阅读说明：本技术 包括感测闭塞器的骨内装置 (Intraosseous device including sensing obturator ) 是由 E·W·林德库格尔 D·佩特 于 2021-06-02 设计创作，主要内容包括：本文公开了用于自动检测对髓腔的进入的医疗装置系统及其方法。实施方案包括具有感测闭塞器的骨内进入系统,该感测闭塞器配置为检测其远侧尖端处的模态变化,例如压力、氧饱和度、电阻抗等。信号可以被传输至可以响应地修正驱动器的激活的控制逻辑。信号可以借助于有线或无线通信被传输。在实施方案中,信号可以被传输通过传导性聚合物材料,该传导性聚合物材料形成闭塞器并且允许闭塞器足够柔性以减轻意外的针刺伤害。(Medical device systems and methods thereof for automatically detecting access to a medullary cavity are disclosed herein. Embodiments include an intraosseous access system having a sensing obturator configured to detect modal changes at its distal tip, such as pressure, oxygen saturation, electrical impedance, and the like. The signal may be transmitted to control logic that may responsively modify the activation of the driver. The signals may be transmitted by means of wired or wireless communication. In embodiments, the signal may be transmitted through a conductive polymer material that forms the obturator and allows the obturator to be sufficiently flexible to mitigate accidental needle stick injury.)

1. An obturator assembly configured for use with an intraosseous access system, the obturator assembly comprising:

an elongate obturator body; and

a sensor disposed proximate a distal end of the obturator body and configured to detect a modal change to determine access to a medullary cavity.

2. The obturator of claim 1, wherein the sensor is selected from the group consisting of a pressure transducer, an oxygen saturation sensor, an electrical impedance sensor, a temperature sensor, and a pH sensor.

3. The obturator of claim 1, wherein the sensor is communicatively coupled with control logic disposed in a driver of the intraosseous access system, the control logic configured to modify operation of the driver when the sensor detects the modal change.

4. The obturator of claim 3, wherein the sensor comprises a passive RFID chip, and wherein the control logic is configured to provide an interrogation signal configured to induce a response signal from the passive RFID chip to determine entry into the intramedullary canal.

5. The obturator of claim 3, further comprising a sensor interface disposed at a proximal end of an obturator hub, the sensor interface configured to rotatably and communicatively couple the sensor with the control logic.

6. The obturator of claim 5, wherein the obturator comprises one of an electrically conductive thermoplastic or an optically conductive thermoplastic configured to communicatively couple the sensor with the sensor interface.

7. The obturator of claim 5, comprising a wire extending axially therethrough to communicatively couple the sensor with the sensor interface.

8. The obturator of claim 1, wherein the obturator is configured to be disposed within a needle, and wherein the sensor is disposed proximate a distal end of the needle.

9. The obturator of claim 1, further comprising a second sensor configured to detect a second modality, the second modality configured to determine access to the intramedullary canal.

10. The obturator of claim 9, wherein the second sensor is selected from the group consisting of a pressure transducer, an oxygen saturation sensor, an electrical impedance sensor, a temperature sensor, and a pH sensor.

11. A method of detecting access to a medullary cavity, the method comprising:

providing an elongate obturator body comprising a sensor disposed at a distal end of the obturator body;

urging the elongate obturator body through cortical bone;

detecting a first modality level;

accessing the medullary cavity;

detecting a change in modality level from the first modality level to determine access to the medullary cavity; and

communicating the modal level change to control logic.

12. The method of claim 11, wherein the elongate obturator body is disposed within an intraosseous access needle.

13. The method of claim 11, wherein the sensor is selected from the group consisting of a pressure transducer, an oxygen saturation sensor, an electrical impedance sensor, a temperature sensor, and a pH sensor.

14. The method of claim 11, wherein the control logic is disposed within an intraosseous access driver releasably coupled to an elongate medical device.

15. The method of claim 14, wherein the control logic is configured to modify operation of the intraosseous access driver when the sensor detects the modal level change.

16. The method of claim 14, wherein the obturator further comprises a sensor interface disposed at a proximal end of the obturator and configured to engage with the driver and communicatively and rotatably couple the sensor and the control logic.

17. The method of claim 16, wherein the obturator comprises an electrically conductive thermoplastic material configured to communicatively couple the sensor with the sensor interface.

18. The method of claim 16, wherein the medical device includes a wire extending axially therethrough and configured to communicatively couple the sensor with the sensor interface.

19. The method of claim 11, further comprising detecting a second modal level change to determine access to the lumen, and communicating the second modal level change to the control logic.

20. The method of claim 11, wherein the sensor comprises a passive RFID chip, and wherein the control logic is configured to provide an interrogation signal configured to induce a response signal from the passive RFID chip to determine entry into the intramedullary canal.

Technical Field

The present application relates to the field of medical devices, and more particularly to intraosseous devices including sensing obturators.

Disclosure of Invention

Embodiments disclosed herein relate to an Intraosseous (IO) access device including a sensing obturator (sensing obturator) configured to automatically detect access to a medullary cavity and modify activation of a drill bit. Intraosseous access devices often require training to ensure proper placement of the access device. The user must apply sufficient distal driving force to penetrate the bone, but not excessive driving force that could cause "back walling" (in this case, the needle penetrates the distal wall of the bone). Further complications may arise when entering bones of different sizes and densities, depending on the age and health of the patient. Furthermore, IO access devices are often used in emergency situations where delays can be fatal and may not always be found by a well-trained user.

An obturator configured for use with an intraosseous access system including the obturator and a sensor disposed proximate a distal end of the obturator, the sensor configured to detect a modal change to determine access to a medullary cavity is disclosed herein.

In some embodiments, the sensor comprises one of a pressure transducer, an oxygen saturation sensor, an electrical impedance sensor, a temperature sensor, or a pH sensor. The sensor is communicatively coupled with control logic disposed in a driver of the intraosseous access system, the control logic configured to modify operation of the driver when the sensor detects a modal change. The obturator also includes a sensor interface disposed at a proximal end of the obturator hub and configured to rotatably and communicatively couple the sensor with the control logic. The obturator includes one of an electrically or optically conductive thermoplastic material configured to communicatively couple the sensor with the sensor interface. The obturator includes a wire extending axially therethrough and configured to communicatively couple the sensor with the sensor interface. The obturator is configured to be disposed within the needle, and wherein the sensor is disposed proximate a distal end of the needle.

In some embodiments, the obturator further comprises a second sensor configured to detect a second modality configured to determine entry into the intramedullary canal. The second sensor includes one of a pressure transducer, an oxygen saturation sensor, an electrical impedance sensor, a temperature sensor, or a pH sensor. The sensor comprises a passive RFID chip, and wherein the control logic is configured to provide an interrogation signal (interrogation signal) configured to sense a response signal from the passive RFID chip to determine entry into the intramedullary canal.

Also disclosed is a method of detecting access to a lumen, comprising: providing an elongate medical device comprising a sensor disposed at a distal end thereof; advancing an elongate medical device through a first tissue; detecting a first modality level; entering the inner cavity; detecting a mode level change from the first mode level to determine access to the lumen; and communicating the modal level change to the control logic.

In some embodiments, the elongate medical device comprises an obturator configured to be disposed within the intraosseous access needle, and wherein the first tissue is cortical bone and the lumen is a medullary cavity. The sensor includes one of a pressure transducer, an oxygen saturation sensor, an electrical impedance sensor, a temperature sensor, or a pH sensor. The control logic is disposed within an intraosseous access driver releasably coupled to the elongate medical device. The control logic is configured to modify operation of the intraosseous access driver when the sensor detects a change in modal level.

In some embodiments, the obturator further comprises a sensor interface disposed at a proximal end thereof and configured to engage the driver and communicatively and rotatably couple the sensor and the control logic. The obturator includes an electrically conductive thermoplastic material configured to communicatively couple the sensor with the sensor interface. The medical device includes a wire extending axially therethrough and configured to communicatively couple the sensor with the sensor interface. In some embodiments, the method further comprises detecting a second modality level change to determine access to the lumen, and communicating the second modality level change to the control logic. The sensor includes a passive RFID chip, and wherein the control logic is configured to provide an interrogation signal configured to induce a response signal from the passive RFID chip to determine entry into the intramedullary canal.

Drawings

A more particular description of the disclosure will be rendered by reference to specific embodiments thereof which are illustrated in the appended drawings. It is appreciated that these drawings depict only typical embodiments of the invention and are therefore not to be considered limiting of its scope. Exemplary embodiments of the invention will be described and explained with additional specificity and detail through the use of the accompanying drawings in which:

fig. 1A illustrates an exploded view of an embodiment of an intraosseous access medical device system in accordance with embodiments disclosed herein, with the access assembly subassembly of the system depicted in somewhat enlarged and elevational view, and the automated driver component depicted in perspective view.

Fig. 1B shows a cross-sectional view of an access assembly according to embodiments disclosed herein.

Fig. 1C illustrates a cross-sectional view of an obturator tip and safety shield (safety shield) in a locked position and removed from the access assembly of fig. 1B, according to embodiments disclosed herein.

Fig. 1D-1F show close-up detailed views of the access assembly of fig. 1B, according to embodiments disclosed herein.

Fig. 2A-2C illustrate various embodiments of sensing an obturator according to embodiments disclosed herein.

Fig. 3A-3B illustrate various embodiments of sensing an obturator according to embodiments disclosed herein.

Fig. 4 illustrates an embodiment of a sensing obturator according to embodiments disclosed herein.

Detailed Description

Before disclosing in greater detail some specific embodiments, it should be understood that the specific embodiments disclosed herein do not limit the scope of the concepts presented herein. It should also be understood that features of particular embodiments disclosed herein can be readily separated from the particular embodiments, and optionally combined with or substituted for features of any of the various other embodiments disclosed herein.

With respect to the terminology used herein, it is also to be understood that these terminology is for the purpose of describing some particular embodiments, and that these terminology is not intended to limit the scope of the concepts provided herein. Ordinals (e.g., first, second, third, etc.) are generally used to distinguish or identify different features or different steps in a set of features or a set of steps, and do not provide sequence or numerical limitations. For example, "first," "second," and "third" features or steps need not necessarily be present in order, and particular embodiments that include such features or steps need not necessarily be limited to the three features or steps. Labels such as "left", "right", "top", "bottom", "front", "back", and the like are used for convenience and do not imply, for example, any particular fixed position, orientation, or direction. Rather, such tags are used to reflect, for example, relative position, orientation, or direction. The singular forms "a", "an" and "the" include plural references unless the context clearly dictates otherwise.

For example, when the needle is used on a patient, reference to a "proximal," "proximal portion," or "proximal portion" of the needle disclosed herein includes the portion of the needle that is intended to be proximate to the clinician. Likewise, for example, when the needle is used on a patient, the "proximal length" of the needle includes the length of the needle that is intended to be near the clinician. For example, when the needle is used on a patient, the "proximal end" of the needle includes the end of the needle that is intended to be proximate to the clinician. The proximal portion, or proximal length of the needle may comprise the proximal end of the needle; however, the proximal portion, or proximal length of the needle need not include the proximal end of the needle. That is, unless the context indicates otherwise, the proximal portion, or proximal length of the needle is not the end portion or end length of the needle.

For example, when the needle is used on a patient, reference to a "distal", "distal portion", or "distal portion" of the needle disclosed herein includes the portion of the needle that is intended to be near or in the patient. Likewise, for example, when the needle is used on a patient, the "distal length" of the needle includes the length of the needle that is intended to be near or in the patient. For example, when the needle is used on a patient, the "distal end" of the needle includes the end of the needle that is intended to be near or in the patient. The distal portion, or distal length of the needle may comprise the distal end of the needle; however, the distal portion, or distal length of the needle need not include the distal end of the needle. That is, unless the context indicates otherwise, the distal portion, or distal length of the needle is not the tip portion or length of the needle.

In the following description, certain terminology is used to describe various aspects of the invention. For example, in some cases, the term "logic" is representative of hardware, firmware, or software configured to perform one or more functions. As hardware, logic may include circuitry with data processing or storage functionality. Examples of such circuitry may include, but are not limited to, a hardware processor (e.g., a microprocessor with one or more processor cores, a digital signal processor, a programmable gate array, a microcontroller, an application specific integrated circuit "ASIC," etc.), a semiconductor memory, or a combination of elements.

Alternatively, logic may be software, such as executable code in the form of an executable application, an Application Programming Interface (API), a subroutine, a function, a procedure, an applet, a servlet, a routine, source code, object code, a shared library/dynamic load library or one or more instructions. The software may be stored in any type of suitable non-transitory or transitory storage medium (e.g., electrical, optical, acoustical or other form of propagated signals, such as carrier waves, infrared signals, or digital signals). Examples of non-transitory storage media may include, but are not limited to, programmable circuits; a semiconductor memory; volatile memory such as volatile memory (e.g., any type of random access memory "RAM"); or a persistent storage device such as non-volatile memory (e.g., read only memory "ROM," power backed RAM, flash memory, phase change memory, etc.), a solid state drive, a hard disk drive, an optical disk drive, or a portable storage device. As firmware, the executable code may be stored in a persistent storage device.

The term "computing device" should be interpreted as an electronic device having data processing capabilities and/or the ability to connect to any type of network, such as a public network (e.g., the internet), a private network (e.g., a wireless data telecommunications network), a Local Area Network (LAN), etc., or a combination of networks. Examples of computing devices may include, but are not limited to, the following: a server, an endpoint device (e.g., a laptop, a smartphone, a tablet, a "wearable" device such as a smartwatch, an enhanced or virtual reality reader, etc., a desktop computer, a netbook computer, a medical device, or any general or special user-controlled electronic device), a mainframe, an internet server, a router, etc.

A "message" generally refers to information conveyed in one or more electrical signals that collectively represent electronically stored data in a specified format. Each message may be in the form of one or more packets, frames, HTTP-based transmissions, or any other sequence of bits having a prescribed format.

The term "computerized" generally means that any corresponding operation is performed by hardware in conjunction with software and/or firmware.

As shown in fig. 1, and to aid in the description of the embodiments described herein, the longitudinal axis extends substantially parallel to the axial length of the needle 204 extending from the driver 101. The lateral axis extends perpendicular to the longitudinal axis, and the transverse axis extends perpendicular to both the longitudinal axis and the lateral axis.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art.

The disclosure relates generally to an Intraosseous (IO) access device system including a sensing obturator configured to detect access to a medullary cavity. Fig. 1A illustrates an exploded view of an exemplary intraosseous access system ("system") 100, with some components shown in elevation and others shown in perspective. In embodiments, the intraosseous access system 100 may be used to penetrate the skin surface tissue layer 70 and underlying hard bone (i.e., cortical bone 80), such as for intraosseous access, for example, to the bone marrow and/or vasculature of a patient via a pathway through the interior of the bone (i.e., medullary cavity 90). As used herein, an "access event" includes accessing the intramedullary canal 90 using the intraosseous access system 100.

In an embodiment, the system 100 includes a drive 101 and an access assembly 109. The driver 101 may be used to rotate the access assembly 109 and "drill" the needle 204 into the patient's bone. In embodiments, the driver 101 may be automatic or manual. As shown, the drive 101 is an automated drive 101. For example, the automatic driver 101 may be a drilling machine that achieves high rotational speeds. In embodiments, the intraosseous access system 100 may further include an obturator assembly 102, a safety shield ("shield") 105, and a needle assembly 202, which may be collectively referred to as an access assembly 109. The needle assembly 202 may include an access needle ("needle") 204 supported by a needle hub 203. In an embodiment, the obturator assembly 102 includes an elongated obturator body ("obturator") 104. As used herein, the obturator 104 comprises an elongate medical device configured to be disposed within the lumen of the needle and prevent bone debris, tissue, etc. from entering the needle lumen. Advantageously, the obturator prevents tissue from obstructing fluid flow through the needle lumen after the needle has been placed into the intramedullary canal 90. As will be appreciated, in some embodiments, the obturator 104 may be replaced with a different elongate medical instrument. As used herein, the term "elongate medical instrument" is a broad term used in its ordinary sense, including, for example, devices such as needles, cannulas, trocars, obturators, stylets, and the like. Accordingly, the obturator assembly 102 may be more generally referred to as an elongate medical instrument assembly. In a similar manner, the obturator 104 may be more generally referred to as an elongate medical device.

In embodiments, the obturator assembly 102 includes a coupling sleeve 103 attached to the obturator 104 in any suitable manner (e.g., one or more adhesives or overmolding). Coupling bushing 103 may be configured to interface with drive 101. The coupling sleeve 103 may alternatively be referred to as an obturator sleeve 103, or more generally, an elongated instrument sleeve 103. In an embodiment, the shield 105 is configured to couple with the obturator 104 to prevent accidental needle stick injury when the obturator is removed after deployment of the needle 204.

In an embodiment, the needle assembly 202 includes a needle 204. However, in some embodiments, the needle 204 may be replaced with a different instrument (e.g., a cannula, tube, or sheath) and/or may be referred to using a different name, such as one or more of the foregoing examples. Accordingly, the needle assembly 202 may be more generally referred to as a cannula assembly or tube assembly. In a similar manner, the needle 204 may be more generally referred to as a cannula. In an embodiment, the needle assembly 202 includes a needle hub 203 attached to a needle 204 in any suitable manner. The needle hub 203 may be configured to couple with the obturator hub 103, and thus may couple with the driver 101. The needle hub 203 may alternatively be referred to as a cannula hub 203. In embodiments, a cover 107 may be provided to cover the needle 204 and at least a distal portion of the obturator 104 prior to use of the access assembly 109. For example, in an embodiment, the proximal end of the cap 107 may be coupled to the obturator sleeve 103.

FIGS. 1B-1F show further details of the entry assembly 109. Fig. 1B shows a cross-sectional view of the access assembly 109 with the needle hub 203 retained by the obturator hub 103. The obturator 104 is disposed within the needle and the shield 105 is in an unlocked position within the access assembly 109. Fig. 1C shows a cross-sectional view of the access assembly 109 with the obturator 104 removed from the needle and the shield in a second, locked mode of operation. Fig. 1D shows an exploded view of the access assembly 109. Fig. 1E shows a close-up cross-sectional view of the distal portion of the needle 204. Fig. 1F shows a close-up cross-sectional view of the distal portion of the obturator 104. In embodiments, the shield 105 may engage the recess 150 to lock the shield 105 relative to the obturator tip 146 as the obturator 104 is withdrawn from the needle lumen 251 to prevent accidental needle stick injury.

As discussed herein, the obturator 104 may be formed of any suitable material to inhibit tissue and/or bone from entering the lumen of the needle 204 during an access event. Exemplary materials may include, but are not limited to, metals, alloys, stainless steel, copper, aluminum, titanium, plastics, polymers, thermoplastics, electrically conductive thermoplastics, combinations thereof, and the like.

With continued reference to fig. 1A, the drive 101 may take any suitable form. The driver 101 may include a handle 110 that may be held in one hand by a user. In an embodiment, the driver 101 further comprises a coupling interface 112, the coupling interface 112 being formed as a socket 113 defining a cavity 114. The coupling interface 112 may be configured to couple with the obturator sleeve 103. In an embodiment, the socket 113 includes sidewalls that substantially define a hexagonal cavity into which the hexagonal protrusion of the obturator bushing 103 may be received. Other suitable connection interfaces are also contemplated.

The driver 101 may include any suitable kind of energy source 115, the energy source 115 being configured to power and power the rotational movement of the coupling interface 112. For example, in some embodiments, the energy source 115 may include one or more batteries that provide electrical energy to the driver 101. In some embodiments, the energy source 115 may include one or more springs (e.g., coil springs, leaf springs, etc.) or other biasing members that may store potential mechanical energy that may be released when the driver 101 is actuated.

The energy source 115 may be coupled with the coupling interface 112 in any suitable manner. For example, in an embodiment, the driver 101 includes an electrical, mechanical, or electro-mechanical coupling 116 to a gear assembly 117. In some embodiments, the coupling 116 may include an electric motor that generates mechanical motion from electrical energy provided by the electrical energy source 115. In other embodiments, the coupling 116 may include a mechanical link to a gear assembly 117. The drive 101 may include any suitable kind of mechanical coupling to couple the gear assembly 117 with the coupling interface 112. In other embodiments, the gear assembly 117 may be omitted.

Further details and embodiments of the intraosseous access system 100 may be found in WO 2018/075694, WO 2018/165334, WO 2018/165339, and US 2018/0116693, each of which is incorporated by reference in its entirety herein.

In embodiments, the system 100 can include a sensing obturator 304 supported by the obturator liner 303 and configured to be coupled to the access assembly 109 and the driver 101, as described herein. An exemplary embodiment of a sensing obturator 304 is shown in fig. 2A-4. The sensing obturator 304 may include one or more sensors, such as sensor 310, disposed proximate the distal tip 146 of the obturator. In an embodiment, the sensor 310 can be disposed on the beveled distal surface 147 of the sensing obturator 304 and can contact tissue of the patient during an access event.

In an embodiment, the sensor 310 may be configured to detect a modal change to determine whether the distal tip 346 of the obturator 304 and the distal tip 246 of the needle 204 have entered the intramedullary canal 90. As described in more detail herein, exemplary modalities may include, but are not limited to, pressure, oxygen saturation, electrical impedance, temperature, pH, combinations thereof, and the like.

In an embodiment, the sensing obturator 304 may include a sensor interface 320 disposed at a proximal end thereof. In an embodiment, as shown in fig. 2A, the sensor 310 and the sensor interface 320 may be communicatively coupled by way of a wire 322 extending axially through the sensing obturator 304. In an embodiment, the wire 322 may be co-extruded with the sensing obturator 304. In embodiments, the wire 322 may extend through a lumen defined by the obturator 304.

In embodiments, as shown in fig. 2B, the obturator 304 may be formed from a conductive material (e.g., an electrically conductive polymer, a fiber optic conductive thermoplastic, combinations thereof, etc.). In this way, input detected by the sensor 310 may be communicated to the sensor interface 320 by the sensing obturator 304 body itself. In an embodiment, the sensing obturator 304 may be formed of an electrically conductive material that also exhibits flexible properties to mitigate needle stick injury. For example, when disposed within the needle lumen 251, the obturator 304 may exhibit sufficient compressive resistance to prevent tissue from entering the needle lumen 251 during an access event. Further, the obturator 304 may exhibit sufficient flexible characteristics to deform and mitigate needle stick injury when force is applied when removed from the needle lumen 251. Further details and embodiments may be found in U.S. patent application No. 17/183,820, filed 24/2/2021, which is incorporated herein by reference in its entirety.

In an embodiment, the sensor interface 320 may be configured to communicatively couple with control logic 380 disposed within the drive 101. In an embodiment, the sensor interface 320 may be rotatably and communicatively coupled with the driver 101 to allow the access assembly 109 and the sensing obturator 304 disposed therein to rotate relative to the driver 101 while maintaining a communicative coupling therebetween. As used herein, control logic 380 may include one or more processors, memory devices, communication logic, etc., configured to receive information from one or more sensors 310, determine whether distal tip 246 of needle 204 has entered intramedullary canal 90, and modify activation of driver 101. In an embodiment, the reusable components (e.g., control logic 380, associated components, etc.) may be disposed within the reusable rig 101. As such, only the sensor 310 is disposed within the disposable sensing obturator 304 and is configured to communicate with the reusable components disposed within the drill 101. Advantageously, the cost and complexity of the disposable component (i.e., the obturator 304) is reduced.

In an embodiment, the sensor 310 may include a pressure transducer configured to detect changes in the compressive force applied to the proximal end of the sensing obturator 304 and provide a signal to the sensing interface 320. Sensing interface 320, in turn, provides signals to control logic 380, and control logic 380 detects and interprets the pressure transducer signals. In the event that the pressure transducer signal indicates a relatively high pressure level, the control logic 380 may determine that the needle tip 246 and the obturator tip 346 are disposed within the relatively hard cortical bone 80. In the event that the pressure transducer signal indicates a decrease in the relative pressure level, the control logic 380 may determine that the needle tip 246 and the obturator tip 346 have passed through the cortical bone 80 and into the relatively soft tissue disposed within the medullary cavity 90. In this way, control logic 380 may automatically stop motor 116 to indicate to the user that the intramedullary canal 90 has been accessed and/or to prevent access to the posterior wall.

In an embodiment, the sensor 310 may include an oxygen saturation sensor configured to detect changes in oxygen saturation of tissue in contact with the distal tip of the sensing obturator 304 and provide a signal to the sensing interface 320. Sensing interface 320, in turn, provides signals to control logic 380, and control logic 380 detects and interprets the oxygen saturation signal. In the event that the signal indicates a relatively low oxygen saturation level, the control logic 380 may determine that the needle tip 246 and the obturator tip 346 are disposed within cortical bone 80. In the event that the signal indicates an increase in relative oxygen saturation level, the control logic 380 may determine that the needle tip 246 and the obturator tip 346 have passed through cortical bone 80 and into relatively oxidized tissue disposed within the medullary cavity 90. In this way, control logic 380 may automatically stop motor 116 to indicate to the user that the intramedullary canal 90 has been accessed and/or to prevent access to the posterior wall.

In an embodiment, the sensor 310 may include an electrical impedance sensor configured to detect changes in electrical impedance of tissue in contact with the distal tip of the sensing obturator 304 and provide corresponding changes in signals to the sensing interface 320. Sensing interface 320, in turn, provides signals to control logic 380 disposed within drilling rig 101, and control logic 380 detects and interprets the electrical impedance signals. In the event that the signal indicates the first electrical impedance, the control logic 380 may determine that the needle tip 246 and the obturator tip 346 are disposed within cortical bone 80. In the event that the signal indicates that the electrical impedance change is to a second electrical impedance level, the control logic 380 may determine that the needle tip 246 and the obturator tip 346 have passed through the cortical bone 80 and into tissue disposed within the intramedullary canal 90. In this way, control logic 380 may automatically stop motor 116 to indicate to the user that the intramedullary canal 90 has been accessed and/or to prevent access to the posterior wall. These and other modalities are also contemplated, including sensors configured to detect temperature changes, pH changes, etc., which may be used to determine when needle tip 251 has entered intramedullary canal 90.

As shown in fig. 2C, the sensing occluder may include two or more sensors 310, e.g., a first sensor 310A and a second sensor 310B, each configured to detect a different modality, such as pressure, oxygen saturation, electrical saturation, temperature, pH, combinations thereof, and the like. Advantageously, the control logic 380 may receive information from two or more sensors 310A, 310B to provide accuracy in when the needle tip 251 has passed through cortical bone 80 and into the medullary cavity 90. The first sensor 310A and the second sensor 310B may be communicatively coupled to the sensor interface 320 via wires 322A and 322B, respectively.

As shown in fig. 3A, in an embodiment, sensor 310 and control logic 380 may be communicatively coupled by way of wireless communication. Exemplary wireless communication modalities may include WiFi, bluetooth, Near Field Communication (NFC), Electromagnetic (EM), Radio Frequency (RF), combinations thereof, and the like. In an embodiment, the control logic 380 may include communication logic configured to provide an interrogation signal 382. Sensor 310 may include a passive RFID chip configured to activate in the presence or absence of a given modality or modality change, as described herein. Such as pressure drop, oxygen saturation increase, relative electrical impedance change, combinations thereof, and the like. As such, when the sensor 310 is activated, the interrogation signal 382 may cause the sensor 310 to provide a response signal 384, which response signal 384 may be detected and interpreted by the control logic 380 to determine that the obturator tip 346, and thus the needle tip 246, has entered the intramedullary canal 90, as described herein.

In embodiments, as shown in fig. 3B, the sensor 310 may be communicatively coupled with the sensor interface 320 via a wired coupling 322 or via the electrically conductive obturator body 304, as described herein. Interface 320 may include a passive RFID chip, and when sensor 310 detects a modal change indicating that it has entered intramedullary canal 90, a signal transmitted to sensor interface 320 may activate the RFID chip, which causes the RFID chip to respond to interrogation signal 382. The interrogation 382 can then cause the RFID to provide a response signal 384, which response signal 384 can be detected and interpreted by the control logic 380, as described herein.

In an embodiment, as shown in fig. 4, the distal portion of the obturator 304 may include a marker 390 configured to be detected by a tracking system. In embodiments, the marker 390 can be a passive magnet configured to be detected by a multi-mode tracking system that can use magnetic modes, electromagnetic modes, ultrasonic modes, combinations thereof, and the like. Details of exemplary tracking systems configured to detect marker 390 may be found in U.S. patent No. 8,388,541, U.S. patent No. 8,781,555, U.S. patent No. 8,849,382, U.S. patent No. 9,445,743, U.S. patent No. 9,456,766, U.S. patent No. 9,492,097, U.S. patent No. 9,521,961, U.S. patent No. 9,554,716, U.S. patent No. 9,636,031, U.S. patent No. 9,649,048, U.S. patent No. 10,159,531, U.S. patent No. 10,172,538, U.S. patent No. 10,413,211, U.S. patent No. 10,449,330, U.S. publication No. 2014/0031674, U.S. publication No. 2014/0188133, U.S. publication No. 2015/0080762, and U.S. publication No. 2018/0116551, each of which is incorporated by reference in its entirety. Advantageously, the obturator 304 with the marker 390 and the needle tip 246 may be detected and tracked using a tracking system to facilitate determining access to the intramedullary canal 90.

As will be appreciated, although embodiments are described herein in terms of sensing an obturator of the intraosseous access system 100, embodiments of sensing an obturator, an elongate medical device, etc., may also be used with various medical device systems (e.g., ultrasound systems, medical device tracking systems, catheter systems, or similar electronic devices) configured to access the interior of a patient. Thus, sensing an obturator or the like may be used to detect a modal change and modify operation of the medical device system or provide an alert to indicate that access to the target zone has been achieved.

Although certain specific embodiments have been disclosed herein, and although specific embodiments have been disclosed in detail, specific embodiments are not intended to limit the scope of the concepts presented herein. Additional adaptations and/or modifications will be apparent to those skilled in the art and are intended to be included in the broader aspects. Thus, departures may be made from the specific embodiments provided herein without departing from the scope of the concepts disclosed herein.