CA2097355C - Cardiopulmonary resuscitation device - Google Patents

Abstract

A battery operated portable self-contained apparatus for delivery of cardiopulmonary resuscitation (CPR) comprising means for administrating cyclical chest compression, lungs ventilation means operatively connected to the chest compressor means to deliver volume control high pressure ventilation simultaneously with chest compression, volume control ventilation asynchronously to chest compression and volume control ventilation without chest compression. Span adjustment means to set the span between the base member and the chest compression means to accommodate patients with a different chest size. Adjustment means for adjusting the length of stoke and force of chest compression means and adjustment o ventilation volumes in proportion to the patient chest size. Releasable locking means (ratchet) operatively coupled with driving means for holding said chest compression means in a reset position thus allowing expansion of the chest during patient ventilation and engaging driving means with thumper for chest compression. Control means to selectively operate the chest compression and the ventilation means in a predetermined sequence as well monitoring patient's vital signs.

Description

.
f~'.~R~~I~~~LTLhIOlvTARY F~ESUSCITAT I ~~Pd DEVICE
FIELB OF THE INVENTION
Thin invention rel atea t.~~ a new cardi~~pulmonar~~
y i resuscitation fC'FR) devrice that. is. por~a~~le, simple ~o install an a -pati ent, and iJrOVi dF's effaCti iTe ~p~', jJy vend lating pati ent l~~znges simultaneously with chest compression. The device can be used on a wide range of patient .sizes. In addition, the device provides a means of adjuCti_ng aeveral CPR paramet.er~
proportionally and sim~.iltane~~usl ~ T~Yith the adjustment of a single parameter, relating t~ patient chest size. The device is Capable of deli :rer j~ of v'entila tion during Coml~ressi~:~r~ ~'JDC ) , asyr~
Chronous VentllatiOn ~~wT) between pr'e~eleCted numbers Of Chest cc~nzpreasi~?n' s and ~.rentilati~n without Compression (VG~C) when 15 required.
BAC~~GROt~ND OF THE INVENTION
it 15 M:el l known that viCt im8 Of ~:. heart attaC,~ shOLll d receive immediate aid in the form of Cardiopulmonary resusCltat:ion, icllo~'~ina an attack. The time delay frOI;1 the moment of an attack, to the ir:itia tion of C<PR by a rescuer and the effe~ti~Teness u'f the C.PR, greatly influences the Chance Of ,~ur'Vitr~l Of the '~TlCti.ITI. In an emergency, in addltl0n trr ITilnimilng the !~ela~% for lr~itlcatlrtg treatment, it is eC~LIaliy 25 important that the CPS received is highly' effective, requiring the minimum oL ~:~perat0~' input tC' ePsure effGc~:ti'.%~'.?'lesS. ~e:~earCh n ~ ~ t r t- 1- t h ~. a a .~ t- ,r n has dem..r.~~_a~ed than fi~~~.i- e..ess ~~~f the C:Pr~ is impro~red :~1~'1en Chest COmpra_ssinn i_~ pF?rfprmed sl.mLlltaneO11S1jT, znrltYi lLZnC.~
ventilation i~~ addition tc asynchronous lung ventilation cycles betLleeT2 ~ seier"ted number ~.yf ~~!;~TTIk;rE?~~l.Or~ Cycles. It haS a~~,O
been ,s~i,~:.~~n that increased th orax pressure, and nCrt the heart pL~TTlplnr~ action d~.lrl:"ig Chest COmpressl.On, CciUSeS ''Ialves 1n the j~_~gular reins t~o ~Jpen and pav~s blood through. These valves Close ,_ durir!~~ decompress~.an. Tn?hile there are deviceu available that can del:iT.'er GheSt C»mpreSSi <;W ~ that are C~Cupied 4Ji th Ventilati.:W~ , t here s;rstems are h i gr!1 y ct~,m!p i et, requi ri ng a hi gh level of i ;~,~ t- ~ a ~ a ~ p r a r~ ~ ~ C i operator ski l .~, to ~ imi~_ p~rfarm~nc~ a_am_tvr,~. r_ous injury 'o the patient can be the re,ult of zlnpr_r~perl y set i'~arai:leterS l.nc t ilding fracture Of the S ternLiill ~Cr lui!g rll~'ature, if tao much pressure is applied.
As well , Vi dims of heart attacks are not lim ited to a particul ar chest size or weight= T'ite t%ic.tim of a heart attack can rapqe i n Che,S t SlZe f rOiTl that ~~f a SL?"~all Chl1 d, tr that rvf large adult. 'The C"PR required by different sized Victims t-herefr~,re zr~rieS. LOr et ample, SITtaller VlCti1?1S hrlth a Smaller Ghent, require a lower compression force, shorter compression dlplacement' lower 'TC~rltl.l.atlc:ln 'v"olLll'lleS arid f.'~reSSl.;ireS.
,, 1F~ :~1.P11.LarL~r, tliOSe VlCtilTiS ~rJl.th a .Larger Chest Size require a 1'l l.Ctller CGiTipreSSion fOrCe, a higher Chest CCmpreSSlOn displacement, higher Ventilation volumes and pressures.
United States Patent 4,39'7,30 discloses an integrated, Icon-portable, S~rSteT(1 fior C~rdiO~,~ulmonaryT rF'SLiSCitation and 0 ClrCUlat:iGn Si:ppOr~. 'f!~!1.S deVlCe Comprises a C.lleSt COmpre,SSiGrt means in conjunction with a lung Ventilation means, capal~la of providing hi_~h preSSt.ire VerltilatirJn 5~11~C_h_rori~:~LISly ~n~l.tl'1 Chest CoIElpreSSl.on, a loGd pressure Vent11at10n itleanS for inflating the lungs at lo:~J presau}~-e, k:~etw~seen a selected number of ~~ompression 2= cycles and a negati:.re pressure ~.Tentilator for deflating the lungs ~et,~eeTl ClleSt CC~T11~'~reSSiOUS, the device 18 further comprised of a 5ral~-e means for or~erating one of the Ventilatorw, a means for restricting tha aladorrten to exert pressure thereon and a control selectively c~eratin the chest Gom cession means, the m~an,s ~or ~ g p sQ VentilatlnCf 1'?'ieanS, the ValZre ??leans and 3~~dOTtlen reStrlCt111g means in a selected sequence and for selected duration.
t~'.,~~.ntrr_~1 G,f tre ,Sj'~:telT' iS CCh'Iplei~, and req111reS frOiT'~ tile operator high s~>ills and good Knowledge of hur:~an physiology.
,,.

inCGrreCt ad~UStItent Gf the Opel:atln~ ~araileterS, IlialtUTlCtiol: O~
the ~hillTij~er Or CGntrpl system GCC.yrs, h?gh vent11at1Gn ~.'.resstore Could enter pa ti°ntj ,l Lilrl.~.fs. Iia an a~SenCe Qf CoUn teraCtli2!x lntr_'athOraGiC preSStlre, i~~r7l~Ch ?s CTenerated ~y Chest Compression may lead to the l~_kn~~s rapture.
lFni tech State patei'lt ~,..~~~'~, g»x dl.sClosBs Car'ulOpUlIT~Onary reCi.isCltatlnl'1 devl.Ce. T he devlCe 7..riCiUdeC a frame COmpri.Sed of a ma~.n support base assembly and upright portion with a top arm pnrtinp y:,rhiCh 7.c pl."~rOted i~:~.erItlE'dl.ate 1tS length tip the Uprl:~ht.
i0 F. '~:Gnv~'ntiGnczi air Cylinder assel~'alV that is p~votal~.y connected between first end and ti,~e base assembly and pivotal arm L--. +- ~- o p'wr a' n pp'y f'p p~"lclto pres"1"F' tJ tt'1e ;..t_! aC:.~,.i..:tat.e 'h..~ 1'~'.~tu1 arm t... a 1 a Lt7 ~. .~ i chest ~~f Sri Gti.m. G'Gnventlonal tank of pressurized oxygen C~Gri=AeCte~~ t0 pTIeUITIatlC SystE'm tG ClrCIlCali~ operate the a1T"
cyli:~der assembly t'~ apply the pressure tG the ~~~est and tG feed the oxygen through a conventional face mask.
TO lTiSta.L~ the detrlCt?~ p~t'Ji.ent has t0 ~e 1? fted arid pos.~.tiGr~ between the base and arm whych may create problem with ~1.'~t~el sl.Ze pat'.ent and In effir'Ct may re~Ulre more theI'? One cu Cy:era tOr . rrtead j us tment Gi uhe C~ie'St. Cemp~'ASsIGi'7 Clep th ~ilr inC~
CPS procedure may b~e rea_.uired, position of the adjustment means or~ ar..rn that is in recipro~_atinc~ motion prevent; the device from ~~eiTl~ ad ~LiSted dUrlTl~ n~eratlC~T'1. The prG;:edLrC-' i.n prn~reSS has to b~e interrupted sG the adjustment can b~e corrected. Also the device has to be rerncved from patient if an access to patients C:':eSt ~S 1"eC~i..ilred e.~~. for ad:'111nistra''lC~n Oi (~lPCtrG-ShGC~ tG
restart pat? ent heart . The devlCe does not dl.SCl Ose a means f~:~r s~II't~altal'?eGos Ver?tll_~tLr_;n and Chest CG:TI~JreSslOn nor ~djL;;Stment Qf critical CPk parameters.

3~ r~ail3Q'lan ratent ~t'7~, ~~~i ~alaClw~Ses a Sell-COntalTlet~
resLisc?tation device that can provide cardiac massage ~r;th artificial. respirat_on to a patient. The device provides a manually adjustable chest compression means and asynchronous ~ ~~~~ss V~i1t11Stl.n~ means. The de'JlGe t:iQE'S not ~~1SG~OS.°_ a, means fo.l=' ad?l.i.~tln~~ Ver:tiiation and Jettllati_pl"1 dUrln~ GnmprFSSior_~1 ~jOls.~ITeS, t t i c~ W=-- '"1.I?lt~ltaneoUS~ ~- witi~ ad~UStin~~r th~~mpin~ Strove and hamp_1:' fJ~rc..
the S;Yar: ad~u"itlnent (d? StaIiC:e ~~etvde~n t~'c~ thi.,lirper and dare to aCCornmoda t.e a patient' ~ chesty .
re l d pa tents lnClUde Canadian Patent r Ott?r-r ate dlS..a,iOW..n~ a heart 1'??c'3SSa~r apparatUS ~,wltil COlTlpreSSed ~c~.S
i a ~ ? r '=' i a~,~tiiatl.I':~~ i?lear:S, Canad...ar: Dat...W vv, 5~~ diSCl oSln~ care E?Xterna.:.
heart mas~a~~F appara tUS, Canadi ar: apparatus ?75, 356 disc 1 o~in~~ an iE e:;ternai '..:arL'~2ai.: IaaSSaC~e appal"atUS, :.ia Pater:t ..~~, ~2~J, 4~~~
L7iSCio5111~ ali e.a>ternal cardiac 1T'~acSa~~~ apparati_1S i~llth asvnchronoL~S ventilation, US Pate_rit 4,'?9'7, r~g9 disCloSir?g a nr,,I".ta~ie '"eSUSC7.tat? on apparatus to ~e Uaced i n C~or_~t!_rlCt? On :nlltr:
?TLanUal ~XtPrna~ card? aC i??aSS~3~~P, li ~ Patent 4, ~~~, 3~4 d.l.C~C~
OSi.rl~~ a Z5 ~"PR device that provides ventilation from conventional cori:prCSS°d C~aS C~'~ in derS, LiS Patent 4, ~(~~, ~'.~~ r~'2SCZoSInC~
a p~~~ta~~' = h cart lTtaSSa~e ap pa ratiaS and aUXilla.l:'~l Zienfi.11at1.riCJ
TlleanS
ane :~anadiar: Patent i, ~~i, ro'~i.~ diSwio,~in~~ an eXternal CaYc:~iaC
ITiaSSaC~e C~eVICE' OBJECTS OF THE IN~IENTIQt~
it ? S, tliprefOrF', an ~?~~eGtlVe r~~ th.e ? I'1VF'ntlrJn to pLO~ilde ~';F'R rle;,ricr~ t hat al ~ o:~.,r,~ Cp~rat,J,r rr~ alt2rnatE ~etE~JeE.'n SeVera' f~'P''t~
modes of operation, like:
~r, Standard CPR p~~C,C:e~.ft;re ( r'2~..olli.'?lende~ ~~y ~llTlerlCan 1-F2a~f=
~lSaoClatlon~ .
~,.TEI?tilatlon Z~tJ~ln~~t 1~~OT1?preSSlon (~ilj~C:l ~l'l~ie SivlUTCie Control i:l~~h preCSilre '~~erlt.i.iatl~~n l.delivrered .:~llTtUitar~eCUSliI vviti?
Chest Compression in a safe manner.
~,Teritl~.at~pr: TI4w.thot,it ~'Omp_reSSir~n ~ljt~i~.~ av~?e_re V~ntilatlon iS
dell.Ve_rF'C1 'vd~ thOi,lt Chest GOITtp_raSS7.On.
Zfi iS a fy_rth,r._r pr~-ieCtiVe Of tha in5y?ntion to prn~,tdV daViCe that eli~ninateS a need for indiTaidual ad~uStment of Critical CPR

parameters by Ope ra tt:r . At~j :StiCtent Of thumping lenCjtli Of StrO~ a a_n_d fOrCe, aS-~.rrtChr':GnOUS Vend latlt~n (AZ') j ventll atlOn durl.ng CfJTitpI:eS~l.i:W ~lrl~iG}, artd Ventilatl.On WlthOUt C~~mpreSSaOn volume:Sj are Sldired t~~ the adjustment G~ SinC:~le par~m~'tery nar,'tely span adjustment that i~ proportional to a patient's chest size.
It is a further =~bjective of the znventlon to provide device th:~t iS effeCtlve, faSer friendly portable, arid Se~.f Contained. A
de~;rlCe that C3n be tranSpOrt and operate In a safe ?T'tanner bar 20 single reacuer i~.rith a ver~~ basic CPR l~nowledge.
It i~ still further objective Gf the ?nventiort to facilitate u.~e cf the deirice during patient tran.eportation e.g. on a Sti-C'tCher.
It i ~ ;~ti 11 further objective of the lrtVention tc~ provide 25 device that. eliminates ~.iftin~:~ of a patient during device installation.
~t .S Sell ~. fi"lrtrle?" Ob jeCtlve Of the ? I?ventj_C,n tG p rOVld~.
de<.ri:~e ti:a t open in,~talla tion, operta patientu air~Taz for ventilation.
LJ Tt 7.S affil further ObjeCtlve Of the lnventlOrl t0 utll i_z~. an ~ r h ~ ~ ~~n~:~ered b~ i.nterrtal battrrr~r ,r~r (nnt Sl-IJGfn7 eieGt rl~.. mOtO t a t ~...
external battery (t...ar) or eXternal A~: power ~,ource. The motor prG-,,rZc~e.~ drlirln j iT?OtlCrn tO t~-1e thi.Imper and irentllatOrS tl'1~.15 a:~Sl3rt~S 'kSe Of '~ h° de 4Ti_~'e e~,Ten Lvhen f;he Oay~TeI7 1.-_~--nOt aval! ab I a 25 Or eXrla~lSted by .St_kbStltt~~inr oxygen for ambient air .
~R~~~ s~Am~r~nrrl o~ ~~~ I~i~°~~aT~~r3 s n accordance with one embodiment of the pre.~ent ~n-,rention, there is provided a device for use in card? opulmonary 30 resuscitation comprising:
a base merriber;
Chest C~JT?lpre.~v~i0:1 meartS adjuStabli r!'tU>inted On Sa? d base ~lelrber and adapted to be p<:~SltlGne~ OvJer a pat::.eTlt ~ S SternLlITt aI~d r~

operable to compress said sternum at selected intervals with a selected force;
means to drive said chest compression means;
means operatively coupled with said driving means to provide ventilation asynchronously with chest compression;
ventilation-during-compression means operatively coupled with said driving means to provide ventilation synchronously with chest compression; and means to count a selected number of chest compression cycles and then disengage said chest compression means from said driving means so as to enable a ventilation cycle, and to re-engage with said driving means following said ventilation cycle.
A preferred embodiment of the invention further includes an adjustment means adapted to provide thumping length of stroke adjustment, thumping force adjustment, ventilation volume adjustment, and ventilation-during-compression volume adjustment proportionally and simultaneously with span adjustment.
DESCRIPTION OF THE DRAWINGS
Figure 1 is a perspective view of a preferred embodiment of the invention;
Figure 2 is a plan view of the embodiment shown in Figure 1 in position for simultaneous chest compression and ventilation of a patient;

Figure 3 is a plan view of the embodiment shown in Figure 1 in position for ventilation of a patient;
Figure 4. is a cross-sectional view of the vertical upright of the embodiment shown in Figure 1 showing details of the span adjustment crank and the resilient reservoir during filling at line I-I;
Figure 5 is a cross-sectional view of the drive mechanism support of the embodiment shown in Figure 1 showing details of the ventilation cylinders and thumping mechanisms at line I-I at the LO end of the compression cycle;
Figure 6 is a cross-sectional view of the upright support of the embodiment shown in Figure 1 showing detaiis of the resilient reservoir during emptying and span adjustment crank at line I-I;
Figure 7 is a cross-sectional view of the drive mechanism support of the embodiment shown in Figure 1 showing details of the thumper, and thumper drive mechanisms during the upstroke of the decompression cycle at line I-I;
Figure ~ is a cutaway cross-sectional view of the drive mechanism support of the embodiment shown in Figure 1 showing details of the thumper, locking mechanism and thumper drive mechanisms during asynchronous ventilation at line I-I;
Figure 9 is a block diagram illustrating the electrical circuits associated with the embodiment of Figure 1; and Figure 10 is an enlarged isometric view of the locking mechanism shown in Figure 7.

BETAILEv DES~P,1P~'ION OF THE PPEFERP,ED E~~iBnDIMENT
T,~~i th reference t0 the drawings. and S~eClfiCa ~ Z~' to c ~ - j the t~'F'~ de'lrlG'e ~ 1S CC:TiI~ L'1SE'_d ~Gf the fO.ll r,G~Tl._rirJ~
malrt :..l.~l.i,r e.j ccam~~onents: a base 11 that pra~:~ides the fc~llaw;ng functions:
The ~-~a.se slope.: dwwnwaz:d a~:ray from the Vertical t elescope ~~olumn _r _'~ fr_,r ea~, Se Of de Vice l.nStai l at i On On a ~a tlent ~1'l t~1 this :Shade the ~a5e 1S Sllde under ~atientr S back r'~, thUS t~l.liTtincztF_'S
li ftin~~ of the patient by ~~~.>eL~t c~r, further, the base lifts patient' s back so ~~atient' s head til is backward thus opens -? ~~, '" a t tae:~i le.~ ~'airl,.,rli.... ' ~~~' ~ 1 ' , '.~'~:J"'.'it~',...''uaCtel:.t lr: hear._ al~ way a...~a~ iS uSi..a~iy -~ri ,CtIT?1 ~y tt.'.~n~~ue. II°: addltiOri the ~~aSe ~YOju i deS
Vertical stability to the device 2.
The base 1 1 is i~,'_VOtal l y cannected to a Vertical upri ght 3 and a aenerall~r horizonr_al arm G5. Movement of ~%ertical upright 3 ° s ~~inc~ de tent arm lock ing relatl'V~e tm..he base ~1 is inh:ibit..~d by p meCllaniS r? % 1 . ~uffl~,.~.lent latera 1 fOrGe a~pl7.ed tC~ tr.e arm ~' wTiil dl SeriiTage trle arid iOt~~:ln~ meCl2a121Sm Ll and al.LOw nt~:~VePleilt Of the Vertical upright 3 and arm 2f~ rel ative to the base 11 . The ;,rrVrtir-al i~~ri~llt .~~ iS COmt:=Y'iSed Of t:IG L!~,ri~~it te~eSCG~':lrlg ;~n ~~;OllimTlS, the u~~'er eXternal i~~Ll~r:t teleSCO~e C'G~iiam il ~.G alid the lower internal upright telescol~~ columr: ~ ~ ITcaUnted Cun the C~rillidriCai ~aSe er!d ii' . The e~.tet:nal ll~rig~7.t t~e~P_SCO~~e Coii..tlTtn 1? and tree ! nternal '?r?'lght tel !=_'SCOr~e ry-:l UI'nn Can both ~e mOVe~
l r,riqitt.ldinal l-~r and aria ~iy with ~'~'spec..'.t t~:~ one another. Tree ~5 Ve}~t_ical upright 3 also comprises an upright telescope calumn i'~curtitlOil ~ 3' Se~aratiry ~citter~j ~~ fiGTa ~eS7.~.ler:t L'eSerirOiL G~.
A batter; Cam~artTTlent CaVer ~ ~ ? S alSt~ rJr~CVider~ Within c.~.-liudrica~. base end 11' . The top of Vertical upright 3 has a r'eSer'-JOlr COmjJartl?lellt ~.1.C1 1~ to fa:~illtate aCCeSC t~u trle lilte_riOZ' 34 of said upright 3.
The arrn >5 which is moflnted on colurrtn 12 at one end thereof includes a -,.~alzre 4~ which supports the pro~,irr~al end of a VerWilcxtlG~n ttlb2 i t~ ;IhlCh haS a ~TE'Iltl-~-atl.On IT'~aSk i ~ and Ventliatian tj a ~a'i_va i'~!r at the distal end t~':Er~'O~. The ~rIt1 25 i S al sr~
connected to a hc,,_{sing ~ which supports the c~Jmponents for driving the ar=est cGmpre;~sir,n rr~eans of thun~per 71 and vFntilatiGn rnear._s . The housing 4 is c.c-~mprised Gf dri ve mechanism housing F?
and ~:'~i~: ~~~iinder ~7. TtiA reiati~~re pGSitiGns of the main strl.tCt;lral r~:C~~;,yre~nts Can bP a~~llstEd SG as tG pr0'Jl.d~ trW
n~C~SSar~% Gl ~arance f in OrdF'r thSt ~ patient. is Can ~JE pGSl.t7.OnPd i~et~ieers the ti~:un~,per ?1 and base 12 as indr sated in Figures ~ and 3.
A patient is pGSitiGned on top of the base 11 and beneath th2 tuLimpE?r ~r'~ si.~}1 that t ie st~rr:Um Gf t~'1~ patient' S Chest ~~3 1.5 ~.~'c~r~'Ctl~ ~E'~rWath tl"!~ t'"=llmp~r ~~, :nl~?~n tilUm~~.r ~? is ir1 ? t' S i,ippPr pGSiti~.Wl, as sh~:~Wrt 1u F l~~tlr~ ? . ~~lth r~~erenCe tC: C l~~llr~s 4 r~i'i:~

5, pat.i ent C~tPSt ;~Ompressr On 1s achieved ~.n the fr_=llo~~lng manners an ~iE?~~triC I?:Otr ~:o pGYVprGd '~yl° l:lternal ~atter~ ~~ Or ~Xt~rrea~
~5 ~;~ pGW °r sG;JrG~ Gr W:L~rn~l ~~.C. pGGdpr s0).irC';: ~nGt shG~;Jn~
, prOV~dCS rotary ?TIGtlOr~ aiGry a mOtOr shaft 4v l.tfi VvrGrTTi tTheel ~~.
Ti a mGtor shaft ~r:it?~~ wVGrm ~r heel 29 is engaged upon a eranJ> shaft 'v~lt~'1 i~~rGrIa ~eai: ~~, L'"c'3ta~ly r;tGLirtt~'d Grt a dri~T~
ITl~CnanlsITt t~Jh~G~
pl.~:'Gt ~U ~FriiC h 1s s~c;i.ir2~~' tC h01~s1nQ 6~. '~t2~ t.'.ran~ shaft Witri Vl~~rriTE c~E'ar .'W is fIXE'~ t:~ One sid~' Gf a drive Ta?eCrtarilsTU Craru:
~irl~'~'1. ~~ sl!~11~.a~'ZjT TriC?Ur?tad ~Jn the. dri_va n2avhar?lSTl1 i~i~lPf'~ plvrJt if), lrlis ~~Gar a?"rar:~~4TTtG?:t rW'cwl~~~S speF'd r~dUC,tlOn t0 trlF' rOtStlGr~
sp~~C~ c..'~ t ie Ii2Gt!ir ~'~~. ~ CraruC aria Shaft j~ Ls ~;IVOt:xily CC,nnaCt~d tG thE' drive i'?i2Crlanlsm ~~ran~ trJ~'1F_'~1 ~1 . ~OtatlsJil Of t~l~
mvtGr shaft t~~PL'~~ f CG:'c':i~rta rrJtar~J tTtOtl.t'?rt tG r~CiprGC:Bt~~ nCf llnCar mOtlGrl.

v Toe crank arm shaft :~6 is pivotally conr~GcteC'~ to a r.iur~;aer 3~ by a ;_~lun~~er ~Jivrot. ~ . Th a plunger ~8 paase:~ t:~rougi N' anti is cc-nst~"wined bi% t~'le for portion of a ventilation cylinder ~g to op and dc;wn vertical n~oti~Jn. The p longer ~~, in its c~own:~Tard stro ke, ert.gagew. the thurr~per leG~:ing mechanism key 4~ a.nd ~i.ia ie5 it <~C,sr~ln'vvar~. 'iriiim,.'~~~' lOClCiilC~ ITleCharil..~TCl key ~~ iS prOVidec:~
w; th a thaimper locking rneGhanism key guide pin 52 ~n;hich cooperates with spiral groove Gr:L.
Lor_~.kin~Jl kPy 49 whir_.h ha.s a cyi indrical upper section iia~~lr>r~ a Sp~rai grG«ve Or Slot ..~~1 lri itS iJU~F_'.r ClrCUmfArel'iCe c3nC't l ,~,z,~; r p nd th ~ ~ a ~.
a -:~~?r"JeIi~er;t rG'i~~angt5l~r flange ~L at ~~"le a r~r of tt = %t? , iS ?T!Ot?nte~ wi thln thumper S'iait ~~. AS key ~~ II?rweS
~l.g_r_ t~~t~J and down in Shaft ~~ Ayr ~iW~VeIrzeilt ~Jf plunger i~ l.t .L:~ CauSe(~
tU
iwtate by gu? de pln ~? 4~'ra7..t,~'? erigag~"B i?~1 :~1~. irai r~rnpVe. ~1 .
A.S' seen more clearly in Higure 10, the luilrer portion 53 of the 1~.:~Ckir~g meC~"~aIl:iSm 15 alSr.: ~Gyiin~riGal in Shape :3r1~~ 1:~ pr0'Tl~e~
with a r3C~'!~~ =:LGt i~ i il'lt~J whiGll ~~'c~nge ?f~ lzlajJ Slide, aS
a G'~e ~lri~.'..'W d 1-~;=rgijlaiter. ~url.ry i.~'.e CO?Tl'j'JieSSiOI"~ StrCi:e in eaCr~
1F kcy 4~ FT'GO~i~S ~~C~MTilv~,3.L'~~'Zy 3T'?~ rO~ateS SO tl'lr~t flarge ~~
15' CjTC_~, _ ?Q iTtlSalign in'ith Slot i r and Cannot outer ltr SO tllc'it the QOwi'lzaard r~r7Sre~~erit 1S tiW~ trarl=p"a'~tte~ t iLOUgh ~ Ower pOrtlOri ~~, tllt'FClper ~r_~ .,~thi_C~'1 lOwcr pOrtisan C~fi ZOCI~~ii?g meGhaniwiTi ~~ 1S S~Cltre~
y~ J 1S. -a J
~, and t~lenGe tC~ tha th1_iITrper ~~ 5nr~1? Grl i::l p1 l0t_a_ .Grew r ,y o..~~.T r-, ;-,",~f-~-,:-,-; '.-p yrr,j~~e E~~ at t~le lO~rier E~n~"ya t~?ere0i, thus ~'t':~e3~.a~, i O_~~.._ ...~._...
C~.:~I'C;preS.: i.IW- ~ ~ ) _ x e~ g Ct'rmpreSSeS
~5 "' ~ ~ '-~ie patient t S Chest ( ~ lgL:re Spx'11~g .'_?~ Oil lt.S C~Ot~IIl StrOkE' c~nC~ 3t ~l'~1° °nt~ Oi t.~lB C02~i1~re,S:~lOrl stro?ce r ~'; lure 5 ) , l~:ey 49 is urged upi~~ardly by decompression of spring 54, thus separates from lower key 53 and rotates back to its initial position under the action of pin 52 in slot 51. The flange 76 is now in alignment with radial slot 77 but separated therefrom.
The thumper shaft 48 is part of the locking mechanism and travels longitudinally with key 49 and is connected to the ventilation cylinder piston 40 within the ventilation cylinder 39 whereby downward motion of the thumper shaft 48 causes an increase in pressure within the ventilation chamber 80 beneath the lower surface of the ventilation piston 40. An increase of pressure in ventilation chamber 80 opens outlet check valve 56 thereby enabling expulsion of ventilation chamber 80 gases through said valve 56 to ventilation reservoir tube 27 and resilient reservoir 23.
At the completion of the downstroke of ventilation piston 40, the outlet check valve 56 closes.
The downward stroke of the ventilation piston 40 also compresses ventilation piston return spring 55 within ventilation chamber 80. Spring 55 returns ventilation piston 40 and thumper shaft 48 to the resting position during the upstroke of plunger 38.
During the piston 58 upstroke, negative pressure within chamber 80 bellow piston 40 opens inlet check valve 57 enabling entry of fresh ventilation gases into ventilation chamber 80 from an external source. The inlet check valve 57 closes at the top of upstroke.
The resilient reservoir 23 is provided with a resilient reservoir stretching rod 24 to prestretch the reservoir 23 so as to ensure complete emptying thereof.

2Q'~~~~
When the asynchronous ventilation after preselected number of chest compressions mode is activated, the VDC select valve 41 opens outlet check valve 56' whereby gases from VDC
chamber are expelled to the atmosphere during compression cycle.
Valve 41 is a valve through which ventilation gases from VDC
chamber are passed to patient in VDC mode or to atmosphere in asynchronous ventilation mode.
After completion of selected number of compressions cycles, preferably five, the resilient reservoir 23 has been filled by the emptying of the ventilation chamber 80. The volume of gas in the reservoir 23 is proportional to the chest size of the patient.
Following detection of fifth chest compression signal from bottom dead centre (BDC) sensor 35', control circuit 66 activates valve 46 enabling gases within the resilient reservoir 23 to be passed through ventilation reservoir tube 27, solenoid valve 46, ventilation tube 70, ventilation valve 72', ventilation mask 72 to the patient's lungs. Following detection of the fifth BDC
signal control circuit 66 stops the thumping strokes at top dead centre (TDC). At this point in the cycle (Figures 8 and 10), the flange 76 of key 49 and slot 77 on lower portion 53 of locking mechanism are aligned. When ventilation take place the thumper 71, yoke 61 and lower portion 53 of locking mechanism rise in response to the patient's rising chest, so that the slot 77 surrounds flange 76. The lower portion 53 of locking mechanism compresses the locking mechanism spring 54 during this action. As inhalation is a'-ar~i ~-r~ rr,,rCSSLtre drGpS t~~ltriin tree re.°~liler?t reSer~fOir cn'..>
~~n?~ l v w .~
aTli~ vTeittilat lOn 'v'3lve ~~f t iereb~T ::~perllit~ ti"te e~~'ia~~ti;;W
~,.:~Git 'rv:..ti'lirl -File 53entilatiGrt Vai~fe ~ ~' . ~X~'lcl~.a~l.c%n .feS~:~,t~
t'rGIT? tile C~;~Se;a pr2SSUre tfJiti'iin the pdti2nt' S iLln~S c'?rlCi t~'le natUrai S~.°?.i_'1.i1~
fyrC,a yf tr~.e patient's Chest ~.~. 'Z'he ~~':llI?l~er ~'~, ti~tiamper ~rGi~e ~~%
arid lOt~Ier pGrtiGn ~-'~ Oi i'~,~::i~::irt~ meCi:arIlSICl retLlfn t0 their initial ~:GSltiOr? b~ deGGiEljJl:eSSl.Or't O~ trle t ii.iriiper iO~;li~:ln~
meCilartiSTl1 Spr111~
i n ~-trrlCrt.LGfiO~ac;
54. Tt.r~ aCtiorl complete Grt~ full r~T~R. cy-~y _ ,_x ventilation mode.
' ~ 1 el;iTilln~te t ie r:eed iG:C tree re:~.i.llerit si'ilS ~:~Sl~rt 'vua.i~
re,.~. e.r'SfC.~lr G.'~ .
~f~ert the 'sTW: mGde is ~eleCted and tie th3amper s~laft 48 mGi'eC ra'~ iVvrt4Jc3r~5, the ti'llamper ,~il~ f t C~;..~lZar 'Jn eil~aE~eg tile ire-ntliat?_Gn-~t..irlIl~-Cr'~mpreSC7.0i1 (V~C.~ C~%lih~'~r'r plStGn ~~. ~tI1 1s i .r a I nreSSUre t,,ri ti'ti rt ti'te jJ~~,.. Ci'la?Tlber ~'% beilG;~,r pi StOn J
,, r....re se i ~: ~.
ppenC tTrl~' nUt i et t"~?eG?r zJa~,~re. J~' ti;ereb3~ en3bli n~ eXieaiSlGrl Gi qase~ througi, ~;'LC select Valve 41, tJDw ~~utflow tube 68, solenoid STa~~fe ~~, 'vTerl~iiati0it t'abe ~i~~ =fentiiatlGrl ~f~~v,%e ~~l ~
wfeTltll~tl~;?n mask '?:' and thence tG the patient's ~.un~s. The dGwn~ard mGtiGn of zo 20~'~3~~
,.~....
VDC cylinder piston 58 compresses VDC piston return spring 64 within a VDC chamber 82. Preferably, springs 55 and 58 are conical spirals so that they flatten when compressed, thus enabling improved volume control of the ventilation gases as there is minimum dead space under the pistons at the end of the dawn stroke.
At the completion of the downstroke of the VDC cylinder piston 58, outlet check valve 56' closes. The resulting stop in gas flow through the inlet side of ventilation valve 72' causes the outlet side of ventilation valve 72' to open, whereby gases within the patient's lungs are expelled to the atmosphere by pressure within the lungs and the natural spring force of the chest.
The downward stroke of the VDC cylinder piston 58 also compresses VDC piston return spring 64 within ventilation chamber 82. VDC piston return spring 64 returns VDC cylinder piston 58 to its resting position during the upstroke of thumper shaft 48.
During the piston 58 upstroke, negative pressure within VDC chamber 82 under the VDC piston 58 opens VDC inlet check valve 5T enabling entry of fresh ventilation gases into the VDC chamber 82 from an external source. The VDC inlet check valve 57' closes at the top of the upstroke.
At the completion of a selected number of compression /ventilation cycles, preferably five, ventilation takes place as described in asynchronous ventilation mode above. This action completes one full CPR cycle in VDC mode.
Another feature of the device enables the operator to select no exhalation during compression (NEDC) mode. When the VDC

mode Select vaW 'e ~ ~ 1S p~ rt'~all~l Gpene~~ t~C~ perT"lt enOil~~'1 ~c'~SeS
frolrl V'~f. CrtaICt~e.L' ~~ t~~~ .be dl. re 'Cited tG 'trentllatl.on mask ~~>
fOrC:l.ng CioSilre C'f tile eXi'la~ at7.on port In 'tralve f~~ t t11~_'re~Ore preVerltS
earia! afilol~ Ce ~.~aSe.S frrm the j~at? ent 1_i,;nC.~S during Co??':preSSl.On, thus increasing intrathorax pre:~sure.
Yet another feature of the device enables the pp~5-~tr~r tn SPIe~.'::t -a ~~V~'n tl~ataon 5n~7..thC~t...tt CrJTT?;'~reSSi r,rtr' 1~~~~~ P?Ode in the event that chest compression fs not re~,uired, or to a~dl'C!i_r:lS,te_r el,t=?atri_C, Shock, v'y applyi.nJ ai.ifflClent lateral force t.o t.:i:: ay~~m 25 t he spring loaded aria loc kinc; mechanism 21 Figure 6 ) disen~~ages to allo~r rotation of co:l_umn 3 arid attacrted to it 3rt~Ei 'J~; reiatlve to tile ~~aSe ~ ~ ~~l.~LlrE'S ~: and ~~ . Ti~4~~'iel't the arm '' ~ i S rel-n!s~jrvd ~Eryrrr~ ~~0'Ie pat? ~rtt r,lwieS t I ~ ~ g ~ ~ ~ t}Ze Z'T~1(~ Sel eCt.
;~ J
-i _ _~ n / ~ t- :- .. z7~ 'r~ ~ i. : 1 vas'v... 'i ~''.J .,~-.. 4,:.7 ~~~~.r ~'Ci..Cil i_1~11, al~'..~.c ''Ja~1' ~ FJ
a~.r.. P'-~.l~..ic~. t~.ol'i syrl:~hronized ~-ith compression stroke, gases from the ventilation chamber ~0 simuitaneou.slyr ~:~; th ~aJes from ~%Dr chamber ~2 are directed to patient lungs. In or~:~er to erlsure that Slot ~~ and flanur' !F ai;rray:= remcln 1n their reSpeGtlve Orlent,~t10r1;~, a Spiral tenSl0l: Spri.nC~ ~Jn 1S Secured bete~leen lo;nTer ~Ort.3.On ~',~ arid ti:umper yo~~: ~~1, W~'2lCh 1S tlC~htened as flanGe ~~, turns 1.G~'er Oortlon cJ~ ~~ien 1t de~CendS 1I1 i'11~t1n~~ enC~~~3e~ent 'rvlth Slot i~. i''-iSGoTl aS fian~e r ~ di':eT2C~a~eS ir~.:ITI 5~~..~t ~~', Sprlrig vJ
un~tinds and returns slot '~7 to its rest position. Spring 60 is a s,a fety device tt:~ kel- 53 in case of impr=per setting of the span adjustment.
Yat ~~nother featore of the de~~rlC~ named ".:zpcln adjuStmerit mec~lanism" enables to use the device on r..~atients ~rith dlfferer~t Chest SlZeS. '~'~I ad~nStment of the d? Stance ~'~F'tTr'~en th2 249'~~~~
thumper 71 and base 11 to accommodate the patient' s chest 73. A
span adjustment crank 20 is provided on the upper surface of the arm 25 (Figure 4). The span adjustment crank 20 is connected to a span adjustment screw 16 which cooperates with a span adjustment nut 17. The span adjustment nut 17 is mounted on the upper surface of a span adjustment nut extension tube 18 extending vertically from a bracket 18' which is fixed to the lower region of the internal telescoping column as shown in Figure 4. Actuation of the span adjustment crank 20 causes the span adjustment screw 16 to move relative to the span adjustment nut 17, thereby causing the external upright telescope column 12 to move relative to internal upright telescope column 13. This changes the distance between the base 11 and thumper 71, thereby enabling adjustment for different patient chest sizes. Movement of adjustment crank 20 is sensed by span adjustment sensor 75 which feeds this information to central processing unit (CPU) 90. Based on the information from sensor 75, the CPU 90 adjusts thumper compression force by controlling the motor current.
To control thumping length of stroke and ventilation volumes of ventilation chambers 80 and 82, the shaft of the span adjustment screw 16 is engaged with stroke adjustment worm gear 19, which engages a stroke adjustment gear 19' mounted on a stroke adjustment shaft 26 within the arm 25. The stroke adjustment shaft 26 is rotatably mounted between the vertical upright 3 and the drive mechanism support 4 and extends inside and along the arm 25.
The thumper-side stroke adjustment gear 42 is mounted on the stroke adjustment shaft 26 and engages with the thumper-side stroke adjustment rack 43. The thumper-side stroke adjustment rack 43 cooperates with the ventilation cylinder piston 40 through the ventilation cylinder 39. Movement of the thumper-side stroke adjustment rack 43 downwardly, limits the upward displacement of the ventilation cylinder piston 40 and the attached thumper shaft 48, VDC cylinder piston 58, thumper yoke 61 and thumper 71 relative to the plunger 38 by delaying engagement of plunger 38 with the thumper locking mechanism key 49. In this arrangement thumper 71 and ventilation pistons 40 and 58 always travel to the bottom, regardless of the span adjustment setting thus protecting the patient against excessive chest compression or ventilation.
The alteration of span adjustment mechanism to change the distance between the base 11 and thumper 71, to accommodate patient different chest size, simultaneously and proportionally changes the thumper length of stroke and the ventilation volumes within ventilation chambers 80 and 82.
The maximum ventilation pressure in resilient reservoir 23 can be set through the adjustable pressure relief valve 22. The pressure relief valve 22 releases pressure in excess of a preselected level.
Additional adjustment to the VDC volume can be made by actuation of the VDC volume adjustment arm 69' , which engages the VDC volume adjustment screw 69. The VDC volume adjustment arm 69' engages the upper surface the VDC cylinder piston 58, which is slidably mounted on thumper shaft 48 thus inhibiting its upward 209~3~~
'motion as shown in Figure 7. This adjustment additionally reduces the ventilation during compression volume relative to the length of chest compression stroke.
The maximum ventilation pressure during compression is adjusted by the VDC pressure relief valve 22' . This valve 22' is provided to ensure that maximum ventilation during compression is not exceeded.
The CPR device 2 is provided with a crank shaft top dead centre sensor (TDC) 35, bottom dead centre (BDC) 35' and cooperating with them TDC indicator 34.. In the event of a power shortage or a pause in the motion of the drive mechanism crank wheel 31, the TDC sensor is to ensure the crank shaft arm 36 returns to the TDC position so that the patient's chest 73 is not compressed. The BDC sensor is activated with each stroke. It's signal is used by CPU 90 to count compression strokes so that after reaching preselected number of strokes CPU 90 activates valve 46 to deliver ventilation to the patient lungs.
The C.P.R device control is achieved by electronics control circuit 66 located within electronic panel housing 65.
Figure 9 illustrates in schematic form the electronic control circuit which may be contained in electronics panel 66. Power may be provided to the device by internal battery 45, which may be charged by battery charger 91 connected to an external AC power source 92; or an external DC power source 93. If an AC source is used, an internal AC/DC converter 66' is provided. Motor 28 is 2~9'~3~~
controlled, via a central processing unit (CPU) 90 which is part of the control circuit 66, through an on/off switch 94, speed controller 95, reversing switch 96 and current sensor 97. Solenoid valve 46 is controlled by CPU 90 via a valve driver 98. The motor reversal switch 96 is used to reverse rotation of the motor 28 to interrupt thumper 71 chest compression and withdraw it to top-dead-centre whenever thumping force exceeds a preset value.
The central processing unit (CPU) 90 includes a counter which counts the number of compression strokes based on impulses arriving from bottom dead centre (B.D.C.) sensor 35' and when it reaches the preset number, the valve 46 opens allowing gases stored in reservoir 23 to pass to patient 73, via mask 72. Soon after the valve 46 opens, the thumper stops at TDC. The duration of the thumper pause is controlled by a timer in CPU 90, and after the pause, valve 46 closes the motor restarts and the cycle repeats.
A preferred embodiment has been set forth in the description and drawings and is intended for illustration and not limitation. Various changes can be made without departing from the spirit and scope of the invention.

Claims (13)

1. An apparatus for a administration cardiopulmonary resuscitation comprising:
a base member for supporting and lifting a patient's back;
an adjustable mounting means on said base member means for accommodating patients with different chest sizes;
a chest compression means operatively coupled to said mounting means for cyclically compressing and releasing the chest of a patient;
a ventilation means for providing respirable gas to the patient operatively coupled to said chest compression means;
a driving means to deliver reciprocating motion for activating said chest compression and ventilation means;
an adjustment means for adjusting the chest compression and ventilation means;
a control means for controlling said apparatus operation and monitoring the patient's vital signs.

2. The apparatus of claim 1 wherein said base member has sloped shape with an elevated end lifting the patient's back and opening the patient's airways during the apparatus installation which consists in sliding the base member under the patient's back from between head and shoulder therefore eliminating the need for lifting the patient.

3. The apparatus of claim 1 wherein said mounting means includes a telescope upright means for allowing adjustment of said mounting means, said telescope upright means is pivotally mounted to said base member.

4. The apparatus of claim 3 wherein said mounting means includes an arm coupled to the telescope upright means, furthermore said chest compression and ventilation means are operatively coupled to said arm.

5. The apparatus of claim 4 wherein said mounting means includes a span adjustment means that in conjunction with the telescope upright means allow for adjustment of the span between said base member and arm to accommodate patients with different chest sizes, said span being adjusted proportionally to the patient's chest size.

6. The apparatus of claim 1 wherein said adjustment means includes means for adjusting the volume of respirable gas delivered by said ventilation means and for adjusting said length of stroke and relative force of compression applied by said compression means.

7. The apparatus of claim 6 wherein said adjustment means is slaved to the span adjustment means of the mounting means, and is therefore adjusted simultaneous with said span adjustment means and proportional to the patient's chest size.

8. The apparatus of claim 1 wherein said driving means includes a crank shaft operatively connected to a geared electric motor powered by an on board battery to provide reciprocating motion to said chest compression and ventilation means.

9. The apparatus of claim 1 wherein said ventilation means comprises a low volume ventilation means for supplying respirable gas to a patient after a preselected number of chest compressions and furthermore supplying respirable gas to a patient notwithstanding the position of said chest compression means.

10. The apparatus of claim 1 wherein said ventilation means further comprises a high volume ventilation means for supplying respirable gas to a patient during chest compression by said chest compression means.

11. The apparatus of claim 1 wherein said chest compression means comprises a locking mechanism for transferring of said driving means to said chest compression means and furthermore allows expansion of said patient's chest during ventilation.

12. The apparatus of claim 1 wherein said control means comprises a microprocessor and software for selectively operating said drive means, chest compression means andventilation means in a predetermined sequence.

13. The apparatus of claim 11 wherein said control means further comprises a monitoring means for monitoring said patient's vital signs, the mounting means, the chest compression means, the ventilation means and the adjustment means, and to communicate the status of the patient and said apparatus to an operator by an audio-visual interface.