CN1279599A - Device for assisted cardiopulmonary resuscitation - Google Patents

Device for assisted cardiopulmonary resuscitation Download PDF

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Publication number
CN1279599A
CN1279599A CN98811241A CN98811241A CN1279599A CN 1279599 A CN1279599 A CN 1279599A CN 98811241 A CN98811241 A CN 98811241A CN 98811241 A CN98811241 A CN 98811241A CN 1279599 A CN1279599 A CN 1279599A
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CN
China
Prior art keywords
patient
piston
chest
controller
rescuer
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
CN98811241A
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Chinese (zh)
Inventor
约拉姆·拉斯
阿哈龙·拉米什
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CPR DEVICES Ltd
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CPR DEVICES Ltd
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Application filed by CPR DEVICES Ltd filed Critical CPR DEVICES Ltd
Publication of CN1279599A publication Critical patent/CN1279599A/en
Pending legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004Heart stimulation
    • A61H31/005Heart stimulation with feedback for the user
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004Heart stimulation
    • A61H31/006Power driven
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004Heart stimulation
    • A61H31/007Manual driven
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022Control means therefor
    • A61M16/024Control means therefor including calculation means, e.g. using a processor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39Heart defibrillators
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39Heart defibrillators
    • A61N1/3904External heart defibrillators [EHD]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39Heart defibrillators
    • A61N1/3904External heart defibrillators [EHD]
    • A61N1/39044External heart defibrillators [EHD] in combination with cardiopulmonary resuscitation [CPR] therapy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12Driving means
    • A61H2201/1238Driving means with hydraulic or pneumatic drive
    • A61H2201/1246Driving means with hydraulic or pneumatic drive by piston-cylinder systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50Control means thereof
    • A61H2201/5056Control means thereof pneumatically controlled
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2230/00Measuring physical parameters of the user
    • A61H2230/04Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0057Pumps therefor
    • A61M16/0063Compressors

Abstract

A system for assisted cardiopulmonary resuscitation to allow a rescuer to apply his/her body weight to the chest of a victim comprising: a contact surface (4) for contacting the victim's chest; a support member (3) for enabling the rescuer to apply his/her body weight to the contact surface (4); and a displacer (9) operative to move the support member (3) relative to the contact surface (4).

Description

The device of assisted cardiopulmonary resuscitation
Invention field
What the present invention relates to is the method and apparatus of assisted cardiopulmonary resuscitation.
Background of invention
At the heart beating stopping period, heart is in inharmonious heart contraction (ventricle fibrillation) or complete halted state, and such state stops blood to flow to brain and comprises other vitals of heart itself.Only just having every year 300,000 people of surpassing to die from heart beating in the U.S. stops.The purpose of cardio-pulmonary resuscitation (CPR) is to keep blood and oxygen flows to heart and brain, to avoid damage, up to the heart beating that can rebulid patient oneself.
The simplest form of CPR, manual CPR comprises with carrying out twice oxygen supply of enforcement circulation that the breast compressions of the 3.75-5cm degree of depth produces with hands with the speed of about per minute 100 times compression.Manual CPR is typically utilized the most muscle of rescuer synchronously, so that needs doing the best on the real muscle power concerning the rescuer.Because CPR may need 20 minutes or the longer time, it is exhausted that the rescuer usually becomes, and is forced to stop CPR, and/or revive or specialized salvage service reaches (Baubin etc.) and acts on CPR before mistakenly patient.Therefore rescuer's fatigue is great limiting factor in the effectiveness of manual CPR.
When manual CPR provides when initiatively compressing, it depends on the passive expansion of the chest of following each compression.On the other hand, initiatively compression-decompression (ACD) CPR initiatively compresses and decompression by also at full tilt the chest pull-up being provided to intrinsic pressure chest.
Be used to provide the several means of ACD-CPR to describe to some extent.United States Patent (USP) the 5th, 636 No. 789, discloses a kind of vacuum cup that is placed directly in patient's chest the 5th, 295, No. 481 and the 5th, 645, No. 522.By pressing vacuum cup compression chest downwards, lift chest so that decompression initiatively to be provided by the pull-up sucker.Yet the ACD-CPR device does not solve rescuer's fatigue problem.In fact, compare with manual CPR, carry out ACD-CPR needs to do 25% work such as (recover (Resuscitation) 29:23-31 (1995)) Shultz more.
United States Patent (USP) the 4th, 928 discloses the Inflated vest that patient's chest is taken up in a kind of design No. 674.This device is inflated pressure by computer-controlled compressor and is exitted from all directive effects to trunk.The automatic CPR device solves of even now rescuer's fatigue problem, but their effectiveness never obtains confirming (Halperin etc.).Their operation is except that a large amount of professional technique of needs, and is very heavy as disclosed full-automatic device in ' No. 674 patents, therefore is difficult to take to patient at one's side.In addition, the assembling design of this sampling device it is to be difficult to accept.
The reference of being quoted
such as Baubin recover (Resuscitation), 33:135-139 (1996).
such as Shultz recover (Resuscitation), 29:23-31 (1995).
N.Engl.J.Med 329:762-768 (1993) such as Halperin.
Summary of the invention
A purpose of some preferred embodiments of the invention is to reduce the fatigue of rescuer between the CPR implementation period.Best, the CPR of enforcement satisfies American Heart Association (AmericanHeart Association) criterion that CPR implements.Best, help to satisfy these criterions according to a preferred embodiment of the invention.
An aspect of some preferred embodiments of the invention is the rescuer to be used as " flexibly weight (smart weight) ", thus the rescuer by with he/her weight shifts to patient and removed by patient, carries out the pith of CPR task.Best, the live part of the mechanical energy that the removing patient chest needs is provided by motorisation unit.In addition or in addition, such device also helps the rescuer to move his weight.In a preferred embodiment of the invention, the center of rescuer's action is to be transformed into control CPR action by carrying out mechanical power.Best, a result of center conversion is that the rescuer carries out higher-quality CPR.In addition or in addition, another result of center conversion needs the rescuer to do still less merit, therefore by CPR he can fatigue, can continue the longer time.
The interaction that the aspect is the people in the CPR process of some preferred embodiments of the invention.In a preferred embodiment of the invention, the people plays " weight flexibly ", as whole machinery and the rescuer part of interior CPR system again that comprises.In a preferred embodiment of the invention, the CPR process can be controlled by the weight that shifts the rescuer.Therefore, as the intact part of CPR action, the rescuer can change his action, so that ongoing CPR carries out with rescuer's wish.In addition or in addition, for example according to other feedback of vision and/or patient, the rescuer can make ongoing CPR consistent with the CPR of patient's needs more accurately.
An aspect of some preferred embodiments of the invention is built-up times of the CPR device of hope.In some embodiments of the invention, the CPR device is placed on the suitable position of patient's chest simply.Therefore, built-up time identical with pure manual CPR basically.
What an aspect of some preferred embodiments of the invention related to is CPR device and/or the method for regulating concerning specific rescuer/patient/CPR position.In a preferred embodiment of the invention, the rescuer uses identical CPR device, with different slightly mode, for example change he clock and/or the center of center of gravity realizes regulating.In addition or in addition, change the vertical dimension of CPR device, for example, change setting wherein or the pillar or the spacer that can freely stretch is provided, the realization adjusting.In addition or in addition, the modifier operating parameter, for example, and waveform, the response of frequency and/or the physiologic variables that perceives realizes regulating.
An aspect of some preferred embodiments of the invention is to help the rescuer to place his weight of his weight/removed by patient's chest.In one embodiment of the invention, help can make better thrust to chest, impels CPR more effective.In one embodiment of the invention, help to comprise that the weight with the rescuer is lifted away from patient.In addition or in addition, help to comprise that rescuer's weight is reduced to patient's chest.
An aspect of some preferred embodiments of the invention is linkage units of restriction access times.In one embodiment of the invention, use linkage unit that the CPR device is connected to patient's chest, this linkage unit only can use once or seldom several times.In addition or in addition, linkage unit is by itself being fixed to patient's chest, the CPR device is connected to linkage unit then.Best, finish CPR one time, the CPR device is unloaded by linkage unit, this linkage unit may still be connected to chest.In an example, linkage unit comprises sucker or adhesive pad.In addition or in addition, linkage unit comprises best belt around patient's trunk.In the present invention in a preferred embodiment, linkage unit comprises the biosensor such as chest displacement transducer or EGG electrode.In addition or in addition, linkage unit comprises effective unit, as remove heart fibrillation electrode and/or outside pacing electrode.
Therefore, provide a kind of assisted cardiopulmonary resuscitation to allow the rescuer his/her body wt to be affacted the system of patient's chest according to a preferred embodiment of the invention, this system comprises:
(a) be used to contact the contact surface of patient's chest;
(b) be used for to make the rescuer his/her body wt to be affacted the supporter of contact surface;
(c) arrive the displacer of selecting height with frequency and the speed of selecting with respect to contact surface lifting or reduction supporter.
Best, this system comprises the controller that starts said displacer.
In a preferred embodiment of the invention, provide a kind of assisted cardiopulmonary resuscitation to allow the rescuer his/her body wt to be affacted the system of patient's chest, this system comprises:
(a) cylinder assembly, this assembly comprise closed cylinder and the piston component with bottom, the piston rod that this piston component comprises piston and slides and accept in said cylinder;
(b) link to each other, be used to contact the contact surface of patient's chest with the bottom of said cylinder;
(c) mention the displacer of piston;
(d) link to each other, be used for to make the rescuer that his/her weight is affacted piston with said piston rod so that press piston apace and cause the supporter that patient's chest is compressed;
(e) can start said device, be used to mention piston so that piston is mentioned the controller of selecting height with frequency and the speed selected.
In preferred embodiment operating period, the rescuer kneels by patient's chest, the contact surface of cylinder assembly is placed on the patient's chest, for example, with the piston that is in the stroke bottom.The rescuer is delivered to his body wt on the supporter.When piston was risen, rescuer's head and shoulder were raised, so that rescuer's gravitional force increases.When rescuer's head and shoulder when being raised, his knee and buttocks become more crooked, so that his body wt is transferred to his knee by supporter.Rescuer's body wt is discharged into patient's chest by the transfer of supporter with pressure, and patient's chest is depressurized.When the top of piston at stroke, the rescuer transfers to supporter with his body wt, impels piston to descend fast, and therefore the gravitional force with the rescuer changes into kinetic energy.When the piston of quick decline bumped against the bottom of cylinder assembly, rescuer's kinetic energy was delivered to patient's chest, and chest is compressed, and can begin such circulation again.Those skilled in the art will recognize, similar with manual CPR, preferred embodiments more of the present invention also provide initiatively compression except relying on the passive decompression of chest.In addition, in preferred embodiments more of the present invention, for example, use sucker, bonding agent and/or belt the CPR device to be connected to patient's chest.When the rescuer further leaned on backward, chest can upwards be mentioned, so that initiatively decompression to be provided.In addition or in addition, in case rescuer's weight has departed from patient's chest, if the rescuer keeps its position, the active of this device is shortened can cause the chest decompression.
In case the present invention can comprise the rescuer selectively and his weight transmitting has been used to reduce the reduction device of piston during to supporter.Except that effect gives the piston kinetic energy to supporter by rescuer's body wt, reduce device and also give piston kinetic energy.
The circulation frequency, the height that piston will rise, and piston rises or the speed that descends is all determined by controller, and can by the rescuer select with patient need consistent.In addition or in addition, for example, use the height that telescopic prop can setting device itself.
Therefore provide a kind of assisted cardiopulmonary resuscitation to allow the rescuer his/her body wt to be affacted the system of patient's chest according to a preferred embodiment of the invention, this system comprises:
Be used to contact the contact surface of patient's chest;
Be used for to make the rescuer his/her body wt to be affacted the supporter of contact surface;
Move the displacer of the supporter relevant effectively with contact surface.
Best, this system comprises can start displacer to obtain the controller of needs motion.Best, said desired movement comprises the direction of hope.In addition or in addition, said desired movement comprises the active force of hope.
In the present invention is in the preferred embodiment, and said displacer increases the displacement between said supporter and the said contact surface.In addition or in addition, said displacer reduces the distance between said supporter and the said contact surface.In addition or in addition, said displacer comprises electric notor.In addition or in addition, said controller comprises electric controller.In addition or in addition, controller comprises pneumatic controller.
Provide a kind of assisted cardiopulmonary resuscitation selectively his/her body wt to be affacted the system of patient's chest to allow the rescuer according to a preferred embodiment of the invention, this system comprises:
(a) comprise cylinder assembly and piston component, the piston rod that this piston component comprises piston and slides and accept in said cylinder with bottom closure cylinder;
(b) link to each other, be used to contact the contact surface of patient's chest with the bottom of said cylinder;
(c) mention the displacer of piston;
(d) link to each other, be used for to make the rescuer that his/her weight is affacted piston with said piston so that press piston apace and cause the supporter that patient's chest is compressed.Best, this system comprises can start said displacer to carry out the controller of needs motion.In addition or in addition, the frequency shifts of piston to select.In addition or in addition, said piston moves with the speed of selecting.In addition or in addition, said piston moves the height of selected amount.
In the preferred embodiment of the present invention, system comprises electrocardiogram monitor and the monitor that links to each other with controller, and wherein said controller responds said ECG and starts and stop lifting device.In addition, system comprises electrocardiogram monitor and the monitor that links to each other with controller and can produce the realizable signal of rescuer, this signals direct cardio-pulmonary resuscitation.Best, said guidance comprises when stopping said CPR and provides indication to the rescuer.
In a preferred embodiment of the invention, said system comprises biosensor, the said patient's of this sensor physiological parameter.Best, said controller responds said the moving of value change that said sensor arrives.In addition or in addition, said controller respond said sensor to value produce indication to said rescuer.
In a preferred embodiment of the invention, said displacer comprises and piston descended so that the masterpiece of selecting is used the reduction device of patient's chest.In addition or in addition, by below piston face, introducing Compressed Gas piston is risen.Best, Compressed Gas is an air.In addition or in addition, Compressed Gas is an oxygen.
In a preferred embodiment of the invention, piston is risen.In addition or in addition, by on piston, introducing Compressed Gas piston is descended.In addition or in addition, by electric notor piston is descended.In addition or in addition, electricity consumption operation control.In addition or in addition, controller is air operated.
In a preferred embodiment of the invention, system comprises further linking to each other with controller and is used for the respiratory organ that patient pulmonary breathes that said breathing is consistent with cardio-pulmonary resuscitation.Best, follow per 15 times of patient's chest and compress, control patient pulmonary breathes for about 2 times.
In a preferred embodiment of the invention, system comprises linking to each other with controller and is used for the defibrillator that heart of patient removes heart fibrillation that the said heart fibrillation that goes is consistent with cardio-pulmonary resuscitation.
In a preferred embodiment of the invention, system comprises capnometer.In addition or in addition, system comprises the blood flow instrument.In addition or in addition, system comprises a strap.Best, belt is fixed to system in patient's chest.In addition or in addition, belt comprises the defibrillator electrode.
Said in a preferred embodiment of the invention contact surface comprises sucker.Best, said system is connected to said sucker effectively after said sucker is linked said patient.In addition or in addition, said sucker comprises the heart fibrillation electrode.In addition or in addition, said sucker comprises at least one biosensor.
In a preferred embodiment of the invention, system further comprises the display that is used to represent physiological parameters of patients.Best, said display comprises auditory displays.In addition or in addition, said physiological parameter comprises patient's heart rate.In addition or in addition, said physiological parameter comprises patient's blood pressure.In addition or in addition, said physiological parameter comprises patient's rate of blood flow.In addition or in addition, said physiological parameter comprises CO in the patient expired breathing 2Concentration.In addition or in addition, said physiological parameter comprises the pressure that affacts patient's chest.In addition or in addition, said physiological parameter comprises the patient's chest displacement.
In a preferred embodiment of the invention, system comprises and can monitor and store relevant recovery monitoring of information device.
In addition, the use of the system of the control cardio-pulmonary resuscitation of describing in as mentioned within the scope of the invention.
Brief description of the drawings
Mode by way of example is described with reference to the drawings the present invention now, in the accompanying drawing:
Fig. 1 represents one embodiment of the present of invention;
Fig. 2 represents along the cutaway view of Fig. 1 plane A-A cylinder assembly, supporter and contact surface;
Fig. 3 represents the generalized flow chart of description control Elementary Function;
Fig. 4 represents that the rescuer controls the use of CPR to Fig. 1 embodiment to patient, and wherein the piston of embodiment is in the bottom of its stroke in (a), and piston (c) is represented (a) and stack (b) on the top of its stroke in (b).
The description of the preferred embodiment of the present invention
Fig. 1 represents CPR device according to the preferred embodiment of the invention, and wherein sealing slidably, piston is installed in the closed cylinder 1.The upper end of piston rod 2 is connected to supporter 3, preferably is suitable for the rescuer and holds with a firm grip.(cylinder 1, piston (not having expression) and the said cylinder assembly of piston rod 2 common formations) contact surface 4 links to each other with the basal surface of cylinder.Best, contact surface 4 comprises sucker, and adhesive pad and/or belt are with contacting between holding device and the patient.In a preferred embodiment of the invention, the rising of piston 2 and the descending motion influence of source of the gas 8 (for example nitrogen, air or oxygen) by compression.In a preferred embodiment of the invention, cylinder, for example supply oxygen.In addition or in addition, provide the compressor of compress ambient air.Such compressor can utilize for example chargeable power supply or internal combustion engine.In addition or in addition, can use other external pressure source, for example, the wall source of compressed air or oxygen in the hospital.In addition or in addition, can use other method of mobile piston 2 and/or supporter 3, for example, hydraulic motor or electric notor.
Best, cylinder 1 links to each other with external pressure source 8 with 7 by flexible pipe 5,6.In a preferred embodiment of the invention, controller 9 places between external pressure source 8 and the cylinder 1, with moving of control piston.Best, control to the flow of cylinder 1 by external pressure source 8 by adjustments of gas.In addition or in addition, controller can constitute one with cylinder assembly.In a preferred embodiment of the invention, controller comprises mechanical control device.In addition or in addition, controller comprises analog quantity electric controller (preferably having the solenoid type valve).In addition or in addition, controller comprises pneumatic or hydraulic controller.In addition or in addition, controller comprises digitial controller.In a preferred embodiment of the invention, controller is programmable.
In a preferred embodiment of the invention, before the remainder of CPR device is connected to contact surface, contact surface 4 can be linked to each other with patient.In an example, contact surface can comprise sucker.Like this, exposed patient's chest connects sucker in correct position, then, for example uses the ratchet adapter, and CPR device remainder is connected to sucker.Notice that when each breast compressions sucker was pressed to patient's chest once more, the quality of sucker was not crucial in some embodiments of the invention.In a preferred embodiment of the invention, sucker comprises biosensor, as the ECG electrode, and/or efficient apparatus, as remove the heart fibrillation electrode.
Fig. 2 represents along the cutaway view of Fig. 1 plane A-A cylinder assembly, supporter and contact surface.Can cylinder pressurization causing piston 10 be risen by flexible pipe 6, process valve 15 that is positioned at the cylinder wall bottom and the gas that enters the mouth 11 ' introducing pressurization.In addition or in addition, can pass through flexible pipe 7, through inlet 11 " introduce the gas of pressurization, on piston, make the cylinder pressurization, and below piston, discharge gases through inlet 11 ' and valve 15, cause that piston descends.
Those skilled in the art will readily appreciate that and do not exceeding in the spirit and scope of the present invention and can change the present invention.For example, being used to make the device of piston rising or decline also is feasible as utilizing electric notor to replace Compressed Gas (as shown in Figure 1).Rise and lowering means can be one or more unit, as Fig. 1 compressed gas source with can be complete isolating and independent.Controller and cylinder assembly can be independent devices shown in Figure 1 or can one turn to a unit.In addition or in addition, can for example rise and use a hydraulic means with independent device, a pneumatic means is used in decline, and vertical motion and down maneuver are provided.In certain preferred embodiment of the present invention, use electric notor realize piston 2 rising and or descend, this motor is powered with integrated battery, produces small-sized CPR device, can not need the rope or the pipe of back.
Fig. 3 represents the generalized flow chart of description control device 6 functions.For example can be that agitator control valve a and the b that electronic or pneumatic its frequency can be selected periodically opens.The signal that produces when forcing function generator is greater than 0 the time, and valve a opens, and valve b closes, and valve 15 cuts out and forbids that atmosphere passes through, so as Compressed Gas by external source shown in Figure 18 through pipe 5 to pipe 6, flow to cylinder 1 through inlet 11 ' then, cause the piston rising.Simultaneously, gas is through inlet 11 " and manage 7 and leave cylinder, discharge into the atmosphere.Otherwise valve b opens, and valve a closes, and valve 15 is opened and allowed atmosphere pass through, so as gas by external source 8 through pipe 5 to pipe 7, then through valve 15 and inlet 11 " flow into cylinder 1, cause piston decline.Simultaneously, gas leaves cylinder through inlet 11 ' and valve 15, is released in the atmosphere.Though described the controller based on electricity, those skilled in the art is easy to recognize that the special structure of Fig. 3 only is one of a plurality of feasible variations.Therefore, by infinite example, can main or complete pneumatic operation controller 3.
Fig. 4 represents the control according to preferred embodiment of the present invention CPR.In Fig. 4 a, along with the bottom of piston 10 at its stroke, the contact surface 4 of cylinder 1 has been placed on patient 12 chest.Walk around patient's chest and or the selectable belt 13 of shoulder be preferably in operating period aid-device location.Rescuer 14 arrives supporter 3 with its most of weight transmitting.When because when through valve 15 and inlet 11 ' Compressed Gas being introduced cylinder 1 piston and rises piston 10 below, rescuer's head and shoulder lift, so that the increase of rescuer's gravitional force.When rescuer's head and shoulder when lifting, his knee and buttocks become more crooked, so that his body wt is at first transferred to his knee by supporter 3.Rescuer's body wt has discharged pressure to patient's chest by the transmission of supporter 3, allows patient's chest to be depressurized.In addition, other the motion of vertical direction of rescuer can be easier and/or pressure not be affacted patient's chest.
In Fig. 4 b, piston 10 is on the top of its stroke, and the rescuer is delivered to supporter 3 with his body wt.Valve 15 is opened and is allowed atmosphere pass through now, and Compressed Gas on piston 10 (selectively) is through inlet 11 " introduce in the cylinder 1.Simultaneously, Compressed Gas is discharged by valve 15 through inlet 11 ' below piston 10.Affact rescuer's body wt of supporter 3 and on piston the combination of Compressed Gas cause that piston descends fast, thereby convert rescuer's gravitional force to kinetic energy.When the piston of quick decline bumped against the bottom of cylinder assembly, rescuer's kinetic energy was delivered to patient's chest, and chest is compressed, and can begin the CPR circulation again.
The circulation frequency, the height that piston rises, the speed that the scope of piston motion and/or piston rise or descend determined by controller 9, (if desired) can by the rescuer select with patient need consistently, during rescuing, can change and/or preestablish.The selection of the speed that height that the rescuer rises to cycle frequency, piston or piston rise and descend allows the displacement of rescuer's control example such as patient's chest and or affacts the pressure of chest.In addition or in addition, other parameter that can the control piston motion, the relation between (piston) displacement and speed or the acceleration for example, the delay between the power of effect and/or the compression.
Fig. 4 c is the stack of Fig. 4 a and b, and expression rescuer health only has little vertical and swing offset to be included in posture by Fig. 4 a (dotting among Fig. 4 c) in the process of Fig. 4 B (representing with solid line) posture in Fig. 4 C.Therefore only need the less motion of muscular tissue, so that require rescuer's health firmly to lack than manual CPR basically in some embodiments of the invention.
The embodiment of Fig. 1 is by test special-purpose and that amateur rescuer carries out the CPR body model state that is equipped with computer and suitable mechanical pick-up device.The result shows, compare with manual CPR, when using the CPR device rising of the consumption of rescuer's oxygen and heart rate very little, his/her endurance significantly increases.In addition, can believe that the effectiveness of CPR provided by the invention is identical with manual CPR at least.
Can consider several changes within the spirit and scope of the present invention.The present invention can comprise defibrillator selectively, and this defibrillator links to each other with controller, acts on electroshock to patient when can control with CPR and swings, and is as United States Patent (USP) the 4th, 928, disclosed in No. 674.
The present invention can further have selection to comprise electrocardiogram (ECG) monitor and the monitor that is used for monitoring heart of patient, links to each other with controller, as United States Patent (USP) the 4th, 927, described in No. 674.Controller can use the proper device that is used for the analysing ECG signal so that start and stop riser, when (if and/or) beginning with or when stopping CPR, the signal of notifying him that the rescuer feels.If desired, controller response ECG signal, the motion of piston, the history of CPR effect, the defibrillation concussion and/or the detected physiologic variables of ECG track and/or effect, electric current and/or history value, also should regulate and clock, persistent period, waveform, and/or the electroshock that provides of the defibrillator intensity of swinging.Current like this analysis and/or situation in the past also can be used for instructing the rescuer and/or determining setting or the parameter of device at effect CPR, can change setting automatically by enough devices.In addition or in addition, controller can represent that heart fibrillation will carry out, so the rescuer will allow patient leave, and can remove the CPR device, avoid electrocuting and/or damaging device.In addition or in addition, the CPR device is two from insulating.In addition or in addition, the pipe that leads to external pressure source is insulating.
The invention provides and walk around the selectable belt of patient's chest,, or the electrode of defibrillator is affacted patient's chest so that make the device location.In addition or in addition, such belt can comprise strain gauge, to eliminate the displacement of patient's chest.In addition or in addition, use the accelerometer and/or the belt that are integrated with the CPR device to eliminate displacement.Best, measured acceleration can be used for determining motive force.In addition or in addition, can use the complete acceleration of twice to determine the chest displacement.
The present invention can comprise the respiratory organ that the lung that is used for making patient in CPR control is breathed selectively.This respiratory organ can be regulated with consistent with the CPR circulation breathing cycle by controller, and as United States Patent (USP) the 4th, 928, No. 674 disclosed such.For example, ventilate fan and riser are coordinated, so that follow twice breathing of per 15 compression control patient pulmonarys of patient's chest.Automatically stop such breathing in case detect patient's breathing.
The present invention can further provide the capnometer of selection, to notify CO in the patient expired breathing to rescuer and/or controller 2Concentration is so that provide a kind of demonstration of relevant CPR quality.
The present invention may further include a blood flow instrument, rescues the person of shaking and/or controller patient's rate of blood flow so that a kind of indication of relevant CPR quality is provided with notice.
The present invention may further include the pressure indicator of selection, to affact the pressure of patient's chest to rescuer and/or controller notice during CPR, so that allow the pressure of rescuer and/or controller change effect.
The present invention further comprises and can notify such as one of following parameters and a plurality of selecting arrangements to the rescuer by the mode of detected physiological parameter sensory signal: patient heart rate and/or other ECG feature, blood pressure or rate of blood flow, CO in the patient expired breathing 2Concentration, affact the pressure of patient's chest, the displacement of patient's chest.In a preferred embodiment of the invention, realizable signal comprises audible signal, for example beeps and synthetic language.In addition or in addition, this signal comprises demonstration.In addition or in addition, analyze the parameter of being felt, the effect integrated signal is if for example CPR normally carries out being green light, if not being red light.
In a preferred embodiment of the invention, controller can close the loop circuit operation, for example, has exceeded threshold value if affact the thrust of chest, and controller stops and/or reducing its decline action, to reduce thrust.In addition or in addition, in response to the physiologic variables that detects above, for example, range of movement, the velocity contour of piston, the delay between compression and/or the effect external electrical stimulus, other parameter that also can automaton.
In addition or in addition, controller can determine whether the CPR action satisfies a certain criterion (as the AHA criterion), if do not satisfy, provide warning to the rescuer.For example, if can show warning if the pressure of effect is too big and/or compression speed is too low.In addition or in addition, the CPR device can stop not have the correct operation of using.In addition or in addition, the CPR device can be advised a kind of action to user, for example the pressure of increase effect.In addition or in addition, whether controller reporting CPR rhythm is suitable.In addition or in addition, controller detects not operative installations correctly of rescuer, for example, not have correctly to move his weight, so needs controller help to move downward bigger degree, and perhaps whether rescuer's weight to be removed by patient's chest.
In a preferred embodiment of the invention, the CPR device provides the rhythm (and/or breathing) of CPR, and the rescuer observes this rhythm (can use audible signal to obtain synchronously).Best, the motion of piston is controlled by controller fully.In addition, the motion of piston can be followed rescuer's guiding.In an example, when user is transferred to supporter with his weight and/or contracted piston with predetermined piezometric, begin new rising/decline cycle.In an example, such control can not need controller, for example, by the pressure on the supporter by the inlet in the CPR device and or valve directly open or close.In addition, supporter can comprise control, as button, is used to realize the rising and/or the decline of piston.In addition or in addition, control can be controlled by sound.
The present invention may further include monitor, can monitor and the information of storing relevant recovery, as the time of the beginning of recovering, the time that recovery stops, the cycle-index of execution, cycle frequency, incomplete circulation percentage ratio, the frequency of mistake and type, in the power of each cycle period effect, criterion not have situation about satisfying and or in the displacement of the chest of cycle period at every turn.Monitor can be with outer computer online or off line.
The present invention has been described to certain specific degree, but being to be understood that not exceed in the spirit and scope of the present invention to make different changes and variation.For example, be obviously to one skilled in the art, can enoughly not comprise that the rising of piston or lowering means constitute the present invention.For example, can use the rising or the lowering means that comprise electric notor to replace piston (not expression).The multiformity of method and apparatus different characteristic has been described in addition.Obviously, different features can be in conjunction with different modes.Particularly, in each similar preferred embodiment of the present invention, express all features in the above in the certain embodiments.Further, combination of features also should be regarded as in the scope of some preferred embodiments of the invention above.Obviously, many embodiment are only as method or only as unit describe.Scope of the present invention comprises the method for the device and the operative installations of manner of execution.In addition, scope of the present invention comprises use, constitutes, calibrates and/or keeps the method for tracing device in the literary composition.The term that uses in following claim " comprises ", and " comprising ", " comprising ", " comprising " or similar term mean " including but not limited to ".

Claims (51)

1, a kind of assisted cardiopulmonary resuscitation affacts the system of patient's chest to allow the rescuer with his/her body wt, and this system comprises:
Be used to contact the contact surface of patient's chest;
Be used for to make the rescuer his/her body wt to be affacted the supporter of contact surface;
Move the displacer of the supporter relevant effectively with contact surface.
2, according to the system of claim 1, comprising:
Can start displacer to realize the controller of desired movement.
3, according to the system of claim 2, wherein said desired movement comprises the direction of hope.
4, according to the system of claim 2 and 3, wherein said desired movement comprises the power of hope effect.
5, according to the system of any claim among the claim 1-4, wherein said displacer is increased in the displacement between said supporter and the said contact surface.
6, according to the system of any claim among the claim 1-5, wherein said displacer reduces the displacement between said supporter and the said contact surface.
7, according to the system of any claim among the claim 1-6, wherein said displacer comprises electric notor.
8, according to the system of any claim among the claim 1-7, wherein said controller comprises electric controller.
9, according to the system of any claim among the claim 1-8, its middle controller comprises pneumatic controller.
10, a kind of assisted cardiopulmonary resuscitation affacts the system of patient's chest to allow the rescuer with his/her body wt, and this system comprises:
(a) cylinder assembly, this assembly comprise closed cylinder and the piston component with bottom, the piston rod that this piston component comprises piston and slides and accept in said cylinder;
(b) link to each other, be used to contact the contact surface of patient's chest with the bottom of said cylinder;
(c) displacer that piston is moved; With
(d) link to each other, be used for to make the rescuer that his/her weight is affacted piston with said piston rod so that press piston apace and cause the supporter that patient's chest is compressed.
11, according to the system of claim 10, comprising:
Can start said displacer to carry out the controller that needs motion.
12, according to the system of claim 10 or 11, the frequency shifts of wherein said piston to select.
13, according to the system of claim 10-12, wherein said piston moves with the speed of selecting.
14, according to claim 10-13 system, wherein said piston moves the amount of selection.
15, according to the system of claim 2 or 11, further comprise link to each other with controller electrocardiogram monitor and monitor, wherein said controller responds said ECG and starts and stop riser.
16,, further comprise the electrocardiogram monitor and the monitor that link to each other with controller and can produce the realizable signal of rescuer, this signals direct cardio-pulmonary resuscitation according to the system of claim 2 or 11.
17, according to the system of claim 16, wherein said guidance comprises when stopping said CPR and provides indication to the rescuer.
18, according to the system of claim 2 or 11, wherein said system comprises biosensor, the said patient's of this sensor physiological parameter.
19, according to the system of claim 18, wherein said controller response has the value of said sensor to change said motion.
20, according to the system of claim 18 or 19, wherein said controller responds the value of said sensor and sends indication to said rescuer.
21, according to the system of any claim among the claim 10-20, wherein said displacer comprises can make piston descend so that the masterpiece of selecting is used the lowering means of patient's chest.
22, according to the system of any claim among the claim 10-21, wherein piston is risen by introducing Compressed Gas below piston face.
23, according to the system of claim 22, wherein said Compressed Gas is an air.
24, according to the system of claim 22, wherein Compressed Gas is an oxygen.
25,, wherein use electric notor that piston is risen according to the system of any claim among the claim 10-21.
26, according to the system of any claim among the claim 10-21, wherein piston is descended by on piston, introducing Compressed Gas.
27, according to the system of any claim among the claim 10-21, wherein piston is descended by electric notor.
28, according to the system of claim 2 or 11, electricity consumption operation control wherein.
29, according to the system of claim 2 or 11, its middle controller is air operated.
30, require according to aforesaid right in the system of any claim, further comprising links to each other with controller is used for the respiratory organ of patient pulmonary breathing, said breathing is consistent with cardio-pulmonary resuscitation.
31, according to the system of claim 17, wherein follow per 15 compressions of patient's chest, control patient pulmonary approximately breathes 2 times.
32, require according to aforesaid right in the system of any claim, further comprising links to each other with controller is used for the defibrillator that heart of patient removes heart fibrillation, the said heart fibrillation that goes is consistent with cardio-pulmonary resuscitation.
33, according to the system of any claim in the aforesaid right requirement, further comprise capnometer.
34, according to the system of any claim in the aforesaid right requirement, further comprise the blood flow instrument.
35, according to the system of any claim in the aforesaid right requirement, further comprise belt.
36, according to the system of claim 35, wherein belt is fixed to system in patient's chest
37, according to the system of claim 35 or 36, wherein belt comprises the defibrillator electrode.
38, according to the system of any claim in the aforesaid right requirement, wherein above-mentioned contact surface comprises sucker.
39, according to the system of claim 38, wherein said system links to each other with said sucker effectively after said sucker is connected to said patient.
40, according to the system of claim 38 or 39, wherein said sucker comprises the defibrillation electrode.
41, according to the system of claim 38-40, wherein said sucker comprises at least one biosensor.
42,, further comprise expression physiological parameters of patients display according to the system of any claim in the aforesaid right requirement.
43, according to the system of claim 42, wherein said display comprises auditory displays.
44, according to the system of claim 42 or 43, wherein said physiological parameter comprises patient's heart rate.
45, according to the system of any claim among the claim 42-44, wherein said physiological parameter comprises patient's blood pressure.
46, according to the system of any claim among the claim 42-45, wherein said physiological parameter comprises patient's rate of blood flow.
47, according to the system of any claim among the claim 42-46, wherein said physiological parameter comprises CO in the patient expired breathing 2Concentration.
48, according to the system of any claim among the claim 42-47, wherein said physiological parameter comprises the pressure that affacts patient's chest.
49, according to the system of any claim among the claim 42-47, wherein said physiological parameter comprises the displacement of patient's chest.
50, require according to aforesaid right in the system of any claim, further comprise can monitoring and storing relevant recovery monitoring of information device.
51, the use of any claim system was used for the control of cardio-pulmonary resuscitation during aforesaid right required.
CN98811241A 1997-11-18 1998-11-17 Device for assisted cardiopulmonary resuscitation Pending CN1279599A (en)

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IL12223497A IL122234A0 (en) 1997-11-18 1997-11-18 A device for assisted cardiopulmonary resuscitation
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NO20002458L (en) 2000-07-14
AU748550B2 (en) 2002-06-06
AU1256599A (en) 1999-06-07
WO1999025306A1 (en) 1999-05-27
BR9814971A (en) 2000-10-03
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PL340830A1 (en) 2001-02-26
NO20002458D0 (en) 2000-05-12
CA2310618A1 (en) 1999-05-27

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