Methods for preventing tracheal aspiration

Abstract

Devices and methods for preventing tracheal aspiration as described, where a cuff assembly having an inflatable member with an inflation tube fluidly coupled may be placed over a proximal end of an endotracheal tube or laryngeal mask and inserted into the patient trachea with the endotracheal tube or separately after the endotracheal tube has already been positioned. In either case, the inflatable member may be positioned distal (or inferior) to the vocal cords and proximal to the endotracheal balloon via a delivery instrument which automatically positions the balloon in proximity to the vocal cords.

What is claimed is: 
     
         1 . A method of delivering a cuff assembly along an endotracheal tube, comprising;
 inserting an endotracheal tube per-orally into a trachea of a subject;   positioning the cuff assembly over a proximal end of the endotracheal tube;   translating the cuff assembly via a positioning handle assembly distally along the endotracheal tube, wherein the handle assembly comprises an elongate shaft;   further translating the cuff assembly until a distal end of the shaft is positioned proximity to the vocal cords or laryngeal inlet of the subject; and,   positioning the cuff assembly distal to the vocal cords via a cuff engagement member which extends distally from the distal end.   
     
     
         2 . The method of  claim 1  wherein the elongate shaft defines a curvature which presents an atraumatic profile. 
     
     
         3 . The method of  claim 1  further comprising a distal stop at the distal end of the shaft, where the distal stop is sized to prevent passage of the distal stop through the vocal cords or laryngeal inlet. 
     
     
         4 . The method of  claim 3  wherein the distal stop presents a surface which is transversely oriented relative to the shaft. 
     
     
         5 . The method of  claim 1  further comprising disengaging the cuff assembly from the handle assembly. 
     
     
         6 . The method of  claim 1  further comprising inflating the cuff assembly against a tissue wall within a trachea of the subject. 
     
     
         7 . The method of  claim 6  further comprising inflating the cuff assembly against an exterior of the endotracheal tube. 
     
     
         8 . The method of  claim 1  further comprising infusing a composition into proximity of the cuff assembly such that the trachea is obstructed. 
     
     
         9 . The method of  claim 1  wherein inserting an endotracheal tube further comprises inflating an endotracheal balloon into contact against the trachea. 
     
     
         10 . The method of  claim 1  further comprising removing the cuff assembly from the endotracheal tube. 
     
     
         11 . The method of  claim 1  further comprising removing the cuff assembly simultaneously with the endotracheal tube from the subject. 
     
     
         12 . The method of  claim 1  further comprising adjusting a position of the cuff assembly relative to the endotracheal tube. 
     
     
         13 . The method of  claim 1  further comprising deploying a shield over an opening of the trachea. 
     
     
         14 . The method of  claim 1  wherein positioning the cuff assembly distal to the vocal cords comprises positioning the cuff assembly while directly or indirectly visualizing the vocal cords. 
     
     
         15 . The method of  claim 1  wherein positioning the cuff assembly distal to the vocal cords comprises positioning the cuff assembly without visualizing the vocal cords. 
     
     
         16 . A method of delivering a cuff assembly along an endotracheal tube, comprising:
 inserting an endotracheal tube per-orally into a trachea of a subject;   positioning the cuff assembly over a proximal end of the endotracheal tube;   translating the cuff assembly via a positioning handle assembly distally along the endotracheal tube, wherein the handle assembly comprises an elongate arcuate shaft which defines a curvature which presents an atraumatic profile;   further translating the cuff assembly until a-distal end of the shaft is positioned in proximity to the vocal cords of the subject; and,   positioning the cuff assembly distal to the vocal cords via a cuff engagement member which extends distally from the distal end.   
     
     
         17 . The method of  claim 16  further comprising disengaging the cuff assembly from the handle assembly. 
     
     
         18 . The method of  claim 16  further comprising inflating the cuff assembly against a tissue wall within a trachea of the subject. 
     
     
         19 . The method of  claim 18  further comprising inflating the cuff assembly against an exterior of the endotracheal tube. 
     
     
         20 . The method of  claim 16  further comprising infusing a composition into proximity of the cuff assembly such that the trachea is obstructed. 
     
     
         21 . The method of  claim 16  wherein inserting an endotracheal tube further comprises inflating an endotracheal balloon into contact against the trachea. 
     
     
         22 . The method of  claim 16  further comprising removing the cuff assembly from the endotracheal tube. 
     
     
         23 . The method of  claim 16  further comprising removing the cuff assembly simultaneously with the endotracheal tube from the subject. 
     
     
         24 . The method of  claim 16  further comprising adjusting a position of the cuff assembly relative to the endotracheal tube.