Endotracheal Tube Support Device

Abstract

Disclosed is a device that is placed on an endotracheal tube to create a bend in the tube at a predetermined location. In one aspect, the endotracheal tube bending tool includes a spine that creates an angle between a proximal end of the tool and a distal end of the tool, and a plurality of curved extensions that are constructed to trap the tubing against the spine. In another aspect, the endotracheal tube bending tool includes a first prong attached to a base at a first proximal end and having a nub at a first distal end. A second prong and a third prong are attached to the base at second and third proximal ends, respectively, and connected to each other via a bridge structure at the second and third distal ends. A pocket in the bridge is configured to trap the nub to hold the endotracheal tube in a bent position.

Description

[Technical field]

[0001] CROSS REFERENCE TO RELATED APPLICATIONS This patent application claims priority to, and the benefit of, U.S. Provisional Patent Application No. 63 / 179,130, entitled "ENDOTRACHEAL TUBE SUPPORT DEVICES," filed April 23, 2021. The contents of the aforementioned patent application are incorporated by reference in their entirety as part of the disclosure of this patent application.

[0002] This patent document relates to endotracheal tubes, and in particular to devices for controlling the shape of endotracheal tubes to prevent patient injury. [Background technology]

[0003] Endotracheal tubes are used to provide mechanical ventilation to patients undergoing surgical procedures requiring general anesthesia and to patients with various forms of respiratory failure. Not counting short-term intubations, one million U.S. residents require invasive mechanical ventilation annually. Some patients may be intubated for days to weeks. The presence of an endotracheal tube in the airway / trachea is not without complications that can cause laryngeal scarring and stenosis after the patient is extubated. Laryngeal scarring can be very difficult to treat successfully. Therefore, new devices and techniques are needed to prevent patient injury from endotracheal tubes. Summary of the Invention

[0004] A device for bending endotracheal tubes or other medical tubes to bend the tube at a predetermined angle to prevent injury to a patient is disclosed. In one aspect, an endotracheal tube bending instrument is disclosed. The instrument includes a backbone portion including at least a partially curved surface that creates an angle between a proximal end of the instrument and a distal end of the instrument, and a plurality of curved extension portions constructed to capture the endotracheal tube against the backbone portion.

[0005] The device can include the following features in various combinations: Each of the plurality of curved extensions includes a series of ridges configured to press against the spine portion to grip the endotracheal tube in place. The spine portion and the plurality of curved extensions are configured to bend the endotracheal tube at an angle between 60 degrees and 90 degrees. The spine portion and the plurality of curved extensions are configured to bend the tubing at an angle less than 60 degrees or greater than 90 degrees. The device further includes an opening between adjacent extensions. The device further includes a rounded tab structure oriented longitudinally along the device proximate a first end of the device. The device further includes an extension notch in the spine portion configured to engage a pilot balloon tube of the endotracheal tube to fix the position of the device relative to the endotracheal tube. The rounded tab structure has a rotational position extending to an edge of one of the plurality of curved extensions when viewed in cross section at the first end of the instrument, or has a rotational position opposite one of the plurality of curved extensions when viewed in cross section at the first end of the instrument. The rounded tab structure has a rotational position between an edge of one of the plurality of curved extensions and an opposite one of the plurality of curved extensions when viewed in cross section at the first end of the instrument. The rounded tab structure has a hole to allow removal of the instrument from the patient through a safety string.

[0006] In another aspect, another endotracheal tube bending instrument is disclosed that includes a first prong attached to a base at a first proximal end and having a nub at a first distal end, the instrument further includes second and third prongs attached to the base at second and third proximal ends, respectively, and connected to one another via a bridge structure at the second and third distal ends, where a pocket in the bridge is configured to capture the nub, and the instrument is constructed to bend an endotracheal tube captured by the first, second, and third prongs.

[0007] The following other disclosed features may be included in various combinations: The first, second, and third prongs are configured to bend the endotracheal tube a predetermined angle upon capture of the nub by the pocket. The predetermined angle is between 60 degrees and 90 degrees. The predetermined angle is less than 60 degrees or greater than 90 degrees.

[0008] In another aspect, another endotracheal tube bending device is disclosed, the device including a ring portion and a strap portion emanating from the ring portion, where the strap portion is constructed to bend an endotracheal tube passing across the ring portion at a face of the ring portion to cause bending of the tube at an angle, and the strap portion includes teeth on a surface of the strap, the device further including a prong located in a hole in the ring opposite the exit, the prong being constructed to engage with the teeth to enable tightening of the strap to prevent the strap from loosening.

[0009] The device can include the following and other disclosed features: The ring portion, strap portion, and prongs are constructed to bend the tube by the angle, said angle being between 60 degrees and 90 degrees. The ring portion, strap portion, and prongs are constructed to bend the tube by the angle, said angle being less than 60 degrees or greater than 90 degrees.

[0010] The disclosed devices can be manufactured from materials including acrylic materials, ABS plastics, polyethylene, silicone, resins, or other plastic or rubber materials, metals, metal alloys, or combinations thereof.

[0011] In another aspect, a method of intubation is disclosed that includes inserting an endotracheal tube through a patient's mouth and into the trachea to a first predetermined location in the trachea, the method further including attaching an endotracheal tube bending device to the endotracheal tube before or after insertion to bend the endotracheal tube a predetermined angle at a second predetermined location along the endotracheal tube, where the bent endotracheal tube reduces or eliminates pressure or force on the patient's larynx.

[0012] Other disclosed features may include: the predetermined angle is between 60 degrees and 90 degrees; the predetermined angle is less than 60 degrees or greater than 90 degrees. [Brief description of the drawings]

[0013] [Figure 1] FIG. 1 shows an example of orotracheal intubation with an endotracheal tube having a typical bend in the tube that could cause injury to the patient, and another bend created by the disclosed device that does not cause injury to the patient. [Diagram 2] FIG. 1 shows an example of a typical endotracheal tube, including a cuff, a pilot balloon, and a pilot balloon tube. [Figure 3A] FIG. 13 shows a sleeve-type embodiment. [Figure 3B] FIG. 13 is an image of an exemplary sleeve-type embodiment. [Figure 3C] Fig. 13 is an image showing an exemplary sleeve-type embodiment with a notch on the sleeve for engaging the pilot balloon tube and a tab for adjusting the position of the sleeve on the endotracheal tube. [Figure 3D] FIG. 3D illustrates an exemplary sleeve-type embodiment that includes tabs for adjusting the position of the sleeve on the endotracheal tube in a different position than shown in FIG. 3C. [Figure 3E] 11A-11C show different amounts of material removed along a sleeve-type embodiment. [Figure 4A] FIG. 13 is an exemplary diagram showing a three-prong embodiment. [Figure 4B] FIG. 1 is an image illustrating an exemplary three-prong embodiment. [Diagram 5] FIG. 1 illustrates an exemplary clamping embodiment. [Figure 6A] An image showing a typical bend in an endotracheal tube. [Figure 6B] An illustration showing a bend in an endotracheal tube where a sleeve-type clip is placed on the tube creating a 60 degree bend. [Figure 6C] An illustration showing a bend in an endotracheal tube where a sleeve clip is placed on the tube creating a 70 degree bend. [Figure 6D] An illustration showing a bend in an endotracheal tube where a sleeve-type clip is placed on the tube creating a 90 degree bend. [Figure 7] FIG. 2 is a cross-sectional view of an exemplary sleeve-type embodiment. [Figure 8] FIG. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0014] Endotracheal tubes provide mechanical ventilation to patients. Standard endotracheal tubes exert force and pressure on the larynx ("vocal cords"), which can cause injury that can lead to scarring and narrowing after the patient is extubated, as well as other injuries to the trachea, esophagus, etc. Laryngeal scarring, called posterior glottic stenosis (PGS), can form, which is very difficult to treat. Such patients may be left without the ability to speak, requiring a tracheostomy tube. Other injuries can also occur.

[0015] Disclosed is a device that can be placed on the sidewall of a standard endotracheal tube to create a bend in the tube at one or more predetermined locations along the length of the tube. The bend in the tube can eliminate or greatly reduce the pressure exerted by the tube on the "vocal cords" / airway and posterior surface of the trachea. In some exemplary embodiments, the device is a bracket or sleeve that fits over the body of the endotracheal tube. The sleeve can be held in place on the tube by an extension that wraps partially or completely around the tube. The sleeve is sufficiently rigid to hold one portion of the tube at an angle relative to another portion of the tube along the longitudinal axis of the tube without compromising luminal patency.

[0016] In other embodiments, the device has three "prongs" through which a standard endotracheal tube passes, where the prongs bend the tube at a predetermined angle. In some embodiments, the device can be integrated into the sidewall of the endotracheal tube itself, creating a bend in the tube at a desired location along the length of the tube.

[0017] FIG. 1 shows at 100 an example of orotracheal intubation with an endotracheal tube 110 having a curve 118 that is typical after insertion with current medical technology. A first end 112 of the endotracheal tube 110 connects to a ventilator to induce breathing. A second end 114 includes a cuff. The curve 118 is influenced by the stiffness and memory of the tubing material, as well as the forces exerted on the tube by contact with the throat or trachea, which causes the tube to bend. The curvature 118 of the tubing material exerts pressure on the posterior surface of the larynx at 116. This pressure can cause injury to the patient. The tubing material is stiff enough to allow the tube to be inserted through the patient's mouth and into the throat or trachea.

[0018] FIG. 1 shows an example of orotracheal intubation with an endotracheal tube 120 having a curvature 140 that has been altered from the curvature 118 by one of the devices disclosed in this patent document at 150. In the example of FIG. 1, a device with three prongs 130 is shown that alters the curvature of the endotracheal tube 120 at 150 so that the tube exerts no or greatly reduces pressure on the posterior surface of the larynx at 126. The endotracheal tube 120 has a first end 122 that connects to a ventilator and a second end 124 that is similar or identical to the first and second ends shown at 100. In the example of 150, the curvature 140 is influenced by the stiffness of the tubing material and the force exerted on the tube by the three prongs 130 of the disclosed device that contact the tube. The curvature 140 of the tubing exerts no or very little pressure on the posterior surface of the larynx at 126. This lack of pressure prevents injury to the patient.

[0019] FIG. 2 shows an example of a typical endotracheal tube 200 including a tube 205, a cuff 210, a pilot balloon 220, and a pilot balloon tube 225. At the end of the tube 205 that is inserted into the patient, the endotracheal tube has a cuff 210 near the end of the tube. The cuff 210 expands to provide a seal that ensures that air or oxygen from the ventilator is infused into the patient's lungs. The pilot balloon 220 is used to indicate whether the cuff 210 is inflated or not. When the cuff 210 is inflated, the pilot balloon 220 is inflated and when the cuff 210 is not inflated, the pilot balloon 220 is not inflated. The pilot balloon 220 is inflated via a pilot balloon tube 225 through which air passes between the cuff and the pilot balloon. In some exemplary embodiments of the disclosed device, an engagement mechanism built into the device may be used to engage the pilot balloon tube to stop the sliding movement of the device along the tube 205 towards the cuff 210. By stopping further sliding, the device is fixed at a known location along the tube 205, preventing it from traveling any further towards the cuff than necessary.

[0020] FIG. 3A shows an example of a sleeve-type embodiment at 300. In the example shown at 300, an endotracheal tube (not shown) is pushed into a sleeve 310. The sleeve has a curved extension 320 that wraps around the endotracheal tube. When viewed from the end of the sleeve 310, the curved extension 320 can wrap such that the sleeve 310 and curved extension 320 contact more than 180 degrees around the tube. For example, the extension may extend to cover 190 degrees or 200 degrees or another angle of the tube. Covering more than 180 degrees of the tubing helps capture the tubing within the sleeve. In some embodiments, a ridge 322 on the inside of the sleeve may be used to further grip the tubing inside the sleeve and hold it in place. FIG. 3A shows a sleeve at 300 with three extensions and two openings in the sleeve. Some embodiments may have more or fewer extensions and openings. For example, one embodiment may have four extensions and three openings. In some exemplary embodiments, the sleeve may have no openings or extensions. In these embodiments, the tube may be inserted through the sleeve rather than having an extension that is clipped onto the tube. Various embodiments of the sleeve 310 may bend the endotracheal tube 60-90 degrees or another angle. In some exemplary embodiments, the sleeve 300 is described as having a spine 315 that, together with the curved extension 320, holds the endotracheal tube captured in a curved position. The curved endotracheal tube prevents pressure from being applied to the posterior aspect of the larynx, thereby preventing injury to the patient.

[0021] Figure 3B shows an image of an example of a sleeve-type embodiment, showing the sleeve at 340 and the tube at 205. The pilot balloon tube 225 is also shown in the image.

[0022] FIG. 3C shows an image of an exemplary sleeve-type embodiment 350 with a notch or engagement slot 354 for engaging the pilot balloon tube 225 and a tab 352 that allows pressure to be applied to the sleeve to move it along the endotracheal tube or rotate the sleeve around the tube. The notch or engagement slot 354 is an area of ​​the sleeve 350 where sleeve material has been removed to create the notch or slot. As the sleeve 350 is moved down the endotracheal tube, the notch or engagement slot 352 captures the pilot balloon tube 225 exiting the endotracheal tube and stops further sliding of the sleeve 350 down the endotracheal tube. The notch or engagement slot 354 allows for stable positioning of the sleeve against the pilot balloon tubing exiting the side of the endotracheal tube. Shown at 357 is the exterior portion of the exemplary sleeve and the tab 352 with a hole 353 in the tab. Shown at 355 is the interior view of the exemplary sleeve. Shown at 351 is an inner superior view of an exemplary sleeve.

[0023] The sleeve-type embodiment shown in FIG. 3C is similar to the above-described embodiment with the additional addition of tabs 252 to allow adjustment of the sleeve along the endotracheal tube, holes 352 to allow for a safety string, and notches or engagement slots 354. Tabs 352 are located on the superior aspect of the sleeve to allow for easy adjustment to the sleeve position once secured onto the endotracheal tube. Tabs 352 can be located anywhere in the plane of rotation where there is material for a tab. The tabs are not located within the opening of the sleeve. In some exemplary embodiments, the tabs are located in a rotational position opposite a location midway through the opening, as shown at 352. In this position, the tabs are along the inner portion of the sleeve. A hole or eyelet 353 (shown with an asterisk) is placed through tab 352 to facilitate attachment of a safety string (not shown) to the sleeve. The safety string allows removal of the sleeve from the patient if it becomes dislodged from the endotracheal tube in the mouth and retrieval is required. The safety string may be a loop that passes through a hole or eyelet, or it may be a length of string with a stopper or knot to prevent the string from being pulled through the hole or eyelet 353.

[0024] In another exemplary embodiment shown in Figure 3D, sleeve 360 ​​has a tab 362 located in a rotational position opposite the location of the opening in the sleeve, or rotated approximately 90 degrees clockwise (as viewed from the end of the sleeve closest to the tab) from the location of tab 352 shown in Figure 3C. In this position, the tab is along the inner portion of the sleeve. Notches, holes or eyelets, and a safety string (not shown) can be included in the sleeve shown in Figure 3D, similar to the features described for Figure 3C. Alternatively, the tab can be located in a rotational position between those shown in Figures 3C and 3D, or even another rotational position that translates on the sleeve or down the sleeve.

[0025] FIG. 3E shows a sleeve-type embodiment with different amounts of material removed corresponding to the openings. At 370, sleeve 374 has material removed at openings 372 and 373. Reference line 371 indicates the center of the sleeve along the length of the sleeve. The material removed at 372 and 373 may be the same, i.e. openings 372 and 373 have the same shape, or openings 372 and 373 may be different shapes (not shown), i.e. different amounts of material removed. At 375, sleeve 377 has openings 379 and 376, similar to sleeve 374, which may be the same or different shapes as described above. Reference line 378 is also shown. As shown in the example of FIG. 3E, more material has been removed corresponding to the larger openings at 376 and 379 than at 372 and 373.

[0026] FIG. 4A shows an example of a three-prong embodiment at 400. In the example shown at 400, an endotracheal tube (not shown) is pressed or slid between prong 412 and prong 410. In FIG. 400, the endotracheal tube passes between prong 412 and prong 410, exiting the page left and passing to the page right. After the tube is threaded between the prongs, prong 412 may be bent toward prong 410 and prong 410 may be bent toward prong 412 and then over prong 410 such that nub 415 engages in pocket 420, thereby holding prong 412 in place. The bending of prongs 410 and 412 causes the endotracheal tube to bend in a plane parallel to base 430. Various embodiments of the three-prong device may bend the endotracheal tube material 60-90 degrees or at another angle. The bend in the endotracheal tube prevents pressure from being applied to the posterior aspect of the larynx, thereby preventing injury to the patient.

[0027] 4B shows an image of an example of a three-prong embodiment. Shown at 450 is a three-prong device before the prongs are bent towards each other and the nubs are engaged with the pockets. Shown at 450 is the same three-prong device after the prongs are bent towards each other and the nubs are engaged with the pockets. An endotracheal tube is not shown in 450, but if tubing is present it would pass through the page. At 460, if present, the tube would pass left out of the page and right past the page.

[0028] FIG. 5 shows an example diagram 500 of a clamping type embodiment. The clamping type embodiment includes a ring 510 and a strap 520 with teeth 522 that engage a tab 527 in an opening 525 of the ring. The portion of the strap 520 with the teeth 522 pulled forward through the tab 527 is locked by the tab 527 and cannot slide in the reverse direction. In some exemplary embodiments, the tab can be released with a tool designed for that purpose. An endotracheal tube 540 is placed parallel to the face of the ring 510. The strap 520 is placed over the tube 540 in a position that exerts pressure on the endotracheal tube 540 at the contact points along the strap 520 and on the two sides of the ring 510, causing the tube 540 to bend. The strap 520 can be manufactured as part of the ring 510, or the ring and strap can be manufactured separately and attached to each other by thermal techniques. The amount of bending that occurs in tube 540 can be controlled by the amount of length of strap 520 that is pulled through tab 527.

[0029] Figure 6A shows an image 600 illustrating a typical bend in an endotracheal tube 540. In this image, one end of the endotracheal tube is placed at a start location and the tube is bent to its natural curve without applying pressure along the tube to adjust the curvature. In the example of Figure 6A, the distance between the start location and the end location is approximately 10.25 inches.

[0030] Figure 6B shows an image 610 illustrating a bend in an endotracheal tube with a sleeve-type embodiment 612 placed over the tube to create a 60 degree bend. In this image, one end of the endotracheal tube is placed in a start position and the tube is bent with a sleeve-type embodiment 612 placed over the tube to adjust the curvature. In the example of Figure 6B, the distance between the start and end positions is about 9 inches, about 1.25 inches shorter than the example of Figure 6A.

[0031] Figure 6C shows an image 620 illustrating a bend in an endotracheal tube with a sleeve-type embodiment 622 placed over the tube to create a 70 degree bend. In this image, one end of the endotracheal tube is placed in a start position and the tube is bent with a sleeve-type embodiment placed over the tube to adjust the curvature. In the example of Figure 6C, the distance between the start and end positions is about 8.75 inches, which is about 1.50 inches shorter than the example of Figure 6A.

[0032] FIG. 6D shows an image 630 illustrating a bend in an endotracheal tube with a sleeve-type embodiment 632 placed over the tube to create a 90 degree bend. In this image, one end of the endotracheal tube is placed at a start location and the tube is bent with a sleeve-type embodiment placed over the tube to adjust the curvature. In the example of FIG. 6D, the distance between the start and end locations is about 8.25 inches, which is about 2 inches less than the example of FIG. 6A. In the images shown in FIGS. 6B-6D, the sleeve was placed about 2 / 3 of the way along the tube from the start location (the ventilator end of the endotracheal tube) to the end location (the patient end of the endotracheal tube). The sleeve could be placed elsewhere along the tube, such as at the midpoint of the tube, or closer to the patient end (more than 2 / 3 of the way from the start location to the end location).

[0033] FIG. 7 shows a cross-sectional view of an exemplary sleeve-type embodiment. In the embodiment shown at 710, the sleeve has an inner diameter of 9.00 mm and an outer diameter of 11.00 mm, thus a nominal thickness of 2.00 mm. In the embodiment shown at 715, the sleeve has an inner diameter of 9.40 mm, an outer diameter of 11.40 mm, and a nominal thickness of 2.0 mm. The inner and outer diameters of the sleeve can be adjusted for different diameter endotracheal tubes, with outer diameters ranging from about 3.4 mm to about 13 mm. Different outer diameters of endotracheal tubes are used for different size patients, from neonates (3.4 mm) to adults (up to 13 mm). Different sleeves with different inner and outer diameters can be used for endotracheal tubes of different outer diameters. Similarly, different sizes of three-prong and clamp-type embodiments may be used for different size endotracheal tubes and / or patient sizes / ages. The 2 mm nominal thickness may also vary with smaller diameter endotracheal tubes having sleeves with nominal thicknesses much less than 2 mm. In an exemplary embodiment, a 9 mm inner diameter sleeve may be clipped onto an endotracheal tube with an outer diameter of 9.5 mm. In some embodiments, the sleeve inner diameter is a slightly smaller diameter (0.1-0.75 mm) than the endotracheal tube, while in some embodiments the sleeve may have an inner diameter the same as the outer diameter of the tube, or slightly larger. Each particular sleeve may be clipped onto one or more endotracheal tube diameters. A cross-sectional view of the area where the sleeve material has been removed is shown at 720. In some embodiments, the opening is an arc of about 100 degrees, but in different embodiments it may vary from about 80 degrees to about 120 degrees.

[0034] At 730 in Figure 7 is shown the approximate rotational location of tab 352 shown in Figure 3C when looking at the sleeve from the end nearest tab 352. Shown in Figure 7 at 735 is an alternative approximate radial location of tab 362 shown in Figure 3D when looking at the sleeve from the end nearest tab 352.

[0035] 8 depicts an example of a procedure. At 810, the procedure includes inserting an endotracheal tube through a patient's mouth into the trachea to a first predetermined location in the trachea. At 820, the procedure includes attaching an endotracheal tube bending device to the endotracheal tube before or after insertion to bend the endotracheal tube a predetermined angle at a second predetermined location along the endotracheal tube, reducing or eliminating pressure or force that the bent endotracheal tube exerts on the patient's larynx. In some exemplary embodiments, the endotracheal tube bending device is applied to an endotracheal tube that is already positioned and secured in the airway. In this way, the endotracheal tube bending device does not interfere with intubation and placement of the endotracheal tube through the mouth into the airway / trachea.

[0036] Various embodiments may include one or more materials including one or more of acrylic, acrylonitrile butadiene styrene (ABS), nylon, nylon PA-12, polycarbonate, polyetheretherketone, polyethersulfone, polyethylene, polypropylene, polysulfone, polytetrafluoroethylene, polyurethane, polyvinyl chloride, polyetherimide, silicone, resin (e.g., BioMed Clear Resin, including 4,4'-isopropylidenediphenol, ethoxylated and 2-methylprop-2-enoic acid, urethane dimethacrylate, methacrylate monomers, and photoinitiators), or other plastic, rubber, or elastomeric materials. Some embodiments may be made of a single material, while other embodiments may be made of a combination of materials. As a specific example, the base 280 in a three-prong embodiment may be made of a rigid material and the prongs may be made of a more flexible material. Some embodiments also include metals and metal alloys. In some exemplary embodiments, the sleeve embodiment may include a spine portion and multiple curved extension portions made of a single structure. The spine portion maintains the curvature of the endotracheal tube captured by the multiple curved portions. In another example, the sleeve embodiment may include a metal spine to maintain the curvature of the tubing using a more flexible material for the sleeve. Desirable materials include biocompatible materials that are strong enough to retain their shape but are not too brittle. Suitable materials should be stable at body temperature, have high tensile strength, and low flexural modulus. Suitable materials can be flexible, semi-flexible, or rigid. In some exemplary embodiments, the disclosed devices are three-dimensionally printed.

[0037] Although some variations have been described in detail above, other modifications or additions are possible. In particular, further features and / or variations may be provided in addition to those described herein. Furthermore, the exemplary embodiments described above may be directed to various combinations and subcombinations of the disclosed features, and / or combinations and subcombinations of some additional features disclosed above. Additionally, the logic flows depicted in the accompanying figures and / or described herein do not require the particular order shown, or sequential order, to achieve desirable results. Other embodiments may be within the scope of the following claims.

[0038] Similarly, although elements are depicted in the figures in a particular order, this should not be understood as requiring that the elements be assembled or performed in the particular order or sequential order shown, or that all of the illustrated operations be performed, to achieve desirable results, nor should the division of various elements in the embodiments described in this patent document be understood as requiring such division in all embodiments.

[0039] Only a few implementations and examples have been described; other implementations, extensions and variations can be made based on what is described and illustrated in this patent document.

Claims

1. 1. An endotracheal tube bending device comprising: a spine portion including at least a partially curved surface that creates an angle between a proximal end of the instrument and a distal end of the instrument; a plurality of curved extensions configured to capture an endotracheal tube against said spine portion; 1. An endotracheal tube bending device comprising:

2. 2. The endotracheal tube bending device of claim 1, wherein each of the plurality of curved extension portions comprises a series of ridges constructed to press against the spine portion and grip the endotracheal tube in place.

3. 2. The endotracheal tube bending device of claim 1, wherein the spine portion and the plurality of curved extension portions are constructed to bend the endotracheal tube through an angle.

4. 10. The endotracheal tube bending tool of claim 1, further comprising an opening between adjacent extension portions.

5. 10. The endotracheal tube bending device of claim 1, further comprising a rounded tab structure oriented longitudinally along the device proximate the first end of the device.

6. 6. The endotracheal tube bending device of claim 5, wherein the rounded tab structure has a rotational position that extends to an edge of one of the plurality of curved extensions when viewed in cross-section at the first end of the device, or has a rotational position opposite one of the plurality of curved extensions when viewed in cross-section at the first end of the device.

7. 6. The endotracheal tube bending instrument of claim 5, wherein the rounded tab structure has a rotational position between an edge of one of the plurality of curved extensions and an opposite side of the one of the plurality of curved extensions when viewed in cross-section at a first end of the instrument.

8. 6. The endotracheal tube bending instrument of claim 5, wherein said round tab structure has a hole for allowing a safety string to be passed through to allow removal of the instrument from the patient.

9. 10. The endotracheal tube bending tool of claim 1, further comprising an extension notch in the spine portion configured to engage a pilot balloon tube of the endotracheal tube to fix the position of the tool relative to the endotracheal tube.

10. a first prong attached to a base at a first proximal end and having a nub at a first distal end; and 1. An endotracheal tube bending instrument comprising: second and third prongs attached to the base at second and third proximal ends, respectively, and connected to one another via a bridge structure at second and third distal ends, a pocket in the bridge configured to capture the nub, the instrument constructed to bend an endotracheal tube captured by the first, second, and third prongs.

11. 11. The endotracheal tube bending device of claim 10, wherein the first, second and third prongs are configured to bend the endotracheal tube at an angle upon capture of the nub by the pocket.

12. The ring part and a strap portion extending from said ring portion, said strap portion being constructed to bend an endotracheal tube passing across said ring portion at a plane thereof to cause bending of said tube at an angle, said strap portion including teeth on a surface of said strap; a claw located in a hole in the ring opposite the outlet, the claw constructed to engage with the teeth and enable tightening of the strap to prevent the strap from loosening; 1. An endotracheal tube bending device comprising:

13. 13. The endotracheal tube bending tool of claim 12, wherein said ring portion, said strap portion, and said prongs are constructed to bend said tube by said angle.

14. 14. The device of any of claims 1 to 13, wherein the device comprises an acrylic material, ABS plastic, polyethylene, silicone, resin, or other plastic or rubber material, metal, metal alloy, or combinations thereof.

15. An endotracheal tube bending device as described in claim 3, claim 11 or claim 13, wherein the angle is between 60 degrees and 90 degrees.

16. An endotracheal tube bending device as described in claim 3, claim 11 or claim 13, wherein the angle is less than 60 degrees or greater than 90 degrees.

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