CN101309646A

CN101309646A - Vascular flow sensor with acoustic coupling detector

Info

Publication number: CN101309646A
Application number: CN 200680042719
Authority: CN
Inventors: M·伯切; B·拉朱
Original assignee: Koninklijke Philips Electronics NV
Current assignee: Koninklijke Philips NV
Priority date: 2005-11-17
Filing date: 2006-11-10
Publication date: 2008-11-19

Abstract

A vascular flow sensor assembly includes an ultrasound transducer (1-5) which is attached to the body by an adhesive or mechanical substrate to create acoustic coupling between the ultrasound transducer and the body. The assembly includes a force sensor (150) responsive to the attachment force which produces a signal representative of the force of attachment. The signal is detected by a monitoring instrument and used to alert a user to improper attachment of the vascular sensor. In an illustrated embodiment the signal actuates an indicator located on the sensor assembly.

Description

Vascular flow sensor with acoustic coupling detector

The present invention relates generally to the cardiac resuccitation field, relate in particular to by the ultrasonic multispectral pick off of reining in technology for detection vascular flow and histokinesis.

In first aid and operation process, for problem diagnosis and determine at the suitable treatment of this problem both, the assessment of patient's blood flow state is important.Typically, but by patient's neck being carried out palpation and sensing because the palpation pressure that the variation of patient's carotid artery capacity causes changes the existence that detects patient's heart pulse rate.When ventricle shrank, pressure wave was sent out through patient's peripheral circulation system (peripheral circulation system) in the heart beating process.The carotid pulse waveform is along with at the Ve of paradoxical expansion and rise, and reaches peak value when the pressure wave from heart reaches maximum.When carotid pulse when pulse end pressure descends falls after rise once more.

Do not exist among the patient and can detect the important indication that heart pulse rate is a cardiac arrest.Cardiac arrest is life-threatening medical condition, and patient's heart can not provide support the blood flow of life under this situation.During cardiac arrest; the electrical activity of heart can be upset (ventricular fibrillation); overrun (ventricular tachycardia), stop (asystole), perhaps organize and do not produce blood flow (pulseless electrical activity (pulseless electrical activity)) with normal or slow heart rate.

The form of therapy that will provide for the patient who does not have to detect pulse depends in part on the assessment to patient's heart condition.For example, care-giver (caregiver) can be applied to defibrillation shock the patient of suffer from ventricular fibrillation (VF) or ventricular tachycardia (TV), stopping nonsynchronous or electrical activity fast, and allows to recover the perfusion rhythm and pace of moving things.Particularly, provide external defibrillation by the electrode that is placed on patient's chest surface with the heart that strong electrical shock imposes on the patient.Can detect pulse and suffer from asystole or pulseless electrical activity (PEA) if the patient lacks, can not apply defibrillation, the care-giver can carry out cardio-pulmonary resuscitation (CPR), and this makes some blood flow in patient's body.

Before the therapy that provides for the patient such as defibrillation or CPR, the care-giver must determine at first that the patient is under the cardiac arrest state.Generally speaking, external defibrillation only is suitable for the consciousness that loses, asphyxia, pulseless and VF or VT patient.Medical guidelines points out whether the existence of patient's heart pulse should be determined within 10 seconds.For example american heart association assesses patient's pulse within the kind at 5 to 10 seconds about the protocol requirement health care professional of cardio-pulmonary resuscitation (CPR).It is the indication that outside Chest compressions begins that pulse lacks.Though it is to the eye simple, but to the assessment of pulse is the part of frequent failure in the basic life support assessment sequence, this may since a variety of causes cause, such as lack experience, bad labelling or finding or do not finding mistake aspect the pulse or the like.When providing for the patient or CPR or defibrillation therapy are not provided, whether the existence that can not accurately detect pulse will cause the unfavorable treatment to the patient.

Electrocardiogram (ECG) signal usually is used to determine whether to apply defibrillation shock.But some rhythm and pace of moving things that the deliverer may run into can not only determine by the ECG signal, for example pulseless electrical activity.No matter by the myocardial electrical activity of ECG signal indication, need lack dabbling support evidence to the diagnosis of these rhythm and pace of moving things.

Therefore, in order to make the deliverer determine whether fast to provide treatment for the patient, need develop can be fast and analyze the integrated system of patient's pulse, blood flow and possible ECG signal at an easy rate, so that correctly determine whether there is any TRANSFER BY PULSATING FLOW in patient's tremulous pulse.

Therein the deliverer be unbred and/or inexperienced personnel's situation or system in, as at United States Patent (USP) 6,575, under those deliverers' that the system design of describing among 914 people such as () Rock is used for the situation, this needs are especially urgent.' 914 patent is awarded the assignee identical with the present invention, and comprises in this application by quoting in full.' 914 patent disclosure automated external defibrillator (AED) (after this AED and semi-automatic external defibrillator (SAED) all will be collectively referred to as AED).Can use by the first reaction care-giver who has seldom or do not have medical training, to determine whether defibrillation is imposed on the patient of the consciousness of losing.

Rock AED has defibrillator, is used to transmit and receive the multispectral sensor mat of reining in ultrasonic signal, and whether suitable two be used to gather the sensor mat of ECG signal and be used for receiving and assess multispectral reining in the ECG signal so that treatment such as the CPR that determines defibrillation or another kind of form for patient's (promptly whether having pulse) suitable processor whether for the patient.The multispectral pad of reining in adhesively is fixed in the skin of patient's carotid artery top with the carotid pulse of sensing as the indication of pulsatile blood flow adequacy.Especially, the processor among the Rock AED is analyzed the multispectral signal of reining in can detect pulse to determine whether to exist, and the analysing ECG signal is to determine whether to exist " but shockable rhythm ".Be listed as the 60th row referring to Fig. 7 and the 6th in the patent of ' 914 and be listed as appended explanation in the 52nd row to the 7th.Determining to detect pulse by the processor among the Rock AED is multispectrally to rein in signal and rein in signal static state appropriate threshold for reception multispectral and compare and carry out by what will receive.Based on the result of these two kinds of independent analysis, processor determines whether that suggestion carries out defibrillation.

The application number that on June 29th, 2004 submitted to is 60/583,966 U.S. Patent application (now as international application IB 2005/052127 submit to) has been described the multispectral similarly multispectral pad of reining in of pad of reining in Rock, and it contains a plurality of multiplexed ultrasonic transducers to detect vascular flow and to measure the blood flow characteristic that flows etc. such as perfusion, heart beating, histokinesis, colloid solution or emulsion.The U.S. Patent application of Ti Jiaoing [file number 002603] has been described and has been measured vascular flow to help the similar multispectral pad of reining in of CPR training simultaneously.In order successfully to carry out, importantly be between pad and health, to set up good acoustic path.Particularly, if pad unclamps or is removed from becoming with fixedly contacting of skin surface, successful ultrasonic echo detection can seriously be decayed and be hindered to emission and/or the ultrasound wave that receives.Be to detect this pad contact of not expecting and advise that user's correction contacts with the bad acoustics of health ideally.

According to principle of the present invention, the ultrasonic transducer pick off is attached on the carotid artery or on other blood vessels and be used to the speed of blood motion in the sensing blood vessel.The transducer assembly comprises power or the tensile force transducer that sensing adheres to.Power or tension signal detect by monitor and are used to warn the incorrect of user transducer pick off to adhere to, thus the interruption of warning user transducer acoustic path.

In the accompanying drawing:

Fig. 1 shows the sonac band according to principles of construction of the present invention;

Fig. 2 a-2e shows the different qualities and the structure of the transducer of sonac band;

Fig. 3 a-3b shows the inclination angle of the transducer of sonac band;

Fig. 4 a shows according to the vital sign of principles of construction of the present invention with block diagram form and monitors and therapy system;

Fig. 4 b shows according to the vital signs monitor with pulse detection and CPR guiding of principles of construction of the present invention and the part of therapy system with block diagram form;

Fig. 5 shows the electronic pads of defibrillation system and the applying of pick off of Fig. 4;

Fig. 6 a-6b shows the example of operation in tandem of the transducer of sonac band;

Fig. 7-9 shows blood flow sensing and three the integrated processes of other measurement parameters that are used for the CPR guiding;

Figure 10-14 shows some examples of the ultrasonic transducer band with force transducer and indicator, so that the indication of acoustical coupling abundance between ultrasonic transducer and the patient body to be provided.

At first, shown sonac band 10 according to principles of construction of the present invention with reference to figure 1.Sensor strip 10 comprises the paired transducer 1-5 of delegation.Can use the transducer of any number in given sensor strip, the general number scope is 4 to 6 transducers.Every pair of element of transducer comprises radiated element (T ₁, T ₂Deng) and receiving element (R ₁, R ₂Deng), make it possible to operate with continuous wave (CW) ultrasound mode: the radiated element transmitted wave, and corresponding receiving element receives the echo that returns in response to this emission.In this example, element of transducer is not focused and independent calibration, and be in the overlapping 0.5-4cm scope thereon in the aperture that transmits and receives bundle in the degree of depth of 1.5-2cm intersection is arranged, make the echo that produces by the transmitting transducer element to be received by corresponding receiving transducer element.For pulse wave (PW) ultrasound procedure, the discrete component that only needs sequential transmission to receive then.These transducers are sealed in flexible one-tenth and the flexible matrix 12 that the shape of the skin surface that is applied thereto of band conforms to.Transducer in the illustrated embodiment is the distance of 1-2mm at interval, makes that this row transducer in the matrix can be bent.Matrix 12 keeps the aligning of transducers and electric insulation with health is provided, and can be made by for example silicones or RTV rubber.As described below, extended from matrix 12 is the cable 18 that has with the coupled electric lead of element of transducer.Cable 18 stops at the adapter place that is connected with the monitor that uses its operation sensor band 10.Matrix of transducers is covered by the substrate 14 that sensor strip is adhered to health.Sensor strip can be attached to health by elastic band, necklace or Velcro band.In an example shown, substrate is that adhesive tape or other have the natural or polymeric material of binding agent on skin contact surface.The skin contact surface of matrix of transducers is covered by the material that good acoustical coupling is provided between matrix 12 and health.When binding agent 16 has ideal acoustic characteristic, during such as the adhesive electrode gel rubber material, this acoustical material can be and binding agent 16 identical materials.Replacedly, acoustical material comprises hydrogel material or adhesive patch (adhesive patch) or other solid materials.

Fig. 2 a is the side view of the example of transducer 1-5.As can be seen, the top-emission surface 6 of element of transducer is circular in this example.Element of transducer is bent to the radius of curvature with 25mm in this example.The circle of emitting surface makes the ultrasound wave that sends disperse, and thus bigger body region is carried out insonify, has increased target blood by the probability of insonify, and has prevented any dead band between the element of transducer.As making transducer be shaped as circular substituting, can on flat emission surface, use lens to make the ultrasound wave that sends disperse.

Fig. 2 b has shown and being electrically connected of transducer 1-5.Element of transducer is coated with electrode 22 on the emitting surface of skin, it is grounded for the purpose of safety.Can form each electrode 22 on each element, this element is electrically connected with adapter 20 by cable 18 then.Perhaps, electrode 22 can be continuous paillon foil or other the flexible conductor material that covers element of transducer group or all element of transducers.Component side has signal electrode 24 on the side away from skin surface.The lead of cable 18 is connected with these electrodes 24, emission (driving) signal to be provided and to return the echo-signal of reception from element of transducer.Fig. 2 c is the plane graph of element of transducer, has shown a kind of example that signal conductor connects.In this example, all radiated element T ₁-T ₅Be operated together and be electrically connected with a lead 18a of cable.Receiving element R ₁-R ₅Independent operation also is connected with each lead 18b of cable.This structure makes all radiated elements be driven by same transmitted wave simultaneously, and the echo that receives is at receiving element R ₁-R ₅Independent receiving position be received.Fig. 2 d is the another kind of example that signal lead connects, wherein all radiated element T ₁-T ₅While is by the driving that transmits on the lead 18a, and all receiving element R ₁-R ₅Electric coupling is operated together and one in front and one in back.By all receiving element R ₁-R ₅All echo-signals that receive in their positions separately are combined and are transmitted on the same lead 18b.Fig. 2 e is a kind of example of configuration, but wherein each radiated element and each receiving element independent operation.Each radiated element T ₁-T ₅With the signal conductor 18a coupling of himself, each receiving element R ₁-R ₅With the signal conductor 18b coupling of himself.This example is preferred when the battery-powered instrumentation of sensor strip because at any time only radiated element be driven and only need a receive path, thereby preserved the electric power of battery.

Fig. 3 a has shown how the right element of transducer of transducer is positioned in the matrix 12 so that improve the example that signal receives.The multispectral ultrasonic signal of reining in is that angle is relevant.When the direction of ultrasonic beam and the angle between the blood flow direction were 90 °, the multispectral signal of reining in was in minima, and when blood flow direction directly towards or the strongest during away from transducer.Because approximate parallel with skin surface near blood vessel such as the carotid artery 32 (its mean depth in health is 7mm) of skin surface 30, the orientation of emission and skin surface 30 vertical hyperacoustic transducers will have and be approximated to 90 ° angle of incidence with flow direction.For reduce this quadrature towards probability, element of transducer tilts with low angle (shallow angle), shown in Fig. 3 a.By radiated element T is tilted, between ripple direct of travel 36 and blood flow direction 34, form obtuse angle L as can be seen, shown in Fig. 3 b.In Fig. 3 b, element of transducer T and R are offset each other, make them to keep the orientation of expectation by the matrix of the matrix 12 of less thickness T h rather than the big thickness shown in Fig. 3 a, have reduced the thickness of sensor strip thus.

In the example of Fig. 3 a and 3b, the element inclination angle makes the length dimension lateral tilt of beam direction with respect to this row transducer, thereby makes transducer observe a side of sensor strip effectively.This runs well when sensor strip 10 passes such as the blood vessel of carotid artery 32 location, as shown in Fig. 4 b.Sensor strip 10 is passed (being orthogonal to) blood vessel to be orientated layman user as and provides and use the ultrasonic main chance that comes the cross-section blood vessel that can not observe.Transmitting transducer element aperture (aperture) thus towards or away from the flow direction in the carotid artery 32.When sensor strip was located shown in Fig. 4 b, the transducer by being positioned at carotid artery 32 tops was to T ₃-R ₃Can detect the strongest multispectral signal of reining in, other transducers are not to above blood vessel simultaneously.In the Rock system shown in Fig. 4 of ' 914 patent, the length parallel alignment of the general and blood vessel of this row transducer.An advantage of Fang Zhiing is to receive this signal by a plurality of element of transducers like this, thereby has increased signal to noise ratio, and this is because a plurality of transducers are positioned at the blood vessel top.Shortcoming is, if the position of blood vessel has been judged on user error ground and with the transducer positioned parallel but not above the blood vessel of hiding, then seldom or do not have signal to be received.For layman user, the example of Fig. 3 a, 3b and 4b will improve probability of successful.

Fig. 4 a is the block chart according to the vital signs monitor and the therapy system of principles of construction of the present invention.The various functions and the parts of central authorities' processing and control element (PCE) 160 control system are also handled vital sign data.Central authorities' processing and control element (PCE) is carried out processing and the control algolithm that is fit to by the system monitoring and the vital sign for the treatment of.Central authorities' processing and control element (PCE) can connect or the bluetooth connection is connected with other equipment by wired or WLAN.Other electronic units of central authorities' processing and control element (PCE) 160 and this system are by power subsystem 162 power supplies, and power subsystem can comprise battery, AC line (a.c.line), power supply and other electrical managements and control function.The clinician is by user interface 164 and this system interaction effect, and described user interface can comprise following element, such as display, audio frequency input and output, keypad and printer.Monitoring patient's ECG and by ECG with can be that the processing subsystem 166 of impedance, ventilation and arrhythmia analysis is handled it with these function executing.This system comprises and is used for element 168 that other vital signs are measured and handled that these vital signs are such as SPO ₂, ETCO ₂, IBP, NIBP etc.This system comprises that treatment function 170, high-pressure system and the patient such as pace-making and defibrillation isolates.The performance of CPR is measured subsystem 180 by CPR and is measured, and this will more fully describe below.

Fig. 4 b shows with block diagram form and uses sensor strip 10 to help the vital sign monitoring that guiding CPR bestow and the part of therapy system in accordance with the principles of the present invention.Sensor strip 10 among Fig. 4 b is the radiated element T with common connection by wiring ₁-T ₅With receiving element R with independent output ₁-R ₅(shown in Fig. 2 c).Sensor strip 10 is connected to one of defibrillator 110, treatment function 170, and it comprises the following elements that shows in the accompanying drawings.Emission generator 40 generates the transmitted waveform of the radiated element that is used for sensor strip.Transmitted waveform demonstrates the rated frequency in the 3-7MHz scope, and has the rated frequency of 5MHz in this example, and this is that typical Vascular Ultrasonography is used.Transmitted waveform is exaggerated device 42 amplifications and is applied to the transmitting transducer elements T ₁-T ₅In the time will being coupled to its output by the signal that a receiving transducer element receives, receiving transducer element R ₁-R ₅With multiplexer 44 couplings.Selected received signal is by low-noise amplifier 46 amplifications and by 48 filtering of r.f. band filter.Received signal is reduced to base band by

frequency mixer

52 and 54 mixing, and described frequency mixer drives by the reference signal quadrature (in quadrature) with reference to transmitted waveform.The orthogonal signalling of demodulation are labeled as I and Q in the drawings, and comprise multispectral quadrature detected components of reining in blood flow vector.I and Q signal are by

low pass filter

56 and 58 filtering, by interference filter (thump filter) or

wall filter

62 and 64 filtering, interference filter or wall filter are got rid of velocity component outside DC component (stationary) and the component from blood vessel wall then.Filtered quadrature component is reined in

wave filter

66 and 68 filtering and is applied to two inputs reining in signal digitalized double modulus transducer 70 with multispectral by multispectral.The multispectral signal of reining in converts the multispectral wave spectrum of reining in to by fast Fourier transform (FFT) processor 72.It is well known in the art being used for multispectral FFT processing of reining in signal, and it has different implementations, for example Oppenheim﹠amp; Schafer (Prentice Hall, 1989) describes in " Discrete-Time Signal Processing ".In typical implementation, the multispectral continuous overlapping sequence of reining in sample is loaded in the slip sample window registration form that is filled to zero (paddedzero), and it is handled to center on that 0 (DC) centers and to produce doppler frequency signal f in the wave spectrogram by multispectral multispectral the reining in of reining in sample frequency deckle circle in definite ± 1/2 of transmission interval rate (interval rate) _D, this signal is generally in kilohertz range.Do not handle if carry out FFT, the multispectral amplitude of reining in signal is detected to produce the multispectral output signal of reining in of power by detector 74.

The multispectral signal (power Doppler signal) of reining in of power is coupled with the multispectral analysis module 100 of reining in signal of can analyzing in every way that is included in the CPR measurement subsystem 180.In an example, multiplexer 44 is selected signal every 10 milliseconds from different receiving transducer elements, as the application number submitted in our 29 days June in 2004 is 60/583,966 and the U.S. Patent application submitted to as international application IB2005/052127 now as described in, the content of this application comprises in this application by reference.This is inquired after order and shows in Fig. 6 a.Multiplexer is at first selected from response to from elements T ₁The element R that transmits ₁Signal.After this sampling period for the first time, multiplexer is selected from response to from elements T ₂The element R that transmits ₂Signal.Multiplexer is by selecting from elements T ₃, T ₄And T ₅Signal and continue, and repeat sequence shown in the moment t6 in Fig. 6 a then.In this time period, analysis module 100 is searched the multispectral signal of reining in of the high power that exceeds given threshold value such as predetermined noise level.The multispectral signal of reining in of effective power is identified as one that exceeds given snr threshold.In this example, defibrillation system is carried out CPR on one's body the patient simultaneously to the multispectral signal sampling of reining in of power.When rescuer compresses patient chest, blood flow volume is forced to come out and pressure wave will send by vascular system from heart, and this causes the TRANSFER BY PULSATING FLOW of blood in the carotid artery usually.The appearing to inquire after in the sequence process of this blood flow is detected, and when analyzed module is identified as that effective power is multispectral reins in signal, and multiplexer stops to inquire after and will effectively multispectrally to rein in signal continuous coupled to system.In this example, the effectively multispectral signal of reining in is by the receiving transducer element R that is close to the carotid artery top ₃Detect.As by in Fig. 6 b, starting from t constantly ₁₂The T of place ₃/ R ₃Cycle is indicated, from the signal of receiving transducer R3 then continuously by systematic sampling.The doppler frequency f of useful signal _DExpression flow velocity and peak signal are represented the maximum instantaneous flow rate that caused by VPR.

Can demonstrate the variation of arbitrary number by the sample sequence of multiplexer 44 realizations.For example, if analysis module senses from the multispectral decline of reining in signal intensity of the power of selected receiving element, multiplexer can be controlled, and with to sampling from the signal of the receiving element on the either side of selected element, thereby makes great efforts to find at adjacent reception element place stronger signal.Shown in Fig. 6 b, at moment t15, to from element of transducer R ₂Sampling period of signal sampling, then in next sampling period process to from element R ₄Signal sampling.If do not have all to find the stronger multispectral signal of reining in that multiplexer will return at the either side of these transducer positions, thereby to from element of transducer R ₃Signal sample, shown in moment t17.If in giving locking equipment, can utilize a plurality of treatment channel, can monitor a plurality of element of transducers simultaneously and the strongest multispectral signal of reining in is used for analysis.

Except detection speed, the multispectral cycle of reining in waveform is come sensing by detecting the peak velocity that reproduces when the Chest compressions several times.The periodicity of this recall factor shows the speed of Chest compressions in the CPR process.As the result of this analysis, the deliverer is trained so that suitably bestow CPR by audio frequency and/or video ground.For example, typical C PR agreement must ask the deliverer to bestow 15 extruding with the speed of 100 extruding of per minute.If the recall factor by the analysis module sensing is lower than desired rate, analysis module imposes on audio frequency synthesizer 102 or display screen with signal, to send oral " pushing sooner " instruction.The audio frequency synthesizer will produce audio signal, and it is exaggerated device 104 amplifications and imposes on the speaker 106 that audio frequency ground order deliverer " pushes " sooner.Analysis module also will be in extrusion process the minimum blood flow velocity of the expectation that reaches of peak velocity and each Chest compressions of blood flow compare.For example, typical peak velocity levels is about 1m/sec.The reference value of being used by analysis module can be less than this nominal rated speed, and if do not reach required reference velocity, analysis module can send the order of " more effectively pushing " by the speaker of audio frequency synthesizer and user interface 164.Visual display (such as the LED of delegation) but or the pictorial display vision the intensity of the blood flow signal under absolute or the relative conditon is shown and/or detects the position of the row of strong blood flow signal in the transducer.

Except detection peak speed and multispectral reining in wave period, analysis module can produce other measurements to the adequacy (sufficiency) of the blood flow that is caused by the CPR extruding, such as average speed, volume flow rate, pulsation index and mobile index, as the U.S. Patent application of submitting in 13rd in JIUYUE in 2004 at us 60/609, the United States Patent (USP) 60/613 of 676 and 2004 on JIUYUE submission in 28,, as described in 996, their content all comprises in this application by reference.

The system of Fig. 4 a and 4b has and can rein in other pick offs that blood flow transducer is used in combination with multispectral, to judge the effectiveness of CPR.Shown dummy block 80 among Fig. 4 b, it is placed on patient's chest and relies on it to apply the CPR extruding.Dummy block comprises as U.S. Pat 6,351, and the force transducer shown in 671 is perhaps preferred as U.S. Pat 6,306, the accelerometer described in 107.Produce signal when extruding being applied on the pad 80, this signal is amplified by amplifier 82 and is detected by detector 84 at every turn.The Chest compressions signal that is detected is used in combination then with from multispectral information of reining in the blood flow signal derivation.For example, each generation of compression signal should be in time with effectively multispectral to rein in blood flow signal relevant by the sensor strip sensing.Therefore, compression signal can be used to rein in signal analysis and carry out time gated (time gate) multispectral, and is perhaps related and guarantee periodicity by the extruding rate of analysis module sensing.When existing, the ECG signal also can be used to time gated.The integrated signal for faster of the amplitude of power or secondary is the extruding force of the extruding that applies or measuring of the extruding degree of depth, and can be used to the order whether decision sends " more effectively pushing " or " pushing " lightlyer.For example, though low flow velocity or volume flow rate can represent that the deliverer should more effectively push, compression signal can show that the deliverer has carried out as far as possible firmly or dark as far as possible pushing safely the patient on one's body.Consider that this pushes information, analysis module can stop the order of " more effectively pushing " then.

The system of Fig. 4 b also has

chest electrode

92,94, and they are adhered to patient's chest and are used for sensing patient's ECG signal and thoracic biological impedance, and carries defibrillation shock.ECG and impedance signal are handled by ECG, impedance module 96, and are coupled to analysis module, and they are used to auxiliary CPR training in analysis module.For example, as explaining in the patent of ' 671, when chest is extruded and once more impedance signal can demonstrate variation when extruding force is released.The moment that these impedance variation take place can be used to multispectral rein in signal analysis related or to multispectral rein in signal analysis carry out time gated with confirm or improvement to the appropriateness of the detection and the CPR training order of these signals.

Fig. 5 shows patient's profile and has shown defibrillator 110, and wherein pick off 10 passes carotid artery and correctly is placed on the neck 10, and dummy block 80 is placed on chest central authorities, and

electrode

92,94 is placed on the convention position that is used for defibrillation.It will be apparent to those skilled in the art that analysis module can with from the signal correction of all these pick offs connection or with its combination to produce the training order that is used for CPR better.Sensor strip 10 and top defibrillation electrode 92 can also be combined in the electrode that is placed on patient's cervical region, as described in U.S. Patent Publication 2003/0199929.

Fig. 7 shows the method for using defibrillation system (such as the multispectral system of reining in blood flow transducer 10 and CPR dummy block 80 that has that shows) in Fig. 4.In this example, defibrillator will start from the CPR training mode, shown in step 120.When not advising shocking by electricity or after having bestowed electric shock, defibrillator can be preset to and begin CPR automatically at interval, and perhaps defibrillator can enter the CPR pattern.Analytical technology is known, and defibrillator can change pattern by analytical technology automatically after the analysing ECG signal.For example, the probability correlation of the amplitude of ECG signal and successful defibrillation connection is known.And, shown that the ECG complex wave of two-forty is relevant with the defibrillation success, and advised carrying out the analysis of the Fourier transform of ECG data, and observation is transformed the median frequency of back data to make this decision.Short arc and low rate ECG signal are used as the indication of beginning CPR thus, and make system switch to the CPR training mode.In this example, defibrillator is equipped with CPR metronome (metronome), and it can be with the required CPR speed single-tone or the beeping sound that reproduce of 100Hz for example.Step 122 guiding deliverer, make the reproduction of his or her extruding and this tone synchronous thus.When applying when extruding, will receive the degree of depth or force signal at step 124 analysis module from dummy block, and in fact simultaneously at effective multispectral the rein in blood flow signal of step 126 reception from the sensor strip above the carotid artery 10.Analyze these signals to determine blood flow and adequacy thereof in step 128 by analysis module.If the information indication needs training directive, then send audio frequency and/or video training directive or other feedbacks in step 130.System turns back to then and waits for that Chest compressions next time locates the signal of

step

124 and 126 constantly.

Fig. 8 shown have with Fig. 7 in the method for those same steps as, but compression signal is replaced by impedance change signal in step 125.This information with multispectral rein in blood flow signal be used in combination determine whether sending training directive with the guiding CPR.

Fig. 9 has made up the pick off of Fig. 7 and 8, and uses in guiding CPR process and make decision from the information of all three provenances.This method is used impedance change signal in step 125, use compression signal in step 124, and uses the multispectral blood flow signal of reining in step 126.As shown in the entering on of Fig. 4, can use and multispectrally rein in blood flow signal and do not use these other signals to come guide effective CPR.

As previously mentioned, sensor strip adhesively or mechanically is attached to above the carotid artery of patient's cervical region in the example in front.Importantly, between element of transducer and skin surface, set up good acoustical coupling so that transmit and receive ultrasonic signal reliably.Generally by using hydrophile adhesive mass, the acoustical coupling gel above the skin surface relative with element of transducer, perhaps both combinations provide for this.If but sensor strip unclamps, acoustic path may be interrupted, and this can pass through patient moving, hinders binding agent bonding or hinder the perspire of the exsiccant skin surface of binding agent or make dirty and take place.When this happens, expectation warning deliverer or this situation of care-giver make problem obtain proofreading and correct.According to principle of the present invention, Figure 10 shows the example by force transducer 10 monitorings of adhering to of sensor strip wherein.In this example, force transducer 150 is positioned at substrate 14 (being adhesive tape in this example) and contains between the matrix 12 of ultrasonic transducer T and R.When fixedly remaining on its position, matrix 12 is applied to power on the skin surface 30, shallow draft skin.As shown in the figure.This downward pressure is applied by the tension force of the adhesive tape 14 that adheres to.Related power illustrates separately in Figure 11.The power F that force sensor measuring is applied by the tension force T of adhesive tape 14 ₁Force transducer has weight W _FSAnd ultrasonic transducer 1 has weight W _UT Ultrasonic transducer 1 is subjected to power F on the surface thereon ₁+ W _FS Effect.Skin surface 30 is subjected to power F ₁+ W _FS+ W _UTEffect.In typical implementation, the force rate force transducer 150 that applies by adhesive tape 14 and the weight W of ultrasonic transducer 1 _FSAnd W _UTMuch bigger.Therefore the force measurement value F1 that produces by force transducer 150 weight that is similar to attachment mechanism and device well is applied to the power on the skin.

Force transducer can comprise the known sensor technologies of any amount.For example, force transducer can comprise conductive rubber, and electrode embeds or is positioned on each side of rubber.Force transducer can be that piezoelectric transducer or its can be deformeters.Signal from deformeter can be by being included in the line conduction in the cable 18, and these signals are coupled to defibrillator by cable 18.Processor monitoring force signal in the defibrillator if it drops under the acceptable level, then sends audio frequency or visual alarm.Alarm can be sent from AED or sensor strip monitor attached to it.In example shown in Figure 14, alarm is sent from sensor strip 10.In this example, transducer and force transducer are positioned to be attached to sensor strip are adhered in the shell 250 on the adhesive patch 230 on the health.Cable 18 is connected sensor strip with AED or monitor.Being positioned at shell 250 lip-deep is the LED 252 of three kinds of different colours, and LED 252 is luminous when sensor strip is attached to health.If force sensor senses is fixedly attached on the health to sensor strip, green LED is luminous afterwards at word " GOOD ".If force transducer does not sense adhesive force (attachment force), red " REDO " LED is luminous.If force sensor senses can not resolve to the conflicting power of whether fixedly adhering to for certain, yellow " CHECK " LED is luminous.Index signal can be derived by the force signal of force transducer with by the ultrasonic signal that transducer produces: force signal determines whether pick off is good with Body contact, and lacks acceptable ultrasonic signal indication and no longer exist and contact for good with health.If the signal by force transducer and ultrasonic transducer generating contradicts, for example yellow led can be luminous.As substituting of LED, can use alphanumeric LCD display device to send quantitative information to user if desired, such as the size of the adhesive force of institute's sensing.As the substituting or in addition, also can adopt audio indicator of visual indicator, such as the piezoelectric speaker of describing in the U.S. Patent application of submitting on June 24th, 2,005 60/693,645.

Figure 12 shows the another kind of example of the sound contact of using force sensor measuring sensor strip 10.As shown in the figure, force transducer is above the element of transducer or on the adhesive tape 14 of either side or deformeter 152 wherein in this example.When it links to each other with patient's skin and monitors when keeping required tension level when guaranteeing to use sensor strip, will indicate the tension force of adhesive tape from the signal of deformeter.

Figure 13 shows another kind of example, and wherein, force transducer 150 is included in the matrix 12 adjacent with R with element of transducer T.The advantage of this implementation is, near the contact force the point that direct measurement transducer contacts with skin surface.

Should be understood that, also can in structure equipment of the present invention, use sensors measure pressure rather than power.

The another kind of method of the acoustic path of monitoring transducer is by the near field reflections of signal processing measurement from air pocket in the acoustic path (air pocket).These air pockets will show that their near field echoes and in the ultrasonic signal own are the same strong.But this only can carry out in receiving transducer.

Claims

1, a kind of health that is attached to is used for detecting the motion of described health or the ultrasound transducer assembly of material, comprising:

Ultrasonic transducer;

Attaching substrates, it is connected with described ultrasonic transducer, and the described ultrasonic transducer that is used for contacting with acoustic path is attached to described health; With

Force transducer, it is orientated reception as and also produces the signal of representing described adhesive force by the adhesive force that described attaching substrates applies.

2, ultrasound transducer assembly as claimed in claim 1, wherein, described attaching substrates also comprises adhesive base plate, it is used for by bonding mode described ultrasonic transducer being adhered to for contacting with described health acoustics.

3, ultrasound transducer assembly as claimed in claim 1, wherein, described attaching substrates also comprises the mechanical attachment substrate, it is used for mechanically described ultrasonic transducer being adhered to for contacting with described health acoustics.

4, ultrasound transducer assembly as claimed in claim 3, wherein, described mechanical attachment substrate also comprises elastic band.

5, ultrasound transducer assembly as claimed in claim 3, wherein, described mechanical attachment substrate also comprises the Velcro band.

6, ultrasound transducer assembly as claimed in claim 3, wherein, described mechanical attachment substrate also comprises necklace.

7, ultrasound transducer assembly as claimed in claim 1, wherein, described force transducer also comprises piezoelectric transducer.

8, ultrasound transducer assembly as claimed in claim 1, wherein, described force transducer also comprises deformeter.

9, ultrasound transducer assembly as claimed in claim 1 also comprises:

Monitor, it is coupled the signal that is produced by described force transducer to receive, and is used to produce caution signals when described force signal is in the level of not expecting.

10, ultrasound transducer assembly as claimed in claim 9, wherein, described ultrasonic transducer is used for producing signal in response to blood flow; And

Wherein, described monitor also is used to handle the signal by described ultrasonic transducer generating.

11, ultrasound transducer assembly as claimed in claim 1, wherein, when described assembly was attached to health, described force transducer was positioned between described attaching substrates and the described health.

12, ultrasound transducer assembly as claimed in claim 1, wherein, described force transducer is positioned on the described attaching substrates.

13, ultrasound transducer assembly as claimed in claim 12, wherein, when described assembly was attached to health, described force transducer was used for the tension force of the described attaching substrates of sensing.

14, ultrasound transducer assembly as claimed in claim 1, wherein, described force transducer is positioned in the described attaching substrates.

15, ultrasound transducer assembly as claimed in claim 14, wherein, when described assembly was attached to health, described force transducer was used for the tension force of the described attaching substrates of sensing.

16, ultrasound transducer assembly as claimed in claim 1, wherein, when described assembly was attached to health, described force transducer was positioned near the described health.

17, ultrasound transducer assembly as claimed in claim 1, wherein, when described assembly was attached to health, described force transducer was positioned near the acoustic path of described ultrasonic transducer.

18, a kind of health that is attached to is used for detecting the motion of described health or the ultrasound transducer assembly of material, comprising:

Ultrasonic transducer;

Attaching substrates, it is connected with described ultrasonic transducer, and the described ultrasonic transducer that is used for contacting with acoustic path is attached to described health;

Force transducer, it is orientated reception as and also produces the signal of representing described adhesive force by the adhesive force that described attaching substrates applies; With

Indicator, it is used to warn the attachment state of the described transducer assemblies of user in response to the signal of the described adhesive force of expression.

19, ultrasound transducer assembly as claimed in claim 18, wherein, described indicator also comprises at least one in visual indicator or the audio indicator.

20, ultrasound transducer assembly as claimed in claim 19, wherein, when described transducer assemblies was attached to health, described indicator was positioned on the described ultrasound transducer assembly.

21, ultrasound transducer assembly as claimed in claim 20, wherein, described indicator comprises at least one LED indicator.

22, ultrasound transducer assembly as claimed in claim 18, wherein, described ultrasonic transducer generating ultrasonic signal when being attached to described health; With

Wherein, described indicator is also in response to signal and the described ultrasonic signal of representing described adhesive force.