CN101001668A - External defibrillator with pre-cpr-ecg based defibrillating shock - Google Patents
External defibrillator with pre-cpr-ecg based defibrillating shock Download PDFInfo
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- CN101001668A CN101001668A CNA2005800270940A CN200580027094A CN101001668A CN 101001668 A CN101001668 A CN 101001668A CN A2005800270940 A CNA2005800270940 A CN A2005800270940A CN 200580027094 A CN200580027094 A CN 200580027094A CN 101001668 A CN101001668 A CN 101001668A
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- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/3987—Heart defibrillators characterised by the timing or triggering of the shock
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Abstract
A defibrillator (6) having a pair of electrodes (8) for delivering an artifact-compensated defibrillation shock and a method thereof is provided. Electrocardiographic (ECG) data representative of an ECG signal is acquired for the patient and the ECG data is analyzed to determine whether administration of a defibrillating shock is appropriate. A cardiopulmonary resuscitation (CPR) interval is initiated subsequent to the acquisition of ECG data. Upon completion of the CPR interval, and if administration of a defibrillating shock is determined to be appropriate from the ECG data, arming the AED (6) for delivery of the defibrillation shock to the patient.
Description
Technical field
The present invention relates to be used for the equipment of electricity treatment, relate in particular to the interval of on the patient, carrying out cardio-pulmonary resuscitation (CPR) after minimum delay ground carry the defibrillator of defibrillation pulses fast.
Background technology
Medical equipment manufacturers has been developed autoelectrinic defibrillator (AED) early stage defibrillation is provided.AED carries high-amplitude current pulse, waveform or electric shock so that patient's rhythm of the heart is returned to normal level to heart.For example, Fig. 1 has described just to be applied to by rescuer 4 traditional AED 6 of asystole victim 2.As shown in fig. 1, a pair of defibrillation electrodes 8 is placed on preceding-preceding (AA) position on victim's trunk to be used for carrying electric shock.Usually must on the patient, carry out cardio-pulmonary resuscitation (CPR) during the defibrillating shock every now and then so that the victim is recovered from asystole.
In with defibrillator treatment asystole victim, importantly carry out treatment very apace, because they recover asystolic chance along with the time sharply reduces after asystole.Thereby, be important from the asystolic quick response that stops to begin using first defibrillating shock.And, before carrying out the CPR heart at rescue site extruding with improve resuscitating machine can the time, the long pause time between the discontinuous CPR that suffers to carry out on the patient of ventricular fibrillation and electric shock are carried will significantly reduce the chance of recovering.Thereby, it is essential shorten before the discontinuous CPR or the process of the analysis rhythm of the heart following closely so that prepare AED apace to carry subsequent defibrillation shock.
So, the invention provides a kind of improved defibrillator, it is easy to use and the user that allows to be subjected to few training treats the patient easily, apace and effectively, reduces the interval between extruding and defibrillating shock are carried before the heart simultaneously.
Summary of the invention
The present invention relates to a kind of method and system, it is used for apace and accurately defibrillating shock is applied to sudden asystole victim, after especially pushing before using the CPR heart.
According to an aspect of the present invention, the end by differentiating the CPR cycle apace and to defibrillator charging minimizes delay between the conveying of using of CPR and defibrillating shock.
According to a further aspect in the invention, provide the method for using electrotherapy in one type automatic external defibrillator (AED), the automatic external defibrillator of described type has high voltage energy, ECG detector and CPR treatment module.In the method, obtain the indication that CPR stops so that providing AED to be used for follow-up electrotherapy electric shock.The charging of AED can start before CPR treats the interval end or finish before CPR treatment interval end.Described method further is included in CPR treatment interval end before from ECG detector acquisition ECG signal, and whether definite ECG signal is by the movable destruction of CPR.
According to a further aspect in the invention, provide a kind of defibrillator of the CPR of having induction system, it comprises: the detector that is arranged to detect the signal that indication CPR stops; Be used to provide the energy source of defibrillating shock energy; Be used to the charging circuit of energy source charging; Be used to respond the controller that described signal is controlled charging circuit.CPR stops and defibrillator is recharged to be used to carry interval between the defibrillating shock less than about 10 seconds.Defibrillator further comprises the ECG detector that is used to detect the ECG rhythm signal, comes to be the defibrillator charging thereby processor can respond detected the shocked by electricity ECG rhythm of the heart.
According to another aspect of the invention, provide a kind of device from defibrillating shock to the patient that carry.Described device comprises at least one pick off that is suitable for contacting the patient; Be couple to the detector of described pick off, the interferential input signal that its application that is used to detect indication and cardio-pulmonary resuscitation interrelates; Processor, the input signal that it is used to receive self-check system is used to analyze detected input signal to produce indication from the destructive signal of patient's electrocardiogram (ECG) signal be used to need to determine whether defibrillating shock; And discharger, it is used for providing defibrillating shock to the patient.Described device further comprises and is couple to pair of electrodes determining the ECG front end of patient's impedance, LCD display and notifying operation person's speaker before emitting defibrillating shock.
One side more of the present invention provides a kind of method from defibrillating shock to the patient that use defibrillator to carry.This method is included in cardio-pulmonary resuscitation (CPR) interval and defibrillator is charged before finishing; Analysing ECG signal before cardio-pulmonary resuscitation (CPR) interval finishes; With in cardio-pulmonary resuscitation (CPR) if interval finish after less than the signal corruption that interrelates with using of CPR then carry defibrillating shock.
According to a further aspect in the invention, provide a kind of method of carrying defibrillating shock from defibrillator to the patient.Described method comprises whether the ECG data and the analysing ECG data of gathering the ECG signal of representing the patient are suitable to determine using of defibrillating shock.After gathering the ECG data, start the CPR interval.Respond the CPR end of interval,, prepare AED to be used for carrying defibrillating shock to the patient if determine using suitably of defibrillating shock from the ECG data.
Description of drawings
In the accompanying drawings:
Fig. 1 is according to an embodiment of the invention, just be applied to be subjected to the diagrammatic sketch of asystolic patient's defibrillator;
Fig. 2 has described the exemplary hardware according to defibrillator an embodiment of the invention, shown in Figure 1;
Fig. 3 according to an embodiment of the invention, be configured to carry the diagrammatic sketch of the hardware of defibrillating shock;
Fig. 4 is the flow chart of demonstration according to the operating procedure of the defibrillation system of an embodiment of the invention;
Fig. 5 is the flow chart of demonstration according to the operating procedure of the conveying defibrillating shock of another embodiment of the present invention;
Fig. 6 is the flow chart of demonstration according to the operating procedure of the conveying defibrillating shock of another embodiment of the present invention; With
Fig. 7 is the flow chart of demonstration according to the operating procedure of the conveying defibrillating shock of another embodiment of the present invention.
The specific embodiment
For the ease of understanding the present invention, description is provided the traditional method of victim's recovery.
In being subjected to sudden asystolic victim's recovery process, the rescuer usually according to rules from autoelectrinic defibrillator (AED) use defibrillating shock and carry cardio-pulmonary resuscitation (CPR) interval with blood circulation promoting up to rebuliding normal circulation.In many cases, resuscitation protocol uses voice suggestion to instruct the rescuer by AED.For example, because ventricular fibrillation and asystolic victim can receive some defibrillating shock after the predetermined interval of CPR, before providing the heart, the victim pushes and breathes help the described predetermined interval rescuer of CPR.
Those of ordinary skill in the art will be understood that extruding is considered to provide artificial circulation before the heart during CPR, and this has improved victim's chance for survival.After the predetermined interval of pushing before the heart, typically prompting operation person stops CPR, thereby AED can analyze victim's the ECG rhythm of the heart need to determine whether more electric shock.Yet, the probability that has found that existence along with extruding stop and the conveying of defibrillating shock between time interval increase and descend rapidly.So importantly minimize this critical interval as much as possible, preferably less than ten seconds.
In legacy system, before AED carries electric shock four steps must take place at CPR after interval: (1) is by regulation CPR time interval of rescue protocol setting must expire (typically one to 3 minute); (2) must analyze patient's the ECG rhythm of the heart to determine whether the rhythm of the heart should be shocked by electricity; (3) AED must charge fully to its s energy storage capacitor; (4) AED must prepare to carry electric shock.
Interrelate with these steps, AED typically sends voice suggestion to the operator and does not contact the patient to inform the operator when the CPR EOS, contacts with the patient may disturb and thereby postpone the analysis of patient's the ECG rhythm of the heart.After AED analyzed and prepares electric shock, usually alert operator did not contact the patient and carries electric shock (if equipment is automanual words) or warning electric shock will be transferred (if AED is full automatic words) by pushing shock button once more.
In the equipment of most prior aries, above four-stage carries out continuously, and this has caused the end of pushing before the heart and may carry to the patient typically having 15-30 second or above period between the electric shock.In some cases, the equipment of prior art typically partly charged to save some times to the AED s energy storage capacitor before the ECG analysis is finished, and still charged before analysis is finished and not exclusively.The AED of some prior aries utilizes pseudo-shadow to detect during attempting to analyze patient's ECG signal should carry electric shock so that determine whether.Pseudo-shadow detects gathers the interfering signal that is derived from patient moving or any other possible ECG interference source (for example electro permanent magnetic), and for example by cross-correlation with its with patient's ECG relatively so that whether definite interference itself represents the destruction of ECG.It is that the ECG of purpose analyzes and becomes unreliable that this destruction will make with electric shock consulting, because known ECG has comprised the signal that is not derived from heart.Usually, these pseudo-shadow detection systems have been used to forbid that analysis and prompting operation person ruined or the ruined ECG signal of possibility remove interference source.
Whether in addition, the defibrillator of prior art has the shock hazard to the rescuer, contact with patient body because defibrillator can not detect the rescuer.A kind of method that addresses this problem in the prior art is to provide " noncontact " period before the delivering therapeutic electric shock.Yet, this delay is non-expectation, because it has postponed the interval between the conveying of extruding (if occasion needs) and defibrillating shock before the CPR heart, thereby hindered the quick response of using defibrillating shock, be vital and should respond the chance that asystole is restored for increase fast.
In contrast, an embodiment of the invention provide a kind of defibrillation system, wherein by treating arrhythmia by means of the ECG analyzing and testing and detecting the conveying that the combination that stops or lacking of pushing before the CPR heart triggers the electrotherapy electric shock.According to this embodiment, defibrillation system has reduced the interval time between the subsequent delivery of extruding and defibrillating shock before the heart.
Fig. 2 is the simplified block diagram according to the defibrillator 20 of this embodiment of the present invention.Defibrillator 20 can comprise mechanical disturbance detector 10, electrocardiogram (ECG) front end 32, intervalometer 34, defibrillation activation/deactivation button 36, high pressure (HV) switch 38, processor 40, sound circuit and speaker 41, display 42, energy-storage capacitor network 44, voltage charger 46 and battery 48.Although specifically, should be understood that, can expect that apparatus and method according to the embodiment of the present invention can use with other hardware configuration of flat board in beginning described below with reference to the system block diagram of figure 1.Further, should be noted in the discussion above that and preferred implementation according to the present invention to be configured to produce the many commercial of defibrillating shock or to disclose obtainable defibrillator with various implementation utilizations.
As shown in Figure 2, mechanical disturbance detector 10 is connected to pick off 12, and described pick off is placed on the patient and goes up to detect moving of patient during the conveying of pushing before the CPR heart.The patient that may destroy the accurate assessment of signal of interest moves detected and is forwarded to processor 40.Similarly, ECG front end 32 is connected to electrode 22 and 24, and described electrode is placed on the patient and goes up with amplification, filtration and digitized (use analog-digital converter) the ECG signal of telecommunication by patient's heart generation.Detected ECG sample is received by processor 40, and described processor operation electric shock advisory algoritms is to be used to detect VF or need be by other shocked by electricity rhythms of the heart of defibrillation shock therapy.ECG front end 32 also can use patient's impedance between the low level test signal measurement electrode 22 and 24 of non-treatment pulse with the voltage drop between measurement electrode 22 and 24.In optional embodiment, the function of mechanical disturbance detector 10 and ECG front end 32 can be merged into parts, makes that an electrode that is connected to ECG front end 32 can be with acting on the pick off that detection of cancerous person moves.
HV switch 38 is configured to sequentially the defibrillation pulses between pair of electrodes 22 and 24 is transported to the patient with the polarity and the persistent period of expecting.Should be noted that HV switch 38 can be suitable for carrying unipolarity (single-phase), positive negative bipolar (two-phase) or positive and negative pluripolarity (heterogeneous) in a preferred embodiment.Intervalometer 34 is connected to processor 40 to be used to provide defibrillation pulses at interval or the persistent period during defibrillation pulses between delivery electrodes is to 22 and 24.Activation/deactivation button 36 is connected to processor 40 to allow the conveying of the defibrillation pulses of user's activation/deactivation between electrode 22 and 24 when VF or other rhythms of the heart that can shock by electricity are detected.Should be noted that activation/deactivation button 36 can be with AED and manual two kinds of pattern work in a preferred embodiment.Voice circuit/speaker 41 provides phonetic order in the operating period of defibrillator 20 to the user.Alternatively, activation/deactivation button can be omitted in for example full-automatic AED of other embodiments.The display 42 that is connected to processor 40 is preferably liquid crystal display (LCD) and provides visible feedback to the user.Battery 48 is a defibrillator 20, provides electric power in particular for charger 46, and described charger is the capacitor charging in the energy-storage capacitor network 44.Energy-storage capacitor network 44 comprises a plurality of capacitors and resistor, described capacitor and resistor in series or in parallel or series connection and in parallel being arranged in combination so that a plurality of voltage level outputs between electrode 22 and 24 to be provided.Those skilled in the art will can realize obviously that various RC arrange to produce different defibrillation pulse characteristics.
In operation, the electrode 22 and 24 that is connected to ECG front end 32 is placed on the patient and goes up to be used to obtain patient's impedance.The defibrillation pulses that is transported to the patient can be a fixed level, and perhaps many defibrillation pulses are in different energy levels.This can pass through to select from a configuration set appropriate voltage level of energy-storage capacitor network 44, thereby carries the impedance-compensated defibrillation pulses of expection to realize to the patient.
When the rescuer carries out Chest compressions when carrying out CPR a part of on the patient, the chest exercise of generation trends towards disturbing the electrode that is placed on the chest region.This is nonideal for detecting the ECG signal, disturbs electrical noise or pseudo-shadow because the motion of the electrode on the skin of chest zone produces, and this may destroy the ECG signal.As subsequently specifically as described in, pseudo-shadow in the ECG signal that causes by machinery interference, electromagnetic interference, other environmental conditions of pick off, or by cardio-pulmonary resuscitation (CPR) however the pseudo-shadow that the motion that operation causes causes is useful as the indication that CPR is performed, when CPR finishes and when the patient is just being disposed.Can comprise the accelerometer or other motion sensors that are used for this testing goal in some embodiments.Defibrillator 20 also has display 42 to be used for visually indicating shock annunciation, perhaps can be equipped with sound circuit and speaker 41 and can listen announcement to be used for just providing before carrying defibrillating shock.
It should be noted that and rescuing between trial period that disturb and/or pseudo-shadow if detect the machinery of renewal after AED preparation electric shock, the weak point before treatment is carried postpones to provide in interval defibrillation activation/deactivation 36 to be used for the cancellation electric shock.Alternatively, the motion of new machinery interference and/or pseudo-shadow can be detected and be caused the cancellation or the delay of defibrillation shock therapy automatically.
Fig. 3 allows the detailed description of the parts of rapid analysis during machinery disturbs, thereby can use no pseudo-shadow ECG to determine arrhythmia, especially after the machinery interference stops.It should be noted that detecting pseudo-shadow can be performed in every way.For example, dependency according to signal processing of the present invention and processed signal can be included in U.S. Patent application No.6,287, the various embodiments of describing in 328, above-mentioned patent is applied for by the applicant, be disclosed in calendar year 2001 JIUYUE 11 days, denomination of invention is " the pseudo-film review of multivariate is estimated ", and the instruction of above-mentioned patent is incorporated into this with for referencial use.
Briefly, the input signal of indicating the patient to move is received and is provided for measuring circuit 10 by pick off 12.Signal is sent to signal processor 52 then and is forwarded to correlator 60 being used for the ECG signal correction with the patient, and coherent signal is passed to processor 40.One skilled in the art will appreciate that the appropriate signal processing for example comprises band filter, Fourier transform, wavelet transform, time-domain analysis, or associating time sequence frequency spectrogram.In addition, being used for making the relevant method of data can be any correlation technique of this area.For example, correlation technique comprises specific and general cross-correlation techniques, and it comprises known mathematical function and makes the relevant any method of data effectively.The specific implementation mode includes but not limited to the inclined to one side and no inclined to one side cross covariance and the limited sampling or the assessment continuously of cross-correlation.Alternatively, the relevant similarity that can carry out between any a plurality of signal compares.
Therebetween, the input signal of indication patient's voltage and impedance is received between electrode 22 and 24 and is passed to differential mode amplifier 56 and common mode amplifier 62, amplifying signal before passing the signal along to signal processor.The signal that obtains is passed to their signal processors 58 and 64 separately then, and described processor processing signal is with emphasize particular features.Particularly, signal processor 58 provides signal message relevant with variable to be used for, and described variable comprises common-mode signal, impedance signal, or deal with the motor message of device separately from them.The processing signals that obtains is passed to the correlator 66 that makes signal correction then.Simultaneously, input signal is passed to impedance detector 68, and this impedance detector provides through the electrode impedance signal to signal processor 70.Signal processor 70 is handled signal from impedance detector 68 to emphasize the specific characteristic of signal.The processing signals that obtains is passed to correlator 72 then, and this correlator makes signal processor 70 and from the processed signal correction of differential amplifier 58.In case by relevant, the signal that obtains is passed to processor 40 to signal at their correlators 66,72 separately, the result that this processor is further estimated correlator 66 and 72 then is with the indication of destructiveness that interested ECG signal is provided.Processor 40 finally provides output signal, and this output signal can be described analyzed with reference to following Fig. 4.
Fig. 4 is the flow chart that shows according to operating procedure preferred implementation of the present invention, the pseudo-shadow compensated defibrillation shock of conveying.
Initially, arrange that by pick off 12 and electrode 22,24 being attached to the cardiac defibrillator 20 is to analyze patient's input signal.It should be noted that rescue between trial period carry out usually CPR be included in carry out the heart on the victim before extruding and in conjunction with the use of defibrillator, thereby the ongoing CPR of input signal detection that may origin autobiography sensor 12.
In step 100, the predetermined interval system 20 before extruding finishes before the CPR heart begins capacitor 44 is charged to by-level.In step 102, system 20 sends message to stop CPR to the rescuer, and capacitor is still in charging during this period.In step 104, allow short interval, for example 3 seconds or below.Thereafter, the electrode 22 and 24 that is connected to ECG front end 32 in step 106 detects input signals, i.e. ventricular fibrillation (VF) and patient's impedance, and it is by measurement low level test signal or carry non-treatment signal and measured.Movable information is by motion disturbance detector 10 or motion sensor collection.
Other measured value test ECG signals of contrast are so that determine whether the ECG signal is destroyed in step 108.Carry out signal processing so that emphasize the specific characteristic of the data in the input signal.Here, the various implementations of utilize handling comprise known technology, wave filter for example, Fourier transform, wavelet transform, or associating time sequence frequency spectrogram.For example, the low frequency spectrum of the Fourier transform of ECG signal part can be relevant with the impedance signal of similar processing so that strengthen the detection of pseudo-shadow, and the patient that described pseudo-shadow comes leisure to come under observation goes up the defibrillator operator who carries out CPR.
Therefore, analytical procedure 108 is carried out the function of measuring the similarity between processed heart signal and the processed destruction signal.Analyze the indication of comparative result then with the pseudo-shadow amount determining in may ruined heart signal, to exist.If detect pseudo-shadow and/or motion in step 108, then process is returned step 106.
In case step 108 determines that the ECG data of being gathered are not destroyed, then the ECG data are analyzed need to determine whether electric shock by processor 40 in step 109.If do not need electric shock, AED can provide optional attention instruction to the rescuer.Yet if the ECG rhythm of the heart should be shocked by electricity, AED finishes its capacitor charging in step 110.Further, lack in step 108 that ECG destroys or motion artifacts signal indication rescuer has ended CPR, thus suitable be to prepare defibrillator immediately to carry electric shock.Processor 40 sends signal with starting switch to HV switch 38 then, thereby discharges the defibrillating shock of expection to the patient.Alternatively, processor 40 can be pressed the conveying of shock button 36 with the defibrillating shock that manually boots the patient by display 42 notifying operation persons.Therefore, in step 110 defibrillating shock is discharged into the patient, the heart of monitored patient is to determine whether subsequent defibrillation shock is necessary then.If so, above step can be repeated to carry subsequent defibrillation shock.
Fig. 5 is the flow chart that shows according to operating procedure another embodiment of the present invention, the pseudo-shadow compensated defibrillation shock of conveying.
In operation, in step 200, send indication to stop the CPR operation, begin then capacitor 44 is charged to full up level to the rescuer.In step 202, after ending the CPR extruding, allow short interval, the electrode 22 and 24 that is connected to ECG front end 32 then in step 204 detects input signal, be ventricular fibrillation (VF) and patient's impedance, described input signal owing to may ruined signal and/or patient movement cause.
Analysing ECG and interfering signal, if detect pseudo-shadow and/or motion artifacts in step 206, processor turns back to step 204.If the ECG data are not destroyed, the ECG data are analyzed need to determine whether electric shock by processor 40 in step 209.If do not need electric shock, AED can provide optional attention instruction to the rescuer in step 210.It should be noted that does not have ECG to destroy in step 108 or motion artifacts signal indication rescuer has ended CPR, thus suitable be to prepare defibrillator immediately to carry electric shock.If the ECG rhythm of the heart should be shocked by electricity, then AED finishes the charging of its capacitor in step 208.When capacitor 44 by after the charging fully, processor 40 sends notification signal to the user before carrying defibrillating shock.In this mode, defibrillating shock is released to the patient, and the heart of monitored patient is to determine whether subsequent defibrillation shock is necessary then.
Fig. 6 is the flow chart that shows according to operating procedure another embodiment of the invention, the pseudo-shadow compensated defibrillation shock of conveying.
In this case, the CPR interval of 40 monitoring preset times of processor.In step 300, when the end of CPR interval near the time, processor 40 orders 46 pairs of capacitors 44 of charger to charge fully in one way, this mode is to make in the CPR interval to reach before overtime to be full of.Again, before the CPR interval finishes, in step 302, gather ECG data and the interferential various signals of indication.Check that in step 304 the ECG data are to search destruction.If the ECG data are gathered more data because CPR is destroyed.Yet,, determine in step 306 whether patient's the ECG rhythm of the heart should accept defibrillating shock if data are not destroyed.In step 308, processor 40 continues to upgrade rhythm's shock and determines up to the CPR interval overtime.In case the CPR interval is overtime, processor 40 causes that sound circuit does not contact the patient with speaker 41 prompting rescuers in step 310.In step 312, processor 40 is checked the electric shock decision of determining recently.If defibrillating shock is unsuitable, then the device directive rescuer carries out optional patient care, for example additional CPR.If electric shock is suitable, then step 316 checks that interfering data is stopped with the detected disposal that guarantees the patient.If detect disposal, in step 318, send prompting to stop to contact the patient to the rescuer.If do not detect disposal, processor 40 preparation defibrillators shock by electricity in step 320, and AED sends prompting to carry electric shock to the rescuer immediately.The advantage of this embodiment is if the execution of CPR does not destroy patient's ECG signal, then might still make the decision that all need to shock by electricity next time when carrying out at CPR.In this mode, in case overtime AED of CPR interval can be ready to carry electric shock immediately.Thereby, CPR stop and shocking by electricity between delay can be near zero second.
Fig. 7 is the flow chart that shows according to operating procedure another embodiment of the present invention, the conveying defibrillating shock.
The electrode 22 and 24 that is connected to ECG front end 32 (Fig. 2) in step 702 detects input signal, for example ventricular fibrillation (VF) and patient's impedance, and it is by measuring the low level test signal or carrying non-treatment signal measured.In addition, gather because the input signal that ruined signal of possibility and/or patient movement cause.Movable information is obtained by motion disturbance detector 10 or motion sensor.In step 704, determine whether the ECG data are destroyed.If determine that the ECG data are destroyed, gather more data and can determine up to processor 40 whether electric shock is suitable.
Analyze need to determine whether electric shock by processor 40 in the 702 ECG data of being gathered in step 708.Electric shock can be suitable under certain condition, and described condition is to detect the rhythm of the heart that can shock by electricity, and for example the indication of ECG data exists VF or ventricle tachycardia (VT), and this is known in the art.Processor 40 can utilize analysis previously described or as known in the art to determine whether electric shock is suitable.Determine electric shock whether suitably after, 40 beginning CPR intervals of processor and send signal to provide visual to the rescuer and/or can listen prompting in step 706 with beginning CPR extruding to sound circuit and speaker 41 or to display 42 or to both.In optional embodiment, thus step 706 and 708 be reversed determine electric shock whether suitably before the using of beginning CPR interval and CPR.With random order, whether using and determining to shock by electricity of CPR suitably also can be overlapping.Beginning sometime energy-storage capacitor network 44 chargings in step 710 voltage charger 46, making before interval arrival to be full of finishing CPR.As shown in Figure 7 in step 712, in case finish the CPR interval, processor 40 sends signal to sound circuit and speaker 41 or to display 42 or to both, thereby the instruction rescuer stops to use of CPR and keeps at a distance with the patient.
Determine whether cause using of defibrillating shock in step 714 by the analysis that processor 40 is carried out in step 708.Under the unsuitable situation of electric shock, AED can provide optional attention instruction to the rescuer in step 715.In contrast, determining under the suitable situation of electric shock, checking that at step 716 processor 40 interfering data is stopped with the detected disposal that guarantees the patient.Dispose under the situation about not being stopped in interfering data indication, at step 718 processor 40 to sound circuit and speaker 41 or to display 42 or send signal to both and stop to contact the patient with the prompting rescuer.When processor 40 does not detect interference, prepare defibrillators 20 to carry defibrillating shock to the patient at step 720 processor 40.
Almost carry defibrillating shock according to for example allowing the ECG signal of gathering before interval from beginning CPR, to detect under the situation of the rhythm of the heart that can shock by electricity immediately after finishing in the CPR interval about the described process of Fig. 7.In this mode, CPR extruding stop and the conveying of defibrillating shock between time can be reduced.Previously described process can be utilized together with multiple different resuscitation protocol.
Although shown and described preferred implementation of the present invention, those skilled in the art will appreciate that and under the situation that does not break away from actual range of the present invention, can carry out variations and modifications and equivalent can replace its element.In addition, can carry out many modifications and not break away from essential scope to adapt to particular condition of the present invention and instruction.For example, in step 704, can whether carry out the collection of the ECG signal that is used to analyze under the ruined situation in uncertain ECG data, and keep within the scope of the invention.So the present invention does not also mean that the particular embodiment that is limited in as expecting that execution optimal mode of the present invention is disclosed, but the present invention includes all embodiments that are encompassed in the appended claim scope.
Claims (20)
1. one kind is transported to patient's method with defibrillating shock from defibrillator, and this method comprises:
Gather electrocardiogram (ECG) data of the ECG signal of representing the patient;
Whether the analysing ECG data are suitable to determine using of defibrillating shock;
After the collection of ECG data, begin cardio-pulmonary resuscitation (CPR) interval, the patient is used the CPR extruding at least a portion CPR interval; With
If finishing and determining that from the ECG data using of defibrillating shock is suitable of response CPR interval then prepared AED to be used for carrying defibrillating shock to the patient.
2. method according to claim 1, wherein the analysing ECG data are finished to determine whether using suitably before the CPR interval finishes of defibrillating shock.
3. method according to claim 1, wherein the analysing ECG data are determined ventricular fibrillation and the ventricle tachycardia at least one to determine that whether suitably using of defibrillating shock comprise from the ECG data.
4. method according to claim 1, wherein gather and represent the ECG data of ECG signal to comprise:
Obtain the ECG signal;
Determine whether the ECG signal is destroyed by patient movement; With
Obtaining another ECG signal is not gathered up to destroying signal.
5. method according to claim 1 further is included in and prepares to carry defibrillating shock to the patient after the AED.
6. method according to claim 1 further is included in and prepares to detect the indication that CPR stops before the AED.
7. finishing and when determining that using of defibrillating shock is suitable, providing optional attention to instruct of response CPR interval further is provided method according to claim 1.
8. method that is used for regularly carrying defibrillating shock from automatic external defibrillator (AED), this method comprises:
CPR gathered the ECG signal before interval in beginning;
Finished CPR before interval, determining whether the conveying of defibrillating shock is suitable; With
If determine that the conveying of defibrillating shock is suitable, then just prepare AED being used to carry defibrillating shock in case finish the CPR interval,
Otherwise,, then just postpone AED preparation and collection and analysing ECG signal in case finish the CPR interval if determine that based on the ECG signal of gathering before interval at CPR the conveying of defibrillating shock is inappropriate.
9. method according to claim 8, wherein beginning CPR before interval the analysing ECG signal be included in and finish previous CPR analysing ECG signal after interval.
10. method according to claim 8, wherein beginning CPR before interval the analysing ECG signal be included in beginning CPR analysing ECG signal immediately before interval.
11. method according to claim 8, wherein whether the conveying of definite defibrillating shock suitably comprises at least one from ECG signal analysis detection ventricular fibrillation and ventricle tachycardia.
12. method according to claim 8 further is included in and charges fully for charging capacitor before finishing the CPR interval.
13. method according to claim 8 further is included in and prepares to detect the indication that CPR stops before the AED, wherein prepares AED to be used for carrying defibrillating shock immediately after stopping detecting CPR.
14. method according to claim 8 further is included in and prepares to trigger AED to carry defibrillating shock to the patient after the AED.
15. a defibrillator that is used to carry defibrillating shock, this defibrillator comprises:
The energy delivery unit, it is configured to provide defibrillating shock after being prepared;
Electrocardiogram (ECG) analytic unit, it is configured to gather the ECG signal and analyzes it, and the ECG analytic unit produces the electric shock proper signal in response to suitable based on the conveying of the determined defibrillating shock of ECG signal analysis;
Cardio-pulmonary resuscitation (CPR) interval intervalometer, its be couple to the ECG analytic unit and be configured to after gathering the ECG signal, begin the CPR interval and respond the CPR interval finish the generation timeout signal; With
Prepare circuit, it is couple to ECG analytic unit, CPR interval intervalometer and energy delivery unit, and is configured to prepare the energy delivery unit to carry defibrillating shock in response to receiving electric shock proper signal and timeout signal.
16. defibrillator according to claim 15 further comprises charging circuit, this charging circuit is couple to the energy delivery unit before interval the energy delivery unit is charged fully finishing CPR.
17. defibrillator according to claim 15 further comprises testing circuit, this testing circuit is couple to the preparation circuit and prepares the energy delivery unit to allow preparing circuit in response to detecting active the stopping of CPR.
18. defibrillator according to claim 15, wherein the ECG analytic unit is configured in response to from ECG signal detection ventricular fibrillation and ventricle tachycardia at least one, produces the electric shock proper signal.
19. defibrillator according to claim 15, wherein the ECG analytic unit comprises the ECG signal gathering unit, this signal gathering unit is configured to obtain the ECG signal, determines whether the ECG signal is moved destruction, and obtains another ECG signal and do not gathered up to destroying the ECG signal.
20. defibrillator according to claim 15, wherein the ECG analytic unit is configured to finish the analysis of ECG signal before producing the electric shock proper signal.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US60001004P | 2004-08-09 | 2004-08-09 | |
| US60/600,010 | 2004-08-09 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN101001668A true CN101001668A (en) | 2007-07-18 |
Family
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNA2005800270940A Pending CN101001668A (en) | 2004-08-09 | 2005-07-19 | External defibrillator with pre-cpr-ecg based defibrillating shock |
Country Status (4)
| Country | Link |
|---|---|
| EP (1) | EP1778349A2 (en) |
| JP (1) | JP2008508976A (en) |
| CN (1) | CN101001668A (en) |
| WO (1) | WO2006016289A2 (en) |
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| WO2004058351A1 (en) * | 2002-12-20 | 2004-07-15 | Axon Medical, Inc. | System providing emergency medical care with real-time instructions and associated methods |
-
2005
- 2005-07-19 EP EP05780818A patent/EP1778349A2/en not_active Withdrawn
- 2005-07-19 CN CNA2005800270940A patent/CN101001668A/en active Pending
- 2005-07-19 JP JP2007525389A patent/JP2008508976A/en not_active Withdrawn
- 2005-07-19 WO PCT/IB2005/052420 patent/WO2006016289A2/en active Application Filing
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Also Published As
| Publication number | Publication date |
|---|---|
| WO2006016289A3 (en) | 2006-05-18 |
| JP2008508976A (en) | 2008-03-27 |
| WO2006016289A2 (en) | 2006-02-16 |
| EP1778349A2 (en) | 2007-05-02 |
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