DE102018101417A1 - Device for assisting a first-aider in cardiac massage - Google Patents

Abstract

The invention relates to a device for assisting a first helper in cardiac massage with auxiliary means (1), which can be arranged between the pressure exercising hand of the first helper and the body of the person to be rescued Andrück part and formed for detecting, rating and feedback of the pressure actuation of the pressing part monitoring part comprising evaluation means for deriving and outputting evaluation results and an information output means for presenting information generated therefrom via the print operation. An advantageous user guidance is obtained by virtue of the fact that the information output device has an acoustic output part which can be brought into or can be brought into signal transmission connection with the evaluation device and has a conversion device designed to convert the evaluation results into acoustic information (FIG. 1).

Description

The invention relates to a device for assisting a first helper in cardiac massage with auxiliary means having a pressure exerting hand of the first helper and the body of the person to be rescued Andrück part and formed for detecting, rating and feedback of the pressure actuation of the pressing part monitoring part which comprises an evaluation device for deriving and outputting evaluation results, and an information output device for presenting information generated therefrom via the print operation.

Such a device with display part to assist a first-aider in cardiac massage is in the DE 10 2013 022 397 A1 specified. In this known device, the display part is designed with separate display areas for the frequency and the pressure depth, which allow rapid detection and, if necessary, correction by the first responder when exercising the pressure massage. In such an emergency situation, however, it is important at the same time to observe the patient in order to correctly interpret signs of life and to adequately coordinate additional measures such as ventilation or the use of a defibrillator.

A device for assisting a first-aider in cardiac massage of this kind is also in the EP 1 204 395 B1 shown. In this known device for monitoring a cardiac massage, which exerts a first responder on the chest of a person to be rescued, a aufzustegender on the sternum (sternum) of the patient body is provided, on which a relative to the body movable force receiving element is arranged to those of to increase the pressure exerted on the first responder. The force receiving element is connected to a display device, via which the user is given an optical feedback in the printing operation. It is usually difficult for a first responder without profound experience in cardiac massage to be able to perform an as efficient as possible chest compressions in a particular emergency situation.

In the US 2012/0083720 A1 Another device for assisting a first-aider in cardiac massage is disclosed, with which a pressure depth is measured. In this case, an upper part to be arranged on the breast of the person to be rescued and a lower part to be arranged under the back in the breast region are provided in order to determine the total pressure depth in the chest region from the pressure depth of the upper part relative to the lower part.

In the EP 1 491 176 B1 Another device for assisting a first-aider in cardiac massage is shown. By means of a aufzustegenden on the chest, especially in the area of the pressure pad pad movement of the chest during cardiac massage is detected and a visible or audible signal generated to inform the rescuer on the pressure actuation, namely in particular to indicate whether the chest after the pressing was sufficiently relieved. The device is part of an external defibrillator.

A device for assisting a first-aider in cardiac massage also shows the US 7,993,290 B2 , which is mainly a display device for reporting a print depth.

In the US 2004/0082888 A1 It describes how the pressure depth can be determined on the basis of various parameters such as acceleration, electrocardiogram (ECG). Again, in conjunction with a cardiac massage, a defibrillator is provided for a shock application at a suitable moment.

The US 8,333,720 B2 shows a force measurement in connection with a breast stiffness function as well as an effectiveness indication of the pressurization.

The US 2008/0312565 A1 shows in connection with a device for cardiac massage a sensor array on a flexible substrate on which a processor and an energy source are arranged. To determine the cardiac massage, various parameters such as pressure depth, pressure force, pressure frequency and pressure acceleration are detected.

The US 2010/0312153 A1 shows a device for assisting a first-aider in cardiac massage, in which an indicator of the quality of cardiac massage based on a Transthorax impedance works.

In the US 2011/0301512 A1 is in the context of a device for cardiac massage indicated to detect compression by means of ultrasound signals.

Although the prior art shows many different approaches to improving the effectiveness of cardiac massage performed by a first responder, the most effective, efficient cardiac massage is usually associated with significant problems.

The present invention has for its object to provide a device of the type mentioned above, with which the first-aiders in the cardiac massage is supported as effectively as possible.

This object is achieved with the features of claim 1. In this case, it is provided that the information output device has an acoustic output part, which is brought into or can be brought into signal transmission connection with the evaluation device and has a conversion device designed to convert the evaluation results into acoustic information.

This embodiment of the device with the monitoring part and the acoustic output part comprising the evaluation device and the information output device provides the first aider with essential assistance in the control of the movement processes during the exercise of the pressure massage, whereby the first responder responds to the visual observation of the pressure massage to focus on rescuing patients without being too distracted by device operation.

For the design and function of the device, an advantageous embodiment is that the conversion device is designed to implement the evaluation results on the basis of an at least one-dimensional evaluation function present in the monitoring part.

An advantageous embodiment for the transmission of information consists in the fact that the display part is equipped with display elements for visual information on the pressure actuation and a display area with a frequency display part and a further display area with a pressure indicating part in which information about the pressure depth can be displayed, and that the Frequency display part consists of a display bar, in its central region optimum pressure frequencies and in the lateral areas on the one hand too high and on the other hand too low pressure frequencies are displayed.

Further advantages for the structure and the user guidance result from the fact that the pressure indicating part has the form of an arcuate strip, in which a plurality of display elements are arranged for representing the pressure depth, that the pressure indicating part is offset from the frequency display part and in its central region approximately at right angles to the longitudinal direction of the indicator bar, the optimum decompression and / or zero point in exerting the compressive force is displayed in the middle area of the pressure indicating part and the increasing compression and / or the extent of the decompression is / are displayed laterally.

For the user guidance, the measures are also advantageous in that too high or too low print frequencies are displayed in red and / or rapidly flashing, and that too deep a compression in red and / or fast flashing is displayed in outer regions of the curved strip.

An embodiment which is advantageous for construction and operation also consists in that the display part of the display device comprising the frequency display part and the pressure display part has a flexible carrier on which the display elements are accommodated.

• 1 eine Vorrichtung zur Unterstützung eines Ersthelfers bei einer Herzdruckmassage mit Hilfsmitteln in schematischer Ansicht in Draufsicht und Ansicht von der Kopfseite einer zu rettenden Person in einem Anwendungsfall,
• 2 eine vergrößerte Darstellung der Hilfsmittel nach 1 in perspektivischer Ansicht,
• 3A, 3B und 3C die Hilfsmittel nach 1 in perspektivischer Ansicht in verschiedenen Vorbereitungsstadien,
• 4 eine schematische Darstellung von Anzeigebereichen einer Anzeigevorrichtung,
• 5A, 5B und 5C weitere schematische Darstellungen der Anzeigebereiche nach 4 bei verschiedenen Ausführungen der Herzdruckmassage,
• 6A, 6B und 6C einen Anzeigebereich zur Druckfrequenz bei unterschiedlich schneller Druckfolge,
• 7 eine schematische Darstellung für eine zweidimensionale Bewertungsfunktion der Druckbetätigung hinsichtlich Druckfrequenz und Druckstärke bzw. Drucktiefe,
• 8 eine schematische Darstellung zur akustischen Reaktion nach Maßgabe der Bewertungsfunktion und
• 9 eine eindimensionale Bewertungsfunktion der Druckbetätigung hinsichtlich Druckfrequenz.

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

• 1 a device for assisting a first helper in a cardiac massage with tools in a schematic view in plan view and view from the head of a person to be rescued in an application,
• 2 an enlarged view of the tools after 1 in perspective view,
• 3A . 3B and 3C the aids 1 in perspective view in different preparatory stages,
• 4 a schematic representation of display areas of a display device,
• 5A . 5B and 5C further schematic representations of the display areas after 4 in different versions of the cardiac massage,
• 6A . 6B and 6C a display area for the print frequency at different speeds of printing,
• 7 a schematic representation of a two-dimensional evaluation function of the printing operation in terms of print frequency and pressure or pressure,
• 8th a schematic representation of the acoustic response in accordance with the evaluation function and
• 9 a one-dimensional evaluation function of the pressure operation with respect to printing frequency.

The 1 shows an embodiment of a device for assisting a first-aider in cardiac massage with tools 1 in an application from the head of a person to be rescued. Between the body of the person to be rescued and the one with the cardiac massage concerned first responder is an insulation mat 3 arranged to protect the first responder from a high voltage when delivering an electric shock. Furthermore, in the field of pressure actuation is a sensor 4 arranged.

To perform the cardiac massage, the first responder places his palms in the area of the breastbone of the person to be rescued to perform the pressure operation. The device has to support the Ersthelfers also explained in more detail below information output device, which is provided with a positionable on the chest of the rescued person optical display device and is conveniently visible from the first responder in the execution of the cardiac massage, so that he through the feedback on the display device is immediately informed of the efficiency of its printing operation. For this purpose, the information important to him are reported back to him via the display device. The optical display device preferably comprises a flexible carrier on which display elements are arranged. In addition to or instead of the optical display device, the information output device is provided with an acoustic output part.

In a device body, which is formed, for example, like a housing and are arranged in the electronic circuit parts of the device, such as electronic components of a control device with monitoring part and display control, electromechanical components such as switches, connectors and the like., Also, circuit and power supply parts of a defibrillation device can be accommodated if the device also comprises a defibrillation device in addition to the components for the cardiac massage. On the device body 10 are then z. B. connections for the electrodes of the defibrillation device and elements for operating the defibrillator attached, such as actuators and display elements. By means of the monitoring part, the cardiac massage can be coordinated with the shock release, so that the shock release takes place in an optimal moment for their effectiveness during the cardiac massage or during the shortest possible break. Furthermore, with the help of the monitoring part of the beginning of an ECG analysis or the delivery of a shock can be prevented, as long as activities of the cardiac massage are still detected. The user may also be explicitly requested to discontinue chest compressions to perform the aforementioned actions (ECG analysis, shock delivery) using the defibrillation device.

The monitoring part of the control means is configured to monitor the pressing operation of the pressing member and a respective feedback to the first responder via the information output apparatus. In this case, the position or movement of actuating means is detected via an actuating sensor of the monitoring part in order to generate position and / or movement signals and to derive information about the pressure actuation, in particular about the pressure depth, pressure relief and / or pressure frequency. The actuation sensor system advantageously comprises a suitably designed sensor system 4 For meaningful parameters in the pressure operation, such as pressure frequency, pressure, pressure or pressure relief. In addition, the actuating sensor advantageously may include other sensors, such. B. a zero point sensor for a starting position in the pressure operation in the unloaded state or at the beginning of the breast of the person to be rescued compressive compressive force (threshold). Thus, for example, the pressure depth or the stroke can be determined in the printing operation.

In order to optimize cardiopulmonary resuscitation, in particular in the case of a combined application of cardiac massage and defibrillation by means of an external defibrillator, the device advantageously comprises the already mentioned isolation mat 3 as in the 1 to 6B illustrated by various embodiments. The insulation mat 3 is placed in the implementation of the cardiac massage between the or the massage performing hands of the first responder and the person to be rescued or the actuating means. The insulation mat 3 forms an electrical insulation layer between the body of the person to be rescued and the rescuer, so that it is not endangered by the Defibrillationseinrichtung shock treatment of the person to be rescued and no or no long interruption of the cardiac massage is required. Rather, the defibrillation can be coordinated by means of the monitoring part of the control device with the cardiac massage in order to trigger the delivery of the defibrillation pulse at an optimum moment. In this case, the display device 2 Advantageously designed so that the first responder is visually and / or acoustically informed about an impending triggering of a defibrillation pulse. For example, the defibrillation pulse can be triggered in this way, when the breast of the person to be rescued is just compressed, so that the effect of the defibrillation can be optimized, and because of improved transmission conditions, the defibrillation energy can be registered better and gentler than relaxed chest.

1 shows the combination of the insulation mat 3 with actuating means during the cardiac massage and the sensors 4 for detecting the pressure operation, which is also advantageous for detecting optimal conditions for defibrillation can be trained. In 2 is also a direction indicator 104 shown to the arrangement of the chest part. On the side of the chest are, as from the 3A . 3B . 3C visible, closure elements 102 arranged at which the insulation mat 3 can be attached accurately positioned with adapted locking counter-elements.

2 shows aids 1 in conjunction with a rolled insulation mat 3 in a non-use state as a compact unit. The 3A to 3C show an embodiment in which the chest part of aids 1 a solid part 103.1 and subsequent flexible areas or parts 103.2 and in the region of its mutual flexible parts 103.2 with mutual insulation mats 3 is connected so that in the state of use two first responders can exercise electrically isolated from the person to be rescued from this a cardiac massage.

In a further embodiment, the insulation mat 3 be foldable formed and for easy folding with a folding cord 105 be provided near its two longitudinal edges. Again, both sides of the chest part of relevant closure elements 102 insulation mats 3 be attached. These can then be folded under and / or over the chest part, so that there is a compact unit of actuating means or aids 1 and insulation mat 3 results.

4 shows an embodiment of a display panel with display areas of the optical display device 2 , The display includes z. B. a backlit display area with according to the information to be displayed controllable display elements or self-luminous controllable display elements such. As LCD elements and / or LED elements, for a reasonably bright, high-contrast information display, so that it is easily readable in different light conditions, such as darkness or bright daylight. A display area provides a frequency display part 22 while another display area has a pressure display part 23 includes information on the printing operation, which relate to the printing depth and may also contain information on the pressure force. In this case, additional user information can be displayed, which provide him with the correct pressure actuation or instructions for correction in case of incorrect pressure actuation during the pressure massage. The display panel is advantageously designed so that it can be easily read from two or more different directions, for example, on either side of a person to be rescued kneeling first responders, who alternate in the pressure massage, and optionally a still further first responders who in the head area of rescuing person is located to support the head and neck.

The frequency display part 22 consists of a middle indicator bar with optimal pressure frequencies (eg in green color) in its middle area and unfavorable, too high or too low pressure frequencies (eg in red and / or fast flashing) in the lateral areas become. The display bar of the frequency display section 22 is provided on both sides with a numerical scale of the print frequencies, which are aligned for reading from two 180 ° opposite viewing directions.

The pressure gauge part 23 is clear from the frequency display part 22 discontinued and has the shape of an arcuate, for example, circular section-shaped strip, in which several display elements 20 are arranged to represent the printing depth. Furthermore, information about the compression or decompression can be displayed in addition to the circle-shaped information strip. The middle area of the pressure indicating part is from the display bar of the frequency indicating part 22 discontinued and runs for clear distinction in its central region approximately at right angles to the longitudinal direction of the indicator bar. In the middle area of the pressure indicating part 23 For example, the optimal decompression and / or zero point in applying the compressive force is displayed while laterally indicating the increasing pressure depth or amount of compression or decompression. In the outer region of the arcuate strip, therefore, a too deep compression (eg in red color and / or fast flashing) is displayed, while in the region adjacent to the inside an optimal pressure depth or compression (eg in green color) is displayed so that the first responder is always aware of the impact and thus the efficiency of his pressure operation during the pressure massage. In transition areas between a good and bad pressure operation can in the frequency display part 22 and / or the pressure indicating part 23 (eg in yellow color and / or slowly blinking) a decreasing or to be improved efficiency of the printing operation are displayed.

The display part of the display device 2 advantageously has a flexible support 21 on, on which the display elements 20 or the display panel are included and can be advantageously positioned at a suitable location in the field of view of the first helper.

The 5A to 5C schematically show the display panel of the display device 2 with the frequency display part 22 and the pressure indicating part 23 with a pressure actuation with optimal pressure frequency and pressure force, optimal pressure frequency at too great a pressure depth or with an optimal pressure frequency and too little decompression (ie without complete relief). The 6A to 6C show the frequency display part 22 at optimal printing frequency, too low printing frequency or too high printing frequency.

In the 7 . 8th and 9 Fig. 15 shows parts of a judging means of the acoustic signal output information output device via an acoustic output part (not shown). In order to output acoustic information, the evaluation device is brought into signal transmission connection with the output part in order, for. As the volume, pitch, frequency of the output and / or the information content such. B. linguistic instructions to the first responder to optimize the printing operation to control depending on the evaluation results supplied by the evaluation device and to signal via the acoustic output part. The evaluation device can, for. B. at least partially be formed in the monitoring part and derive the evaluation results on the basis of the evaluation function to convert them by means of the conversion device in the acoustic information and to signal via the output part. Furthermore, in the evaluation device decision criteria, such. B. Threshold values of the relevant parameters to be evaluated in the pressure massage, be deposited or determined to spend based on a matched to the respective decision criterion information for the rescue personnel.

7 shows an embodiment of a two-dimensional evaluation function 6 , The by the evaluation function 6 evaluated parameters of the printing movement are, for example, the printing frequency (pressure strokes per minute) and the pressure depth d or pressure, with which the pressure relief can be assessed. In a rating area B0 both pressure frequency f and pressure depth d are in a favorable or predetermined for the proper cardiac pressure massage area. Outside the rating range B0 close in both low and high pressure frequencies f as well as in the direction of low and high pressure depth d to be corrected behaviors in the pressure operation in terms of printing frequency f or depth of pressure d, namely initially for smaller deviations from the evaluation range to be complied with B0 an evaluation area B1 and for larger deviations, an evaluation area B2 , The evaluation results obtained can be provided in the evaluation device with an indication whether the of the evaluation area to be followed B0 deviating pressure actuation to the pressure depth d or the pressure frequency f is due or that both parameters are outside the standard rating range B0 lie as in 7 indicated by the transitional areas in the corner fields.

On the basis of the evaluation results obtained by the evaluation function, which can be stored, for example, as evaluation data in evaluation tables or a memory device of the evaluation device, then by means of the conversion device and the acoustic output part z. B. a distinguishable depending on the evaluation area acoustic information, such. B. issued different pitch or verbal information for the rescuer, and the frequency of the output may vary.

In 8th is an embodiment of an information output over different signaling zones Z0 . Z1 . Z2 . Z3 likewise for the printing parameters print depth d and print frequency f shown in a two-dimensional representation. The signaling zone Z0 forms the valuation area B0 in which therefore no correction information for the rescue person to be spent or need to be. In the zone Z1 For example, acoustic information for correcting the printing frequency f and / or the printing depth d is output at a relatively low frequency, e.g. After every tenth compression so as not to distract the attention of the rescuer too much from their actual activity. In the signaling zone Z2 a more frequent correction information for the rescuer, z. B. after every fifth compression or pressure operation to the rescuer to correct the operation in terms of pressure frequency f and / or to cause pressure depth d. In the signaling zone Z3 If the frequency of the correction information is increased, for example, it occurs after every third compression, since the effectiveness of the pressure massage is questionable and should be improved as quickly as possible.

9 shows an example of a one-dimensional evaluation function 8th that can be realized in the evaluation device. Here is an example of the period between correction information .DELTA.K during the pressure operation as a function of the pressure frequency f (Strokes h per minute) indicated. In the favorable or optimal range of the print frequency f between 100 and 120 strokes per minute, there is no output of correction information, ie the distance between the correction information .DELTA.K is 100%. On the other hand, the pressure frequency drops f under 100 pressure strokes per minute or increases over 120 strokes H per minute, correction information is output less frequently (relatively large time interval, eg after every tenth compression) with less deviation from the optimum range, and with increasing deviation more and more frequently, e.g. B. at 90 pressure strokes h per minute in Distance of five compressions and with higher deviation more frequently. The frequency, as in 9 shown by way of example, linearly as a function of the deviation from the optimum printing frequency f done and by the evaluation function 8th be predetermined. The same applies to deviations from the optimum printing frequency f towards higher print frequencies f out. For laymen can be given a different evaluation function than for an experienced rescuer, such. B. a doctor or paramedics. This is in 9 represented by the falling straight of 100% at a printing frequency of 120 strokes h per minute to (theoretically) 0% at 130 strokes h per minute, ie for an experienced rescuer is already at a lower deviation from the optimum pressure frequency f a correction information issued at a higher frequency than for a layman, as an inexperienced rescuer could be easily distracted by the correction information from its actual task of printing operation.

The one-dimensional evaluation function 8th to 9 essentially corresponds to a weighting function along the pressure frequency f the two-dimensional evaluation function 6 to 7 , Correspondingly, a one-dimensional evaluation function for the printing depth d or another printing parameter can also be provided.

A further advantageous embodiment of the device is that the monitoring part has an additional sensor for detecting additional signals, which are supplied to the monitoring part. The monitoring part is designed for this purpose with a processing device for the additional signals. In this case, an advantageous embodiment is that the additional sensor has an oximetry device with the z. B. the oxygen saturation of the blood is detectable. The additional sensor system equipped with such a detection device provides for the support of the first helper advantageous additional information that support him in the control of the success of cardiac massage. The additional information can advantageously via the display device 2 the monitoring part optically (eg, via a light emitting diode display) and / or acoustically displayed. The oximetry device comprises z. As an SpO2 measurement, a rSO2 measurement and / or an ETCO2 measurement. By recording the volume pulse using a photoplethysmogram (PPG) and the relationship with the measurement of oxygen saturation, the quality of the cardiac massage can be improved or optimized.

A further embodiment consists in that the device for assisting the first aider in the case of cardiac massage can be adapted to different patient groups, for which purpose they can be operated in corresponding operating modes, such as, for example, in the case of cardiac massage. B. can be operated in a child mode. The mode can be switched via a key or voice instruction. The signal processing in the monitoring part is automatically adjusted according to the operating mode under specification of adjusted operating parameters, whereby the display device 2 is controlled with adapted signals for the user guidance (feedback) of the Ersthelfers. The mode can also be used by the first responder via the display device 2 be signaled.

The structure of the device for assisting a first-helper in cardiac massage results in the exercise of cardiac massage essential advantages and contributes in its extension, inter alia, with the display device 2 and / or the insulation mat 3 for improved function, in particular in conjunction with a defibrillation device.

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

• DE 102013022397 A1 [0002]
• EP 1204395 B1 [0003]
• US 2012/0083720 A1 [0004]
• EP 1491176 B1 [0005]
• US 7993290 B2 [0006]
• US 2004/0082888 A1 [0007]
• US 8333720 B2 [0008]
• US 2008/0312565 A1 [0009]
• US 2010/0312153 A1 [0010]
• US 2011/0301512 A1 [0011]

Claims (6)

Device for assisting a first helper in cardiac massage with aids (1) having a pressure exerting hand of the first helper and the body of the person to be rescued Andrück part and formed for detecting, evaluating and feedback of the pressure actuation of the pressing part monitoring part, which a A rating device for deriving and outputting evaluation results and an information output device for presenting information generated therefrom via the print operation, characterized in that the information output device has an acoustic output part that is brought into signal communication with the evaluation device and one for converting the evaluation results into acoustic output Having information trained conversion device. Device after Claim 1 , characterized in that the conversion device for implementing the evaluation results on the basis of an existing in the monitoring part, at least one-dimensional evaluation function (6, 8) is formed. Device according to one of the preceding claims, characterized in that the information output part is further provided with a display part with optical information display elements (20) via the print actuator and a display area with a frequency display part (22) and a further display area with a pressure display part (23) in which information about the printing depth can be displayed, and in that the frequency display part (22) consists of a display bar, in the middle region of which optimum print frequencies are displayed and in the lateral areas thereof on the one hand too high and on the other hand too low print frequencies. Device according to one of the preceding claims, characterized in that the pressure indicating part (23) has the shape of an arcuate strip in which a plurality of display elements (20) are arranged for representing the pressure depth, that the pressure indicating part (23) from the frequency display part (22) deducted is and extends in its central region approximately at right angles to the longitudinal direction of the indicator bar. in the middle area of the pressure indicating part (23), the optimal decompression and / or the zero point when exerting the compressive force is displayed and that the increasing compression and / or the extent of the decompression is / are displayed laterally. Device after Claim 4 , characterized in that too high or too low print frequencies red and / or flashing quickly displayed and that in outer areas of the arcuate strip too low a compression in red and / or quick flashing is displayed. Device according to one of Claims 3 to 5 , characterized in that the display part (2) comprising the frequency display part (22) and the pressure display part (23) has a flexible support (21) on which the display elements (20) are accommodated.

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