Improvements in or relating to anaesthesia and / or ventilation

Abstract

A portable ventilator module is provided and is configured to be reversibly docked with an anaesthesia module to provide circle system anaesthesia with or without a turbine. The portable ventilator module can be rotated approximately 180 degrees so that patient connection tubing can come from the left or right of the ventilation module when in docked and undocked use.

Description

[0001] IMPROVEMENTS IN OR RELATING TO ANAESTHESIA AND / OR VENTILATION

[0002] Introduction

[0003] This application refers to improvements to the modular ventilation and anaesthesia device concept in patent application (PCT / GB2021 / 052280)[1], describing a modular ventilation and anaesthesia system and patent application (PCT / EP2023 / 055246)[2], describing the docking system that joins the modules and the ability to maintain performance of the blower by using a gas bearing system to prevent contamination by recirculated patient gas and premature failure due to exposure to volatile anaesthetic agents (PCT / EP2023 / 080616)[3] the contents of which are hereby incorporated by reference.

[0004] This application describes modifications to the docking system presented in [2] to allow for rotation of modular ventilation / anaesthesia docking by 180 degrees, thus enabling left- and right-handed use, and improvements to the gas bearing system in [3] to allow for sealing during sterilisation by liquid, gas or vapour phase methods and manufacture.

[0005] In [1], the portable ventilator module docks with the anaesthesia module via a docking port to allow changes to the gas pathway and addition of volatile anaesthetic to allow for efficient, circle system volatile anaesthesia.

[0006] Anaesthesia machines are mostly built with a single configuration for breathing circuit tubing that comes from the left side of the device when viewed from the front. The modular system described in [1] has tubing that comes from one side of the device. Transportable systems tend to have tubing coming from one side to enable the ports to be protected and not interfere with the display or liable to be hit when mounted to beds etc. Portable ventilator modules are designed for normal operation in one orientation. The portable ventilator display is often tipped back by around 15 degrees so that it can be visualised by a standing user when placed on the patient bed. When viewed from the side the basic shape is that of a square and triangle (see figure 1).

[0007] A portable ventilator module that docks with an anaesthesia module to provide volatile anaesthesia and uses a turbine must protect the turbine bearings from contamination with volatile anaesthetic agents and exhaled patient breath (microbial contamination). The use of a gas bearing with flush gas is described in [3],

[0008] A gas bearing is provided in addition to a ball bearing with the gas bearing distal to the ball bearing up the shaft of the motor. The gas bearing is supplied by gas from the pressurised oxygen / air source of the modular ventilator / anaesthesia system and provides a low-friction bearing and seal to the motor. In all cases, clean gas is supplied at the motor shaft and proceeds radially outwards, passing the underside of the impeller and then joins the patient gas in the ventilator manifold. It is therefore desired to keep this flow as low as possible while maintaining the effect. Also as the turbine is highly dynamic, keeping a low mass of the impeller is desired to reduce inertia.

[0009] The gas bearing must work in conjunction with the sterilisation / disinfection method to enable protection of sensitive components of the turbine but also enable efficient decontamination of exposed parts. This requires a clear distinction between the parts that are contaminated and those parts that remain “clean”. The gas bearing system described in [3] may relate to the motor shaft or, equally, may function by using the undersurface of the turbine impeller and the motor casing / heat sink.

[0010] Description

[0011] Aspects and embodiments may provide or relate to one or more of:

[0012] 1 . Operation of ventilation component in either left- or right- handed orientation with rotation capability of docking port.

[0013] 2. Trapezium shape of ventilation component with handle all way around device to allow operation in either orientation.

[0014] 3. Low flow oxygen module.

[0015] 4. J-shaped seal around motor shaft (gas bearing around motor shaft).

[0016] 5. J-shaped seal around impeller (gas bearing under impeller).

[0017] 6. J-shaped seals to reduce flush gas consumption.

[0018] 7. Gas bearing underside of impeller method with grinding referenced to motor shaft.

[0019] 8. Minimising impeller gap and flush gas consumption by grinding surfaces with reference to the motor shaft.

[0020] 9. Impeller with flat underside, filled with internal lattice to reduce mass / inertia.

[0021] 10. Impeller with cone-shaped underside to reduce mass / inertia.

[0022] 11 . Dynamic motor housing cover to maintain minimum gas-bearing distance.

[0023] In a modular ventilation and anaesthesia system (1), it is preferable that the tubing connecting to the patient is not disconnected / reconnected. However, some operating theatres or critical care environments (e.g. recovery, anaesthesia rooms, ICU) are configured with the patient bed on different sides of the machine. Therefore, it is preferable in such a system that the portable ventilator module may be designed so that the patient connection can be on either side of the device when the ventilator and anaesthesia modules are combined. One challenge associated with this requirement is that the modular system needs two gas connections between the modules to allow flow in one direction. Therefore, the docking system must also be capable of configuration to allow rotation. In this situation, the portable ventilator module must be rotated and placed into the docking port of the anaesthesia module or docking station which may be pre-configured to allow docking in only one orientation (right or left sided). In one embodiment of this invention, the portable ventilator module that is designed to be docked with an anaesthesia module can be rotated 180 degrees so that tubing can come from the left or right of the device when in docked and undocked use. In a preferable embodiment of the invention the portable ventilation module, when viewed from the side is shaped like a trapezium, so that the display will still be tilted upwards when rotated by 180 degrees. In another preferred embodiment of the invention, the docking port in the anaesthesia module can be rotated by 180 degrees and configured to operate with the ventilator module in either orientation. This means that left or right sided tubing locations can be accommodated.

[0024] In the situation where the ventilator module is capable of rotation by 180 degrees, the graphical user interface must also rotate so that the user can continue to interact with the device. To do this, the device must detect the change in orientation, for example by using an integrated circuit capable of orientation detection, for example an orientation detection sensor or sensor whereby orientation detection is combined with other related modalities such as motion detection, inertial measurement, although other combinations are familiar to those skilled in the art.

[0025] In one aspect of the invention, a portable ventilator module that can reversibly dock with an anaesthesia module to provide circle system anaesthesia with or without a turbine is able to determine its orientation and rotate the graphical user interface by 180 degrees to correspond with a docking port on the anaesthesia module that is also rotated by 180 degrees so that the portable ventilator module can be docked to the anaesthesia module and the patient connection tubing for the ventilator can come from either side of the ventilator module with respect to the patient with the graphical user interface remaining in the correct orientation for viewing.

[0026] In a further aspect of the invention, a portable ventilator module that reversibly docks with an anaesthesia module to provide volatile anaesthesia with or without a turbine is shaped in a trapezium shape when viewed from the side so that the device always presents the graphical user interface at a slight upwards direction when placed on a flat surface and when rotated perpendicular its long axis by 180 degrees (Figure 2) and wherein the graphical user interface rotates to ensure a correct orientation when the portable ventilator module is rotated.

[0027] The portable ventilator module must have a connection to the anaesthesia module which is capable of the transfer of gas to and from the module and may provide other transfer functions such as power, information transfer for operation or cooperation between module processors, internet connectivity, display connection although other connections are envisaged familiar to those skilled in the art. This connection area may be hereafter referred to as a “docking port”.

[0028] A principle component of the docking port is the gas in / out connection between the ventilator and anaesthesia modules. The anaesthesia module may remain in a single vertical orientation but the ventilator module may be capable of rotation by 180 degrees. Therefore, the gas connections in the docking port must be capable of being configured for rotation or agnostic to the orientation of the ventilator module with respect to the anaesthesia module.

[0029] In this respect, two methods are envisaged.

[0030] In one, where the gas connections are side by side, a configurable section of the docking port in the anaesthesia module is capable of correcting a reversed docking configuration so that the ventilator module can be docked at 0 degrees or 180 degrees.

[0031] In the second, the gas connections are configured in a co-axial configuration. In this configuration wherein the gas connections are rotation-independent.

[0032] In a further embodiment of the invention, a modular anaesthesia system in which a portable ventilator module that reversibly docks with an anaesthesia module to provide circle system volatile anaesthesia with or without a turbine has an anaesthesia module with a docking port that is formed of three parts, first a docking connection to the ventilator module, second a connecting block and third a circle assembly that includes components for carbon dioxide removal, control of exhaust gases and addition of oxygen and air with or without nitrous oxide and volatile anaesthetics and wherein the second connecting block comes in two configurations to support a docking connection that can be rotated by 180 degrees and wherein the connecting block reverses the gas flow change that would result from rotation of the docking connection by 180 degrees and ensures that the third circle system operates with the correct gas flow direction (figure 3).

[0033] In a preferred embodiment, the connector block has two ports in a vertical orientation connected separately to two ports in a horizontal orientation. The docking connection has ports in a horizontal orientation and the circle assembly has ports in the vertical orientation. If the connecting block is removed and flipped front to back and then rotated by 90 degrees, the connecting block will connect each ventilator port to the alternative circle assembly port than when it’s original position. In this way, the anaesthesia module docking port can be rotated, the connection block flipped and rotated and the circle assembly remain in the same orientation in both configuration. Locating pins can ensure that the connection block is never in the wrong position in relation to the docking port rotation.

[0034] In a further embodiment of the invention, a modular anaesthesia system in which a portable ventilator module that reversibly docks with an anaesthesia module to provide circle system volatile anaesthesia with or without a turbine has a co-axial docking port gas connection where gas to and from the ventilator module is separated but wherein the ventilation module can be rotated by 180 degrees maintaining consistent gas in and gas out connectivity.

[0035] When the ventilation module is operating portably (not docked with the anaesthesia module), it may be required to filter the exhaust gases to prevent contamination of the operating environment. This filter needs to be removed prior to docking. This removable filter may also provide a protective cover for the gas ports and electronic confirmation that the cover is in place.

[0036] This docking port cover / expiratory filter assembly may be part of a system of interlinked removable components to enable adequate sterilisation. As the docking port has gas in and gas out connections, it is connected to both the inspiratory and expiratory sides of the ventilator. As gas is recirculated when in docked anaesthesia configuration, inspiratory and expiratory sides of the manifold along with the docking port will be in contact with expired patient gas. Therefore all three components will need to be capable of being sterilised.

[0037] In a further aspect to the invention, a portable ventilator module that reversibly docks with an anaesthesia module to provide volatile anaesthesia with or without a turbine in which the gas docking port is at the rear of the device and where the sections of the gas pathway that come into contact with exhaled patient breath, including the docking port gas connections themselves, are removable from the device without the need of a tool and can be disassembled for sterilisation and re-assembled and reinserted for normal use.

[0038] In a preferred embodiment, the docking port cover / expiratory filter may be removed, which then allows the removal of the inspiratory cartridge from the device. In the same embodiment, the expiratory cartridge consisting of the Positive End Expiratory Pressure (PEEP) valve with or without the expiratory flowmeter may be removed with the docking port cover / expiratory filter removed. In another embodiment, the expiratory cartridge consisting of the Positive End Expiratory Pressure (PEEP) valve with or without the expiratory flowmeter may be removed without the docking port cover / expiratory filter removed.

[0039] Recirculating anaesthesia systems allow for significantly reduced oxygen consumption. With an oxygen fraction of 100%, a typical ventilator circuit where gas is supplied for each breath and exhausted (to prevent rebreathing) must require gas flow of at least minute ventilation (e.g. 5L / min). Whereas a circle anaethesia system must only replace the oxygen that is consumed by the patient and absorb the produced CO2. The basal consumption of oxygen for an adult is around 200mL / min, so 4% of the minute ventilation.

[0040] In the modular ventilation and anaesthesia system, the system is designed for transition between conventional ventilation and also circle system use, with gas ports exposed to allow gas circuit changes. In this circuit, the portable ventilator module may be configured so that the expiratory port is connected to a miniature carbon dioxide absorber and exhaust channel. During inspiration, the turbine draws gas from the exhaust channel connected to the gas inlet of the docking port. This is mixed with fresh oxygen from the oxygen gas inlet. This is then driven into the patient by the turbine. During exhalation, gas is driven by the patient and turbine through the PEEP valve, through the carbon dioxide absorber and into the exhaust channel. The exhaust channel is configured so that the inlet is connected between the carbon dioxide absorber and the turbine / oxygen inlet. During expiration when there is overall a low flow from the turbine to the patient circuit and a higher flow from the patient circuit through the PEEP valve, expired gas with carbon dioxide removed by the absorber, passes into the exhaust channel. Although the channel may be curved to conserve space, it is of a narrow bore between 10mm to 50mm, although other diameters are envisaged, so that gas flow is laminar and minimises mixing with the ambient gas. Therefore, when inspiration occurs, gas is drawn into the turbine as before, pulling with it first the exhaled air from the exhaust channel. In the case that more ambient air is needed, an exhaust valve positioned between the PEEP valve and the carbon dioxide absorber opens to vent exhaust gas prior to the exhaust channel. This leaves a deficit of exhaled gas in the linear reservoir for the next breath. On inspiration, the turbine empties the linear reservoir of exhaled gas and then draws in ambient air. If further oxygen is required, it is provided by the oxygen gas inlet valve from a pressurised oxygen source.

[0041] As the portable ventilator module is intended to operate in a dual left or right orientation (rotated by 180 degrees), it is important to be able to handle the device for operation in both orientations and also to be able to safely transition between orientations without dropping the device.

[0042] In an embodiment of the invention, a portable ventilator module that reversibly connects to an anaesthesia module to provide circle system anaesthesia and in which the ventilator module can be rotated by 180 degrees for docking so that the patient connection ports can come from either side of the device and in which the portable ventilator module has a continuous handle around the device so that the portable ventilator module can be held in an identical posture from the sides or top or bottom of the device to facilitate ease of movement and docking with the anaesthesia module in normal and 180 degree rotated configurations.

[0043] In an aspect of this invention, a continuous handle that is part of the frame of the device and which surrounds the touch screen display.

[0044] In an aspect of this invention, a trapezium-shaped portable ventilator module when viewed from the side so that the display tilts up towards the user when placed on a flat surface (e.g. bed) below eye level of the user when in normal and 180 degree rotated configurations which has a continuous handle forming the frame around the touch screen display and whereby the trapezium shape enables the user to grip the handle from behind the touchscreen display.

[0045] One challenge with handling portable ventilator modules is that the device may need to be passed across the bed safely between users. In this case, it is often a cause of back injury to the user as the receiving user is not able to easily hold the rear of the unit and the handle is only correctly positioned for a user at the front of the device.

[0046] In an aspect of this invention of a trapezium shape wherein a continuous handle surrounds the touchscreen display and a separate handle is provided around the rear of the device so that the device can be passed from one person to another with one user holding the handle around the touch-screen and the other user holds the handle at the rear of the device.

[0047] In an aspect of this invention, any connections to enable the device to be supported on a bed will need to always be mounted to the top surface. Therefore, a connector for additional bracketry may clamp to the handle to enable the bracketry to be moved from one side to the other and enable the ventilator module to be rotated for use in the other orientation.

[0048] As described herein, the modular use of the system leads to the recirculation of exhaled patient gases that can potentially contain contaminants (e.g. exhaled metabolic products, bacteria, virus, fungi and even prions) and volatile anaesthetic agents. The turbine is exposed to these gases when the device is in anaesthesia configuration.

[0049] The turbine consists of the turbine motor surrounded by a heat sink that may support a bearing for the motor shaft, which is connected to the impeller. The use of a gas bearing has been described in (2).

[0050] Evidence from experiments shows that in this system, the motion of the motor spindle is in an elliptical orbit as the bearings allow some movement and the poles of the motor influence the motion of the spindle. Consequently, the use of a gas bearing has two actions. Primarily it protects the bearings and motor from exhaled gases, secondarily it also may stabilise the spindle motion and rotation of the impeller and improve bearing lifespan.

[0051] This gas-bearing turbine described in (2) may be improved by the addition of a contact seal that operates in the case of sterilisation using a sterilising fluid when the turbine is not in use.

[0052] In one embodiment of this invention, the gas bearing is covered by a flexible J-shaped fluoropolymer seal (e.g. PTFE / PFA) that is in close proximity to the motor shaft and has a motor exposed side on the underside of the “J” and a patient exposed, impeller side on the upper side of the “J”. As gas is passed into the gas seal, the gas exits the gas seal through the fluoropolymer seal to the impeller side of the shaft. As the turbine may need sterilisation using gases or liquids that may damage the motor, the seal, when pressurised from the impeller side of the seal, the pressure forces the J-seal to contact the motor shaft and seal the gas bearing from the sterilising fluid.

[0053] In another embodiment of the invention, in a resting state, the “J” seal may be touching the motor shaft and be moved from contact by the gas escaping from the gas bearing. This provides a low-friction bearing and seal and controls the gas pressure in the bearing.

[0054] In another embodiment of the invention, the seal may be a “U” shape or “J” or “U” shape with an energising ring such as a polymer O-ring or stainless-steel spring. In either case, the gas from the gas bearing may or may not be used to maintain a minimal distance of the seal from the motor shaft to provide minimal resistance to rotation when the device is in use and the gas bearing is energised.

[0055] In another embodiment, the fluoropolymer seal may be made of two separate halves so that the seal can be replaced without removing the impeller from the turbine.

[0056] In a further aspect of the invention, a J-shaped seal may be provided around the impeller and secured to the motor housing. The seal is in close proximity to the impeller edge. In circumstances where suction is applied to the gas bearing flush gas port, the negative pressure between the underside of the impeller and the motor housing causes the j-shaped seal to move and press against the impeller, thus sealing the motor components. This is so that sterilising fluids, gases or vapour phase sterilants can be used without coming into contact with sensitive bearings or motor components. Any ingress of sterilising fluid past the seal is removed through the suction port of the gas bearing which is between the sensitive motor components and the lateral edge of the impeller where the seal is located.

[0057] In another aspect of the invention, this j-shaped seal may be replaceable after sterilisation.

[0058] In a separate embodiment of the invention relates to the use of a gas bearing between the motor-side of the impeller (underside) and the motor housing / heat sink. By using a gas bearing in this location, a tight tolerance is achieved between the impeller and casing that reduces the necessary flow of gas, the motion of the impeller is supported and a clear boundary between what is contaminated (outside the boundary of the impeller) and clean (under the impeller) is generated for sterilisation.

[0059] In one embodiment of the invention, a gap of between 5 and 100 microns is made between the underside of the impeller and the motor housing to allow bearing flush gas to pass from the motor shaft central area of the impeller to the lateral extreme.

[0060] In one aspect of the invention, a gap of less than 5 microns may be used.

[0061] In a preferred embodiment of the invention, a fine tolerance between the impeller and the motor casing is generated by covering the motor casing (“motor casing cover”) with a polymer, such as PEEK or metal such as aluminium and then grinding the surface of this layer with the grinding tool being referenced to the motor shaft, as the motor shaft may not be exactly perpendicular to the motor housing. In this preferred embodiment, the grinding tool may incorporate high spots to generate circular recesses in the ground material and may also include a low spot near the motor shaft which generates a precisely machined high stop for the location of the impeller at a precise distance above the motor housing and ground cover. In a preferred embodiment, the impeller has a flat lower surface which is also ground flat, with reference to the shaft fitting. In one aspect of this invention, the impeller may be hollow or filled with a lattice to maintain a low impeller inertia.

[0062] In the case of a centrifugal impeller with the highest point in the centre and falling to the lateral aspect, a cone shape can be formed on the underside of the impeller in order to reduce weight and minimise inertia. In a preferred embodiment of the invention, the underside of the impeller is cone shaped to reduce mass and the corresponding motor housing cover is cone shaped to match the underside of the impeller. The grinding tool for the motor housing cover is shaped to grind this cone shape, referenced from the motor shaft spindle as this is the axis of rotation.

[0063] Further circular channels are generated by the grinding tool in the cone surface of the motor housing cover if required for the gas bearing.

[0064] In the above embodiments referring to the motor housing cover, the motor housing cover can be changed for a bespoke motor housing that is of the same shape as the motor housing and motor housing cover together.

[0065] In one aspect of the invention, the motor housing cover may be energised or retracted by fluid pressure between the motor housing and the cover. This may be a component of the flush gas that supports the air bearing, whereby the gas pressure supplied to the turbine to facilitate the air bearing also provides a supply to drive the cover upwards when required. Proximal to this flow restriction, gas pressure moves the motor housing cover towards the underside of the impeller to reduce the gap between the underside of the impeller and the cover to the specified gap of 5-1 OOmicrons, although other distances less than 5 micron or over 100 micron may be used.

[0066] The distance between the underside of the impeller and the motor housing cover may be dynamically altered either by using pressure feedback from between the underside of the impeller and the cover to restrict the flow of gas to the pressure chamber that drives the cover upwards, or by electronic detection of cover position or pressure between the cover and underside of the impeller with subsequent control of a valve that allows gas to escape from the chamber between the cover and motor housing, thus reducing the pressure in this chamber and lowering the position of the cover.

[0067] In another aspect of the invention the housing that attaches to the motor casing and directs the flow of gas around the impeller is detachable or is part of the manifold of the device “gas pathway housing / manifold”. When decontamination or sterilisation is required, the manifold is separated from the turbine motor casing and replaced with a sterilising component that is applied to the turbine in place of the manifold. In one aspect of the invention, the turbine motor housing is sealed to the gas pathway housing / manifold by a replaceable seal that is changed after sterilisation. The sterilising component generates a seal between itself and the turbine motor housing. Steam, ethylene oxide, ozone, hydrogen peroxide or other sterilising flu id / gas / va pour phase may be used. Suction may be applied to the gas bearing to generate a seal with the impeller and evacuate any penetrating fluid as described.

[0068] In a preferred embodiment, UV light is used to provide surface decontamination / sterilisation. This is possible because the boundary for sterilisation is at the lateral edge of the impeller and therefore the entire contaminated surface is available for UV sterilisation.

[0069] In a preferred embodiment, the UV light used is UV-C (100-290nm),

[0070] In one aspect of the invention, the gas pathway housing / manifold is removed and replaced with the UV sterilising unit. A replaceable seal around the turbine may be removed prior to sterilisation to sterilise the seal location. UV light is delivered to the turbine housing to facilitate sterilisation and then the sterilising unit is removed. The gas pathways housing / manifold is sent for steam autoclave (or other remote) sterilisation and a clean manifold is placed back onto the decontaminated / sterilised turbine motor housing.

[0071] Further aspects and embodiments are listed in the following numbered paragraphs.

[0072] 1 . A portable ventilator module configured to be docked with an anaesthesia module, the portable ventilator module can be rotated approximately 180 degrees so that tubing can come from the left or right of the when in docked and undocked use.

[0073] 2. A module according to paragraph, which when viewed from the side is shaped like a trapezium, so that a display will still be tilted upwards when the module is rotated by 180 degrees.

[0074] 3. A module according to paragraph 1 in combination with an anaesthesia module, a docking port in the anaesthesia module can be rotated by approximately 180 degrees and configured to operate with the ventilator module in either orientation, whereby left or right sided tubing locations can be accommodated.

[0075] 4. A portable ventilator module that can reversibly dock with an anaesthesia module to provide circle system anaesthesia with or without a turbine is able to determine its orientation and rotate a graphical user interface by approximately 180 degrees to correspond with a docking port on the anaesthesia module that is also rotated by approximately 180 degrees so that the portable ventilator module can be docked to the anaesthesia module and patient connection tubing for the ventilator can come from either side of the ventilator module with respect to the patient with the graphical user interface remaining in the correct orientation for viewing. 5. A portable ventilator module that reversibly docks with an anaesthesia module to provide volatile anaesthesia with or without a turbine is shaped in a trapezium shape when viewed from the side so that the device always presents the graphical user interface at a slight upwards direction when placed on a flat surface and when rotated perpendicular its long axis by approximately 180 degrees.

[0076] 6. A portable ventilator module that reversibly docks with an anaesthesia module to provide volatile anaesthesia with or without a turbine in which the gas docking port is at the rear of the device and where the sections of the gas pathway that come into contact with exhaled patient breath, including the docking port gas connections themselves, are removable from the device without the need of a tool and can be disassembled for sterilisation and re-assembled and re-inserted for normal use from the rear of the device.

[0077] 6. A modular anaesthesia system in which a portable ventilator module that reversibly docks with an anaesthesia module to provide circle system volatile anaesthesia with or without a turbine has an anaesthesia module with a docking port that is formed of three parts, first a docking connection to the ventilator module, second a connecting block and third a circle assembly that includes components for carbon dioxide removal, control of exhaust gases and addition of oxygen and air with or without nitrous oxide and volatile anaesthetics and wherein the second connecting block comes in two configurations to support a docking connection that can be rotated by 180 degrees and wherein the connecting block reverses the gas flow change that would result from rotation of the docking connection by approximately 180 degrees and ensures that the third circle system operates with the correct gas flow direction.

[0078] 7. A system according to paragraph 6, in which the connector block has two ports in a vertical orientation connected separately to two ports in a horizontal orientation.

[0079] 8. A system according to paragraph 6 or paragraph 7, in which the docking connection has ports in a horizontal orientation and the circle assembly has ports in the vertical orientation.

[0080] 9. A system according to any of paragraphs 6 to 9, in which if the connecting block is removed and flipped front to back and then rotated by 90 degrees, the connecting block will connect each ventilator port to the alternative circle assembly port than when its original position, whereby the anaesthesia module docking port can be rotated, the connection block flipped and rotated and the circle assembly remain in the same orientation in both configuration.

[0081] 10. A system according to paragraph 9, in which locating pins are provided to ensure that the connection block is never in the wrong position in relation to the docking port rotation.

[0082] 11 . A portable ventilator module that reversibly connects to an anaesthesia module to provide circle system anaesthesia, in which the ventilator module can be rotated by 180 degrees for docking so that the patient connection ports can come from either side of the device and in which the portable ventilator module has a continuous handle around the device so that the portable ventilator module can be held in an identical posture from the sides or top or bottom of the device to facilitate ease of movement and docking with the anaesthesia module in normal and 180 degree rotated configurations.

[0083] 12. A portable ventilator module, the module comprises a frame, a handle and a touch screen display, the handle is a continuous handle that is part of the frame and which surrounds the touch screen display.

[0084] 13. A trapezium-shaped portable ventilator module, when viewed from the side, so that a display tilts up towards the user when placed on a flat surface below eye level of the user when in a normal and a 180 degree rotated configuration, the module has a continuous handle forming the frame around a touch screen display, whereby the trapezium shape enables the user to grip the handle from behind the touchscreen display.

[0085] 14. A module according to paragraph 13, in which a connector for additional bracketry may clamp to the handle to enable the bracketry to be moved from one side to the other and enable the ventilator module to be rotated for use in the other orientation.

[0086] 15. A portable ventilator module that docks with an anaesthesia module to provide volatile anaesthesia and uses a turbine, the module must protect the turbine bearings from contamination with volatile anaesthetic agents and exhaled patient breath, the turbine comprises a gas bearing for use with flush gas.

[0087] 16. A module according to paragraph 15, in which the gas bearing is covered by a flexible seal that is in close proximity to a motor shaft.

[0088] 17. A module according to paragraph 15 or paragraph 16, in which the gas bearing is covered by a flexible J-shaped seal that is in close proximity to a motor shaft and has a motor exposed side on the underside of the “J” and a patient exposed, impeller side on the upper side of the “J”, whereby as flush gas is passed into the gas seal, the gas exits the gas seal through the seal to the impeller side of the shaft.

[0089] 18. A module according to any of paragraphs 15 to 17, in which because the turbine may need sterilisation using gases or liquids that may damage the motor, the seal, when pressurised from the impeller side of the seal, the pressure forces the J-seal to contact the motor shaft and seal the gas bearing from the sterilising fluid. 19. A module according to any of paragraphs 15 to 18, in which in a resting state, a “J” seal may be touching the motor shaft and be moved from contact by the gas escaping from the gas bearing, thereby providing a low-friction bearing and seal and controlling the gas pressure in the bearing.

[0090] 20. A module according to any of paragraphs 15 to 19, in which the seal may be a “U” shape or “J” or “U” shape with an energising ring such as a polymer O-ring or stainless-steel spring.

[0091] 21 . A module according to paragraph 20, in which the gas from the gas bearing may or may not be used to maintain a minimal distance of the seal from the motor shaft to provide minimal resistance to rotation when the device is in use and the gas bearing is energised.

[0092] 22. A module according to any of paragraphs 15 to 21 , in which a fluoropolymer seal is made of two separate halves so that the seal can be replaced without removing the impeller from the turbine.

[0093] 23. A portable ventilator module that docks with an anaesthesia module to provide volatile anaesthesia and uses a turbine, the module must protect the turbine bearings from contamination with volatile anaesthetic agents and exhaled patient breath, the turbine comprises a gas bearing for use with flush gas, a gas bearing is provided between the motor-side of the impeller (underside) and the motor housing / heat sink, whereby a tight tolerance is achieved between the impeller and casing that reduces the necessary flow of gas, the motion of the impeller is supported and a clear boundary between what is contaminated (outside the boundary of the impeller) and clean (under the impeller) is generated for sterilisation.

[0094] 24. A module according to paragraph 23, in which a gap of between 5 and 100 microns is made between the underside of the impeller and the motor housing to allow bearing flush gas to pass from the motor shaft central area of the impeller to the lateral extreme.

[0095] 25. A module according to paragraph 24, in which a gap of less than 5 microns is made between the underside of the impeller and the motor housing to allow bearing flush gas to pass from the motor shaft central area of the impeller to the lateral extreme.

[0096] 26. A module according to any of paragraphs 23 to 25, in which the underside of the impeller is cone shaped to reduce mass and the corresponding motor housing cover is cone shaped to match the underside of the impeller.

[0097] 27. A module according to any of paragraphs 23 to 26, in which a fine tolerance between the impeller and the motor casing is generated by covering the motor casing (“motor casing cover”) with a polymer, such as PEEK or metal such as aluminium and then grinding the surface of this layer with the grinding tool being referenced to the motor shaft, as the motor shaft may not be exactly perpendicular to the motor housing. 28. A module according to paragraph 27, in which the grinding tool incorporates high spots to generate circular recesses in the ground material and with or without a low spot near the motor shaft which generates a precisely machined high stop for the location of the impeller at a precise distance above the motor housing and ground cover.

[0098] 29. A portable ventilator module that docks with an anaesthesia module to provide volatile anaesthesia and uses a turbine, the turbine comprises an impeller with a flat lower surface.

[0099] 30. A portable ventilator module that docks with an anaesthesia module to provide volatile anaesthesia and uses a turbine, the impeller is hollow or filled with a lattice to maintain a low impeller inertia.

[0100] 31. A portable ventilator module that docks with an anaesthesia module to provide volatile anaesthesia and uses a turbine, the turbine comprises an impeller, in the case of a centrifugal impeller with the highest point in the centre and falling to the lateral aspect, a cone shape can be formed on the underside of the impeller in order to reduce weight and minimise inertia.

[0101] 32. A module according to paragraph 31 , in which the underside of the impeller is cone shaped to reduce mass and the corresponding motor housing cover is cone shaped to match the underside of the impeller.

[0102] 33. A module according to paragraph 32, in which the grinding tool for the motor housing cover is shaped to grind this cone shape, referenced from the motor shaft spindle as this is the axis of rotation.

[0103] 34. A module according to paragraph 33, in which further circular channels are generated by the grinding tool in the cone surface of the motor housing cover if required for the gas bearing.

[0104] 35. A module according to any of paragraphs 31 to 34 in which referring to the motor housing cover, the motor housing cover can be changed for a bespoke motor housing that is of the same shape as the motor housing and motor housing cover together.

[0105] 36. A ventilator module comprising a turbine, in which the motor housing cover may be energised or retracted by fluid pressure between the motor housing and the cover, and in which this may be a component of the flush gas that supports the air bearing, whereby the gas pressure supplied to the turbine to facilitate the air bearing also provides a supply to drive the cover upwards when required.

[0106] 37. A module according to paragraph 36, in which proximal to this flow restriction, gas pressure moves the motor housing cover towards the underside of the impeller to reduce the gap between the underside of the impeller and the cover to a specified gap of 5-100microns, although other distances less than 5 micron or over 100 micron may be used.

[0107] 38. A module according to paragraph 36 or paragraph 37 in which the distance between the underside of the impeller and the motor housing cover may be dynamically altered either by using pressure feedback from between the underside of the impeller and the cover to restrict the flow of gas to the pressure chamber that drives the cover upwards, or by electronic detection of cover position or pressure between the cover and underside of the impeller with subsequent control of a valve that allows gas to escape from the chamber between the cover and motor housing, thus reducing the pressure in this chamber and lowering the position of the cover.

[0108] 39. A ventilator module comprising a turbine, a J-shaped seal may be provided around the impeller and secured to the motor housing.

[0109] 40. A module according to paragraph 39, in which suction may be applied to the gas bearing to generate a seal with the impeller and evacuate any penetrating fluid as described.

[0110] 41 . A module according to paragraph 39 or paragraph 40, in which the seal is in close proximity to the impeller edge.

[0111] 42. A module according to any of paragraphs 39 to 41 , in which in circumstances where suction is applied to the gas bearing flush gas port, the negative pressure between the underside of the impeller and the motor housing causes the J-shaped seal to move and press against the impeller, thus sealing the motor components, whereby sterilising fluids, gases or vapour phase sterilants can be used without coming into contact with sensitive bearings or motor components, and in which any ingress of sterilising fluid past the seal is removed through the suction port of the gas bearing which is between the sensitive motor components and the lateral edge of the impeller where the seal is located.

[0112] 43. A module according to any of paragraphs 39 to 42, in which the J-shaped seal may be replaceable after sterilisation.

[0113] 44. A ventilator module comprising a turbine, in which the housing that attaches to the motor casing and directs the flow of gas around the impeller is detachable or is part of the manifold of the device “gas pathway housing / manifold”.

[0114] 45. A module according to paragraph 44, in which when decontamination or sterilisation is required, the manifold is separated from the turbine motor casing and replaced with a sterilising component that is applied to the turbine in place of the manifold. 46. A ventilator module comprising a turbine, in which the turbine motor housing is sealed to the gas pathway housing / manifold by a replaceable seal that is changed after sterilisation.

[0115] 47. A module according to paragraph 46, in which the sterilising component generates a seal between itself and the turbine motor housing.

[0116] 48. A module according to paragraph 47, in which suction may be applied to the gas bearing to generate a seal with the impeller and evacuate any penetrating fluid as described.

[0117] 49. A ventilator module comprising a turbine, in which UV light is used to provide surface decontamination / sterilisation, because the boundary for sterilisation is at the lateral edge of the impeller and therefore the entire contaminated surface is available for UV sterilisation.

[0118] 50. A ventilator module comprising a turbine, in which the gas pathway housing / manifold is removed and replaced with the UV sterilising unit.

[0119] 51. A module according to paragraph 50, in which a replaceable seal around the turbine may be removed prior to sterilisation to sterilise the seal location.

[0120] 52. A module according to paragraph 50 or paragraph 51 , in which UV light is delivered to the turbine housing to facilitate sterilisation and then the sterilising unit is removed.

[0121] Detailed description of drawings

[0122] Embodiments now will be described more fully hereinafter with reference to the accompanying drawings, in which some, but not all embodiments may be shown. Indeed, embodiments may be illustrated or described in many different forms and the present disclosure should not be construed as limited to the embodiments set forth herein.

[0123] The example embodiments are described in sufficient detail to enable those of ordinary skill in the art to embody and implement the systems and processes herein described. It is important to understand that embodiments can be provided in many alternative forms and should not be construed as limited to the examples set forth herein.

[0124] Accordingly, while embodiments can be modified in various ways and take on various alternative forms, specific embodiments thereof are shown in the drawings and described in detail below as examples. There is no intent to limit to the particular forms disclosed. On the contrary, all modifications, equivalents, and alternatives falling within the scope of the appended claims should be included. Elements of the example embodiments are consistently denoted by the same reference numerals throughout the drawings and detailed description where appropriate. Unless otherwise defined, all terms (including technical and scientific terms) used herein are to be interpreted as is customary in the art. It will be further understood that terms in common usage should also be interpreted as is customary in the relevant art and not in an idealised or overly formal sense unless expressly so defined herein.

[0125] Figure 1 . Current outline shape of many current portable ventilators showing display 1 and handle 2 in general a square and triangle configuration with a single vertical orientation.

[0126] Figure 2. Trapezium shape and relation to actual design concept.

[0127] Figure 3. Rotation of ventilator module and configuration of connecting block to allow 180-degree rotation while maintaining the normal orientation of the anaesthesia circle system.

[0128] Figure 4. Continuous handle of ventilator module 3 with space for hand to access the handle provided by trapezium shape of device and lower back profile 4 than front profile 5.

[0129] Figure 5. The gas bearing 5 has flush gas passed through the channel 6 to energise the bearing. Flush gas passes through the “J” shaped seal 7 and through the channel 8 between the seal and the motor shaft 9 to the impeller end 10 of the motor shaft.

[0130] Figure 6. A midline section of a turbine without the gas pathway housing / manifold. The impeller and blades 10 are recessed underneath to form a cone. The impeller is closely attached to the spindle by a collar 12. A gas bearing is formed between the underside of the impeller 10 and the motor housing cover 11 with gas travelling from the motor shaft to the lateral edge of the impeller 13.

[0131] Figure 7. A midline section of a turbine showing the lateral aspect of the impeller. The impeller and blades 10 form a gas bearing with the motor housing cover 11 as described. A J-shaped seal 14 is in close proximity to the lateral edge of the impellerto maintain a close gap and pressure in the gas bearing and also to seal the space between the underside of the impeller 10 and the motor housing cover 11 when negative pressure is applied to the gas bearing gas pathway.

[0132] These and other modifications and variations may be practiced by those of ordinary skill in the art without departing from the spirit and scope. In addition, it should be understood that aspects of the various embodiments may be interchanged in whole or in part. Furthermore, those of ordinary skill in the art will appreciate that the foregoing description is by way of example only, and it is not intended to limit the scope of that which is described in the claims. Therefore, the spirit and scope of the appended claims should not be limited to the exemplary description of the versions contained herein.

Claims

CLAIMS1 . A portable ventilator module configured to be reversibly docked with an anaesthesia module to provide circle system anaesthesia with or without a turbine wherein the portable ventilator module can be rotated approximately 180 degrees so that patient connection tubing can come from the left or right of the ventilation module when in docked and undocked use.

2. A module as claimed in claim 1 , which when viewed from the side is shaped like a trapezium, so that a display will still be tilted upwards when the module is rotated by 180 degrees.

3. A module as claimed in claim 1 , wherein a docking port in the anaesthesia module can be rotated by approximately 180 degrees and configured to operate with the ventilator module in either orientation, whereby left or right sided tubing locations can be accommodated.

4. A module as claimed in 1 , able to determine its orientation and rotate a graphical user interface by approximately 180 degrees to correspond with a docking port on the anaesthesia module so that the portable ventilator module can be docked to the anaesthesia module and patient connection tubing for the ventilator can come from either side of the ventilator module with respect to the patient with the graphical user interface remaining in the correct orientation for viewing.

5. A module as claimed in 1 with a docking port that is formed of three parts, first a docking connection to the ventilator module, second a connecting block and third a circle assembly that includes components for carbon dioxide removal, control of exhaust gases and addition of oxygen and air with or without nitrous oxide and volatile anaesthetics and wherein the second connecting block comes in two configurations to support a docking connection that can be rotated by 180 degrees and wherein the connecting block reverses the gas flow change that would result from rotation of the docking connection by approximately 180 degrees and ensures that the third circle system operates with the correct gas flow direction.

6. A system as claimed in claim 5, in which the connector block has two ports in a vertical orientation connected separately to two ports in a horizontal orientation.

7. A system as claimed in claim 5 or claim 6, in which the docking connection has ports in a horizontal orientation and the circle assembly has ports in the vertical orientation.

8. A system as claimed in any of claims 5 to 7, in which if the connecting block is removed and flipped front to back and then rotated by 90 degrees, the connecting block will connect each ventilator port to the alternative circle assembly port than when its original position, whereby the anaesthesia module docking port can be rotated, the connection block flipped and rotated and the circle assembly remain in the same orientation in both configuration.

9. A system as claimed in claim 8, in which locating pins are provided to ensure that the connection block is never in the wrong position in relation to the docking port rotation.

10. A module as claimed in claim 1 , in which the docking port gas in and gas out connections are co-axial to allow orientation-independent docking of the gas in and gas out connections.

11. A module as claimed in claim 1 , in which the portable ventilator module has a continuous handle around the device so that the portable ventilator module can be held in an identical posture from the sides or top or bottom of the device to facilitate ease of movement and docking with the anaesthesia module in normal and 180 degree rotated configurations.

12. A trapezium-shaped portable ventilator module as claimed in claim 2, whereby the trapezium shape enables the user to grip the handle from behind the touchscreen display.

13. A module as claimed in claim 12, in which a connector for additional bracketry may clamp to the handle to enable the bracketry to be moved from one side to the other and enable the ventilator module to be rotated for use in the other orientation.14 A module as claimed in claim 12, in which when docked with the anaesthesia module, the continuous handle around the ventilator module is used as the handle to move the combined ventilation / anaesthesia machine either as part of a trolley or pendant mounted assembly.15 A portable ventilator module that may reversibly dock with an anaesthesia module to provide circle system anaesthesia with or without a turbine in which a miniaturised low flow oxygen module may be connected to the portable ventilator module docking port gas in and gas out connections to provide carbon dioxide absorption, an exhaled gas buffer and an exhaust valve to facilitate oxygen consumption to basal metabolic oxygen consumption,16. A module as claimed in claim 15, in which the exhaled gas buffer provides a linear gas buffer between the gas circuit carbon dioxide absorber and the gas in connection of the portable ventilator module at one end and is open to ambient air at the other end.

17. A module as claimed in claim 15, in which the buffer has a diameter between 5mm and 50mm to reduce mixing of exhaled gases and ambient air18. A module as claimed in claim 15, in which the buffer is folded to reduce space19. A module as claimed in claim 15, in which the exhaust valve is positioned between the docking port gas out connection of the portable ventilator module and the carbon dioxide absorber20. A portable ventilator module that docks with an anaesthesia module to provide volatile anaesthesia and uses a turbine in which the module protects the turbine bearings from contamination with volatile anaesthetic agents and exhaled patient breath using a gas bearing driven by flush gas and wherein a flexible seal is used to reduce the flush gas consumption21 . A module as claimed in 20, in which the gas bearing applied to the motor shaft is covered by a flexible J-shaped seal that is in close proximity to a motor shaft and has a motor exposed side on the underside of the “J” and a patient exposed, impeller side on the upper side of the “J”, whereby as flush gas is passed into the gas seal, the gas exits the gas seal through the seal to the impeller side of the shaft.

22. A module as claimed in any of claims 20 and 21 , in which sterilising fluid is prevented from contacting the bearings by sterilising fluid pressure from the impeller side of the seal forcing the J-seal to contact the motor shaft and seal the gas bearing from the sterilising fluid.

23. A module as claimed in any of claims 20 to 22, in which in a resting state, a “J” seal may be touching the motor shaft and be moved from contact by the gas escaping from the gas bearing, thereby providing a low-friction bearing and seal and controlling the gas pressure in the bearing.

24. A module as claimed in any of claims 20 to 23, in which the seal may be a “U” shape or “J” or “U” shape with an energising ring such as a polymer O-ring or stainless-steel spring.

25. A module as claimed in claim 20, in which the gas from the gas bearing may or may not be used to maintain a minimal distance of the seal from the motor shaft to provide minimal resistance to rotation when the device is in use and the gas bearing is energised.

26. A module as claimed in any of claims 20 to 25, in which the seal is made of two separate halves so that the seal can be replaced without removing the impeller from the turbine.

27. A module as claimed in 20, in which a J-shaped seal may be provided around the impeller and secured to the motor housing to reduce flush gas consumption.

28. A module as claimed in claim 27, in which suction may be applied to the gas bearing to generate a seal with the impeller and evacuate any penetrating contaminating fluid29. A module as claimed in claim 27, in which the seal is in close proximity to the impeller edge.

30. A module as claimed in any of claims 27 to 29, wherein during sterilisation of the turbine impeller when suction is applied to the gas bearing flush gas port, the negative pressure between the undersideof the impeller and the motor housing causes the J-shaped seal to move and press against the impeller, thus sealing the motor components, whereby sterilising fluids, gases or vapour phase sterilants can be used without coming into contact with sensitive bearings or motor components, and in which any ingress of sterilising fluid past the seal is removed through the suction port of the gas bearing which is between the sensitive motor components and the lateral edge of the impeller where the seal is located.31 . A module as claimed in any of claims 27 to 30, in which the J-shaped seal may be replaceable after sterilisation.

32. A module as claimed in 20 wherein a gas bearing is provided between the motor-side of the impeller (underside) and the motor housing / heat sink, whereby a tight tolerance is achieved between the impeller and casing that reduces the necessary flow of flush gas and wherein the motion of the impeller is supported and a clear boundary between what is exposed to patient gas is generated at the edge of the impeller by grinding the motor cover surface and the underside of the impeller with reference to the motor shaft.

33. A module as claimed in claim 32, in which a gap of between 5 and 100 microns is made between the underside of the impeller and the motor housing to allow bearing flush gas to pass from the motor shaft central area of the impeller to the lateral extreme.

34. A module as claimed in claim 32, in which a gap of less than 5 microns is made between the underside of the impeller and the motor housing to allow bearing flush gas to pass from the motor shaft central area of the impeller to the lateral extreme.

35. A module as claimed in any of claims 32 to 34, in which the underside of the impeller is cone shaped to reduce mass and the corresponding motor housing cover is cone shaped to match the underside of the impeller.

36. A module as claimed in claim 32, in which the grinding process incorporates high spots to generate circular recesses in the ground material and with or without a low spot near the motor shaft which generates a precisely machined high stop for the location of the impeller at a precise distance above the motor housing and ground cover.

37. A module as claimed in claim 32, in which the impeller is hollow or filled with a lattice to maintain a low impeller inertia.

38. A module as claimed in 20, in which the motor housing cover may be energised or retracted by fluid pressure between the motor housing and the cover, and in which this fluid may be a component of the flush gas that supports the air bearing, whereby the gas pressure supplied to the turbine to facilitate the air bearing also provides a supply to drive the cover upwards.

39. A module as claimed in claim 38, in which proximal to this flow restriction, gas pressure moves the motor housing cover towards the underside of the impeller to reduce the gap between the underside of the impeller and the cover to a specified gap of 5-100microns, although other distances less than 5 micron or over 100 micron may be used.

40. A module as claimed in claim 38 or claim 39, in which the distance between the underside of the impeller and the motor housing cover may be dynamically altered either by using pressure feedback from between the underside of the impeller and the cover to restrict the flow of gas to the pressure chamber that drives the cover upwards, or by electronic detection of cover position or pressure between the cover and underside of the impeller with subsequent control of a valve that allows gas to escape from the chamber between the cover and motor housing, thus reducing the pressure in this chamber and lowering the position of the cover.41 A ventilator module as part of a modular ventilation and anaesthesia system comprising a turbine, in which the housing that attaches to the motor casing and directs the flow of gas around the impeller is detachable or is part of the manifold of the device “gas pathway housing / manifold” so that the turbine can be sterilised.

42. A module as claimed in claim 41 , in which when decontamination or sterilisation is required, the manifold is separated from the turbine motor casing and sterilisation of the manifold is performed by a sterilising fluid such as steam, ethylene oxide, ozone, hydrogen peroxide or other sterilising fluid / gas / vapour phase.

43. A module as claimed in 41 , in which a sterilising component is applied to the turbine motor housing and impeller in place of the replaceable manifold / housing for in-situ sterilisation44. A module as claimed in 41 , in which the turbine motor housing is sealed to the gas pathway housing / manifold by a replaceable seal that is changed after sterilisation.

45. A module as claimed in claim 43, in which the sterilising component generates a seal between itself and the turbine motor housing.

46. A module as claimed in claim 43, in which suction may be applied to the gas bearing to generate a seal with the impeller and evacuate any penetrating fluid as described.

47. A module as claimed in claim 43, which UV-C light is used to provide surface decontamination and or sterilisation48. A ventilator module comprising a turbine, in which the gas pathway housing / manifold is removed and replaced with the UV-C sterilising unit.

49. A module as claimed in claim 48, in which UV-C light is delivered to the turbine housing to facilitate sterilisation and then the sterilising unit is removed.

50. A portable ventilator module as part of a modular ventilation and anaesthesia system, the ventilator module comprises a frame, a handle and a touch screen display, the handle is a continuous handle that is part of the frame and which surrounds the touch screen display and wherein, when docked with the anaesthesia module, the handle can be used to move the combined ventilator / anaesthesia machine as part of a trolley or pendant assembly.

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