JP2001522707A - Apparatus for assisted cardiopulmonary resuscitation - Google Patents

Abstract

(57) [Summary] A system is provided for assisted anxiety resuscitation that can reduce the rescuer's effort and maintain the cardiopulmonary resuscitation accurately for a long time. A system for assisted cardiopulmonary resuscitation in which a rescuer applies his or her weight to the patient's chest, comprising: a contact surface (4) for contacting the patient's chest; 4) a support member (3) to be mounted on, and a displacer (9) for moving the support member (3) with respect to the contact surface (4).

Description

DETAILED DESCRIPTION OF THE INVENTION

The present invention relates to a method and apparatus for assisted cardiopulmonary resuscitation.

[0002] During cardiac arrest, the heart is in a state of uncoordinated cardiac contraction (fibrous twitch) or in a state of complete inactivity, thereby causing blood flow to living organs, including the brain and the heart itself. Is hindered. More than 300,000 people each year in the United States alone,
Dies due to cardiac arrest. In order to prevent damage until the patient's heart rate is restored, sustaining blood and oxygen flow to the heart and brain is a matter of cardiopulmonary resuscitation (CP).
R; cardiopulmonary resuscitation).

The simplest form of CPR, manual CPR, performs two breaths, followed by 15 chest compressions of 3.75-5 cm deep at 100 paces per minute. With a cycle. Manual CPR usually utilizes almost all of the rescuer's muscle tissue at the same time, and the rescuer requires significant physical effort. Because CPR may be required for more than 20 minutes, the rescuer is often exhausted, forced to interrupt the CPR and / or inaccurately before the patient is resuscitated or a specialized rescuer arrives. (Baubin and others). Therefore, rescuer fatigue is a factor that greatly limits the effectiveness of manual CPR.

[0004] Manual CPR relies on passive chest expansion following each compression, while actively providing compression. On the other hand, active compression and expansion (ACD)
The sion-decompression CPR provides both aggressive compression and decompression by pushing the chest inward and forcing it out.

Several devices for providing ACD-CPR have been described so far. US Patent 5,
636,789, 5,295,481, 5,645,522 are vacuum cups (v
acuum cup). The chest is compressed by pressing down on the vacuum cup, and the chest is lifted by lifting the cup to provide active extension. However, ACD-CPR devices do not solve the problem of rescuer fatigue. In fact, performing ACD-CPR requires more than 25% more work than manual CPR (Shultz et al. Resuscitation, 29: 23-31 (1995)).

[0006] US Pat. No. 4,928,674 discloses a compressed-air vest that is made to fit around a patient's chest. The device is automatically expanded and contracted by a computer controlled compressor exerting pressure on the body from all directions. Although such automatic CPR devices solve the problem of rescuer fatigue, their efficiency has not been proven (Halperin et al.). In addition to requiring a great deal of expertise in their operation, fully automatic devices, such as those disclosed in U.S. Patent 4,928,674, are extremely heavy, bulky, and difficult to bring to the patient. is there. Also, the setup time of such a device may not be acceptable. References Baubin et al., Resuscitation, 33; 135-139 (1996) Shultz et al., Resuscitation, 29; 23-31 (1995) Halperin et al., N. Engl. J. Med., 329; 762-768 (1993)

It is an object of some preferred embodiments of the present invention to reduce rescuer fatigue while using CPR. The CPR used is the American Heart Association (AH
A: It is preferable to conform to the American Heart Association (CPR) guidelines. Preferably, compliance with these guidelines is aided by a device according to a preferred embodiment of the present invention.

[0008] One aspect of some preferred embodiments of the present invention is that the rescuer is "smart weighted (
smart weight), whereby the rescuer performs a significant portion of the CPR task by moving the weight relative to or from the patient. A significant portion of the energy is provided by mechanized devices, which, alternatively or additionally, also assists in the transfer of the rescuer's weight. The focus of the rescuer's activity is shifted from performing mechanical tasks to controlling CPR operations, and one result of such a shift is that the rescuer performs high quality CPR. Alternatively or additionally, another consequence of such a transition is that the rescuer requires less work, thereby reducing the rescuer's CPR. Labor will be less, might be able to continue for a longer time its work.

One aspect of some preferred embodiments of the present invention relates to human interaction in the CPR process. In a preferred embodiment of the present invention, humans are referred to as "smart weights" as part of a complete CPR, including mechanical devices and rescuers.
ight) ". In a preferred embodiment of the present invention, the CPR process is controlled by the transfer of the rescuer's weight. Thus, as an integral part of the CPR work, the rescuer The operation can be modified such that the CPR performed is as desired by the rescuer to accomplish, alternatively or additionally, the rescuer may, for example, have a patient appearance and / or other response from the patient. , The CPR performed can be more precisely tailored to what is required of the patient.

One aspect of some preferred embodiments of the present invention relates to the expected setup time of a CPR device. In some embodiments of the present invention, the CPR device is simply placed at an appropriate location on the patient's chest. Therefore, this setup time is almost equal to pure manual CPR.

One aspect of some preferred embodiments of the present invention is that certain rescuers / patients /
Relating to the adjustment of CPR equipment and / or methods to the context of CPR. In a preferred embodiment of the invention, the adjustment is accomplished by using the same CPR device in a slightly different manner, for example, by changing the timing and / or center of gravity of the rescuer. Alternatively or additionally, adjustment of the CPR device
This is accomplished by changing the vertical dimensions of the CPR device, for example, by changing the settings therein or by providing telescopic supports or spacers thereon. Alternatively or additionally, the adjustment is accomplished by altering the operating parameters of the device, such as the waveform, frequency, and / or response to a sensed physiological change.

One aspect of some preferred embodiments of the present invention relates to assisting a rescuer in placing / moving his or her weight relative to the patient's chest. In a preferred embodiment of the present invention, the aid makes the impact applied to the chest more desirable, resulting in more effective CPR. In a preferred embodiment of the invention, the assisting comprises increasing the rescuer's weight from the patient. Alternatively or additionally, the assistance includes lowering the rescuer's weight onto the patient's chest.

One aspect of some preferred embodiments of the present invention relates to a limited number of uses of the mounting member. In a preferred embodiment of the present invention, the CPR device is applied to the patient's chest using an attachment that can be used only once or only a few times. Alternatively or additionally, the mounting member is fixed to the patient's torso alone, and then the CPR device is coupled to the mounting member. Once a CPR is completed, the CPR device is preferably removed from the mounting member that remains attached to the chest. In one example, the mounting member includes a suction cup or an adhesive pad. Alternatively or additionally, the attachment member preferably includes a strap surrounding the patient's torso. In a preferred embodiment of the invention, the mounting member is a chest displacement sensor.
sensors) and physiological sensors such as ECG electrodes. Alternatively or additionally, the mounting member includes an active member such as a defibrillation electrode and / or an external pacing electrode.

Thus, provided by a preferred embodiment of the present invention is a system for assisted cardiopulmonary resuscitation in which a rescuer only has to put his weight on the patient's chest, comprising:
A) a contact surface for contacting the patient's chest, (b) a support member for applying the rescuer's weight to said contact surface, and (c) a selectable frequency, speed and selectable for said contact surface. A displacer for raising or lowering the support member to a height.

[0015] Preferably, a controller for operating the displacer is included. A preferred embodiment of the present invention is a system provided for assisted cardiopulmonary resuscitation in which the rescuer only needs to put his weight on the patient's chest, comprising: (a) a bottom surface and a slidable interior within the cylinder. A piston unit including a housed piston and a piston rod,
A cylinder unit including a sealed cylinder having: (b) a contact surface provided on the bottom surface of the cylinder for contacting the patient's chest; (c) a displacer for raising the piston; A support member attached to the piston rod to cause the rescuer to apply its weight to the piston to depress the piston to compress the patient's chest; and (e) selectable frequency, speed and selectable piston. A controller for activating the means for raising the piston so as to move the piston to a desired height.

In operation of the preferred embodiment, the rescuer is kneeling on the side of the patient, for example, with the piston at the bottom of its stroke cycle, placing the contact surface of the cylinder unit on the patient's chest. The rescuer moves his weight on the support member. As the piston is raised by the lifting means, the rescuer's head and shoulders are raised so that the rescuer's gravitational potential energy is increased. As the rescuer's head and shoulders are lifted, the rescuer's knee and hip joints become more curved so that the rescuer's weight is transferred from the support member to the rescuer's knee. Transfer of the rescuer's weight from the support member releases the pressure on the patient's chest, and the patient's chest is depressurized. When the piston is at the top of its stroke cycle, the rescuer transfers weight onto the support member, causing the piston to descend rapidly, thereby converting the rescuer's gravitational potential energy into kinetic energy. When the rapidly descending piston strikes the bottom of the cylinder unit, the kinetic energy of the rescuer is transferred to the patient's chest, which is in a compressed state, allowing the cycle to begin again. Some preferred fruiting forms of the present invention provide active pressurization as well as manual CPR,
It is obvious to one skilled in the art that it relies on passive decompression of the chest. Alternatively, in some preferred embodiments of the present invention, the CPR device is attached to the patient's chest using, for example, a suction cup, adhesive and / or strap. When the rescuer leans further backwards, the chest may be raised to provide active decompression. Alternatively or additionally, once the rescuer's weight has left the patient's chest,
While the rescuer remains in position, the active shortening of the device may cause chest decompression.

The invention may optionally include a descent device that lowers the piston once the rescuer has transferred his weight to the support member. The descent device thus provides the piston with kinetic energy in addition to the kinetic energy provided to the piston by applying the rescuer's weight to the support member.

The frequency of the cycle, the height at which the piston rises, as well as the speed at which the piston rises or falls, is determined by the controller and these are selected by the rescuer to meet the needs of the patient. Alternatively or additionally, the height of the device itself may be set using, for example, telescopic struts.

Thus, provided by a preferred embodiment of the present invention is a system for assisted cardiopulmonary resuscitation in which a rescuer only has to put his weight on the patient's chest,
A contact surface for contacting the patient's chest, a support member for applying the weight of the rescuer to the contact surface, and a displacer for displacing the support member with respect to the contact surface
cer).

Preferably, the system includes a controller that causes the displacer to execute a predetermined operation. Preferably, the predetermined operation includes an operation in a predetermined direction. Alternatively or additionally, the predetermined action includes a predetermined applied force.

In a preferred embodiment of the present invention, the displacer increases a displacement between the support member and the contact surface. Alternatively or additionally, the displacer reduces displacement between the support member and the contact surface. Alternatively or additionally, the displacer includes an electric motor. Alternatively or additionally, the controller includes a pneumatic controller.

Thus, provided by a preferred embodiment of the present invention is a system for assisted cardiopulmonary resuscitation (CPR) in which a rescuer may selectively weight his or her weight on the patient's chest. (A) a cylinder unit including a closed cylinder having a bottom surface and a piston unit including a piston and a piston rod slidably housed inside the cylinder, and (b) for contacting the patient's chest. A contact surface provided on the bottom surface of the cylinder, (c) a displacer for raising the piston, and (d) a rescuer for compressing the patient's chest by quickly depressing the piston. And a support member attached to the piston rod for causing the weight to be applied to the piston.

Preferably, the system includes a controller that causes the displacer to execute a predetermined operation. Alternatively or additionally, the piston moves at a selective frequency. Alternatively or additionally, the piston moves at a selective speed. Alternatively or additionally, the piston moves a selective amount of height.

In a preferred embodiment of the present invention, the system includes an electrocardiograph (ECG) monitor and recorder connected to a controller, the controller operating the lifting means in response to the electrocardiograph. And stop. Alternatively, the system includes an electrocardiograph monitor and recorder connected to the controller and capable of guiding CPR and generating cues that can be sensed by the rescuer. Preferably, the guide includes instructing the rescuer when to stop the CPR.

In a preferred embodiment of the invention, the system comprises a physiological sensor for measuring a physiological parameter of the patient. Preferably, the controller changes the movement according to a value sensed by the sensor. Alternatively or additionally, the controller generates an indication to the rescuer in response to a value sensed by the sensor.

In a preferred embodiment of the invention, the displacer includes a lowering device for lowering a piston to apply a selectable force to the patient's chest. Alternatively or additionally, the piston is raised by the introduction of compressed gas into the lower part of the piston. Preferably, the compressed gas is air. Alternatively or additionally, the compressed gas is oxygen.

In a preferred embodiment of the invention, the piston is raised using an electric motor. Alternatively or additionally, the piston is lowered by the introduction of compressed gas into the top of the piston. Alternatively or additionally, the piston is lowered by an electric motor. Alternatively or additionally, the controller is powered by electricity. Alternatively or additionally, the controller is pneumatically driven.

In a preferred embodiment of the present invention, the apparatus further comprises a ventilator connected to the controller for ventilation of the patient's lungs, said ventilation being associated with said cardiopulmonary resuscitation. Preferably, about two ventilations of the patient's lungs are performed every about 15 depressions of the patient's chest.

In a preferred embodiment of the present invention, a defibrillator for defibrillation of the patient's heart is connected to the controller, said defibrillation being associated with cardiopulmonary resuscitation. In a preferred embodiment of the present invention, the system comprises a capnometer.
eter). Alternatively or additionally, the system includes a blood flow meter. Alternatively or additionally, the system includes a strap. The strap preferably secures the system to the patient's chest. Alternatively or additionally, the strap includes a defibrillation electrode.

In a preferred embodiment of the present invention, the contact surface includes a suction cup. The system is operated to connect to the suction cup after the suction cup has been applied to the patient. Alternatively or additionally, the suction cup includes a defibrillation electrode. Alternatively or additionally, the suction cup includes at least one physiological sensor.

In a preferred embodiment of the present invention, the system further includes a display for indicating a physiological parameter of the patient. Preferably, the indication comprises an auditory indication. Alternatively or additionally, the physiological parameters include the patient's heart rate. Alternatively or additionally, said physiological parameter comprises the blood pressure of the patient. Alternatively or additionally, said physiological parameter comprises the blood flow velocity of the patient. Alternatively or additionally, the physiological parameters includes a CO ₂ concentration in the exhaled breath of the patient. Alternatively or additionally, the physiological parameter includes a pressure applied to the patient's chest. Alternatively or additionally,
The physiological parameters include movement of the patient's chest.

In a preferred embodiment of the invention, the system includes a monitor that monitors and stores information related to resuscitation. The scope of the present invention also includes the use of the system for performing cardiopulmonary resuscitation described above.

FIG. 1 shows a CPR device according to a preferred embodiment of the present invention, in which a tightly sliding piston is fitted in a sealed cylinder 1. The piston rod 2 is attached at its upper end to a support member 3, which is preferably suitable for grasping by a rescuer. (The cylinder 1, the piston (not shown), and the piston rod 2 together form a cylinder unit.) The contact surface 4 is associated with the bottom surface of the cylinder. The contact surface 4 preferably includes a suction cup and adhesive pads and / or straps to maintain contact between the device and the patient. In a preferred embodiment of the invention, the ascending and / or descending movement of the piston 2 is caused by a compressed gas 8, for example nitrogen, air, oxygen. In a preferred embodiment of the present invention, for example, an oxygen gas cylinder is provided. Alternatively or additionally, a compressor is provided to compress the surrounding air. Such a compressor, for example,
A power supply of a rechargeable battery or a combustion engine may be used. Alternatively or additionally, other external pressure sources may be used, such as, for example, a hospital pressurized air or oxygen wall supply. Alternatively or additionally, other methods of moving the piston 2 and / or the support member 3, such as a hydraulic or electric motor, may be used.

The cylinder 1 is preferably connected to an external pressure supply 8 via tubes 5, 6, 7. In a preferred embodiment of the invention, a controller 9 is interposed between the external pressure supply 8 and the cylinder 1 to control the movement of the piston.
The control is preferably performed by adjusting the gas flow from the external pressure source 8 to the cylinder 1. Alternatively or additionally, the controller may be integrated in the cylinder unit. In a preferred embodiment of the invention, the controller comprises a mechanical controller. Alternatively or additionally, the controller includes an analog electrical controller (preferably with a solenoid valve). Alternatively or additionally, the controller includes a pneumatic or hydraulic controller.
Alternatively or additionally, the controller comprises a digital controller.
In a preferred embodiment of the present invention, the controller is programmable.

In a preferred embodiment of the invention, the contact surface 4 may be attached to the patient before other parts of the CPR device are attached to this contact surface. In one example, the contact surface may include a suction cup. In this way, the patient's chest is exposed, the suction cup is mounted in place, and then other parts of the CPR device are coupled to the suction cup, for example, using a ratchet connector. It should be noted that the quality of suction is not critical in embodiments of the present invention, as the suction cup is pushed again against the patient's chest with each chest compression. In a preferred embodiment of the invention, the suction cup includes a physiological sensor such as an ECG electrode and / or an active device such as a defibrillation electrode.

FIG. 2 is a cross-sectional view of the cylinder unit, the support member, and the contact surface along the plane AA ′ in FIG. Through the introduction of compressed gas through the tube 6 and through the valve 15 and the inlet 11 ′ arranged at the bottom of the cylinder wall, the cylinder
The lower part may be pressurized, which causes the piston 10 to rise. Alternatively, optionally, via the tube 7, the introduction of compressed gas through the inlet 11 ″ and through the inlet 11 ′ and the valve 15 the release of the gas under the piston 10 into the atmosphere, the cylinder can The upper part may be pressurized, causing the piston to descend.

It will be readily appreciated by those skilled in the art that the present invention may be modified without departing from the spirit and scope of the invention. Other devices for raising or lowering the piston are also applicable, for example using an electric motor instead of the compressed gas as shown in FIG. The lifting / lowering device may share one or more components, such as the compressed gas supply in FIG. 1, or they may be completely separate and independent. The controller and the cylinder unit may be separate facilities as shown in FIG. 1, or may be integrated as a single unit. Alternatively or additionally, the ascending and descending operations are provided by separate means, such as, for example, hydraulic for ascending and pneumatic for descending.
In a particular embodiment of the invention, the raising and / or lowering of the piston 2 is performed by means of an electric motor with an integrated battery, which may not require a subsequent cord or tube. A small CPR device is provided.

FIG. 3 is a schematic flowchart describing the function of the controller 6. For example, an electronic or pneumatically driven oscillator whose frequency is selected regulates intermittently opening valves a and b. The signal generated by the function generator is 0
When the pressure is larger, the valve a is set so that the compressed gas flows from the external supply source 8 into the tube 6 via the tube 5 and then flows into the cylinder 1 through the intake port 11 'as shown in FIG. The opening valve b closes and the valve 15 closes to the outside air, so that the piston rises. At the same time, the gas passes through the suction port 11 'and the tube 7, leaves the cylinder, and is released to the outside air. Otherwise, valve b is opened so that gas flows from external source 8 into tube 7 via tube 5 and then through valve 15 and inlet 11 "into cylinder 1. Valve a is closed and valve 15 is opened to the outside air, resulting in piston lowering, while gas leaves the cylinder through inlet 11 'and valve 15 and is exhausted to the surroundings. Although an electrical-based controller has been described, those skilled in the art will readily appreciate that the limited configuration of FIG. 3 is only one of many possible variations. Thus, by way of a non-limiting example, the controller 3 may be partially or completely pneumatically driven.

FIG. 4 illustrates performing CPR according to a preferred embodiment of the present invention. FIG. 4a
With the piston 10 at the bottom of its stroke cycle, the cylinder 1
Contact surface 4 is placed on the chest of patient 12. An optional strap 13 surrounding the patient's chest and / or shoulder preferably helps secure the device in place during operation. The rescuer 14 devote almost all of the weight to the support member 3. The introduction of the compressed gas into the lower part of the piston 10 of the cylinder 1 through the valve 15 and the suction port 11 'raises the piston, so that the rescuer's head and shoulders are raised, and the rescuer's gravitational potential energy increases. As the rescuer's head and shoulders are lifted, the rescuer's knees and hips bend further, and the rescuer's weight moves from the support member 3 primarily to the knee. Movement of the rescuer's weight from the support member 3 takes pressure on the patient's chest, and the patient's chest is released. The additional vertical movement of the rescuer also eases and / or does not exert pressure on the patient's chest.

In FIG. 4 b, the piston 10 is at the top of its movement cycle and the rescuer has transferred his weight to the support member 3. Here, the valve 15 is opened to the outside air,
(Optionally) compressed gas is supplied to the piston 10 of the cylinder 1 via the inlet 11 "
Introduced at the top. At the same time, the compressed gas in the lower part of the piston 10 is allowed to rapidly flow out through the valve 15 via the suction port 11 '. The combination of the rescuer's weight on the support member 3 and the compressed gas at the top of the piston causes the piston to descend rapidly, thereby converting the rescuer's gravitational potential energy into kinetic energy. When the rapidly descending piston hits the bottom of the cylinder unit, the rescuer's kinetic energy is transferred to the patient's chest in a compressed state, allowing the CPR cycle to begin again.

The frequency of the cycle, the height at which the piston is raised, the range of movement of the piston and / or the speed at which the piston is raised or lowered are determined by the controller 9;
It can be selected by the rescuer (if desired) according to the needs of the patient and can be changed and / or preset during the rescue. The choice of the frequency of the cycle by the rescuer, the height at which the piston rises or the speed at which the piston rises or falls,
For example, allowing the rescuer to control the displacement of the patient's chest and / or the pressure applied thereto. Alternatively or additionally, other parameters of the movement of the piston may be controlled, such as the relationship between displacement and speed or acceleration (of the piston), the force applied and / or the delay between each compression.

FIG. 4c is a superposition of FIGS. 4a and b, with only a small amount of up and down and rotational movement from the posture of FIG. 4a (shown by dotted lines in FIG. 4c) to the posture of FIG. 4B (solid lines in FIG. 4c). ). Therefore, only a small amount of muscle tissue movement is required, and the physical activity required of the rescuer is, in some embodiments of the present invention, significantly less than manual CPR.

The embodiment of FIG. 1 was tested by professional and non-professional rescuers on a state-of-the-art CPR mannequin equipped with a computer and appropriate mechanical sensors. The results of the test showed that the rescuer's oxygen consumption and heart rate increased significantly less while using the CPR device, and the rescuer's persistence was significantly increased compared to manual CPR.
Further, the effect of the CPR provided by the present invention is at least a manual CPR.
Equal to the effect of

Several modifications are possible without departing from the scope and spirit of the invention. The present invention may optionally include a defibrillator connected to the controller and capable of simultaneously shocking the patient while performing CPR, as disclosed, for example, in US Pat. No. 4,928,674.

The present invention may optionally further include an electrocardiograph (ECG) monitor and recorder connected to the controller and for monitoring the patient's heart, as described in, for example, US Pat. No. 4,927,674. Good. The controller may utilize the optimal means for ECG signal analysis to activate or deactivate the resuscitation means, and when the rescuer should start and / or stop CPR (and / or The rescuer may generate a perceivable cue (informing whether it may start and / or stop). The controller may also provide, if required, ECG signals, piston movements, history of CPR usage, recording of ECG and / or given defibrillation shocks and / or current and / or historical physiological senses. Adjust the timing, duration, waveform, and / or intensity of the electric shock delivered by the defibrillator in response to the value. Such analysis of current and / or past situations may also guide the rescuer performing CPR, possibly using equipment that automatically changes settings, and / or determine settings and device parameters. May be used to Alternatively or additionally, the controller indicates that defibrillation is about to be performed so that the rescuer can go to the patient and possibly remove the CPR device to avoid electrocution and / or damage to the device. You may be able to. Alternatively or additionally, the device is double insulated. Alternatively or additionally, the tubing to the external pressure supply is insulated.

The present invention may include an optional strap for mounting around the patient's chest to secure the device in place or to apply defibrillator electrodes to the patient. Alternatively or additionally, such a strap may include a strain gauge to view movement of the patient's chest. Alternatively or additionally, the movement may be controlled by an accelerator built into the CPR device and / or strap.
Determined using r). The measured acceleration can be used to determine the impact force. Alternatively or additionally, the twice integrated acceleration may be used to determine chest movement.

The present invention provides a ventilator for ventilating a patient's lungs while managing CPR.
or) as an option. This ventilator is disclosed in U.S. Pat.
4, may be adjusted by the controller to operate the ventilation cycle and the CPR cycle in coordination. As an example, the ventilator is operated in conjunction with the resuscitation means in a manner of two ventilations of the patient's lungs followed by a total of 15 depressions of the patient's chest. Such ventilation may be automatically stopped once the patient's breathing is detected.

The present invention provides a capnometer that informs the rescuer and / or the controller of the concentration of CO _{2 in the} exhaled breath of the patient in order to provide an indication of the quality of the CPR.
May be further provided as an option.

The present invention may further include a blood flow meter that informs the rescuer and / or the controller of the patient's blood flow velocity to provide an indication of CPR quality.

The present invention further provides an optional pressure indicator that informs the rescuer and / or controller of the pressure applied to the patient's chest during CPR to change the pressure that the rescuer and / or controller applies to the patient. May be provided.

The present invention senses the patient's heart rate and / or other ECG characteristic values, blood pressure or blood flow rate, CO ₂ concentration in the patient's exhaled breath, pressure applied to the patient's chest, etc. It may further comprise an optional device that can notify the rescuer of one or more physiological parameters with a sensible cue. In a preferred embodiment of the present invention, the sensible cues include audio cues, such as, for example, beeps or synthesized speech. Alternatively or additionally, the cue includes a display. Alternatively or additionally, the sensed parameters are analyzed to provide composite cues, such as a green lamp when the CPR may continue to proceed and a red lamp when not.

In a preferred embodiment of the present invention, the controller is adapted to stop and / or reduce the lowering motion to reduce the impact force, for example, if the applied impact on the chest is above a threshold. Closed loop operation is also possible. Alternatively or additionally, depending on the measured physiological variables mentioned above, for example, operating range,
Other parameters of the device, such as the velocity characteristics of the piston, the delay between each compression and / or the use of external electrical stimulation, may be controlled automatically.

Alternatively or additionally, the controller may determine that the CPR operation is based on well-defined criteria (AH
It is possible to determine whether the movement conforms to the A guideline, etc.), and if not, warn the rescuer. For example, a warning may be displayed when the pressure applied is too high and / or when the pressure is applied too low. Alternatively or additionally, the CPR device shuts down if the operation is used incorrectly. Alternatively or additionally, the CPR device may indicate to the user an action, such as, for example, increasing the applied pressure. Alternatively or additionally, the controller signals whether the rhythm of the CPR is appropriate. Alternatively or additionally, the controller senses that the rescuer is not using the device correctly, for example, if the rescuer is not moving his weight correctly, thereby:
The controller is required to help make the downward movement greater or the rescuer's weight never leave the patient's chest.

In a preferred embodiment of the present invention, CPR provides a rhythm of CPR (and / or ventilation) to which the rescuer follows (perhaps synchronizing using audio signals). Preferably, the movement of the piston is completely controlled by the controller. Alternatively, the movement of the piston follows the rescuer's lead. In one example, a new ascending / descending cycle starts when the user transfers his weight to the support member and / or pushes the piston in a defined amount. In one example, no controller is needed if, for example, the inlet and / or valve of the CPR device is controlled to be opened and closed directly by the pressure on the support member. Alternatively, the support member includes a control (such as a button) that raises and / or lowers the piston. Alternatively or additionally, the control is a voice control.

The invention may be applied during each cycle, for example, the time to start resuscitation, the time to end resuscitation, the number of cycles to be performed, the frequency of the cycles, the percentage of defective cycles, the frequency and type of errors. It further comprises a monitor that monitors and accumulates information about resuscitation, such as force, guidelines not being met, and / or chest displacement during each cycle. This monitor may be online or offline with an external computer.

Although the invention has been described in some detail, it will be understood that various modifications and substitutions can be made without departing from the scope and spirit of the invention. For example, it will be apparent to one skilled in the art that the present invention can be constructed with a lifting / lowering device that does not include a piston. As an example, a lift / including an electric motor instead of a piston
A lowering device is used (not shown). In addition, various features of the method and apparatus have been described. It is obvious that different different features are combined in different ways. In particular, not all features described above in a particular embodiment are required in all similar preferred embodiments of the invention. Furthermore, it is also conceivable to make combinations of the features described above, within the scope of some preferred embodiments of the invention. It should also be understood that many of the embodiments are described only as methods or only as devices. The scope of the present invention also includes devices for performing the method and methods of using those devices. In addition, the scope of the present invention includes a method of using, a method of building, a method of calibrating, and / or a method of maintaining the device described above. "Comprises", "comprising", "include", "includi" as used in the claims of the present invention.
ng) ”and other similar terms are“ including but not limited to
not limited to) ”.

[Brief description of the drawings]

FIG. 1 illustrates one embodiment of the present invention.

FIG. 2 is a cross-sectional view of the cylinder unit, a support member, and a contact surface taken along a plane AA ′ in FIG. 1;

FIG. 3 shows a schematic flow chart describing the function of the control unit.

FIG. 4 illustrates the use of the embodiment of FIG. 1 for performing CPR on a patient by a rescuer, where (A) the piston of the embodiment is at the bottom of its stroke cycle and (B In), the piston is at the top of the stroke cycle, and in (C), the superposition of (A), (B) is shown.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Cylinder 2 Piston rod 3 Support member 4 Contact surface 5, 6, 7 Tube 9 Controller 10 Piston 11 ', 11 "Inlet 12 Patient 13 Strap 14 Rescuer 15 Valve

[Procedural Amendment] Submission of translation of Article 34 Amendment of the Patent Cooperation Treaty

[Submission date] April 10, 2000 (2000.4.10)

[Procedure amendment 1]

[Document name to be amended] Statement

[Correction target item name] Claims

[Correction method] Change

[Correction contents]

[Claims]

──────────────────────────────────────────────────続 き Continuation of front page (81) Designated country EP (AT, BE, CH, CY, DE, DK, ES, FI, FR, GB, GR, IE, IT, LU, MC, NL, PT, SE ), OA (BF, BJ, CF, CG, CI, CM, GA, GN, GW, ML, MR, NE, SN, TD, TG), AP (GH, GM, KE, LS, MW, SD, SZ, UG, ZW), EA (AM, AZ, BY, KG, KZ, MD, RU, TJ, TM), AL, AM, AT, AU, AZ, BA, BB, BG, BR, BY, CA, CH, CN, CU, CZ, DE, DK, EE, ES, FI, GB, GD, GE, GH, GM, HR, HU, ID, IL, IS, JP, KE, KG , KP, KR, KZ, LC, LK, LR, LS, LT, LU, LV, MD, MG, MK, MN, MW, MX, NO, NZ, PL, PT, RO, RU, SD, SE, SG, SI, SK, SL, TJ, TM, TR, TT, UA, UG, US, UZ, VN, YU, ZW

Claims (51)

[Claims] 1. A system for assisted cardiopulmonary resuscitation in which a rescuer applies his or her weight to the patient's chest, comprising: a contact surface that contacts the patient's chest; and a rescuer's weight applied to the contact surface. A support member for moving the support member relative to the contact surface. 2. The system for assisted cardiopulmonary resuscitation according to claim 1, further comprising a controller for causing the displacer to perform a predetermined operation. 3. The system for assisted cardiopulmonary resuscitation according to claim 2, wherein the predetermined motion includes a motion in a predetermined direction. 4. The system for assisted cardiopulmonary resuscitation according to claim 2, wherein the predetermined operation includes a predetermined applied force. 5. The method for assisted cardiopulmonary resuscitation according to claim 1, wherein the displacer increases a displacement between the support member and the contact surface. system. 6. The method for assisted cardiopulmonary resuscitation according to claim 1, wherein the displacer reduces displacement between the support member and the contact surface. system. 7. The system for assisted cardiopulmonary resuscitation according to claim 1, wherein the displacer includes an electric motor. 8. The system for assisted cardiopulmonary resuscitation according to claim 1, wherein the controller includes an electric controller. 9. The system for assisted cardiopulmonary resuscitation according to claim 1, wherein the controller comprises a pneumatically driven controller. 10. A system for assisted cardiopulmonary resuscitation in which a rescuer may selectively apply his or her weight to the patient's chest, comprising: (a) a closed cylinder having a bottom surface; A piston unit including a piston and a piston rod housed in a cylinder unit; (b) a contact surface provided on the bottom surface of the cylinder to make contact with a patient's chest; (D) a displacer for moving the piston; and (d) a support member attached to said piston rod for urging a rescuer to apply his weight to the piston so as to quickly depress the piston to effect compression of the patient's chest. A system for assisted cardiopulmonary resuscitation, comprising: 11. The system for assisted cardiopulmonary resuscitation according to claim 10, further comprising a controller for causing the displacer to perform a predetermined operation. 12. A system for assisted cardiopulmonary resuscitation according to claim 10 or claim 11, wherein the piston moves at a selectable frequency. 13. The system for assisted cardiopulmonary resuscitation according to claim 10, wherein the piston moves at a selectable speed. 14. The system for assisted cardiopulmonary resuscitation according to any of claims 10 to 13, wherein the piston moves a selectable amount. 15. The apparatus according to claim 2, further comprising an electrocardiograph monitor and a recorder connected to the controller, wherein the controller operates and stops resuscitation means in response to the electrocardiograph. A system for assisted cardiopulmonary resuscitation according to claim 11. 16. An electrocardiograph monitor and recorder connected to the controller and capable of guiding a cardiopulmonary resuscitation and generating a cue that can be sensed by a rescuer, further comprising: an electrocardiograph monitor and a recorder. A system for assisted cardiopulmonary resuscitation as described. 17. The system for assisted cardiopulmonary resuscitation according to claim 16, wherein the guide includes instructing the rescuer when to stop the CPR. 18. The system for assisted cardiopulmonary resuscitation according to claim 2 or claim 11, wherein the system includes a physiological sensor that measures a physiological parameter of the patient. 19. The system for assisted cardiopulmonary resuscitation according to claim 18, wherein the controller changes the movement according to a value sensed by the sensor. 20. The assistive cardiopulmonary resuscitation method according to claim 18, wherein the controller generates an instruction to the rescuer according to a value sensed by the sensor. System for. 21. The apparatus according to claim 10, wherein the displacer includes a lowering device that lowers the piston so as to apply a selectable force to the patient's chest. For assisted cardiopulmonary resuscitation in children. 22. The system for assisted cardiopulmonary resuscitation according to claim 10, wherein the piston is raised by introducing compressed gas into a lower portion of the piston. 23. The method according to claim 22, wherein the compressed gas is air.
A system for assisted cardiopulmonary resuscitation according to claim 1. 24. The method according to claim 22, wherein the compressed gas is oxygen.
A system for assisted cardiopulmonary resuscitation according to claim 1. 25. The system for assisted cardiopulmonary resuscitation according to claim 10, wherein the piston is raised using an electric motor. 26. The system for assisted cardiopulmonary resuscitation according to any one of claims 10 to 21, wherein the piston is lowered by the introduction of compressed gas into the upper part of the piston. 27. A system for assisted cardiopulmonary resuscitation according to any of claims 10 to 21, wherein the piston is lowered by an electric motor. 28. The system for assisted cardiopulmonary resuscitation according to claim 2 or claim 11, wherein the controller is operated electrically. 29. The system for assisted cardiopulmonary resuscitation according to claim 2 or claim 11, wherein the controller is pneumatically driven. 30. The ventilator for ventilating the patient's lungs, the ventilator coupled to the controller, the ventilation being associated with the cardiopulmonary resuscitation. 30. A system for assisted cardiopulmonary resuscitation according to any of the preceding claims. 31. The method of claim 17, wherein about two ventilations of the patient's lungs are performed every approximately 15 depressions of the patient's chest. system. 32. A defibrillator connected to the controller for defibrillation of the patient's heart, wherein the defibrillation is associated with the cardiopulmonary resuscitation. A system for assisted cardiopulmonary resuscitation according to any of the preceding claims. 33. The system for assisted cardiopulmonary resuscitation according to any one of claims 1 to 32, further comprising a capnometer. 34. The system for assisted cardiopulmonary resuscitation according to any one of claims 1 to 33, further comprising a blood flow meter. 35. The system for assisted cardiopulmonary resuscitation according to any one of claims 1 to 34, further comprising a strap. 36. The system for assisted cardiopulmonary resuscitation according to claim 35, wherein the strap secures the system to the patient's chest. 37. The system for assisted cardiopulmonary resuscitation according to claim 35 or claim 36, wherein the strap includes a defibrillation electrode. 38. A system for assisted cardiopulmonary resuscitation according to claim 1, wherein the contact surface comprises a suction cup. 39. The system as set forth in claim 31, wherein the suction cup is applied to the patient.
39. The system for assisted cardiopulmonary resuscitation according to claim 38, operable to be connected to the suction cup. 40. The system for assisted cardiopulmonary resuscitation according to claim 38 or claim 39, wherein the suction cup includes a defibrillation electrode. 41. The system for assisted cardiopulmonary resuscitation according to any of claims 38 to 40, wherein the suction cup includes at least one physiological sensor. 42. The system for assisted cardiopulmonary resuscitation according to any one of claims 1 to 41, further comprising a display for indicating a physiological parameter of the patient. 43. The system for assisted cardiopulmonary resuscitation according to claim 42, wherein the indication comprises an auditory indication. 44. The system for assisted cardiopulmonary resuscitation according to claim 42 or claim 43, wherein the physiological parameter comprises a heart rate of the patient. 45. The physiological parameter includes a blood pressure of the patient.
The system for assisted cardiopulmonary resuscitation according to any one of claims 42 to 44, characterized in that: 46. The system for assisted cardiopulmonary resuscitation according to any one of claims 42 to 45, wherein the physiological parameter comprises a blood flow velocity of the patient. 47. A method for assisted cardiopulmonary resuscitation according to any one of claims 42 to 46, wherein the physiological parameter comprises a concentration of CO ₂ contained in the patient's exhaled breath. System. 48. The system for assisted cardiopulmonary resuscitation according to any one of claims 42 to 47, wherein the physiological parameter comprises a pressure applied to the patient's chest. 49. A system for assisted cardiopulmonary resuscitation according to any one of claims 42 to 47, wherein the physiological parameter comprises movement of the patient's chest. 50. The system for assisted cardiopulmonary resuscitation according to any one of claims 1 to 49, further comprising a monitor for monitoring and accumulating information related to resuscitation. 51. The system according to any one of claims 1 to 50,
Use for cardiopulmonary resuscitation methods.