DE102014108197A1 - A device for assisting rescue personnel in performing cardiopulmonary resuscitation - Google Patents

Abstract

The invention relates to a device for assisting the rescue personnel in carrying out cardiopulmonary resuscitation with a monitoring device for cardiac massage, which has at least one sensor unit (1) for the pressure actuation and a processing device (2) for its supplied sensor signals. Advantages for the construction and the function result from the fact that the sensor unit (1) comprises at least one strain sensor element (10) of a material which changes its electrical properties during elongation and is provided with a holding device, by means of which the at least one strain sensor element (10) the breast of the person to be rescued is fixable in such a way that the at least one strain sensor element (10) is deformed synchronously with the pressure actuation and thereby the sensor signal is formed.

Description

The invention relates to a device for supporting the rescue personnel, such as trained professionals or z. As a layman as a first responder, in carrying out a cardiopulmonary resuscitation with a monitoring device for cardiac massage, which has at least one sensor unit for the pressure actuation and a processing device for their supplied sensor signals.

A device of this kind is in the US 2008/0312565 A1 shown. This known device comprises a so-called CPR sensor (cardiopulmonary resuscitation sensor), which has a thin, flexible carrier on which one or more sensor arrays, a power source, an output interface and a processor or an analog circuit are applied. The sensor arrays are designed as so-called MEMS (microelectromechanical systems). The flexible substrate may be made stretchable. By means of the sensor arrays, pressure parameters, namely the pressure depth, pressure force, pressure frequency and pressure acceleration can be detected in order to give the rescuer (helper) feedback on the success of the performed heart pressure massage. However, a reliable determination of pressure parameters in cardiac massage is difficult and still associated with relatively large uncertainties, but on the other hand important for the success of the resuscitation measures.

Various other devices to assist the rescuer in performing cardiopulmonary resuscitation include, for example, US Pat US 2012/0089055 A1 and the EP 1 491 176 B1 shown.

In the case of cardiac massage, exceeding a minimum force and a minimum compression depth in the case of pressure actuation are essential parameters, and an evaluation of the direction of the action of force during cardiac massage is also essential since it provides valuable clues for the assessment of the efficiency of cardiac massage. Corresponding feedback provides the helper with a check on how well he succeeds in initiating the force applied via the palm of his hand vertically to the thorax of the patient during the pressure actuation. Therefore, it is also desirable to determine the angle at which the force is applied to the pressure point during cardiac massage. Also, in chest compressions, proper chest pressure relief is one of the important cardiopulmonary resuscitation parameters (CPR parameters or CPR parameters) to ensure adequate heart filling with blood and, as a result, sufficient ejection volume can be achieved. Therefore, the detection of correct relief of the chest in the pressure massage is a quality feature of the cardiopulmonary resuscitation is also the detection of a phase in which the hands no longer exert pressure (so-called hands-off time), in which no chest compressions is a quality feature of cardiopulmonary resuscitation. Since this time must be kept as short as possible, as accurate as possible detection of the beginning of the hands-off time is also important.

It is an object of the present invention to provide a device for assisting the rescuer in performing cardiopulmonary resuscitation that achieves enhanced cardiopulmonary resuscitation efficiency.

This object is achieved with the features of claim 1. In this case, it is provided that the sensor unit comprises at least one strain sensor element of a material which changes its electrical properties during elongation and is provided with a holding device, by means of which the at least one strain sensor element can be fixed with respect to the breast of the person to be rescued in such a way that the at least one Strain sensor element is deformed in synchronism with the pressure operation and thereby the sensor signal is formed.

With these measures, advantageous detection options are offered in the implementation of a cardiac pressure massage, wherein the sensor unit with the at least one strain sensor element, in particular at least one elastomer sensor element, enables an advantageous signal detection. There are also advantageous customization options for different requirements.

An advantageous mode of action is obtained in that the at least one strain sensor element can be fixed in relation to the breast such that it is stretched or relieved synchronously with the pressure actuation.

Another advantageous embodiment for the signal detection is that the strain sensor element is mechanically biased in its initial position.

To a reliable function, the measures contribute to the fact that the sensor unit generates electrical energy even during the pressure actuation and is ready for operation without additional power supply or that the sensor unit is supplied from the outside via high-frequency energy pulse packets.

Advantageous embodiments further consist in that the sensor unit is designed as a pressure sensor, force sensor, position sensor or angle sensor. For example, the function of an angle sensor can be used to monitor that the helper is using his power efficiently.

A design which is advantageous for the function is that a change in capacitance is caused by the deformation of the at least one strain sensor element, by which the sensor signal is formed.

For the structure and the function, the measures are also advantageous in that the at least one strain sensor element is formed from an elastomeric film and coated on one or both sides with flexible electrodes.

Various advantageous embodiments of the device are obtained in that the processing device for determining the extent of the pressure actuation from the strength, the frequency and / or the phase of the sensor signal or the change of at least one of these sizes is formed.

Further advantageous measures for the construction and the function of the device are that the processing device for determining the frequency of the pressure actuation from the repetition of the same strength, frequency and / or phase of the sensor signal is formed.

Further advantageous design variants result from the fact that the extent of the pressure actuation comprises the pressure depth, the pressure force, the speed of the pressing and / or unloading, the pause time or a combination of at least two of these parameters.

For the function and the structure advantageous embodiments also result from the fact that the holding device has at least one holding part and two spaced from each other on the respective strain sensor element or attachable fixing units, between which an expandable portion of the respective strain sensor element extends, wherein the respective strain sensor element with Assistance of the one fixing means is attached to the associated holding part and with the help of the other fixing means to a in the printing operation relative to the holding part of this away and the relieving to this moving body.

It contributes to an advantageous function in that the moving body is an operating part acting on the chest of the person to be rescued in the pressure actuation by the manual force.

Various further advantageous embodiment variants result from the fact that the holding part is a fastening piece attached to the breast or a holding member attached to a supporting body.

Also, the measures that the processing device for determining the pressure depth depending on the changing in the pressure actuation angle between the direction extending in the vertical direction of gravity and the extension of the strain sensor element is formed at a known or detected length of the same, advantageously contribute to the function of the device. In this case, a constant horizontal distance between the fixing points of the strain sensor element can also be included.

Differentiated assessment options for the execution of the pressure actuation result from the fact that the sensor unit has a plurality of strain sensor elements and a plurality of these associated holding parts or a common holding part and that all strain sensor elements are mounted at a distance from the one or more holding parts on the moving body.

A further advantageous feature for the construction and the function is that the common holding part is designed as a retaining ring.

For an advantageous signal detection, the measures contribute that a sensor array of a two-dimensional (two-dimensional, in a plane) related strain sensor element or a plurality of strain sensor elements is extended as a sensor array in an xy direction and along its peripheral edge by means of a fixing unit continuously or at individual fixing points is attached to the then circumferentially formed holding part and that the moving body is mounted by means of the other fixing unit in the central region of the sensor assembly.

For a differentiated evaluation, the measures are advantageous in that the capacitances of the individual strain sensor elements of the sensor arrangement are detected by the processing device by the sensor signals and included in the evaluation.

The reliability of the signal evaluation can be increased by configuring the sensor unit such that at least one strain sensor element can be placed around the breast transversely to the longitudinal extent of the person to be rescued and the respiratory muscles of the thorax be changed by a change in strain of the at least one strain sensor element during respiration by the processing device detectable and in the evaluation for determining the pressure depth and / or the pressure frequency can be included. As far as the activity of the respiratory muscles is recorded, conclusions about the effectiveness of the ventilation can be drawn. In general, the circumferential change of the rib cage can also be determined in this arrangement and correlated with the pressure depth.

An advantageous for the pressure actuation by the helper and the signal derivative training is that the sensor unit is provided at least in the region of the at least one strain sensor element with an insulating protective layer.

Various advantageous output signals for user guidance and / or control of a defibrillator device are obtained in that at least one threshold value is predetermined in the processing device, with which the sensor signal is compared, and that by means of the processing device from the comparison result, the start of printing, a minimum pressure depth maximum pressure and / or a complete relief in the printing operation can be determined / are.

A further advantageous embodiment for the structure and the function results from the fact that the sensor unit has at least one switching stage for specifying at least one threshold value for the start of printing, a minimum pressure depth, a maximum pressure depth and / or a complete relief in the pressure actuation.

A further advantageous embodiment for the function and signal generation is that at least one strain sensor element is received in a receiving unit of the sensor unit under bias and that the receiving unit is designed such that the at least one strain sensor element is relieved when pressurized.

To a reliable signal evaluation, the measures contribute that it comprises at least one further detection unit, which is designed to detect the respiratory activity, respiratory gases, blood flow, oxygen saturation or carbon dioxide accumulation of the blood, the volume pulse and / or a body impedance of the person to be rescued , and that the detection signals of the at least one further detection unit of the processing device can be supplied during operation and evaluated by the latter.

It is advantageously provided for the user guidance that the device has a display device controlled by the processing device with an optical display unit and / or acoustic output unit in order to inform the rescue person performing the cardiac pressure massage about the pressure actuation.

Further, in the context of cardiopulmonary resuscitation, the measures are advantageous in that the device includes a defibrillator device that is signaled or brought into signal communication with the processing device to tune the initiation of a defibrillation shock to the cardiac pressure massage.

It is advantageous for the efficiency of the resuscitation measures that a trigger time for the triggering of a defibrillation shock by means of the processing device is tuned to the sensor signal during the pressure actuation, that the shock triggering takes place when the thorax is maximally compressed or maximally relieved during a pressure cycle.

Advantages for the structure and the operation are obtained by integrating at least one strain sensor element into at least one defibrillation electrode.

For a reliable signal evaluation, the measures contribute that the device has a selection device for a setting on the height, the body weight, the age group and / or the sex of the person to be rescued, the selected setting is included in the evaluation by the processing device.

The reliability of the evaluation can also be assisted by providing it with an additional pressure detection unit comprising a fluid enclosed in a closed volume. As a result, z. B. the pressure relief can be detected advantageous.

Various advantageous design variants are that the at least one strain sensor element is designed as an elastomeric film, piezoelectric film, strain gauges or potentiometer film.

The invention will be explained in more detail by means of embodiments with reference to the drawings. Show it:

1 a schematic view of a device for assisting the rescue personnel in performing a cardiopulmonary resuscitation, which is assigned to a person to be rescued,

2 an embodiment of a device according to 1 usable strain sensor element in schematic view,

3 an embodiment of a device according to 1 usable sensor unit,

4A and 4B two further embodiments of the device according to 1 usable sensor units,

5 a further embodiment of a device connected to a person to be rescued to assist the rescuer in performing a cardiopulmonary resuscitation, which comprises a defibrillator device,

6A and 6B a further embodiment of a device connected to a person to be rescued to assist a rescuer in performing a cardiopulmonary resuscitation and a graphical representation of the procedure for determining a pressure depth,

7A a schematic representation of a further embodiment of a sensor unit with assignment to a person to be rescued, wherein in a xy plane (horizontal plane) stretchable planar strain sensor element is used,

7B FIG. 2 a schematic representation of a further exemplary embodiment of a sensor unit with a plurality of strain sensor elements arranged in different directions of the xy plane, FIG.

7C a further exemplary embodiment of a sensor unit with a plurality of strain sensor elements arranged in different directions of the xy plane,

8th a further embodiment of a person to be rescued associated with a device to assist the rescuer in performing a cardiopulmonary resuscitation and a sensor unit used in plan view and front view,

9 a further embodiment of a sensor unit attached to a person to be rescued, wherein two strain sensor elements are arranged transversely over the chest, in a schematic view,

10 a further embodiment of a sensor unit which is arranged on an insulation mat and to which a display unit is assigned,

11 a further embodiment of a sensor unit applied to a person to be rescued,

12 a further embodiment of a device connected to a person to be rescued to assist the rescuer in performing a cardiopulmonary resuscitation and two different views on the arrangement of a sensor unit of the device in the chest area of the person to be rescued,

13 a further embodiment of a device connected to a person to be rescued to assist the rescuer in performing a cardiopulmonary resuscitation and a separate view of the sensor unit used therein,

14 an embodiment of a usable in the device display unit in a schematic view and

15A . 15B and 15C different display situations of a section of the display unit 14 while performing a cardiac pressure massage.

1 shows a device for assisting the rescue personnel in carrying out a cardiopulmonary resuscitation (CPR) with the arrangement of a sensor unit 1 on the chest of a patient. The sensor unit 1 is via a connection cable 21 for data transmission of sensor signals to a processing device 2 connected in the embodiment shown with a defibrillator 20 , such as B. an automatic external defibrillator device (AED), is brought together in a housing thereof. The processing device 2 or parts thereof may instead be spatially z. B. in the area of the sensor unit 1 , in particular of the actuating part 3 be arranged.

From the sensor unit 1 Sensor signals detected during the pressure massage become the processing device 2 supplied there and processed and evaluated to provide appropriate output signals for informing the pressure-operated rescue person (assistant) of the quality of CPR and / or triggering a defibrillation shock via the defibrillator unit 20 depending on the chest compressions.

About the connection cable 21 may instead of or in addition to data transmission, a power supply of the sensor unit 1 be made. The device may be designed for bidirectional data transmission, for example one in the region of the sensor unit 1 to control arranged or integrated in this display unit to inform the helper. The information output can be viewed visually via the display unit and / or acoustically, wherein the electroacoustic transducer for the sound output (speech and / or other acoustic signals) in the region of the sensor unit 1 or z. B. in the area of the defibrillator unit 20 is arranged.

In an alternative embodiment, the data transmission can be performed wirelessly, wherein the device also for unidirectional signal or data transmission between the sensor unit 1 and the processing device 2 or may be designed for bidirectional transmission.

In a further embodiment variant, an energy source for supplying the sensor unit 1 be arranged in their area, such. As a battery, an accumulator or other energy storage, such as a capacitor or an inductively operating unit. Because the sensor unit 1 advantageous works with low energy consumption, it can also be equipped or connected to a power generation unit, the z. B. converts the energy generated by the pressure actuation into electrical energy and provides for the supply (energy harvesting). Especially with wireless connection between sensor unit and processing device 2 is also a Energieeinkopplung over high-frequency pulse packets a possible design variant.

The sensor unit 1 has at least one strain sensor element 10 on, in the embodiment according to 1 is designed as a film strip, which is located between an actuating part 3 and a fixing piece 11 extends on the chest of the person to be rescued in the longitudinal direction. The actuating part 3 serves as an intermediary between the operator's pressure-exerting hand and the pressure-receiving site of the chest, which overlies the sternum for efficient pressure actuation. The actuating part 3 forms in the cardiac massage a moving body and is advantageous as hand-adapted print edition, z. B. formed as a pressure pad. The attachment piece 11 is z. B. in the neck or collarbone on the chest fixed by gluing and the strain sensor element 10 is with its end side sections on the one hand on the actuating part 3 and on the other hand on the attachment piece 11 fixed, such. B. by means of an adhesive bond, welded joint, by sewing or a stable Velcro connection, clip connection, clamp connection or the like. By the vertical (in the z-direction, with respect to the body from front to back or perpendicular to the plane in FIG 1 ) When the pressure is applied, chest movement in the area of the pressure point becomes the strain sensor element 10 stretched and generates an electrical signal, for example, by a capacitance change of the strain sensor element 10 ,

The change in capacitance may be caused, for example, by a change in the amplitude, the frequency and / or the phase of the strain sensor element caused by it 10 applied AC voltage is expressed, which is expressed in the sensor signal. The strain sensor element 10 is advantageous z. B. made of an elastomeric film. The elastomeric film is provided on one or both sides with electrodes, which are preferably formed as a thin, highly flexible layer. Between the electrodes, a voltage signal changing as a result of stretching and the change in capacitance caused thereby can be tapped in order to form the sensor signal. The region of the elastomeric film forms a dielectric.

Alternatively, the strain sensor element 10 be designed as piezo film, strain gauge film or potentiometer, which can also be generated in deformation, in particular strain changing voltage signals.

2 shows an exemplary embodiment of a strip-shaped strain sensor element 10 , For example, made of elastomeric material, with a sensor section 100 in the middle area, extending between two end-side sections 101 extends. The sensor section 100 forms the strain responsive region for the generation of the sensor signal, while the side sections 101 serve for attachment to respective attachment sites whose distance changes in the cardiac massage in synchronism with the pressure actuation and thus leads to a change in the sensor signal, by means of the processing device 2 is evaluated.

At an in 3 shown another embodiment of a sensor unit 1 is a fastening device 4 for attaching the sensor unit 1 on the chest of a person to be rescued present, which can be fixed in the region of the clavicle of the person to be rescued by gluing large-scale holding part 40 at the one end portion of the strain sensor element 10 having. The other end region of the strain sensor element 10 is by means of a lanyard 41 with the actuating part 3 in the form of a cushion-like print pad 30 connected. The print run 30 is in turn on its underside with an adhesive surface 31 provided to fix them in the area of the pressure point on the chest. Before use, the adhesive surfaces of the holding part 40 and the print run 30 preferably covered with a peelable protective film. The sensor unit 1 if necessary, including the holding part 40 or the like. Or only the strain sensor element 10 can / can be designed for single or multiple use.

At the in 4A shown another embodiment of a sensor unit 1 is a Strain sensor element 10 also between a fixable in the upper region of the chest of the person to be rescued by gluing holding part 40 and an operable in the region of the pressure point actuating part 3 , in particular a likewise fixable by gluing pressure pad 30 , Positioned and with its end side portions on the holding part 40 on the one hand and the fastening device 3 on the other hand. To the print run 30 closes towards the upper chest area towards a display unit 5 on, on one with the operating part 3 contiguous flat carrier is arranged. The helper can thus be displayed advantageously in his field of view information about the quality of the cardiac massage. In the lower chest area, an arrow-like tongue-like grip portion is attached to the sensor unit 1 with the strain sensor element 10 when attached to the correct position on the chest to pull. On the top of the holder 40 is pictographically the correct positioning of the sensor unit 1 graphically displayed on the chest.

At the in 4B shown embodiment is opposite 4A the display unit 5 in the holding part 40 integrated, whereby the information displayed during the cardiac pressure massage are also well recognized by the rescuer.

5 shows the arrangement of a sensor unit 1 with a similar construction as in the 4A and 4B when placed on the chest of a person to be rescued and with a connection to a processing device 2 in combination with a defibrillator unit 20 , The processing device 2 and the defibrillator unit 20 have a common, easy to handle housing. The defibrillator unit 20 is part of a defibrillator device that has defibrillator electrodes placed on the chest of the person to be rescued at appropriate locations 22 includes, which via relevant connection cable 21 to the defibrillator unit 20 are attached to the rescued person with a defibrillation shock. The defibrillator electrodes 22 can also be used to derive measurement signals to adequately control the defibrillation shock. As the processing device 2 with the defibrillator unit 20 is brought into electrical signal or data communication connection, the triggering of the defibrillation shock can be optimally adapted to the cardiac massage to cause a suitable time of shock triggering and an adapted control of the shock energy in the context of cardiopulmonary resuscitation measures. For example, the shock release can take place in a moment when the chest is maximally compressed, as in this situation, the lung is also compressed and the defibrillation can flow through the heart optimally, without too much energy must be applied. Alternatively, the moment of maximum or near maximum relaxation may be favorable for the choice of shock triggering. Conversely, one may be from the defibrillator electrodes 22 information received is included in the assessment of the efficiency of CPR and taken into account in the information displayed to the helper.

At one in the 6A and 6B shown further embodiment, the sensor unit 1 a supported in the shoulder area of the person to be rescued support device 12 with an upwardly projecting columnar support body, which may be telescopically extendable and at the upper end portion of a strain sensor element 10 by means of a holding part 40 is fixed. The other end portion of the strain sensor element 10 is again on the operating part 3 fixed. How out 6B As can be seen, the pressure depth can be determined from the difference between a vertical end position H2 at maximum pressure and a starting position H1 at a defined start of pressure, the starting position being the length L1 present and the angle Phil present in relation to the vertical (direction of gravity) and the end position H2 from the length L2 present and the angle phi2 of the strain sensor element 10 be determined against the vertical. The respective length L1, L2 is due to the strain of the strain sensor element 10 given and the respective angle phi1, phi2 can z. B. detected by means of an angle detector. As additional information, the known horizontal distance between the attachment points on the holding part 40 and the operating part 3 be used.

The 7A . 7B and 7C show further embodiments of the sensor unit 1 , These have in common that they have a two-dimensionally extended in the horizontal XY plane sensor array and thus can be used to capture parameters that are dependent on the position and / or movement components in the xy direction, such. As an inaccurate positioning of the pressure point in the xy plane or deviates from the vertical direction of the pressure force. Since the efficiency of CPR is greatest when the helper initiates the force applied via the palms of the hand perpendicular to the thorax of the person to be rescued, the detection and display of an angular deviation from the vertical for him is an important piece of information different strains in the xy-direction dependent sensor signals provide additional information to the sensor signals in the processing device 2 to analyze more closely with respect to other parameters such as compressive force and pressure depth.

In the in the 7A . 7B and 7C shown embodiments is centrally in the area of the extensively stretched in the xy direction strain sensor element 10 or more strip-like strain sensor elements 10 an actuating part 3 in particular in the form of a print run 30 arranged and in the radially spaced therefrom outer edge region a holding part in the form of a circumferential retaining ring 112 in which the ends of the one or more strain sensor elements facing away from the center 10 are attached. The sensor unit 1 can be with the retaining ring 112 Simply position on the chest of the person to be rescued, with the central area with the operating part 3 is to be placed exactly above the optimal pressure point on the chest. While the 7A an embodiment of the sensor unit 1 with one inside the retaining ring 112 flat extended contiguous strain sensor element 10 shows are in the embodiment after 7B four at right angles to each other oriented strip-shaped strain sensor elements 10 also in different numbers between the operating part 3 and the retaining ring 112 arranged and according to the embodiment 7C eight strip-shaped strain sensor elements 10 arranged at an angle of 45 ° to each other. Also other similar planar arrangements of strain sensor elements 10 also in different numbers are possible. By the structuring of strip-shaped strain sensor elements 10 In two-dimensional arrays, their capacitance can be measured separately via individual electrode fields and thus the differentiation of the deformation or the applied force can be localized.

Also at the in 8th shown further embodiment of the sensor unit 1 are several strain sensor elements 10 , For example, based on elastomer strips arranged two-dimensionally in the xy plane. Here are individual strip-shaped strain sensor elements 10 between a centrally arranged fastening device or an actuating part 3 and a surrounding holding part, also as a rigid retaining ring 112 is formed or at least includes such. The fastening device is in this case as a solid inner body 113 formed or includes such. The strip-shaped strain sensor elements 10 are on the one hand end on the fixed inner body 13 and on the other hand on the retaining ring 112 fixed so that they are on the operating part 3 applied pressure and thus caused movement to be stretched and cause a signal change associated with it. Advantageously, the strain sensor elements 10 by means of a protective film 102 z. B. covered by a textile or other insulating laminate material.

At an in 9 shown further embodiment, two strip-shaped strain sensor elements 10 with its one end portion on the centrally arranged actuating part 3 , such as B. a print run 30 attached, run to the side across the breast and are fixed in the side region of the chest or in the back of the person to be rescued with its other end portion. With this arrangement of the strain sensor elements 10 , Especially based on strip-shaped elastomeric films, the change in the respiratory muscles of the chest z. B. are detected for determining the compression depth and the compression frequency. By changing the volume of air in the lungs during cardiac massage, this changes via the strain sensor elements 10 obtained sensor signal, for example due to a capacitance change, and the change of the sensor signal is a measure, for example, the compression depth or compression frequency.

Similar arrangements as 9 also show in the 11 and 12 illustrated embodiments of the sensor unit 1 , Also here are two strip-shaped strain sensor elements 10 across the chest of the person to be rescued and are with their one end portion on the central operating part 3 and with its other end portion on lateral holding parts 40 fixed. Further, they are with a protective film 102 covered.

10 shows an insulation mat 6 that an assistant is electrically isolated from the body of the person to be rescued so as not to endanger him or her when a defibrillation shock is triggered. This can avoid unnecessary waiting times before triggering a defibrillation shock. On the insulation mat 6 is a strain sensor element 10 arranged, which can be positioned with its central area above the pressure point for the cardiac massage. Thus, in the cardiac pressure massage, an elongation of the strain sensor element 10 This is done together with the insulation mat 6 Fixed at its peripheral edge on the chest of the person to be rescued or provided to the strain sensor element with a retaining ring. The insulation mat 6 also serves as a support for a display unit 5 to inform the helper about the efficiency of his printing operation. The display unit 5 can be omitted or attached elsewhere. An isolation mat per se can also be used in conjunction with the other embodiments of the device for assisting the rescue personnel disclosed herein. Instead of the insulation mat 6 An isolation pad in the region of the operating part can also help to prevent the risk of touching the ribcage with the hands.

13 shows another embodiment of the device for assisting a rescuer in performing a cardiopulmonary resuscitation. This is to be arranged on the on the chest of the person to be rescued sensor unit 1 an electrode assembly with two defibrillator electrodes 22 attached so that these together with the sensor unit 1 defined on the chest of the patient can be easily positioned. The actuating part 3 the sensor unit 1 is positioned at the pressure point of the person to be rescued and the sensor unit 1 with the from the operating part 3 on the one hand down and on the other hand upwardly extending strain sensor elements 10 aligned in the longitudinal direction of the person to be rescued. In the process, the defibrillator electrodes come 22 in the correct position for the defibrillation, by simply being able to unfold laterally. In this embodiment, the lines to the defibrillator electrodes 22 in the connection cable 21 be guided, so that a simple connection with the defibrillator unit 20 and the processing device 2 when connecting to the person to be rescued results. Also other sensor units 1 , such as As such with extending across the chest strain sensor elements 10 As described above, as one with defibrillator electrodes 22 be executed coherent unit.

14 shows a display device advantageously used in the previously described device for assisting the rescuer in performing cardiopulmonary resuscitation 5 , The display unit 5 preferably has self-illuminating or actively backlit or backlit display elements. The display unit comprises two display sections 50 of which one is a frequency display part 51 forms for the printing frequency and the other a pressure indicating part for the pressure force or pressure depth. The display unit 5 is advantageous in the field of vision of the helper during cardiac massage in the region of the sensor unit 1 arranged, such. For example, those described above 4A and 4B demonstrate. Further details on the design of the display unit 5 are in the (not pre-published) German Patent Application No. 10 2013 114 565 made. The 15A . 15B and 15C show as an example the display of the frequency display 51 in different situations of chest compressions.

In the embodiments described above, in a further embodiment, a selection device for a setting on the height, the body weight, the age group and / or the sex of the person to be rescued be present, the selected setting is included in the evaluation by the processing device. The selection device may be for manual adjustment via a switch or button and / or for language selection or for selection via a communication interface to the defibrillation unit 20 be educated. For example, a child mode or baby mode can be selected. Furthermore, it can be provided that the setting selected by means of the selection device is displayed via the display unit 5 or another display device is displayed.

When the rescue personnel support device is operated in conjunction with a defibrillator device, a detection signal may be generated during cardiopulmonary resuscitation that suppresses artifacts (CPR artifacts) in the ECG signal caused by CPR, such that the defibrillator device (FIG. AED) in the analysis phase is able to perform a rhythm analysis more quickly. For example, by measuring the CPR artefacts or the disturbance variable via an ECG channel, a signal for disturbance suppression by a feedforward control of the defibrillator unit 20 so as to reliably enable rhythm analysis during cardiopulmonary resuscitation.

In a further embodiment it can be provided that the strain sensor elements 10 integrated into the defibrillation electrodes or attached thereto or in it or attachable.

In the exemplary embodiments described above, various threshold values are furthermore provided, by means of which, by comparison with the current sensor signals or variables derived therefrom, excessive pressurization or too low compression, insufficient relaxation in the pressure relief and / or too high or too low Pressure frequency can be signaled and displayed. Thus, proper chest pressure relief during the cardiac pressure massage is an important CPR parameter to ensure that adequate filling of the heart with blood and, as a result, sufficient ejection volume can be achieved, as stated at the outset. It can be assumed that from a certain minimum force, which applies the assistant directly or indirectly to the pressure point, the restoring forces of the thorax a complete relief of the chest is reached. Furthermore, the detection of the beginning of a loading phase by the pressure force and the detection of a minimum compression depth are important CPR parameters, as explained in the introduction.

The determination of the times for exceeding or falling short of the minimum force (detection of a correct discharge or start of a load phase) can in various ways by means of the device described are solved. Thus, by means of the sensor unit 1 the zero position of the strain sensor (s) 10 or elastomer sensor elements are determined based on their complete relief or a defined bias voltage. The bias can z. B. advantageous in the sensor unit described above 1 with the rigidly formed retaining ring 112 respectively. In another embodiment, the strain sensor element 10 or an array of multiple strain sensor elements 10 be biased in the starting position and relaxed when pressurized. Such a structure exists z. B. in that the one or more strain sensor elements 10 in an actuating part designed as a housing 3 mounted vertically or with a vertical component and z. B. by means of a spring, such as. B. compression spring, are biased in the starting position. When pressure on the actuating part 3 the compression spring is compressed and the strain sensor (s) 100 becomes or become more or less relaxed and, as a result of their elasticity, contracts accordingly, resulting in a detectable and evaluable change in capacity or signal change.

The exceeding or falling below a minimum force for the detection of a correct discharge or the beginning of a load phase can also take place in that a switching element is used, which is structurally integrated into the device that it only when the minimum force is exceeded or fallen short of is activated or deactivated. For example, the switching element can be realized so that it is activated when the minimum force is exceeded and is deactivated when the minimum force is exceeded (power switch). However, it is also a reverse logic conceivable (off switch).

• – ein Schaltelement wird mit einer Feder kombiniert, die bei der Druckbetätigung mit der Mindestkraft so komprimiert wird, dass das Schaltelement betätigt wird. Dazu kann die Feder durch eine entsprechende Aufnahme in eine Druckplatte integriert sein, so dass das Schaltelement auch dann ansprechen kann, wenn die Krafteinwirkung seitlich versetzt zur Feder erfolgt.
• – Es kann eine vorgespannte Druckplatte verwendet werden, die bei Überschreiten der Mindestkraft in eine andere plastische Kontur springt und dadurch das Schaltelement aktiviert, bei Unterschreiten der Mindestkraft aber in die Ursprungskontur zurückspringt und dadurch das Schaltelement deaktiviert.
• – Es können auch mehrere Schaltelemente in den vorgenannten Kombinationen zur Anwendung kommen, um die Zuverlässigkeit der Vorrichtung hinsichtlich der korrekten Detektion des Auftretens der Mindestkraft zu erhöhen. Dies gilt insbesondere für den Fall, dass der Helfer nicht zentral auf die für das Auflegen der Handballen bei der Herzdruckmassage bezeichneten Fläche drückt.
• – Eine weitere Ausführungsvariante besteht darin, dass durch das Aufbringen von leitfähigen Strukturen auf einem sphärisch oder zylindrisch ausgestalteten Druckkörper eine Mindestbewegung (und damit das Auftreten der Mindestkraft) detektiert wird. Dazu wird auf dem Druckkörper oder einer flächig gestalteten Unterstruktur der Sensoreinheit 1 (z. B. bei der flächigen Verspannung von Dehnungssensorelementen 10 in einem Ring, der auf den Brustkorb aufgebracht wird) eine Folie mit elektrisch leitfähigen Strukturen aufgebracht. Diese können z. B. metallisch aufgedampft oder aufgedruckt werden. Als Gegenstück fungiert ein sphärisch gestalteter Druckkörper, der als Handauflage dient. Wird die Mindestkraft aufgebracht, geht dies mit einer Bewegung des Druckkörpers einher, der dann in die Unterstruktur bzw. Folie eintaucht. Auf der Oberfläche des Druckkörpers sind Kontaktflächen aufgebracht, die durch leitfähige Strukturen auf der Unterstruktur kurzgeschlossen werden. Bei Unterschreiten der Mindestkraft wird diese elektrische Verbindung gelöst.

Constructively, the exceeding or falling below the minimum force can also be detected in other ways, namely:

• - A switching element is combined with a spring which is compressed in the pressure operation with the minimum force so that the switching element is actuated. For this purpose, the spring may be integrated by a corresponding receptacle in a pressure plate, so that the switching element can respond even when the force is laterally offset from the spring.
• - It can be used a prestressed pressure plate which jumps when the minimum force is exceeded in another plastic contour and thereby activates the switching element, falls back falls below the minimum force but in the original contour and thereby deactivates the switching element.
• It is also possible to use a plurality of switching elements in the aforementioned combinations in order to increase the reliability of the device with regard to the correct detection of the occurrence of the minimum force. This is especially true in the event that the helper does not press centrally on the area designated for the application of the heelballs in the cardiac massage.
• - A further embodiment is that a minimum movement (and thus the occurrence of the minimum force) is detected by the application of conductive structures on a spherically or cylindrically configured pressure body. For this purpose, on the pressure body or a flat-shaped substructure of the sensor unit 1 (eg in the areal strain of strain sensor elements 10 in a ring which is applied to the thorax) applied a film with electrically conductive structures. These can be z. B. vapor-deposited or printed metallic. The counterpart is a spherically shaped pressure body, which serves as a hand rest. If the minimum force applied, this is accompanied by a movement of the pressure hull, which then dips into the substructure or film. On the surface of the pressure body contact surfaces are applied, which are short-circuited by conductive structures on the substructure. When falling below the minimum force this electrical connection is released.

A determination of the minimum compression depth can be achieved by the same construction with conductive structures on a spherical or cylindrical pressure body and sub-structure or film. For this purpose, the geometric arrangement of the conductive structures is selected so that the electrical contact is made only when the minimum pressure depth is reached. This arrangement can be realized alone or in addition to an arrangement for detecting the minimum movement.

With the same principle, it is also possible to determine the angle of the force on the pressure body. This will tilt according to the direction of the force relative to its mounting point on the film and therefore not make contact with the film as in a vertical force on concentric circles around the mounting point around, but only in some areas. By a corresponding configuration of the conductive structures, a contact array can be produced, which allows conclusions about the angle of the force to the vertical. In the formation of the at least one strain sensor element 10 An exemplary embodiment of one or more piezo foils is that different piezo foils are arranged in radial alignment in a foil to be adhesively attached to the sternum or sternum around the pressure point. The piezo films can be used to improve the signal generation in so-called bimorph Be integrated alignment. In CPR resuscitation, the piezo foils thus arranged are alternately stretched and unloaded, giving an electrical response or signal change proportional to the extent of the strain. This can be used to easily determine the pressure frequency or number of pressurizations. By combining the various signals, it is also possible to determine the pressure depth due to the known geometric arrangement of the piezo-films. In the pauses of the pressure massage, the rib cage movement during ventilation can also be detected, drawing a conclusion on the effectiveness of the ventilation. It is also possible to model the HLW artifact signal and then correct the ECG signal to perform an ECG analysis during CPR resuscitation.

In order to increase the reliability of the evaluation of the sensor signals in the various embodiments or to obtain additional statements, the processing device 2 various additional information or additional signals are supplied, which can be included in the evaluation. Thus, the relief in the cardiac massage can be measured by the fact that a fluid-filled chamber is provided or connected in the region of the pressurization, and the change of pressure in the closed volume, such as. As a gas-filled pad is detected.

Further additional information for evaluating the efficiency of cardiopulmonary resuscitation may include signals from a blood flow sensor, an impedance measuring device, an oximetry measuring device (SpO2, rSO2 and / or ETCO2 measurement) and / or a photoplethysmogram measuring device (PPG). in addition to the evaluation in the processing device 2 be used.

The device described is easy to use and has low energy consumption. With low construction costs, an efficient cardiac massage is achieved even in a disturbing environment. Especially in conjunction with defibrillation measures, interruptions are minimized, thereby also increasing the efficiency of the resuscitation measures.

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• US 2008/0312565 A1 [0002]
• US 2012/0089055 A1 [0003]
• EP 1491176 B1 [0003]
• DE 102013114565 [0077]

Claims (31)

Device for assisting the rescue personnel in carrying out a cardiopulmonary resuscitation with a monitoring device for the cardiac pressure massage, the at least one sensor unit ( 1 ) for the printing operation and a processing device ( 2 ) for their supplied sensor signals, characterized in that the sensor unit ( 1 ) at least one strain sensor element ( 10 ) comprising a material which changes its electrical properties during elongation and is provided with a holding device, by means of which the at least one strain sensor element ( 10 ) is fixable with respect to the breast of the person to be rescued in such a way that the at least one strain sensor element ( 10 ) is deformed in synchronism with the pressure operation and thereby the sensor signal is formed. Apparatus according to claim 1, characterized in that the at least one strain sensor element ( 10 ) is fixable with respect to the breast such that it is stretched or relaxed synchronously with the pushing operation. Apparatus according to claim 1 or 2, characterized in that the strain sensor element ( 10 ) is mechanically biased in its initial position. Device according to one of the preceding claims, characterized in that the sensor unit ( 1 ) generates electrical energy even during the pressure actuation and is ready for operation without an additional power supply or that the sensor unit ( 1 ) is supplied from the outside via high-frequency energy pulse packets. Device according to one of the preceding claims, characterized in that the sensor unit ( 1 ) is designed as a pressure sensor, force sensor, position sensor or angle sensor. Device according to one of the preceding claims, characterized in that by the deformation of the at least one strain sensor element ( 10 ) causes a capacitance change, by which the sensor signal is formed. Device according to one of the preceding claims, characterized in that the at least one strain sensor element ( 10 ) is formed of an elastomeric film and coated on one or both sides with flexible electrodes. Device according to one of the preceding claims, characterized in that the processing device ( 2 ) for determining the extent of the pressure operation from the strength, the frequency and / or the phase of the sensor signal or the change of at least one of these sizes is formed. Device according to one of the preceding claims, characterized in that the processing device ( 2 ) for determining the frequency of the pressure actuation from the repetition of the same strength, frequency and / or phase of the sensor signal is formed. Apparatus according to claim 8 or 9, characterized in that the extent of the pressure actuation comprises the pressure depth, the pressure force, the speed of pressing and / or unloading, the pause time or a combination of at least two of these parameters. Device according to one of the preceding claims, characterized in that the holding device at least one holding part and two spaced from each other on the respective strain sensor element ( 10 ) has attached or attachable fixing units, between which a stretchable portion of the respective strain sensor element ( 10 ), wherein the respective strain sensor element ( 10 ) is mounted by means of a fixing means on the associated holding part and with the aid of the other fixing means to a in the pressure actuation relative to the holding part of this away and during unloading to this moving body. Device according to claim 11, characterized in that the moving body actuates an actuating part acting on the chest of the person to be rescued during the pressure actuation by the manual force ( 3 ). Apparatus according to claim 12, characterized in that the holding part ( 40 ) a fastening piece attached to the breast ( 11 ) or attached to a support body retaining member. Device according to claim 13, characterized in that the processing device ( 2 ) for determining the pressure depth as a function of the angle (phi) which changes during the pressure actuation between the vertical direction in the direction of gravity and the extent of the strain sensor element ( 10 ) is formed at a known length thereof. Device according to one of claims 11 to 14, characterized in that the sensor unit ( 1 ) several strain sensor elements ( 10 ) and several of them each has associated holding parts or a common holding part and that all strain sensor elements ( 10 ) are mounted at a distance from the one or more holding parts on the moving body. Apparatus according to claim 15, characterized in that the common holding part as a retaining ring ( 112 ) is trained. Apparatus according to claim 12, characterized in that a sensor arrangement of a surface-connected strain sensor element ( 10 ) or several strain sensor elements ( 10 ) is extended as a sensor array in an xy direction and is mounted along its peripheral edge by means of a fixing unit continuously or to individual fixing points on the then circumferentially formed holding part and that the moving body is mounted by means of the other fixing unit in the central region of the sensor arrangement. Apparatus according to claim 17, characterized in that the capacities of the individual strain sensor elements ( 10 ) of the sensor arrangement by means of the processing device ( 2 ) and included in the evaluation. Device according to one of the preceding claims, characterized in that the sensor unit ( 1 ) is formed such that at least one strain sensor element ( 10 ) transversely to the longitudinal extent of the person to be rescued around the breast and the change of the thorax circumference and / or the respiratory muscles of the chest during respiration by strain change of the at least one strain sensor element ( 10 ) by means of the processing device ( 2 ) and can be included in the evaluation for determining the pressure depth and / or the pressure frequency. Device according to one of the preceding claims, characterized in that the sensor unit ( 1 ) at least in the region of the at least one strain sensor element ( 10 ) is provided with an insulating protective layer. Device according to one of the preceding claims, characterized in that in the processing device ( 2 ) at least one threshold is given, with which the sensor signal is compared, and that by means of the processing device ( 2 ) can be determined from the comparison result of the start of printing, a minimum pressure depth, a maximum pressure depth and / or a complete relief in the pressure actuation / are. Device according to one of the preceding claims, characterized in that the sensor unit ( 1 ) Has at least one switching stage for specifying at least one threshold value for the start of printing, a minimum pressure depth, a maximum pressure depth and / or a complete relief in the printing operation. Device according to one of the preceding claims, characterized in that in a receiving unit of the sensor unit ( 1 ) at least one strain sensor element ( 10 ) is received under bias and that the receiving unit is designed such that the at least one strain sensor element ( 10 ) is relieved when pressurized. Device according to one of the preceding claims, characterized in that it comprises at least one further detection unit, which is designed to detect the respiratory activity, blood flow, oxygen saturation or carbon dioxide accumulation of the blood, the volume pulse and / or a body impedance of the person to be rescued, and in that the detection signals of the at least one further detection unit of the processing device ( 2 ) can be supplied during operation and evaluated by this. Device according to one of the preceding claims, characterized in that it comprises a display device controlled by the processing device with an optical display unit ( 5 ) and / or acoustic output unit for informing the person performing the cardiac pressure massage about the pressure actuation. Device according to one of the preceding claims, characterized in that it comprises a defibrillator device connected to the processing device ( 2 ) is brought into signal communication or can be brought to tune the triggering of a defibrillation shock on the cardiac massage. Apparatus according to claim 26, characterized in that a triggering time for the triggering of a defibrillation shock by means of the processing device ( 2 ) is adjusted to the sensor signal in the pressure operation, that the shock triggering takes place at a selectable time during the printing cycle. Device according to claim 26 or 27, characterized in that at least one strain sensor element ( 10 ) is integrated in at least one defibrillation electrode. Device according to one of the preceding claims, characterized in that it comprises a selection device for adjustment to the height, body weight, age group and / or sex of the person to be rescued, the selected setting being evaluated by the processing device ( 2 ) is included. Device according to one of the preceding claims, characterized in that it is provided with an additional pressure detection unit comprising a fluid enclosed in a closed volume. Device according to one of the preceding claims, characterized in that the at least one strain sensor element ( 10 ) Is designed as elastomeric film, piezoelectric film, strain gauges or potentiometer.

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