufactured by CareFusion Corporation (San Diego, Calif., US), BodyGuard® Infusion Pumps manufactured by CMA America, L.L.C. (Golden, Colo., US), and Flo-Gard® Volumetric Infusion Pumps manufactured by Baxter International Inc. (Deerfield, Ill., US) are examples of typical infusion pumps.
Intravenous infusion or therapy typically uses a fluid (e.g., infusate, whole blood, or blood product) to correct an electrolyte imbalance, to deliver a medication, or to elevate a fluid level. Typical infusates predominately consist of sterile water with electrolytes (e.g., sodium, potassium, or chloride), calories (e.g., dextrose or total parenteral nutrition), or medications (e.g., anti-infectives, anticonvulsants, antihyperuricemic agents, cardiovascular agents, central nervous system agents, chemotherapy drugs, coagulation modifiers, gastrointestinal agents, or respiratory agents). Examples of medications that are typically administered during intravenous therapy include acyclovir, allopurinol, amikacin, aminophylline, amiodarone, amphotericin B, ampicillin, carboplatin, cefazolin, cefotaxime, cefuroxime, ciprofloxacin, cisplatin, clindamycin, cyclophosphamide, diazepam, docetaxel, dopamine, doxorubicin, doxycycline, erythromycin, etoposide, fentanyl, fluorouracil, furosemide, ganciclovir, gemcitabine, gentamicin, heparin, imipenem, irinotecan, lorazepam, magnesium sulfate, meropenem, methotrexate, methylprednisolone, midazolam, morphine, nafcillin, ondansetron, paclitaxel, pentamidine, phenobarbital, phenytoin, piperacillin, promethazine, sodium bicarbonate, ticarcillin, tobramycin, topotecan, vancomycin, vinblastine and vincristine. Transfusions and other processes for donating and receiving whole blood or blood products (e.g., albumin and immunoglobulin) also typically use intravenous infusion.
Unintended infusing typically occurs when fluid from cannula 20 escapes from its intended vein/artery. Typically, unintended infusing causes an abnormal amount of the fluid to diffuse or accumulate in perivascular tissue P and may occur, for example, when (i) cannula 20 causes a vein/artery to rupture; (ii) cannula 20 improperly punctures the vein/artery; (iii) cannula 20 backs out of the vein/artery; (iv) cannula 20 is improperly sized; (v) infusion pump 50 administers fluid at an excessive flow rate; or (vi) the infusate increases permeability of the vein/artery. As the terminology is used herein, “tissue” preferably refers to an association of cells, intercellular material and/or interstitial compartments, and “perivascular tissue” preferably refers to cells, intercellular material and/or interstitial compartments that are in the general vicinity of a blood vessel and may become unintentionally infused with fluid from cannula 20. Unintended infusing by a non-vesicant fluid is typically referred to as “infiltration,” whereas unintended infusing by a vesicant fluid is typically referred to as “extravasation.”
The symptoms of infiltration or extravasation typically include blanching or discoloration of the skin S, edema, pain, or numbness. The consequences of infiltration or extravasation typically include skin reactions (e.g., blisters), nerve compression, compartment syndrome, or necrosis. Typical treatment for infiltration or extravasation includes applying warm or cold compresses, elevating an affected limb, administering hyaluronidase, phentolamine, sodium thiosulfate or dexrazoxane, fasciotomy, or amputation.
Embodiments according to the present invention are directed to a clip that includes a first passage, a second passage, and a body. The first passage is configured to receive a tube that delivers an intravascular fluid in Animalia tissue. The second passage is configured to receive a cable of a sensor that aids in diagnosing at least one of infiltration and extravasation in the Animalia tissue. The body completely cinctures the first passage and includes a first cantilever arm that incompletely cinctures the second passage. A first arrangement of the body is configured to retain the cable in the second passage and a second arrangement of the body is configured to release the cable from the first arrangement.
Other embodiments according to the present invention are directed to a clip that includes first and second surfaces, first and second passages, and a body. The second surface is spaced along a longitudinal axis from the first surface. The first passage is configured to receive a cable of a sensor that aids in diagnosing at least one of infiltration and extravasation in the Animalia tissue. The first passage extends along a first axis between the first and second faces. The second passage is configured to receive a tube that delivers an intravascular fluid in Animalia tissue. The second passage extends along a second axis between the first and second faces. The body is disposed between the first and second faces and separates the first and second passages.
Other embodiments according to the present invention are directed to a clip that includes first and second surfaces, first and second conjoined passages, and a body that is disposed between the first and second faces. The second surface is spaced along a longitudinal axis from the first surface. The first passage is configured to receive a cable of a sensor that aids in diagnosing at least one of infiltration and extravasation in the Animalia tissue. The first passage extends along a first axis between the first and second faces. The second passage is configured to receive a tube that delivers an intravascular fluid in Animalia tissue. The second passage extends along a second axis between the first and second faces.
Other embodiments according to the present invention are directed to a coupling system that includes an intravascular fluid delivery tube, a cable, and a clip set. The intravascular fluid delivery tube extends along a first axis between first and second ends. The cable extends along a second axis between a transcutaneous sensor and a connector. A first arrangement of the clip set is configured to couple the cable with respect to the intravascular fluid delivery tube. A second arrangement of the clip set is configured to decouple the cable from the first arrangement.
Other embodiments according to the present invention are directed to a system that includes a mono-directional carrier, a bi-directional carrier, and at least one clip. The mono-directional carrier extends along a first axis between an inlet and an outlet. The bi-directional carrier extends along a second axis between first and second ends. The at least one clip is configured in first and second arrangements. The first arrangement of the at least one clip is configured to couple the mono-directional carrier to the bi-directional carrier. The second arrangement of the at least one clip is configured to decouple at least one of the mono-directional and bi-directional carriers from the first arrangement.
The accompanying drawings, which are incorporated herein and constitute part of this specification, illustrate exemplary embodiments of the invention, and, together with the general description given above and the detailed description given below, serve to explain the features, principles, and methods of the invention.
In the figures, the thickness and configuration of components may be exaggerated for clarity. The same reference numerals in different figures represent the same component.
The following description and drawings are illustrative and are not to be construed as limiting. Numerous specific details are described to provide a thorough understanding of the disclosure. However, in certain instances, well-known or conventional details are not described in order to avoid obscuring the description.
Reference in this specification to “one embodiment” or “an embodiment” means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment according to the disclosure. The appearances of the phrases “one embodiment” or “other embodiments” in various places in the specification are not necessarily all referring to the same embodiment, nor are separate or alternative embodiments mutually exclusive of other embodiments. Moreover, various features are described that may be exhibited by some embodiments and not by others. Similarly, various features are described that may be included in some embodiments but not other embodiments.
The terms used in this specification generally have their ordinary meanings in the art, within the context of the disclosure, and in the specific context where each term is used. Certain terms in this specification may be used to provide additional guidance regarding the description of the disclosure. It will be appreciated that a feature may be described more than one-way.
Alternative language and synonyms may be used for any one or more of the terms discussed herein. No special significance is to be placed upon whether or not a term is elaborated or discussed herein. Synonyms for certain terms are provided. A recital of one or more synonyms does not exclude the use of other synonyms. The use of examples anywhere in this specification including examples of any terms discussed herein is illustrative only, and is not intended to further limit the scope and meaning of the disclosure or of any exemplified term.
Electromagnetic radiation sensor 100 preferably is coupled with the skin S. Preferably, electromagnetic radiation sensor 100 is arranged to overlie a target area of the skin S. As the terminology is used herein, “target area” preferably refers to a portion of a patient's skin that is generally proximal to where an infusate is being administered and frequently proximal to the cannulation site N. Preferably, the target area overlies the perivascular tissue P. According to one embodiment, adhesion preferably is used to couple electromagnetic radiation sensor 100 to the skin S. According to other embodiments, any suitable coupling may be used that preferably minimizes relative movement between electromagnetic radiation sensor 100 and the skin S.
Electromagnetic radiation sensor 100 preferably emits and collects transcutaneous electromagnetic radiation signals, e.g., light signals. Preferably, electromagnetic radiation sensor 100 emits electromagnetic radiation 102 and collects electromagnetic radiation 106. Emitted electromagnetic radiation 102 preferably passes through the target area of the skin S toward the perivascular tissue P. Collected electromagnetic radiation 106 preferably includes a portion of emitted electromagnetic radiation 102 that is at least one of specularly reflected, diffusely reflected (e.g., due to elastic or inelastic scattering), fluoresced (e.g., due to endogenous or exogenous factors), or otherwise redirected from the perivascular tissue P before passing through the target area of the skin S.
The transcutaneous electromagnetic radiation signals emitted by electromagnetic radiation sensor 100 preferably are not harmful to an Animalia body. Preferably, the wavelength of emitted electromagnetic radiation 102 is longer than at least approximately 400 nanometers. The frequency of emitted electromagnetic radiation 102 therefore is no more than approximately 750 terahertz. According to one embodiment, emitted electromagnetic radiation 102 is in the visible radiation (light) or infrared radiation portions of the electromagnetic spectrum. Preferably, emitted electromagnetic radiation 102 is in the near infrared portion of the electromagnetic spectrum. As the terminology is used herein, “near infrared” preferably refers to electromagnetic radiation having wavelengths between approximately 600 nanometers and approximately 2,100 nanometers. These wavelengths correspond to a frequency range of approximately 500 terahertz to approximately 145 terahertz. A desirable range in the near infrared portion of the electromagnetic spectrum preferably includes wavelengths between approximately 800 nanometers and approximately 1,050 nanometers. These wavelengths correspond to a frequency range of approximately 375 terahertz to approximately 285 terahertz. According to other embodiments, electromagnetic radiation sensor 100 may emit electromagnetic radiation signals in shorter wavelength portions of the electromagnetic spectrum, e.g., ultraviolet light, X-rays or gamma rays, preferably when radiation intensity and/or signal duration are such that tissue harm is minimized.
Emitted and collected electromagnetic radiation 102 and 106 preferably share one or more wavelengths. According to one embodiment, emitted and collected electromagnetic radiation 102 and 106 preferably share a single peak wavelength, e.g., approximately 940 nanometers (approximately 320 terahertz). As the terminology is used herein, “peak wavelength” preferably refers to an interval of wavelengths including a spectral line of peak power. The interval preferably includes wavelengths having at least half of the peak power. Preferably, the wavelength interval is +/− approximately 20 nanometers with respect to the spectral line. According to other embodiments, emitted and collected electromagnetic radiation 102 and 106 preferably share a plurality of peak wavelengths, e.g., approximately 940 nanometers and approximately 650 nanometers (approximately 460 terahertz). According to other embodiments, a first one of emitted and collected electromagnetic radiation 102 and 106 preferably spans a first range of wavelengths, e.g., from approximately 600 nanometers to approximately 1000 nanometers. This wavelength range corresponds to a frequency range from approximately 500 terahertz to approximately 300 terahertz. A second one of emitted and collected electromagnetic radiation 102 and 106 preferably shares with the first range a single peak wavelength, a plurality of peak wavelengths, or a second range of wavelengths. Preferably, an optical power analysis at the wavelength(s) shared by emitted and collected electromagnetic radiation 102 and 106 provides an indication of anatomical change over time in the perivascular tissue P.
The power of collected electromagnetic radiation 106 preferably is impacted by the infusate F accumulating in the perivascular tissue P. Prior to the infiltration/extravasation event (
Electromagnetic radiation sensor 100 preferably aids healthcare givers in identifying infiltration/extravasation events. Preferably, changes in the power signal of collected electromagnetic radiation 106 with respect to emitted electromagnetic radiation 102 alert a healthcare giver to perform an infiltration/extravasation evaluation. The evaluation that healthcare givers perform to identify infiltration/extravasation events typically includes palpitating the skin S in the vicinity of the target area, observing the skin S in the vicinity of the target area, and/or comparing limbs that include and do not include the target area of the skin S.
Electromagnetic radiation sensor 100 preferably communicates via a cable 130 with an electro-optical unit 160. Preferably, electro-optical unit 160 supplies emitted electromagnetic radiation 102 to electromagnetic radiation sensor 100 over a first transmission line 132 and receives collected electromagnetic radiation 106 from electromagnetic radiation sensor 100 over a second transmission line 134. According to one embodiment, first and second transmission lines 132 and 134 preferably include respective sets of optical fibers. Preferably, emitted electromagnetic radiation 102 includes a first near-infrared wavelength signal that is transmitted by first transmission line 132 over at least one optical fiber, and collected electromagnetic radiation 106 includes a second near-infrared wavelength signal that is transmitted by second transmission line 134 over at least one optical fiber. Accordingly, an advantage of this embodiment preferably is that electromagnetic radiation sensor 100 and cable 130 substantially exclude ferrous materials that may interact with magnetic fields, e.g., a magnetic field induced during a magnetic resonance imaging procedure. According to another embodiment, first and second transmission lines 132 and 134 preferably include respective sets of metal wires. Preferably, emitted electromagnetic radiation 102 includes a first electrical signal that is transmitted by first transmission line 132 over at least one metal wire to a light source, e.g., a light emitting diode, disposed in electromagnetic radiation sensor 100, and collected electromagnetic radiation 106 includes a second electrical signal that is transmitted by second transmission line 134 over at least one metal wire from a light collector, e.g., a photodiode, disposed in electromagnetic radiation sensor 100. Accordingly, an advantage of this embodiment preferably is that cable 130 and electromagnetic radiation sensor 100 preferably are disposable after a single-use because metal wires typically are less expensive than optical fibers.
Cable 130 preferably extends along a longitudinal axis between first and second ends 130a and 130b. According to one embodiment, electromagnetic radiation sensor 100 preferably is hermetically coupled at first end 130a. Preferably, a connector 136 is hermetically coupled at second end 130b to facilitate repeatable coupling and decoupling of cable 130 with respect to a mating feature of electro-optical unit 106. According to other embodiments, first end 130a preferably includes a connector to facilitate repeatable coupling and decoupling of cable 130 with respect to a mating feature of electromagnetic radiation sensor 100.
First and second transmission lines 132 and 134 preferably are bundled in cable 130. Preferably, a sheath 138 cincturing first and second transmission lines 132 and 134 extends between first and second ends 130a and 130b. Sheath 138 preferably includes a thermoplastic urethane or another suitably flexible material. Tecoflex®, manufactured by The Lubrizol Corporation (Wickliffe, Ohio, USA), is an example of a typical thermoplastic urethane for bundling optical fibers in a sheath. According to one embodiment, sheath 138 preferably includes an inner core contiguously engaging first and second transmission lines 132 and 134, and a relatively thin (e.g., approximately 0.010 inches) outer core that further includes an antimicrobial additive, such as a quaternary ammonium. Biosafe®, manufactured by BIOSAFE Inc. (Pittsburgh, Pa., USA), is an example of a typical antimicrobial additive. Preferably, the inner and outer layers of sheath 138 are co-extruded around first and second transmission lines 132 and 134. According to other embodiments, a biocompatible material preferably is incorporated throughout sheath 138. According to other embodiments, sheath 138 preferably includes electromagnetic radiation shielding. According to other embodiments, sheath 138 preferably includes a formation that resists crushing and/or breaking first and second transmission lines 132 and 134. According to other embodiments, one or both of first and second transmission lines 132 and 134 preferably include individual encasements that are cinctured by sheath 138.
The inventors discovered a problem regarding dislodging cannula 20 or electromagnetic radiation sensor 100 due to individually snagging or pulling administration set 30 or cable 130. The inventors also discovered, inter alia, that mutually controlling administration set 30 and cable 130 reduces opportunities for dislodging cannula 20 or electromagnetic radiation sensor 100.
Individual clips 210 preferably have first and second arrangements. According to the first arrangement, clip 210 preferably contiguously engages tubing 32 and sheath 138 to retain a longitudinal axis 30c of administration set 30 proximate to a longitudinal axis 130c of cable 130. According to the second arrangement, clip 210 preferably relinquishes at least one of the longitudinal axes 30c and 130c from the first arrangement. Thus, the inventors discovered, inter alia, that a clip 210 for mutually controlling administration set 30 and cable 130 preferably reduces opportunities for dislodging cannula 20 or electromagnetic radiation sensor 100.
The first arrangement of clip 210 preferably mutually controls administration set 30 and cable 130 by retaining longitudinal axes 30 and 130c in relative proximity to one another. First and second passages 222 and 226 preferably extend longitudinally through body 212 along axes 223 and 227, which generally coincide with longitudinal axes 30c and 130c, respectively, in the first arrangement of clip 210. Preferably, axes 223 and 227 are generally centered in passages 222 and 226, respectively. According to the embodiment shown in
Body 212 preferably includes one or more cantilever arms that are resiliently deformable between the first and second arrangements of clip 210. According to the embodiment shown in
The cross-sectional area of passage 222 may be smaller, generally equivalent, or larger than the cross-sectional area of passage 226. Preferably, the cross-sectional areas of passages 222 and 226, which are measured orthogonal to first and second axes 223 and 227, generally correspond to the cross-sectional areas of tubing 32 and sheath 138, respectively. According to the embodiment shown in
Accessing passage 222 preferably requires a relatively greater effort as compared to accessing passage 226. A method of accessing passage 222 preferably includes (i) applying a first longitudinally directed force to first surface 214; and (ii) applying a second longitudinally directed force to second surface 216. Accordingly, the first and second forces are directed in generally opposite longitudinal directions and preferably are applied proximate to opposite sides of narrow gap 236. Preferably, body 212 is therefore resiliently deformed into a generally helical form about axis 223 so as to longitudinally separate edges of narrow gap 236 and thereby increase accessibility to passage 222. Preferably, clip 250 provides a number of advantages including (i) providing an option for nurses or other practitioners to laterally access passage 222 in addition to the option for longitudinally sliding along axis 223; and (ii) requiring an increased effort by pediatric or curious patients to separate clip 250 from coupling system 200.
The inventors therefore discovered, inter alia, that a coupling system to mutually control a mono-directional carrier and a bi-directional carrier preferably includes at least one clip having first and second passages. Preferably, a first arrangement of an individual clip preferably includes the mono-directional carrier, e.g., an intravascular fluid delivery tubing line, being coupled in the first passage and the bi-directional carrier, e.g., emitter and detector lines for a transcutaneous anatomical sensor, being coupled in the second passage. Preferably, a second arrangement of the individual clip decouples at least one of the mono-directional and bi-directional carriers from the first arrangement.
While the present invention has been disclosed with reference to certain embodiments, numerous modifications, alterations, and changes to the described embodiments are possible without departing from the sphere and scope of the present invention, as defined in the appended claims. Accordingly, it is intended that the present invention not be limited to the described embodiments, but that it has the full scope defined by the language of the following claims, and equivalents thereof.
This application claims the priority of U.S. Provisional Application No. 61/770,641, filed 28 Feb. 2013, which is hereby incorporated by reference in its entirety.
Number | Date | Country | |
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61770641 | Feb 2013 | US |