Embodiments herein relate to medical devices for applying a medical composition to a patient and, in more particular applications, to such medical devices and methods for controlling bleeding and treating wounds.
A leading cause of preventable battlefield death is non-compressible, intracavitary bleeding. Projectiles from weapons and improvised explosive devices frequently create small entrance wounds having limited or no visibility to the sites of non-compressible, intracavitary bleeding. Although several wound dressing technologies are being marketed to control aggressive hemorrhages from severe external injuries, these devices are particularly ineffective against narrow-entry wounds and the survival of the soldier is entirely dependent on immediate access to blood products and emergent surgical repair.
A principal method for treating bleeding wounds is to stop the flow of blood by applying pressure with a bandage to facilitate formation of a clot. Current wound dressings are often too stiff and too rigid to fit into a narrow space of a cavity wound or, if sufficiently pliable, do not adequately conform to irregular tissue geometries to cause rapid and effective hemostasis.
Granular and powder based hemostatic products have been employed to address the deficiency of current wound dressings for non-compressible wounds; however, these products also have significant drawbacks. Hemostats in the form of powders, particulates or granules pose an unacceptable risk in forming emboli, are difficult to deploy in austere environments (e.g., environments that include wind, darkness, etc.), are susceptible to washing or migration away from the wound site, and are difficult to retrieve from the wound site at a place of definitive care. Additionally, granular and powder based hemostatic products are difficult to handle because they may have high electrostatic charge causing them to stick to instruments, gloves and tissues, thus preventing adequate penetration into irregular wound cavities. Also, in windy environments, powders or granules may be very difficult to get into the wound and may actually blow back into a caregiver's eyes. Powder or granule based hemostats also exhibit a lack of physical cohesion, making them unable to sufficiently withstand the chaotic fluid environments created by severe, high pressure bleeding. Thus, these granular and powder based hemostats may simply wash away before effectively contributing to hemostasis.
One effective way to treat noncompressible hemorrhagic injuries is disclosed in U.S. patent application Ser. No. 12/773,680, filed May 4, 2010 and entitled “Hemorrhage Control Devices and Methods”, the disclosure of which is incorporated herein by reference in its entirety. The Ser. No. 12/773,680 application discloses hemostatic compositions in the form of a plurality of liquid expandable articles that have proven to be very successful in treating non-compressible hemorrhagic injuries. The Ser. No. 12/773,680 application also discloses a suitable medical applicator device.
Embodiments will be readily understood by the following detailed description in conjunction with the accompanying drawings and the appended claims. Embodiments are illustrated by way of example and not by way of limitation in the figures of the accompanying drawings.
In the following detailed description, reference is made to the accompanying drawings which form a part hereof, and in which are shown by way of illustration embodiments that may be practiced. It is to be understood that other embodiments may be utilized and structural or logical changes may be made without departing from the scope. Therefore, the following detailed description is not to be taken in a limiting sense, and the scope of embodiments is defined by the appended claims and their equivalents.
Various operations may be described as multiple discrete operations in turn, in a manner that may be helpful in understanding embodiments; however, the order of description should not be construed to imply that these operations are order dependent.
The description may use perspective-based descriptions such as up/down, back/front, and top/bottom. Such descriptions are merely used to facilitate the discussion and are not intended to restrict the application of disclosed embodiments.
The terms “coupled” and “connected,” along with their derivatives, may be used. It should be understood that these terms are not intended as synonyms for each other. Rather, in particular embodiments, “connected” may be used to indicate that two or more elements are in direct physical contact with each other. “Coupled” may mean that two or more elements are in direct physical contact. However, “coupled” may also mean that two or more elements are not in direct contact with each other, but yet still cooperate or interact with each other.
For the purposes of the description, a phrase in the form “NB” or in the form “A and/or B” means (A), (B), or (A and B). For the purposes of the description, a phrase in the form “at least one of A, B, and C” means (A), (B), (C), (A and B), (A and C), (B and C), or (A, B and C). For the purposes of the description, a phrase in the form “(A)B” means (B) or (AB) that is, A is an optional element.
The description may use the terms “embodiment” or “embodiments,” which may each refer to one or more of the same or different embodiments. Furthermore, the terms “comprising,” “including,” “having,” and the like, as used with respect to embodiments, are synonymous, and are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.).
With respect to the use of any plural and/or singular terms herein, those having skill in the art can translate from the plural to the singular and/or from the singular to the plural as is appropriate to the context and/or application. The various singular/plural permutations may be expressly set forth herein for sake of clarity.
Embodiments herein provide hemostatic compositions and devices, as well as methods of manufacturing such compositions and applicator devices. In addition, various embodiments include methods for treating hemorrhagic injuries.
In an embodiment, a medical device is provided in the form of an applicator for applying a medical composition to a patient. The applicator includes a body, a tip, and a delivery mechanism. The body defines a storage chamber for the medical composition and has an opening for deploying the medical composition from the storage chamber. The tip covers the opening and has a closed state wherein the tip maintains the medical composition in the storage chamber and an open state wherein the medical composition can be deployed through the opening and the tip.
In an embodiment, the delivery mechanism is a telescoping delivery mechanism that is moveable between a compact position for storage and transport and a cocked position for deployment of the medical composition from the applicator.
The telescoping delivery mechanism may include a piston and a user interface in the form of an ergonomic handle. The piston may be located in the storage chamber to deploy the medical composition stored in the chamber through the opening and the tip as the piston moves toward the opening from a stored position spaced from the opening. In an embodiment, the handle has a compact position and a cocked position. In the compact position, the handle may be located adjacent the body with the piston located in the stored position. In the cocked position, the handle may be spaced from the body and in operable engagement with the piston in the stored position to move the piston from the stored position toward the opening in response to an actuating force applied to the handle by a user.
In an embodiment, the telescoping delivery mechanism further includes a rod connected to the handle for translating movement therewith, the rod having a first state wherein the rod is free to translate relative to the piston and a second state wherein the rod is connected to the piston to transmit an actuating force thereto from a user engaging the handle.
In an embodiment, the tip may have a convex shaped portion extending outwardly from the body and the opening. The convex shape of the tip may be a generally semi-spherical or bullet shape, and in another embodiment, may be a generally semi-spherical profile defined by a plurality of radially extending stiffening ribs. One or more of the stiffening ribs may have a frangible section in the form of a thinned section extending along the corresponding rib. In a further embodiment, the tip may include six of the stiffening ribs, with three of the stiffening ribs having the frangible section and three of the stiffening ribs being free of a frangible section. Alternatively, the tip may be formed of a plurality of deformable elements responsive to force applied by a user dispensing a medical composition. The term “deformable” is used broadly herein to include elastic or plastic deformation.
In an embodiment, the medical composition is a hemostatic composition comprising a plurality of liquid expandable articles capable of expanding upon contact with a liquid. In the following description, unless further particularized or otherwise noted, the term “liquid expandable” is intended to refer to any material or substance that expands upon contact with a liquid.
Thus, in an embodiment, there is an applicator device, comprising a body having a storage chamber for holding a composition, the storage chamber having an opening; and a delivery mechanism for dispensing the composition from the storage chamber through the opening in response to actuation by a user, the delivery mechanism comprising a delivery mechanism that is moveable between a compact position for storage and transport and a cocked position for deployment of the composition from the applicator.
In another embodiment, there is provided an applicator device, comprising a body having a storage chamber for holding a composition, the storage chamber having an opening; a tip covering the opening of the storage chamber, wherein the tip has a closed state in which the composition is maintained within the storage chamber and an open state in which the composition can be dispensed through the opening and the tip; and a delivery mechanism for dispensing the composition from the storage chamber through the opening in response to actuation by a user.
With reference to
The applicator 10 includes a body 14, a tip 16, and a telescoping delivery mechanism 18. The body 14 defines a storage chamber 20 for the medical composition 12 and has an opening 22 for deploying the medical composition from the storage chamber 20. The tip 16 covers the opening 20 and has a closed state wherein the tip 16 maintains the medical composition 12 in the storage chamber 20 and an open state wherein the medical composition 12 can be deployed through the opening 22 and the tip 16. The telescoping delivery mechanism 18 includes a piston 24 and a user interface shown in the form of a handle 26. As best seen in
With reference to
The tip 16 preferably has a deformable, convex shaped portion 28 extending outwardly from the body 14 and the opening 22. This convex shaped portion 28 assists in allowing the applicator 10 to be successfully located relative to a hemorrhagic injury, such as at least partially inserted into a hemorrhagic injury/wound, particularly one having a small entrance wound leading to cavity wound having non-compressible, intracavitary bleeding. In this regard, the convex shape of the tip 16 is generally semi-spherical or bullet shaped, and even more preferably is a generally semi-spherical profile defined by a plurality of radially extending stiffening ribs 30, as best seen in FIGS. 5 and 9-14. In some embodiments, to insure that the convex portion 28 is deformable without requiring undue force, one or more of the stiffening ribs 30 has a thinned (frangible) section 32 extending along the corresponding rib 30, as best seen in
Thinned sections 32 may be frangible and, as such, may be formed of a thinned wall of material that may be torn or separated by application of force by a user. Alternatively, the sections may be coupled by a seam formed by any suitable mechanism including adhesive, ultrasonic welding, etc. The seam between the sections may then be torn or separated by application of force by a user. In either situation, portion 28 is deformable/frangible and, upon application of force to portion 28, results in formation or propagation of an opening through which medical composition 12 may be dispensed.
In some embodiments such as shown in
As seen in
Cylindrical portion 46 is sized to fit over a closely conforming cylindrical portion 48 (see, for example,
Mount ring 40 may be injection molded and may be formed of any suitable material, with one example material being polycarbonate. In an embodiment, portion 28 and mount ring 40 may be bonded to each other during a suitable molding process, such as an insert molding process, a bi-injection molding process, and/or a two shot molding process. It should be understood that many other suitable forms of connections may be provided between mount ring 40 and body 14, and that no limitation to the specific form shown herein is intended unless specifically stated in an appended claim. It should further be understood that in some embodiments it may be desirable for tip 16 to just include portion 28, with portion 28 being connected to body 14 using other suitable means, such as a suitable bonding agent or method.
As seen for example in
In an embodiment, a tip may fit on and/or around opening 22. Alternatively, a tip may fit at least partially within opening 22, such as in the form of a plug. An embodiment in the form of a plug may be formed of any suitable material, including a liquid expandable material. In an embodiment, a plug formed from a liquid expandable material may be the first of a plurality of liquid expandable articles, such that, when dispensed, the plug and the remaining liquid expandable articles are dispensed, such as into a wound.
As seen for example in
Rod 60 may be formed of any suitable material, such as machined type 304 stainless steel, and collet 66 may be formed of any suitable material, including any suitable injection-molded material. While collet 66 and annular channel 72 are shown, it should be understood that there are other suitable forms/constructions for the engagement structure that may be utilized in applicator 10, including for example, a cotter pin that engages a mating feature on rod 60, or an external retaining ring that engages a mating feature on rod 60.
In an embodiment, handle 26 is attached to rod 60 so that handle 26 is rotatable relative to rod 60 about axis 62, while being fixed to rod 60 for translation along axis 62. In this regard, while any suitable attachment may be used, in the illustrated embodiment such as seen in
In accordance with various embodiments, piston 24 has a cylindrical shape that conforms to the interior of tube 52 to be guided thereby for translating movement along central axis 62 from the stored position shown in
As seen for example in
In an embodiment, medical composition 12 may be loaded into storage compartment 20 via opening 22 prior to assembly of tip 16 onto body 14, but after piston 24, rod 60, and handle 26 are assembled with body 14 and placed in storage and compact positions, respectively. In this regard, it should be understood that while medical composition 12 is shown as four stacked columns, this is for illustration purposes only and the medical composition 12 may be loaded into the storage chamber 20 in an ordered or random arrangement. Once medical composition 12 is loaded into chamber 20, tip 16 can be assembled to body 14 to place applicator 10 in a usable condition. In operation, a user grasps handle 26 and moves handle 26 and rod 60 from the compact position to the cocked position. The user then inserts applicator 10 into a desired position in the wound, using tip 16 as required to aid in such insertion. Once a user believes applicator 10 is properly positioned, the user presses handle 26 toward body 14 to apply an actuating force to medical composition 12 via piston 24 and rod 60. The actuating force is transmitted from medical composition 12 to the interior of tip 16, tearing/opening portion 28 to place tip 16 in its open condition and allow medical composition 12 to be deployed from compartment 20 through tip 16 to the wound. In an embodiment, the user continues to apply an actuating force to handle 26 until piston 24, rod 60, and handle 26 reach the deployed position shown in
Thus, in an embodiment, there is provided a method of treating a wound, comprising providing an applicator device, the applicator device having a body having a storage chamber for holding a composition, the storage chamber having an opening, and a delivery mechanism for dispensing the composition from the storage chamber through the opening in response to actuation by a user, the delivery mechanism comprising a delivery mechanism that is moveable between a compact position for storage and transport and a cocked position for deployment of the composition from the applicator, locating the opening of the storage chamber in proximity of the wound; and actuating the applicator to dispense the composition from the applicator into the wound.
It should be understood that while specific forms and constructions of embodiments have been shown and described herein, further modifications that will be seen by those skilled in the art and that may be desirable depending upon the particular requirements for each form of the applicator are contemplated. For example and without limitation, while several of the components have been disclosed as one-piece injection molded components, it may be desirable in some cases to make one or more of the components using other methods and/or to make one or more of the components a multi-piece assembly. By way of further example and without limitation, several of the components have been disclosed as having cylindrical shapes and/or circular cross-sections, but in some cases it may be desirable to make one or more of those components with something other than a cylindrical shape and/or circular cross-section. Accordingly, no limitation to a particular form, construction, shape, or material should be inferred to the invention unless expressly recited in an appended claim.
It is believed that applicator 10, as disclosed herein, is of particular use for combat medics and/or other emergency personnel for the local management of non-compressible hemorrhage, and is designed to function safely and reliably in a range of combat use scenarios. Applicator 10 is easy to operate, portable, and durable. It can provide a compact and lightweight construction that is impact and crush resistant and can function across extreme use environments and temperature. Applicator 10 provides the storage, transport, and rapid field deployment of medical composition 12, including the preferred hemostatic composition comprising a plurality of liquid expandable articles 13. Telescoping delivery mechanism 18 allows for rapid manual operation via a simple two-step process that requires minimal preparation by the user. Preferably, applicator 10 has a working volume of 90 cubic centimeters and can deliver an effective treatment dosage of 100 liquid expandable articles 13, which, in a suitable form, can expand up to ten times the initial volume in a few seconds. Tip 16 allows for safe and easy wound-track insertion, limited fluid ingress, and controlled delivery of medical composition 12. Applicator 10 requires minimal training and will fit standard training protocols for military medics. Delivery mechanism 18 provides both audible and tactile feedback when moved to the cocked position by virtue of the engagement of collet 66 with rod 60.
The present application claims priority to U.S. Provisional Patent Application No. 61/523,024, filed Aug. 12, 2012, entitled “Medical Applicator Device,” the entire disclosure of which is hereby incorporated by reference in its entirety.
This invention was made with United States government support pursuant to various contracts from the United States Special Operations Command. The government has certain rights in the invention.
Number | Date | Country | |
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61523024 | Aug 2011 | US |