Apparatus, systems, and methods for accessing the airway with medical instruments without interruption of assisted respiration

Abstract

Systems for use in assisted respiration can permit insertion of one or more elongated medical instruments into the proximal and/or distal airway of a patient during administration of assisted respiration, which may, in some instances, proceed with a patient awake or only minimally sedated. In some systems, a bite block is coupled with a mask and is movable relative to the mask such that the system is capable of accommodating differing patient anatomies.

1 - 19 . (canceled) 
     
     
         20 . A system for use in assisted respiration, the system comprising:
 a mask that defines a cavity configured to encompass the mouth of a patient, wherein the mask comprises a shell that defines an adapter opening configured to be coupled with an assisted respiration source adapter, and wherein the adapter opening is sufficiently large to permit passage of at least one elongated medical instrument through it such that a distal end of the medical instrument can be advanced through the airway of the patient from a position exterior to the mask; and   a bite block coupled to the mask without any portion thereof extending through the adapter opening of the shell, the bite block defining a passageway through which at least one elongated medical instrument can pass, wherein the bite block is sufficiently rigid to maintain the passageway open when biting forces are applied to the bite block by a patient, and wherein the bite block is movable relative to the mask such that a plurality of different orientations of the bite block relative to the mask are possible so that the system is able to accommodate differing patient anatomies.   
     
     
         21 . The system of  claim 20 , further comprising an assisted respiration source adapter coupled to the mask, wherein the adapter is configured to be coupled with an assisted respiration source of one or more pressurized or unpressurized gases and to permit transfer of one or more gases through the shell of the mask. 
     
     
         22 . The system of  claim 21 , further comprising the assisted respiration source, wherein the assisted respiration source comprises one or more of a non-invasive positive pressure ventilation system and a bag configured for use in bag valve mask ventilation. 
     
     
         23 . The system of  claim 21 , wherein the adapter defines a first passageway through which at least one of an endotracheal tube and a fiberscope can be advanced through the adapter opening of the shell and further defines a second passageway through which one or more gases from the assisted respiration source can pass, wherein the second passageway is in fluid communication with the first passageway. 
     
     
         24 . The system of  claim 23 , wherein the first passageway comprises a valve through which at least one of an endotracheal tube and a fiberscope can be advanced. 
     
     
         25 . The system of  claim 24 , wherein the second passageway comprises a one-way valve. 
     
     
         26 . The system of  claim 20 , wherein the bite block is coupled to the mask via a conduit. 
     
     
         27 . The system of  claim 26 , wherein the conduit is flexible. 
     
     
         28 - 45 . (canceled) 
     
     
         46 . A system for use in assisted respiration, the system comprising:
 a mask that defines a cavity configured to encompass the mouth of a patient, wherein the mask comprises a shell that defines an adapter opening configured to be coupled with an assisted respiration source adapter, and wherein the adapter opening is sufficiently large to permit passage of at least one elongated medical instrument through it such that a distal end of the medical instrument can be advanced through the airway of the patient from a position exterior to the mask;   a bite block defining a passageway through which an elongated medical instrument can pass; and   a conduit coupled with the bite block and configured to be coupled with the mask, wherein the conduit is configured to permit movement of the bite block relative to the mask when the conduit is coupled to the mask such that a plurality of different orientations of the bite block relative to the mask are possible so that the system is able to accommodate differing patient anatomies.   
     
     
         47 . The system of  claim 46 , further comprising an assisted respiration source adapter coupled to the mask, wherein the adapter is configured to be coupled with an assisted respiration source of one or more pressurized or unpressurized gases and to permit transfer of one or more gases through the shell of the mask. 
     
     
         48 . The system of  claim 47 , further comprising the assisted respiration source, wherein the assisted respiration source comprises one or more of a non-invasive positive pressure ventilation system and a bag configured for use in bag valve mask ventilation. 
     
     
         49 . The system of  claim 47 , wherein the adapter defines a first passageway through which at least one of an endotracheal tube and a fiberscope can be advanced through the adapter opening of the shell and further defines a second passageway through which one or more gases from the assisted respiration source can pass, wherein the second passageway is in fluid communication with the first passageway. 
     
     
         50 . The system of  claim 49 , wherein the first passageway comprises a valve through which at least one of an endotracheal tube and a fiberscope can be advanced. 
     
     
         51 . The system of  claim 49 , wherein the second passageway comprises a one-way valve. 
     
     
         52 - 82 . (canceled) 
     
     
         83 . An assembly for use with a mask for assisted respiration, wherein the mask comprises a shell that defines an adapter opening that is sufficiently large to permit passage of at least one elongated medical instrument through it such that a distal end of the medical instrument can be advanced through the airway of the patient from a position exterior to the mask, the assembly comprising:
 an assisted respiration source adapter configured to be selectively coupled with the mask at the adapter opening;   a conduit coupled with the assisted respiration source adapter, wherein an outer surface of the conduit is sized to pass through the adapter opening; and   a bite block coupled with the conduit, wherein the bite block defines a passageway through which at least one elongated medical instrument can pass, wherein an outer surface of the bite block is sized to pass through the adapter opening, and wherein the conduit is configured to permit movement of the bite block relative to the mask when adapter is coupled to the mask such that a plurality of different orientations of the bite block relative to the mask are possible so that the system is able to accommodate differing patient anatomies.   
     
     
         84 . The assembly of  claim 83 , wherein the adapter is configured to be coupled with an assisted respiration source of one or more pressurized or unpressurized gases and to permit transfer of one or more gases through the shell of the mask. 
     
     
         85 . The assembly of  claim 84 , wherein the assisted respiration source comprises one or more of a non-invasive positive pressure ventilation system and a bag configured for use in bag valve mask ventilation. 
     
     
         86 . The assembly of  claim 84 , wherein the adapter defines a first passageway through which one or more of an endotracheal tube and a fiberscope can be advanced through the adapter opening of the shell and further defines a second passageway through which one or more gases from the assisted respiration source can pass, wherein the second passageway is in fluid communication with the first passageway. 
     
     
         87 . The assembly of  claim 86 , wherein the first passageway comprises a valve through which one or more of an endotracheal tube and a fiberscope can be advanced. 
     
     
         88 . The assembly of  claim 87 , wherein the second passageway comprises a one-way valve. 
     
     
         89 . The assembly of  claim 83 , wherein the bite block is rigid or semi-rigid. 
     
     
         90 . The assembly of  claim 83 , wherein the conduit is flexible. 
     
     
         91 - 99 . (canceled) 
     
     
         100 . An adapter for use with a mask for assisted respiration, wherein the mask comprises a shell that defines an adapter opening that is sufficiently large to permit passage of at least one elongated medical instrument through it such that a distal end of the medical instrument can be advanced through the airway of the patient from a position exterior to the mask, the assembly comprising:
 a housing that defines a first passageway and a second passageway that are in fluid communication with each other, wherein the first passageway defines a longitudinal axis that is configured to be generally aligned with the adapter opening of the mask and the mouth of a patient when the adapter is coupled with the mask and the mask is coupled with the patient, and wherein the second passageway is configured to permit one or more gases to pass through it from an assisted respiration source;   a connector that is configured to selectively couple the housing with the mask; and   a valve through which one or more medical instruments can be inserted through the first passageway.   
     
     
         101 . The adapter of  claim 100 , wherein the second passageway comprises a one-way valve that permits gases to flow toward the first passageway. 
     
     
         102 - 117 . (canceled)