Johns Hopkins University

Easy-Stik, LLC

Robert S Greenberg

Wayne I Sternberger

Edward J Moses

Carol M Gentry

John A Christion

An apparatus for neural block determination is provided including processing circuitry configured to receive muscle movement measurements, analyze the muscle movement measurements in a frequency domain, and determine an effectiveness of an anesthetic based on the analysis of the muscle movement measurements in the frequency domain.

Neural block determination

An apparatus and method for fetal heart and maternal heart and uterine monitoring is provided which acquire biopotential waveforms indicative of the mother's heart beat from sensors located at or near the mother's chest, and waveforms indicative of the combined maternal and fetal heart beats from abdominal sensors located on the mother's abdomen, lower back, or both. The signals from the abdominal sensors are divided into a plurality of channels. An adaptive signal processing filter (ASPF) algorithm or other suitable algorithm is then used to cancel the estimated maternal waveform from each channel derived from the abdominal sensors. The system then selects from the resulting waveforms at least one waveform to serve as the reference fetal waveform. The reference waveform is then processed against the other abdominal waveforms preferably using the ASPF algorithm again to form an enhanced fetal signal that is a representation of the fetus's biopotential electrocardiogram (EKG ). The EKG can subsequently be used to measure fetal heart rate and other biophysical profile parameters. Surface electromyogram (EMG) signals allow for concurrent monitoring of uterine contractions and afford improved cancellation of motion artifacts.

Apparatus and method for non-invasive, passive fetal heart monitoring

A catheter assembly is provided that has an adhesive on an undersurface of the hub thereof, which is revealed following catheter insertion so that the catheter hub can be secured to the skin while maintaining universal precautions. A protective covering is applied over the adhesive material to preclude adhesion of the catheter hub to the medical practitioner's gloves or premature adhesion to the patient's skin. Once the catheter has been properly positioned, the protective covering is removed by gripping a pull tab, which projects proximally, away form the inserted catheter tip and beyond the catheter hub. Pulling the tab everts the protective cover by folding the cover back over itself to gradually reveal the adhesive surface of the skin. The catheter hub is pressed firmly to the skin in order to create an effective adherence. If deemed necessary or desirable, additional tape or other securing devices may be applied to the adhered catheter hub.

Catheter hub attachment assembly

Electromyogram, temperature and heart rate measurements, which correlate to the dermatomal level and density of neural blockade, are obtained in a passive manner, i.e., the patient is not stimulated or exposed to any sensor that requires an active conduction in order to make a measurement and no active patient participation or response is required. The measurements obtained provide objective and quantitative indications of, for example, epidural blockade with local anesthetics, thus, allowing objective real-time assessment of density and level of neural blockade.

Passive, non-invasive method to quantify objectively the level and

For fiberoptic endotracheal intubation, a method is disclosed that uses a device having a cannula with a first, distal end for placement within the pharynx of a patient, a second, proximal end for being disposed outside of the patient's oral cavity, and a flow passage between the first and second ends. The cannula has a length such that, when the distal end is placed within the pharynx, it terminates distally at a point near the patient's epiglottis. The device includes an inflatable cuff structure for forming a seal between a wall of the cannula and the patient's pharynx. The cuff is positioned adjacent to the distal end of the device and defines, on inflation, a ventral/anterior portion and a posterior portion. The method involves a step of inserting the device, with cuff deflated, into a patient's mouth so that the distal end of the device is disposed at a point near the patient's epiglottis to establish an airway column down the core of the device. Once the cuff structure is inflated, the patient's airway is supported to provide spontaneous breathing and controlled ventilation through the flow passage of the device. Then, a fiberoptic scope, on which an endotracheal tube has been preloaded so that the distal tip of the scope projects beyond the endotracheal tube, is inserted into the patient through the patient's oral cavity so that the lip is in the throat past the uvula, whereby after insertion of the device and insertion of the fiberoptic scope, the scope is disposed exteriorly of the device. Then, the tip of the fiberoptic scope is advanced so that it enters the trachea. The endotracheal tube is then advanced through the oral cavity and into the trachea using the fiberoptic scope as a guide. Finally, the fiberoptic scope is removed from the trachea.

Copa method for fiberoptic endotracheal intubation

A new type of airway, the cuffed oro-pharyngeal airway (COPA), is described, which may be used as a less cumbersome alternative to face mask/oral airway technique for maintenance of general anesthesia. The airway includes an elongated tube having a length such that the proximal end is adapted to be disposed adjacent to but outside the oral cavity of the patient and the distal end is adapted to be disposed in the lower pharynx of the patient, above the epiglottis. an inelastic, inflatable cuff is mounted to the tube adjacent the distal end. On inflation, the inflatable cuff displaces the soft palate against the nasopharynx to seal-off the nasal passages and defines a seal between the tube and the pharyngeal wall. The inflatable cuff also displaces the base of the patient's tongue, thereby locking the tube in the pharynx and displacing the patient's epiglottis to a more open disposition for more effective anesthesia gas delivery to the lungs.

Cuffed oro-pharyngeal airway

A new type of airway, the cuffed oro-pharyngeal airway (COPA), is described, which may be used as a less cumbersome alternative to face mask/oral airway technique for maintenance of general anesthesia. The airway includes an elongated tube having a length such that the proximal end is adapted to be disposed adjacent to but outside the oral cavity of the patient and the distal end is adapted to be disposed in the lower pharynx of the patient, above the epiglottis. An inelastic, inflatable cuff is mounted to the tube adjacent the distal end. On inflation, the inflatable cuff displaces the soft palate against the nasopharynx to seal-off the nasal passages and defines a seal between the tube and the pharyngeal wall. The inflatable cuff also displaces the base of the patient's tongue, thereby locking the tube in the pharynx and displacing the patient's epiglottis to a more open disposition for more effective anesthesia gas delivery to the lungs.

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Glenelg, MD, United States of America

Robert S Greenberg