1. Field of the Invention
The present invention relates to the providing of anesthesia during surgery, and particularly to devices and methods for coordinating and organizing the numerous patient tubes, catheters, wires, monitoring lines and other objects used by an anesthesiologist during surgery, particularly major surgery. The invention is designed to travel with the patient for use by other health care practitioners following surgery, particularly in the intensive care unit and in the recovery room.
2. Description of the Prior Art
When a patient arrives at the operating room (OR) for major surgery (such as, for example, heart, major chest, abdominal, renal or liver surgery), the anesthesiologist will ordinarily attach a host of invasive tubes, lines, catheters, wires and other devices to the patient that are used throughout the surgery and often afterwards. These include such things as one or two intravenous peripheral lines that are attached to an upper extremity of the patient; an arterial line that is attached to an arm or the groin of the patient; one or two central lines that are attached to the neck or upper chest of the patient; a cordis line that is attached to the neck or upper chest of the patient; and a Swan-Ganz catheter attached to the neck or upper chest of the patient.
During and after surgery, the patient will need drugs (such as, for example, vasopressor and other supportive drugs) some of which are administered via dripping methods, and others via injection into tubes. The patient may also require blood, plasma and other fluids. These materials and drugs may be supplied directly to the patient through the central line, or through one of the lines extending through the Swan-Ganz catheter. Depending upon which Swan-Ganz catheter is used, it may have several ports which will be connected to different tubing, monitoring cables and pressure transducers. One of these ports may also be connected to a drip line that holds several stopcocks which could receive different medications from the dripping machines to be given to the patient.
All of these lines, tubes, and catheters come from different parts of the patient body and lead around the head of the patient where the anesthesiologist is stationed during surgery. Here, the multitude of lines and tubes are connected to monitors, screens, drip lines, injection ports and other devices that the anesthesiologist must keep control of during the hours of surgery. It is easy to confuse these numerous lines and tubes. This can be dangerous in the event that an emergency situation arises during surgery where the anesthesiologist is required to quickly provide a drug or other medication to the patient. Delay by the anesthesiologist while trying to locate the correct tube to administer the drug, or inadvertent administration of a drug to the wrong site could endanger the life of the patient and affect the outcome of the surgery.
During lengthy surgery, a first anesthesiologist may be relieved by a second anesthesiologist who must step in and figure out how the tubes, lines and wires have been set up by the first anesthesiologist. Since there is no established or standard way to set up these tubes, lines and wires, the second anesthesiologist must figure out how the first anesthesiologist set everything up. If the transition from one health care practitioner to another is not smooth, there is another dangerous potential for delay or error by the second anesthesiologist in administering a needed drug during an emergency situation. Similarly, the maze of unorganized tubes, lines, tape, labels and devices make it difficult to teach student doctors (residents and fellows).
It is also very easy for the tubes and lines to become tangled, and unless they are well secured and supported, it is possible that they can be pulled out, or become dislodged or disconnected—sometimes without the knowledge of the anesthesiologist—placing the patient in a threatening and risky situation. This is especially true for the Swan-Ganz catheter which can cause serious or potentially fatal results if dislodged.
Once surgery is completed, the patient must be transported from the operating room to an intensive care unit or elsewhere. Many of the monitors, drip lines and other tubes must remain inserted into the patient for hours or days after surgery. The simple act of transporting the patient down the hall from an operating room to an intensive care unit requires bringing all of these wires, tubes and lines along too—as well as the machines, drip bags/bottles, pacemaker, and other devices that they are connected to. There is a serious risk of pulling out a tube, line or catheter as all of these things are manipulated during transport.
Some of the devices must be disconnected while the patient is traveling, and reconnected when the patient arrives at the intensive care unit. Once the patient arrives at the intensive care unit for recovery, the nurses and other health care providers must again untangle and sort out all of the tubes and lines, and reconnect the lines and wires to their associated monitors and other devices. Some of the monitors provide critical data regarding the condition of the patient, such that any unnecessary delay in reconnecting could pose serious risks to the patient.
There are some organizational tools in the prior art that begin to address these situations, including the invention disclosed in U.S. Pat. No. 4,988,062. This patent discloses a multi-part pad with pivotally attached wings, the wings having manifold devices attached at their distal ends for receiving and separating the tubes and lines coming out of the patient. However, this device is not designed to travel with the patient, and once the tubes are placed in the manifolds, the wings may still be pivoted which could cause the tubes to be pulled out or disconnected, having potentially disastrous results. Another device disclosed in U.S. Pat. No. 5,624,403 is a removable pad that is designed to be placed across the torso of a patient, the upwardly facing surface of the pad being composed of loop pile material (such as Velcro®) for receiving corresponding strips that hold down the tubes and lines leading from the patient. However, this device is designed to stretch across the torso of the patient, and therefore cannot be used during abdominal surgery, nor can it be used by an anesthesiologist who is stationed above the head of the patient. There are also elaborate trays such as those disclosed in U.S. Pat. Nos. 4,720,881, 5,334,186 and 5,435,448. None of these prior art inventions provides an organizational guide for the numerous tubes, lines, catheters and wires used by an anesthesiologist during major surgery; none of them are designed to travel with the patient from the operating room to intensive care or elsewhere for use by other health care providers; and none of them serves as an educational tool or reference for the new anesthesia student, resident, fellow or new graduate anesthesiologist to learn about Swan-Ganz catheter usage, pacemaker modes, doses, and administration of commonly used drugs during surgery.
It is therefore desirable to provide devices and methods for coordinating and organizing the numerous patient tubes, catheters, wires, monitoring lines as well as other objects and machines (e.g., pacemaker, pressure monitors) used by an anesthesiologist during major surgery; to provide standardization for the positions of these various tubes, wires and lines so that the anesthesiologist, his/her replacement and other health care providers (particularly residents and fellows) can know instantly where everything is; to provide coordination and organization devices that prevent inadvertent disengagement of tubes, lines and wires leading from the patient during and after surgery; and to provide coordination and organization devices that can travel with the patient and remain with the patient during recovery for hours or days after surgery.