EP3253355A1 - Apparatus for cardiopulmonary massaging and/or resuscitation - Google Patents

Apparatus for cardiopulmonary massaging and/or resuscitation

Info

Publication number
EP3253355A1
EP3253355A1 EP16701208.7A EP16701208A EP3253355A1 EP 3253355 A1 EP3253355 A1 EP 3253355A1 EP 16701208 A EP16701208 A EP 16701208A EP 3253355 A1 EP3253355 A1 EP 3253355A1
Authority
EP
European Patent Office
Prior art keywords
plunger
massage
patient
locking
chest
Prior art date
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.)
Granted
Application number
EP16701208.7A
Other languages
German (de)
French (fr)
Other versions
EP3253355B1 (en
Inventor
Günter Stemple
Christian Klimmer
Michael Heller
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
GS Elektromedizinische Geraete G Stemple GmbH
Original Assignee
GS Elektromedizinische Geraete G Stemple GmbH
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by GS Elektromedizinische Geraete G Stemple GmbH filed Critical GS Elektromedizinische Geraete G Stemple GmbH
Publication of EP3253355A1 publication Critical patent/EP3253355A1/en
Application granted granted Critical
Publication of EP3253355B1 publication Critical patent/EP3253355B1/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
    • A61H31/006—Power driven
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
    • A61H31/005—Heart stimulation with feedback for the user
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A61H2031/002—Artificial respiration or heart stimulation, e.g. heart massage fixed on the chest by adhesives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/01—Constructive details
    • A61H2201/0173—Means for preventing injuries
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/01—Constructive details
    • A61H2201/0192—Specific means for adjusting dimensions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1207—Driving means with electric or magnetic drive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1657—Movement of interface, i.e. force application means
    • A61H2201/1664—Movement of interface, i.e. force application means linear
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5007—Control means thereof computer controlled
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5061—Force sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5064—Position sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5097—Control means thereof wireless
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL 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
    • A61H2205/00—Devices for specific parts of the body
    • A61H2205/08—Trunk
    • A61H2205/084—Chest

Definitions

  • the invention relates to a device for cardiopulmonary massage and / or resuscitation, with a massage device having a reversible movable in an operating direction, actuated by a drive and positioned on the chest of a patient at a desired contact area plunger.
  • the invention further relates to a locking mechanism for blocking a mobility between two translationally and / or rotationally interconnected transmission elements, in particular for locking a joint mechanism of the device according to the invention for cardiopulmonary massage and / or resuscitation.
  • a respiratory or cardiac arrest for a patient means Hoechsmann ⁇ te death. Only if it is possible to initiate and maintain a "rescue cycle" within a very short time by means of a CPR is there a real chance of survival without permanent damage -The recovery is the implementation of a cardiac massage to build up a replacement bloodstream, so that vital organs such as the brain are supplied with oxygen.
  • the classic chest compressions is carried out manually, for example, by a paramedic, the thorax of the patient in the sternum Compresses and releases frequencies on the order of 80-140 per minute and thereby causes a circulation of the blood through the body of the patient and thus the oxygen supply to the organs.
  • the pressure point is directly above the sternum, more precisely at the upper end of the lower sternum.
  • the sternum is therefore the best area to perform the cardiac massage, because directly below the heart is located, so the organ that is to be compressed.
  • the sternum is a solid bone, which is connected to cartilage elastically to the ribs and thus can be moved.
  • a deviation from the correct pressure point can lead not only to a reduction in the effectiveness of the cardiac massage, but sometimes severe injuries to the patient, of which rib fractures are usually still the least problematic. If the pressure point in the cardiac massage toward the upper ⁇ belly moves, it can lead to serious injury to the internal organs.
  • the cardiac pressure massage device for example, automatically silenced or an alarm signal is issued, which indicates to the paramedics that a readjustment is required.
  • an active position control of the massage device can be realized transversely to its direction of actuation, including a massage device or its plunger in the plane normal to the actuating direction verstellender actuator is provided with the help of the determined actual position of the plunger on the Target position is adjusted.
  • the known device has proven to be very successful and reliable, but in particular the realization of akti ⁇ ven tracking the plunger with an actuator to be provided for this purpose is relatively expensive and therefore expensive.
  • the object of the invention is therefore to provide a device of the type mentioned, in which the maintenance of the correct position of the plunger is achieved reliably with less effort.
  • the plunger is locked in a load state during a Massa ⁇ stroke in the plane transverse to the direction of actuation in its position relative to the ribcage of the patient.
  • the position of the plunger in the plane transverse to the actuation direction (XY plane) during the Massa ⁇ stroke so the chest of the patient compressing movement of the punch downwards, not changed.
  • the punch can not be changed on this move its position unintentionally laterally as ⁇ ago, for example, as a result of acting between the chest and the printing surface of the die shear forces, which could be dangerous for the patient during the printing process.
  • the function according to the invention can advantageously be realized in that the massaging device has at least one articulated mechanism which can be adjusted and unlocked about an axis running parallel to the actuating device. It is particularly advantageous if a preferably acted upon by a force and / or displacement sensor lock mechanism for stopping the transverse movement of the pressure stamp is provided during a Massagehubs, in particular for locking the at least one Gelenkmecha ⁇ mechanism is.
  • the plunger is expediently fixed or fixable to a holding means which can be fixed to the patient's chest, wherein the holding means tel can be designed as preferably by means of an adhesive layer on the chest ankleb ⁇ bares support pad. It has proven to be quite be ⁇ particularly advantageous if the fixation between the plunger and the holding means is created by an effective between these two velcro connection.
  • the holding pad is thus provided on its upper side with the one Velcro fastener element, preferably the mesh fabric, to which the other, on the pressure stamp formed on the pressure surface Velcro element, in which before ⁇ preferably used constellation of the hook fastener, can be releasably fixed.
  • the retaining means preferably has a contact surface, the big ⁇ SSER than the pressure surface formed by the pressure piston, on the chest of the patient via the sternum and can target the plunger over the support pad exactly in the correct position and by (preferably manual) lowering bring into contact with the Hal ⁇ tesch, so that the Velcro connection closes and thereby the fixation of the plunger is made.
  • a correction of the position is possible at any time, it being ensured by the enlarged contact surface ⁇ contact surface of the holding means compared to the pressure surface of the punch that this - for example, in case of inaccurate Ap ⁇ plication of the adhesive pad on the patient's chest, in a range laterally projecting beyond this and then not connected to the pedestrian over its entire printing area.
  • an abutment board which can be positioned under the body of the patient can be provided, on which the massage device is arranged.
  • the massage device can be adjustable in its altitude relative to the abutment board, so that the device can be easily customized to the particular patient.
  • the plunger is mounted freely rotatably mounted on the massage device, so that the massage device or its hinge mechanism can be adjusted as desired, even if the plunger was already fixed with his Druckflä ⁇ che on the patient's chest.
  • the plunger on the massage device has a game of about 10-15mm in the direction of actuation. This ensures that in the discharge phase when lifting the punch, ie in the ventilation ⁇ phase, the plunger exerts no pulling force on the thorax. Thus, in the ventilation phase , the thorax can freely move and lift around this play.
  • the plunger may invest op ⁇ timal to the shape of the patient's chest, it is preferably connected a ball joint at the massage device.
  • FIG. 1 shows a device applied to the thorax of a patient Vorrich ⁇ device for cardiopulmonary massage according to the invention in a perspective view obliquely from above;
  • Fig. 2 shows the subject matter of Fig. 1 in perspective Dar
  • FIG. 4 shows a detail IV of Figure 3 in a vertical
  • Fig. 5 is a schematic sectional view of a in the
  • FIG. 6 shows a modified version of a Verriegelungsmecha mechanism in a schematic side view.
  • FIG. 1 and 2 in its entirety designated 10 device for cardiopulmonary massage and / or resuscitation of a patient 11 is shown in its applied to the thorax 12 position.
  • the device 10 has a placed under the back 13 of the patient 11 abutment board 14, in which a Eckbe a designated in its entirety with 15 massaging device is disposed ⁇ rich.
  • the massaging device 15 has an abutment board 14 connected ⁇ joint mechanism 16, which essentially consists of a abutment board 14 upstanding portal support 16 a and at the upper, cantilevered end articulated boom 16b, at the free, outer end of a plunger unit 17 is provided with a drive 18.
  • a plunger 19 of the punch unit 17 is driven up and down.
  • the arrangement is such that the gantry support 16a relative to the abutment board 14 and the boom 16b relative to the gantry support 16a are pivotable about vertical axes.
  • a (not shown) locking mechanism in the housing ⁇ inner of the hinge mechanism 16 the pivoting movement between the ⁇ rule the parts of the hinge mechanism in the following still beschrie ⁇ bener manner be prevented or released.
  • the portal support is arranged adjustable in height on the abutment board 14, so that they - preferably continuously - in different Altitudes can be set and locked in the set positions.
  • the plunger 19 of the plunger unit 17 has a lower pressure surface 20, the intended use of the device on the chest 12 of the patient 11 at a desired contact area 21 - namely normally on upper end of the lower Sternumdrittels - po ⁇ sitioned and performs the operation of the massage device the cardio ⁇ pulmonary massage in the patient by using the up and down moving plunger 19 compresses with a set frequency the chest 12 and relieved again.
  • the plunger 19 is erfin ⁇ tion according to the target contact area 21 fixed .
  • a fixable on the chest 12 of the patient 11 holding means 22 in the form of a anklebbaren Craigpads 24 which is provided on its obe ⁇ ren contact surface 25 having a mesh 26 of a Klettverbin ⁇ dung 27th
  • the counterpart for this Velcro connection 27, namely a cooperating with the mesh fabric 26 hook braid 28 is disposed on the pressure surface 20 of the plunger 19.
  • the hinge mechanism 16, on which the pressure ⁇ stamp is arranged, with the help of the locking mechanism locked and unlocked, of which in Fig. 3 of the between the portal support 16a and pivotally connected thereto boom 16b effective part schematically at 29 is shown.
  • the entire Ver ⁇ latching mechanism has a plurality of bolt locks 30, preferably at least in each such bolt lock 30 on each of the locking mechanism portion 29 is provided for each of the during a Massa ⁇ gehubs to be locked joint compounds or linear guides of the hinge mechanism.
  • the latch ⁇ lock 30 (or the bolt locks are) actuated electromagnetically in the preferred embodiment, for which purpose it has a loaded with a switching current electromagnet 31 and a pre-stressed by a helical compression spring 32 in the locking direction locking plunger 33 from the spring 32 is pressed against a provided with a plurality of closely adjacent detent openings 34 detent plate 35.
  • the closure plunger 33 is facing is ⁇ nem of the latch plate 35 provided forward end with a latching lug 36 with which it selectively defining in each case one of several locking positions detent openings 34 may enclose, to thereby inhibit the movement of the relevant joint, or a linear guide mechanically .
  • the closure plunger 33 is retracted by the electromagnet 31 against the action of the helical compression spring 32, so that the detent no longer engages in one of the detent openings 34 and thus the given during the loaded movement phase of the plunger (Massagehub) locking is then canceled in the unloaded or no-load movement phase.
  • FIG. 5 further shows that the latching openings 34 are arranged at the smallest possible, discrete distances from one another in order to enable locking in correspondingly small steps.
  • the latching openings 34 are also provided on their side facing the plunger 33 with conical guide cones 37, wherein the guide cone 37 of each adjacent latching openings 34 tangent or intersect. This ensures that the latch 36 of the Lock plunger always safely in one of the latching openings 34 when the electromagnet is de-energized.
  • the lock in any case between two massage strokes, so the part of the movement of the plunger in which this is relieved and the chest 12 of the patient 11 is not compressed with force, the lock is released, which causes the plunger in this state of relief between two massage strokes in the plane transverse to the direction of actuation 23 (xY plane) is freely movable.
  • any changes in the relative position between the patient and the massage device are compensated, ie the plunger, which is indeed fixed on the patient's chest, follows the position ⁇ changes, which experiences the chest, for example due to external influences.
  • the plunger is therefore constrained in the XY plane Zvi ⁇ rule two massage strokes of the adhered to the body of the patient support pad and its print area is located at the beginning of a subsequent Massagehubs exactly above the desired pressure point on the patient's chest.
  • the hinge mechanism of the massage ⁇ device is then blocked by means of the locking mechanism, so that the plunger during the Massagehubs moves only in the vertical direction (Z-axis) perpendicular thereto, but locked in the directions. This ensures that during the printing phase, a lateral bleeding of the plunger is prevented, what else it could come through as a result of shear forces that regularly occur more or less due to an inhomogeneous trained thorax.
  • the plunger 19 is freely rotatably mounted in the punch unit 17 about the vertical axis.
  • the pressure stamp 19 or its lower punch head 38 forming the pressure surface 20 can be connected to a ball joint 39 (FIG. 4), so that the pressure surface can tilt freely and thereby optimally adapt to the shape of the thorax.
  • the locking mechanism of the device can be actively controlled.
  • the lock is automatically activated or released in response to the detection of a back pressure on the stamp unit.
  • Verriegelungsmechanis ⁇ mechanism which can be used in the device of the type according to the invention, but has its own inventive meaning is sketched in Fig. 6. It arises when the locking of the hinge mechanism 16 of the device 10 at least one locking strip at one of the transmission elements, for example on the portal ⁇ support 16a is located 40, wherein the locking strip 40 a plurality of spaced apart at a constant first distance A latching openings 34 has.
  • the boom 16b in this particularly advantageous embodiment, a plurality n, in the embodiment shown namely three, of actuatable closure elements 33, each with one in the Latching openings 34 snap-latch 36 is provided.
  • a n is enough.
  • k is an integer constant or zero.
  • the Tei ⁇ division ratio T can thus correspond to a vernier scale when nine closure elements are provided 33rd
  • a plurality of locking strips 40 a, b, c may be arranged parallel to each other, the latching openings 34 are arranged out of phase with the latching openings 34 of an adjacent locking strip, each locking bar at least ⁇ a closure element 33 is assigned as shown schematically in Fig. 6.

Landscapes

  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Emergency Medicine (AREA)
  • Pulmonology (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Therapy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Percussion Or Vibration Massage (AREA)

Abstract

The apparatus of the invention is used for cardiopulmonary massaging and/or resuscitation of a patient and includes a massaging device (15) which can be reversibly driven in an actuating direction (23) by a drive unit (18) and which has a pressure surface (20) that can be placed in a target contact zone (21) on the rib cage (12) of a patient (11). In order to easily and reliably prevent the pressure surface of the massaging device to deviate from a target pressure point (21), the plunger (19) can be secured to the rib cage (12) of the patient (11) in the target contact zone (21) and is mounted in such a way as to be freely movable in a plane running transversely to the actuating direction (23) at least during an unloaded state between two massaging strokes.

Description

Anmelder: GS Elektromedizinische Geräte G. Stemple GmbH, Hauswiesen- str. 26, 86916 Kaufering Applicant: GS Elektromedizinische Geräte G. Stemple GmbH, Hauswiesenstr. 26, 86916 Kaufering
Titel: Vorrichtung zur kardiopulmonalen Massage und/oder Reanimation  Title: Device for cardiopulmonary massage and / or resuscitation
Die Erfindung betrifft eine Vorrichtung zur kardiopulmonalen Massage und/oder Reanimation, mit einer Massagevorrichtung, die einen in einer Betätigungsrichtung reversierend beweglichen, von einem Antrieb betätigbaren und am Brustkorb eines Patienten an einem Soll-Kontaktbereich positionierbaren Druckstempel aufweist. Die Erfindung betrifft ferner einen Verriegelungsmechanismus zur Blockierung einer Beweglichkeit zwischen zwei translatorisch und/oder rotatorisch miteinander verbundenen Getriebeelementen, insbesondere zur Verriegelung eines Gelenkmechanismus der erfindungsgemäßen Vorrichtung zur kardiopulmonalen Massage und/oder Reanimation. The invention relates to a device for cardiopulmonary massage and / or resuscitation, with a massage device having a reversible movable in an operating direction, actuated by a drive and positioned on the chest of a patient at a desired contact area plunger. The invention further relates to a locking mechanism for blocking a mobility between two translationally and / or rotationally interconnected transmission elements, in particular for locking a joint mechanism of the device according to the invention for cardiopulmonary massage and / or resuscitation.
Ein Atem- oder Kreislaufstillstand bedeutet für einen Patienten höchs¬ te Lebensgefahr. Nur wenn es gelingt, innerhalb sehr kurzer Zeit durch eine Herz-Lungen-Wiederbelebung einen „Notkreislauf" in Gang zu bringen und aufrecht zu erhalten, besteht für den Patienten eine reelle Überlebenschance ohne bleibende Schädigungen. Neben der Beatmung ist zentraler Bestandteil der Herz-Lungen-Wiederbelebung die Durchführung einer Herzdruckmassage zum Aufbau eines Ersatz-Blutkreislaufes, so dass lebenswichtige Organe wie insbesondere das Gehirn mit Sauerstoff versorgt werden. Die klassische Herzdruckmassage wird dabei manuell durchgeführt, d.h. beispielsweise von einem Rettungssanitäter, der den Thorax des Patienten im Bereich des Sternum mit Frequenzen in der Größenordnung von 80-140 pro Minute komprimiert und wieder freigibt und hierdurch eine Zirkulation des Bluts durch den Körper des Patienten und damit die Sauerstoffversorgung der Organe bewirkt . A respiratory or cardiac arrest for a patient means Hoechsmann ¬ te death. Only if it is possible to initiate and maintain a "rescue cycle" within a very short time by means of a CPR is there a real chance of survival without permanent damage -The recovery is the implementation of a cardiac massage to build up a replacement bloodstream, so that vital organs such as the brain are supplied with oxygen.The classic chest compressions is carried out manually, for example, by a paramedic, the thorax of the patient in the sternum Compresses and releases frequencies on the order of 80-140 per minute and thereby causes a circulation of the blood through the body of the patient and thus the oxygen supply to the organs.
Die manuelle Thoraxkompression zur Reanimation ist für den diese aus¬ führenden Helfer sehr anstrengend und kann nur begrenzte Zeit mit der erforderlichen Frequenz durchgeführt werden. Da sie häufig auch bei Überführung des Patienten ins Krankenhaus weiter fortgesetzt werden soll, sind mechanische Vorrichtungen zur kardiopulmonalen Massage vorgeschlagen worden, die die technische Ausrüstung von Rettungsfahrzeu¬ gen, Hubschraubern oder dergleichen ergänzen und mit deren Hilfe die Herzdruckmassage an Patienten mechanisch über praktisch beliebige Zeit ausgeführt werden kann, ohne dass die Retter dabei ermüden. Sie können vielmehr ergänzende lebensrettende Maßnahmen einleiten, während die mechanische Vorrichtung die Thoraxkompression zur Aufrechterhaltung des Notkreislaufes durchführt. Hierfür weist eine solche Vorrichtung eine Massagevorrichtung mit einem Druckstempel auf, der von einem Antrieb mit der gewünschten Frequenz, also ca. 80-140 pro Minute rever- sierend, also auf und nieder angetrieben wird. Der Druckstempel wird am Brustkorb des Patienten vom Arzt oder Sanitäter an der für die Herzdruckmassage vorgesehenen Stelle positioniert und kann so die Mas¬ sage ausführen. Manual chest compression for resuscitation is this limited time only be carried out at the required frequency very stressful and can consist ¬ leading helper for. Since they are also common Transfer of the patient to the hospital is to be continued, mechanical devices for cardiopulmonary massage have been proposed that complement the technical equipment of Rettungsfahrzeu ¬ gen, helicopters or the like and with the help of the cardiac massage can be performed on patients mechanically over virtually any time, without that the rescuers tire. Rather, they can initiate supplementary life-saving measures while the mechanical device performs chest compression to maintain the emergency circuit. For this purpose, such a device has a massaging device with a plunger, which is driven by a drive with the desired frequency, ie about 80-140 per minute rever- sierend, ie up and down. The plunger is positioned on the chest of the patient by the doctor or paramedics at the intended place for the cardiac massage and can thus perform the Mas ¬ sage.
Wichtig für eine korrekte Ausführung der Herzdruckmassage ist es, den korrekten Druckpunkt hierfür zu verwenden und während der Massage auch beizubehalten. Der Druckpunkt befindet sich direkt über dem Brustbein (Sternum) , genauer am oberen Ende des unteren Sternumdrit- tels. Das Sternum ist deswegen der beste Bereich zur Durchführung der Herzdruckmassage, weil sich direkt darunter das Herz befindet, also das Organ, das zusammengepresst werden soll. Außerdem ist das Brustbein ein solider Knochen, der mit Knorpelverbindungen elastisch an den Rippen angeschlossen ist und sich somit bewegen lässt. Eine Abweichung vom korrekten Druckpunkt kann nicht nur zu einer Verringerung der Effektivität der Herzdruckmassage führen, sondern zu zum Teil schwer wiegenden Verletzungen des Patienten, von denen Rippenbrüche meist noch die am wenigsten problematischen sind. Wenn sich der Druckpunkt bei der Herzdruckmassage in Richtung auf den Ober¬ bauch verschiebt, kann es zu schwerwiegenden Verletzungen der inneren Organe kommen. Es ist daher sowohl bei der manuellen kardiopulmonalen Reanimation als auch bei deren Durchführung unter Verwendung einer mechanischen Vorrichtung erforderlich, den korrekten Druckpunkt während der Massage beizubehalten. Aus der DE 10 2013 100 943 AI ist eine Vorrichtung der gattungsgemä¬ ßen Art bekannt, bei der Abweichungen der tatsächlichen Position des Druckstempels in X-Y-Richtung, also der Ebene quer zur Betätigungs¬ richtung der Massagevorrichtung von einem Soll-Druckpunkt an der Brust des Patienten festgestellt werden, indem eine Positions¬ sensoreinrichtung vorgesehen ist, mit der Änderungen der Lage der Massagevorrichtung und/oder deren Druckstempels relativ zum Soll- Kontaktbereich am Brustkorb des Patienten in einer Ebene normal zur Betätigungsrichtung der Massagevorrichtung feststellar sind. Wenn die Ist-Lage des Druckstempels von einer Soll-Lage abweicht und ein vorher festgelegter Grenzwert überschritten wird, wird die Herzdruckmassagevorrichtung beispielsweise automatisch still gesetzt oder es wird ein Alarmsignal ausgegeben, das die Sanitäter darauf hinweist, dass eine Nachjustage erforderlich ist. Alternativ kann mit der bekannten Vorrichtung auch eine aktive Lageregelung der Massagevorrichtung quer zu ihrer Betätigungsrichtung verwirklicht werden, wozu ein die Massagevorrichtung bzw. deren Druckstempel in der Ebene normal zur Betätigungsrichtung verstellender Stellantrieb vorgesehen ist, mit dessen Hilfe die ermittelte Ist-Position des Druckstempel auf die Soll-Lage hin eingeregelt wird. It is important to use the correct pressure point for the heart pressure massage and to maintain it during the massage. The pressure point is directly above the sternum, more precisely at the upper end of the lower sternum. The sternum is therefore the best area to perform the cardiac massage, because directly below the heart is located, so the organ that is to be compressed. In addition, the sternum is a solid bone, which is connected to cartilage elastically to the ribs and thus can be moved. A deviation from the correct pressure point can lead not only to a reduction in the effectiveness of the cardiac massage, but sometimes severe injuries to the patient, of which rib fractures are usually still the least problematic. If the pressure point in the cardiac massage toward the upper ¬ belly moves, it can lead to serious injury to the internal organs. It is therefore necessary both in manual cardiopulmonary resuscitation and in its implementation using a mechanical device to maintain the correct pressure point during the massage. From DE 10 2013 100 943 AI a device of the generic type ¬ Shen type is known in the deviations of the actual position of the plunger in the XY direction, ie the plane transverse to the actuation ¬ direction of the massage device from a target pressure point on the chest Patients are determined by a position ¬ sensor device is provided with the changes in the position of the massage device and / or the pressure stamp are feststellar relative to the target contact area on the chest of the patient in a plane normal to the direction of actuation of the massage device. If the actual position of the plunger deviates from a desired position and a predetermined limit is exceeded, the cardiac pressure massage device, for example, automatically silenced or an alarm signal is issued, which indicates to the paramedics that a readjustment is required. Alternatively, with the known device also an active position control of the massage device can be realized transversely to its direction of actuation, including a massage device or its plunger in the plane normal to the actuating direction verstellender actuator is provided with the help of the determined actual position of the plunger on the Target position is adjusted.
Die bekannte Vorrichtung hat sich als sehr erfolgreich und zuverlässig erwiesen, allerdings ist insbesondere die Realisation der akti¬ ven Nachführung des Druckstempels mit einem hierfür vorzusehenden Stellantrieb vergleichsweise aufwendig und dementsprechend teuer. Aufgabe der Erfindung ist es daher, eine Vorrichtung der eingangs genannten Art zu schaffen, bei der die Einhaltung der korrekten Position des Druckstempels mit geringerem Aufwand zuverlässig erreicht wird . The known device has proven to be very successful and reliable, but in particular the realization of akti ¬ ven tracking the plunger with an actuator to be provided for this purpose is relatively expensive and therefore expensive. The object of the invention is therefore to provide a device of the type mentioned, in which the maintenance of the correct position of the plunger is achieved reliably with less effort.
Diese Aufgabe wird mit der Erfindung dadurch gelöst, dass der Druck¬ stempel am Brustkorb des Patienten an dem Soll-Kontaktbereich fixierbar ist und mindestens während eines Entlastungszustands zwi¬ schen zwei Massagehüben in einer Ebene quer zur Betätigungsrichtung frei beweglich gelagert ist. This object is achieved with the invention in that the pressure ¬ stamp on the patient's chest at the desired contact area is fixed and at least during a discharge state between two massage strokes ¬ is mounted freely movable in a plane transverse to the direction of actuation.
Mittels dieser Lösung wird eine passive, quasi automatische Positio¬ nierung des Druckstempels in der X-Y-Ebene möglich, bei der durch die Fixierung des Druckstempels an dem Soll-Kontaktbereich am Brustkorb des Patienten ein Stellantrieb nicht länger erforderlich ist. Vielmehr ist durch die Fixierung sichergestellt, dass der Druckstempel immer die korrekte Relativposition zum Brustkorb des Patienten einnimmt. Infolge der freien Beweglichkeit des Druckstempels quer zur Betätigungsrichtung, also in der X-Y-Ebene, wird der Stempel zwischen jeweils zwei Massagehüben passiv nachgeführt, gleicht also etwaige Lageänderungen des Patienten im Laufe der anhaltenden Massage immer sofort wieder aus und befindet sich zu Beginn eines jeden folgenden Massagehubs infolge der während der Massage bestehenden Fixierung immer in korrekter Position, also über dem Brustbein des Patienten . By means of this solution, a passive, quasi-automatic positioning ¬ tion of the plunger in the XY plane is possible in the by the fixation of the plunger to the desired contact area on the patient's chest an actuator is no longer required. Rather, it is ensured by the fixation that the plunger always occupies the correct relative position to the ribcage of the patient. Due to the free movement of the plunger transversely to the direction of actuation, ie in the XY plane, the stamp is passively tracked between two massage strokes, so that compensates any changes in position of the patient during the ongoing massage always immediately back and is at the beginning of each following Massage hubs as a result of the existing during the massage fixation always in the correct position, ie over the breastbone of the patient.
In vorteilhafter Weiterbildung der Erfindung ist vorgesehen, dass der Druckstempel in einem Belastungszustand während eines Massa¬ gehubs in der Ebene quer zur Betätigungsrichtung in seiner Position relativ zum Brustkorb des Patienten verriegelbar ist. Hierdurch kann sichergestellt werden, dass sich die Lage des Druckstempels in der Ebene quer zur Betätigungsrichtung (X-Y-Ebene) während des Massa¬ gehubs, also der den Brustkorb des Patienten komprimierenden Bewegung des Stempels nach unten, nicht verändert. Der Stempel kann da¬ her bei dieser Abwärtsbewegung seine Position nicht ungewollt seitlich verändern, beispielsweise infolge von zwischen dem Brustkorb und der Druckfläche des Stempels wirkenden Schubkräften, was während des Druckvorgangs gefährlich für den Patienten werden könnte. In an advantageous embodiment of the invention, it is provided that the plunger is locked in a load state during a Massa ¬ stroke in the plane transverse to the direction of actuation in its position relative to the ribcage of the patient. In this way it can be ensured that the position of the plunger in the plane transverse to the actuation direction (XY plane) during the Massa ¬ stroke, so the chest of the patient compressing movement of the punch downwards, not changed. The punch can not be changed on this move its position unintentionally laterally as ¬ ago, for example, as a result of acting between the chest and the printing surface of the die shear forces, which could be dangerous for the patient during the printing process.
Die erfindungsgemäße Funktion kann vorteilhaft dadurch verwirklicht werden, dass die Massagevorrichtung mindestens einen, um eine parallel zur Betätigungsvorrichtung verlaufende Achse verstellbaren, ver- und entriegelbaren Gelenkmechanismus aufweist. Besonders vorteilhaft ist es, wenn ein vorzugsweise von einem Kraft- und/oder Wegsensor beaufschlagter Verriegelungsmechanismus zur Unterbindung der Querbeweglichkeit des Druckstempels während eines Massagehubs vorgesehen ist, insbesondere zur Verriegelung des mindestens einen Gelenkmecha¬ nismus . The function according to the invention can advantageously be realized in that the massaging device has at least one articulated mechanism which can be adjusted and unlocked about an axis running parallel to the actuating device. It is particularly advantageous if a preferably acted upon by a force and / or displacement sensor lock mechanism for stopping the transverse movement of the pressure stamp is provided during a Massagehubs, in particular for locking the at least one Gelenkmecha ¬ mechanism is.
Der Druckstempel ist zweckmäßig an einem am Brustkorb des Patienten festlegbaren Haltemittel fixiert oder fixierbar, wobei das Haltemit- tel als vorzugsweise mittels einer Klebeschicht am Brustkorb ankleb¬ bares Haltepad ausgebildet sein kann. Dabei hat es sich als ganz be¬ sonders vorteilhaft erwiesen, wenn die Fixierung zwischen dem Druckstempel und dem Haltemittel durch eine zwischen diesen beiden wirksame Klettverbindung geschaffen wird. Das Haltepad ist dabei also an seiner Oberseite mit dem einen Klettverschlusselement, vorzugsweise dem Maschengewebe versehen, an dem das andere, am Druckstempel an dessen Druckfläche ausgebildete Klettverschlusselement, bei der vor¬ zugsweise verwendeten Konstellation der Hakenverschluss , lösbar fixiert werden kann. Der Arzt oder Sanitäter klebt dann zunächst das Haltemittel, das vorzugsweise eine Kontaktfläche aufweist, die grö¬ ßer ist als die vom Druckstempel gebildete Druckfläche, am Brustkorb des Patienten über dessen Brustbein an und kann dann den Druckstempel über dem Haltepad genau in der korrekten Position ausrichten und durch (vorzugsweise manuelles) Absenken bis in Kontakt mit dem Hal¬ temittel bringen, so dass die Klettverbindung schließt und hierdurch die Fixierung des Druckstempels hergestellt ist. Eine Korrektur der Position ist jederzeit möglich, wobei durch die vergrößerte Kontakt¬ fläche des Haltemittels im Vergleich zur Druckfläche des Stempels gewährleistet bleibt, dass dieser - beispielsweise bei ungenauer Ap¬ plikation des Klebepads an der Brust des Patienten, in einem Bereich seitlich über dieses vorsteht und dann nicht über seine gesamte Druckfläche mit dem Päd verbunden ist. The plunger is expediently fixed or fixable to a holding means which can be fixed to the patient's chest, wherein the holding means tel can be designed as preferably by means of an adhesive layer on the chest ankleb ¬ bares support pad. It has proven to be quite be ¬ particularly advantageous if the fixation between the plunger and the holding means is created by an effective between these two velcro connection. The holding pad is thus provided on its upper side with the one Velcro fastener element, preferably the mesh fabric, to which the other, on the pressure stamp formed on the pressure surface Velcro element, in which before ¬ preferably used constellation of the hook fastener, can be releasably fixed. The doctor or paramedic then adhered first, the retaining means preferably has a contact surface, the big ¬ SSER than the pressure surface formed by the pressure piston, on the chest of the patient via the sternum and can target the plunger over the support pad exactly in the correct position and by (preferably manual) lowering bring into contact with the Hal ¬ temittel, so that the Velcro connection closes and thereby the fixation of the plunger is made. A correction of the position is possible at any time, it being ensured by the enlarged contact surface ¬ contact surface of the holding means compared to the pressure surface of the punch that this - for example, in case of inaccurate Ap ¬ plication of the adhesive pad on the patient's chest, in a range laterally projecting beyond this and then not connected to the pedestrian over its entire printing area.
Erfindungsgemäß kann ein unter dem Körper des Patienten positionierbares Widerlagerbrett vorgesehen sein, an dem die Massagevorrichtung angeordnet ist. Die Massagevorrichtung kann dabei in ihrer Höhenlage relativ zum Widerlagerbrett verstellbar sein, so dass sich die Vorrichtung leicht individuell an den jeweiligen Patienten anpassen lässt . According to the invention, an abutment board which can be positioned under the body of the patient can be provided, on which the massage device is arranged. The massage device can be adjustable in its altitude relative to the abutment board, so that the device can be easily customized to the particular patient.
Als vorteilhaft hat es sich auch erwiesen, wenn der Druckstempel an der Massagevorrichtung frei drehbar gelagert angeordnet ist, so dass die Massagevorrichtung bzw. deren Gelenkmechanismus beliebig verstellt werden kann, auch wenn der Druckstempel mit seiner Druckflä¬ che bereits am Brustkorb des Patienten fixiert wurde. In Weiterbildung der Erfindung kann vorgesehen sein, dass der Druckstempel an der Massagevorrichtung ein Spiel von ca. 10-15mm in Betätigungsrichtung aufweist. Hierdurch wird sichergestellt, dass in der Entlastungsphase beim Anheben des Stempels, also in der Beatmungs¬ phase, der Druckstempel keine Zugkraft auf den Thorax ausübt. Somit kann sich der Thorax in der Beatmungsphase frei um dieses Spiel sen¬ ken und heben . It has also proven to be advantageous if the plunger is mounted freely rotatably mounted on the massage device, so that the massage device or its hinge mechanism can be adjusted as desired, even if the plunger was already fixed with his Druckflä ¬ che on the patient's chest. In a further development of the invention can be provided that the plunger on the massage device has a game of about 10-15mm in the direction of actuation. This ensures that in the discharge phase when lifting the punch, ie in the ventilation ¬ phase, the plunger exerts no pulling force on the thorax. Thus, in the ventilation phase , the thorax can freely move and lift around this play.
Alternativ ist es aber auch möglich, eine negative Kompression zu verwirklichen, indem eine Anordnung ohne oder mit nur geringem Spiel des Druckstempels in Betätigungsrichtung zum Einsatz kommt. Hierdurch kann man eine feste Kopplung des Druckstempels mit dem Thorax sowohl auf Druck als auch auf Zug bewirken und den Brustkorb mit dem Antrieb der Massagevorrichtung aktiv anheben, wenn der Druckstempel beispielsweise durch eine Klettverbindung am Thorax auch zugfest fixiert ist. In diesem Fall erfolgt die Entlastung aktiv durch den Stempel . Alternatively, it is also possible to realize a negative compression by an arrangement without or with little play of the plunger is used in the direction of actuation. In this way, one can bring about a firm coupling of the plunger with the thorax on both pressure and on train and actively lift the chest with the drive of the massage device when the plunger is fixed, for example, by a Velcro connection on the chest and tensile strength. In this case, the discharge takes place actively by the stamp.
Damit sich der Druckstempel an die Form des Thorax des Patienten op¬ timal anlegen kann, ist er vorzugsweise an der Massagevorrichtung kugelgelenkig angeschlossen. Thus, the plunger may invest op ¬ timal to the shape of the patient's chest, it is preferably connected a ball joint at the massage device.
Weitere Merkmale und Vorteile der Erfindung ergeben sich aus der nachfolgenden Beschreibung und der Zeichnung, worin eine bevorzugte Ausführungsform der Erfindung anhand eines Beispiels näher dargestellt und erläutert ist. Es zeigt: Further features and advantages of the invention will become apparent from the following description and the drawing, wherein a preferred embodiment of the invention is illustrated and explained in more detail by way of example. It shows:
Fig. 1 eine am Thorax eines Patienten applizierte Vorrich¬ tung zur kardiopulmonalen Massage nach der Erfindung in einer perspektivischen Darstellung von schräg oben; 1 shows a device applied to the thorax of a patient Vorrich ¬ device for cardiopulmonary massage according to the invention in a perspective view obliquely from above;
Fig. 2 den Gegenstand der Fig. 1 in perspektivischer Dar Fig. 2 shows the subject matter of Fig. 1 in perspective Dar
Stellung von schräg unten;  Position from diagonally below;
Fig. 3 die am Thorax des Patienten angesetzte Massagevor richtung der erfindungsgemäßen Vorrichtung in einerFig. 3 on the thorax of the patient scheduled Massagevor device of the invention in one
Ansicht ; Fig. 4 eine Einzelheit IV nach Fig.3 in einem Vertikal View ; Fig. 4 shows a detail IV of Figure 3 in a vertical
schnitt ;  cut ;
Fig. 5 eine schematische Schnittdarstellung eines bei der Fig. 5 is a schematic sectional view of a in the
Vorrichtung eingesetzten Verriegelungsmechnismus; und  Device used Verriegelungsmechnismus; and
Fig.6 eine abgewandelte Version eines Verriegelungsmecha nismus in einer schematischen Seitenansicht. 6 shows a modified version of a Verriegelungsmecha mechanism in a schematic side view.
In den Fig. 1 und 2 ist eine in ihrer Gesamtheit mit 10 bezeichnete Vorrichtung zur kardiopulmonalen Massage und/oder Reanimation eines Patienten 11 in ihrer an dessen Thorax 12 angelegten Position gezeigt. Die Vorrichtung 10 weist ein unter dem Rücken 13 des Patienten 11 platziertes Widerlagerbrett 14 auf, in dessen einen Eckbe¬ reich eine in ihrer Gesamtheit mit 15 bezeichnete Massagevorrichtung angeordnet ist. 1 and 2, in its entirety designated 10 device for cardiopulmonary massage and / or resuscitation of a patient 11 is shown in its applied to the thorax 12 position. The device 10 has a placed under the back 13 of the patient 11 abutment board 14, in which a Eckbe a designated in its entirety with 15 massaging device is disposed ¬ rich.
Die Massagevorrichtung 15 hat einen am Widerlagerbrett 14 ange¬ schlossenen Gelenkmechanismus 16, der im Wesentlichen besteht aus einer vom Widerlagerbrett 14 nach oben aufragenden Portalstütze 16 a und einem an deren oberen, auskragenden Ende gelenkig angeschlossenen Ausleger 16b, an dessen freien, äußeren Ende eine Druckstempeleinheit 17 mit einem Antrieb 18 vorgesehen ist. Mit Hilfe des An¬ triebs kann ein Druckstempel 19 der Stempeleinheit 17, beispielswei¬ se mittels einer nicht gezeigten Antriebsspindel, reversierend in einer im Wesentlichen vertikalen Richtung 23 auf und nieder angetrieben werden. Die Anordnung ist so getroffen, dass die Portalstütze 16a relativ zum Widerlagerbrett 14 und der Ausleger 16b relativ zur Portalstütze 16a um vertikale Achsen verschwenkbar sind. Mithilfe eines (nicht dargestellten) Verriegelungsmechanismus im Gehäuse¬ inneren des Gelenkmechanismus 16 kann die Schwenkbeweglichkeit zwi¬ schen den Teilen des Gelenkmechanismus in nachstehend noch beschrie¬ bener Weise unterbunden oder freigegeben werden. The massaging device 15 has an abutment board 14 connected ¬ joint mechanism 16, which essentially consists of a abutment board 14 upstanding portal support 16 a and at the upper, cantilevered end articulated boom 16b, at the free, outer end of a plunger unit 17 is provided with a drive 18. With the help of the on ¬ drive a plunger 19 of the punch unit 17, beispielswei ¬ se by means of a drive spindle, not shown, reversing in a substantially vertical direction 23 are driven up and down. The arrangement is such that the gantry support 16a relative to the abutment board 14 and the boom 16b relative to the gantry support 16a are pivotable about vertical axes. By means of a (not shown) locking mechanism in the housing ¬ inner of the hinge mechanism 16, the pivoting movement between the ¬ rule the parts of the hinge mechanism in the following still beschrie ¬ bener manner be prevented or released.
Die Portalstütze ist am Widerlagerbrett 14 in ihrer Höhe verstellbar angeordnet, so dass sie - vorzugsweise stufenlos - in verschiedene Höhenlagen eingestellt und in den eingestellten Lagen arretiert werden kann. The portal support is arranged adjustable in height on the abutment board 14, so that they - preferably continuously - in different Altitudes can be set and locked in the set positions.
Wendet man sich nunmehr den Fig. 3 und 4 zu, erkennt man, dass der Druckstempel 19 der Druckstempeleinheit 17 eine untere Druckfläche 20 hat, die bei bestimmungsgemäßer Verwendung der Vorrichtung am Brustkorb 12 des Patienten 11 an einem Soll-Kontaktbereich 21 - nämlich normalerweise am oberen Ende des unteren Sternumdrittels - po¬ sitioniert ist und im Betrieb der Massagevorrichtung die kardio¬ pulmonale Massage bei dem Patienten durchführt, indem der sich auf und ab bewegende Druckstempel 19 mit einer eingestellten Frequenz den Brustkorb 12 zusammenpresst und wieder entlastet. Turning now to Figs. 3 and 4, it can be seen that the plunger 19 of the plunger unit 17 has a lower pressure surface 20, the intended use of the device on the chest 12 of the patient 11 at a desired contact area 21 - namely normally on upper end of the lower Sternumdrittels - po ¬ sitioned and performs the operation of the massage device the cardio ¬ pulmonary massage in the patient by using the up and down moving plunger 19 compresses with a set frequency the chest 12 and relieved again.
Damit sich bei dieser kardiopulmonalen Massage der Soll- Kontaktbereich 21 oder Druckpunkt , an dem die Druckfläche 20 des Druckstempels 19 angreift, auch beispielsweise während des Trans¬ ports des Patienten nicht verändert, ist der Druckstempel 19 erfin¬ dungsgemäß an dem Soll-Kontaktbereich 21 fixierbar. Dies wird bei der gezeigten, bevorzugten Ausführungsform der Erfindung mit Hilfe eines am Brustkorb 12 des Patienten 11 festlegbaren Haltemittels 22 in Form eines anklebbaren Haltepads 24 erreicht, das an seiner obe¬ ren Kontaktfläche 25 mit einem Maschengewebe 26 einer Klettverbin¬ dung 27 versehen ist. Das Gegenstück für diese Klettverbindung 27, nämlich ein mit dem Maschengewebe 26 zusammenwirkendes Hakengeflecht 28, ist an der Druckfläche 20 des Druckstempels 19 angeordnet. Somit kann der Druckstempel am Thorax 12 des Patienten nach seiner Ausrichtung durch entsprechendes Verschwenken des Gelenkmechanismus 16 oberhalb den Soll-Kontaktbereich 21 und Absenken des DruckstempelsThus, in this cardiopulmonary massage of the target contact area 21 or pressure point at which the pressure surface 20 of the plunger 19 engages, not changed, for example, during the trans ¬ ports of the patient, the plunger 19 is erfin ¬ tion according to the target contact area 21 fixed , This is achieved in the illustrated, preferred embodiment of the invention with the help of a fixable on the chest 12 of the patient 11 holding means 22 in the form of a anklebbaren Haltepads 24 which is provided on its obe ¬ ren contact surface 25 having a mesh 26 of a Klettverbin ¬ dung 27th The counterpart for this Velcro connection 27, namely a cooperating with the mesh fabric 26 hook braid 28 is disposed on the pressure surface 20 of the plunger 19. Thus, the pressure stamp on the thorax 12 of the patient after its alignment by corresponding pivoting of the hinge mechanism 16 above the desired contact area 21 and lowering the plunger
19 bis in Kontakt der Druckfläche 20 mit dem Haltemittel 22 fixiert werden, denn dann schließt die Klettverbindung 27 und öffnet erst wieder, wen eine nach oben gerichtete Zugkraft die Lösekraft des Klettverschlusses übersteigt. Damit der Arzt oder Sanitäter den Druckstempel 19 auch bei anfänglich nicht 100-prozentiger Platzie¬ rung des Haltepads beim Ankleben an der Brust des Patienten optimal ausrichten kann, ist das Haltemittel 22 größer als die Druckfläche19 are fixed in contact with the pressure surface 20 with the holding means 22, because then closes the Velcro connection 27 and only opens again, when an upward pulling force exceeds the release force of the hook and loop fastener. So the doctor or paramedic 19 can optimally aligned in adhering to the patient's chest the plunger even when not initially 100 percent Platzie ¬ tion of Haltepads, the holding means 22 is larger than the print area
20 des Stempels 19, so dass seitlich ausreichend Einstellmöglichkeit geschaffen wird. Wie bereits erwähnt, ist der Gelenkmechanismus 16, an dem der Druck¬ stempel angeordnet ist, mit Hilfe des Verriegelungsmechanismus ver- und entriegelbar, von dem in Fig. 3 der zwischen der Portalstütze 16a und dem daran schwenkbeweglich angeschlossenen Ausleger 16b wirksame Teil schematisch bei 29 dargestellt ist. Der gesamte Ver¬ riegelungsmechanismus weist mehrere Riegelschlösser 30 auf, wobei vorzugsweise mindestens je ein solches Riegelschloss 30 an jedem Verriegelungsmechanismusteil 29 für jede der während eines Massa¬ gehubs zu verriegelnden Gelenkverbindungen oder Linearführungen des Gelenkmechanismus vorgesehen ist. Wie Fig. 5 zeigt, ist das Riegel¬ schloss 30 (bzw. sind die Riegelschlösser) bei dem bevorzugten Ausführungsbeispiel elektromagnetisch betätigt, wozu es einen mit einem Schaltstrom beaufschlagten Elektromagneten 31 sowie einen von einer Schraubendruckfeder 32 in Verriegelungsrichtung vorgespannten Verschlussstößel 33 aufweist, der von der Feder 32 gegen eine mit einer Vielzahl von dicht nebeneinander liegenden Rastöffnungen 34 versehenen Rastplatte 35 gedrückt wird. Der Verschlussstößel 33 ist an sei¬ nem der Rastplatte 35 zugewandten, vorderen Ende mit einer Rastnase 36 versehen, mit der er wahlweise in jeweils eine der verschiedene Raststellungen definierenden Rastöffnungen 34 einfassen kann, um hierdurch die Beweglichkeit des betreffenden Gelenks oder einer Linearführung mechanisch zu blockieren. Bei Beaufschlagung des Elektromagneten 31 mit dem Schaltstrom, wozu es zwischen zwei aufeinander folgenden Massagehüben während des entlasteten Zustands kommt, wird der Verschlussstößel 33 von dem Elektromagneten 31 entgegen der Wirkung der Schraubendruckfeder 32 zurückgezogen, so dass die Rastnase nicht länger in eine der Rastöffnungen 34 einfasst und somit die während der belasteten Bewegungsphase des Druckstempels (Massagehub) gegebene Verriegelung dann in der entlasteten bzw. lastfreien Bewegungsphase aufgehoben ist. Eine Nachstellung der Lage des Druckstempels in X-Y-Richtung ist dann möglich. Fig. 5 lässt weiter erkennen, dass die Rastöffnungen 34 in möglichst kleinen, diskreten Abständen voneinander angeordnet sind, um eine Verriegelung in entsprechend kleinen Schritten zu ermöglichen. Die Rastöffnungen 34 sind an ihren dem Verschlussstößel 33 zugewandten Seite außerdem mit konischen Führungskegeln 37 versehen, wobei die Führungskegel 37 von jeweils benachbarten Rastöffnungen 34 sich tangieren oder miteinander verschneiden. Hierdurch ist sichergestellt, dass die Rastnase 36 des Verschlussstößels immer sicher in eine der Rastöffnungen 34 ein- fasst, wenn der Elektromagnet stromlos geschaltet wird. 20 of the punch 19, so that laterally sufficient adjustment is created. As already mentioned, the hinge mechanism 16, on which the pressure ¬ stamp is arranged, with the help of the locking mechanism locked and unlocked, of which in Fig. 3 of the between the portal support 16a and pivotally connected thereto boom 16b effective part schematically at 29 is shown. The entire Ver ¬ latching mechanism has a plurality of bolt locks 30, preferably at least in each such bolt lock 30 on each of the locking mechanism portion 29 is provided for each of the during a Massa ¬ gehubs to be locked joint compounds or linear guides of the hinge mechanism. As Fig. 5 shows, the latch ¬ lock 30 (or the bolt locks are) actuated electromagnetically in the preferred embodiment, for which purpose it has a loaded with a switching current electromagnet 31 and a pre-stressed by a helical compression spring 32 in the locking direction locking plunger 33 from the spring 32 is pressed against a provided with a plurality of closely adjacent detent openings 34 detent plate 35. The closure plunger 33 is facing is ¬ nem of the latch plate 35 provided forward end with a latching lug 36 with which it selectively defining in each case one of several locking positions detent openings 34 may enclose, to thereby inhibit the movement of the relevant joint, or a linear guide mechanically , Upon actuation of the electromagnet 31 with the switching current, which occurs between two successive massage strokes during the unloaded state, the closure plunger 33 is retracted by the electromagnet 31 against the action of the helical compression spring 32, so that the detent no longer engages in one of the detent openings 34 and thus the given during the loaded movement phase of the plunger (Massagehub) locking is then canceled in the unloaded or no-load movement phase. An adjustment of the position of the plunger in the XY direction is then possible. FIG. 5 further shows that the latching openings 34 are arranged at the smallest possible, discrete distances from one another in order to enable locking in correspondingly small steps. The latching openings 34 are also provided on their side facing the plunger 33 with conical guide cones 37, wherein the guide cone 37 of each adjacent latching openings 34 tangent or intersect. This ensures that the latch 36 of the Lock plunger always safely in one of the latching openings 34 when the electromagnet is de-energized.
Erfindungsgemäß ist jedenfalls zwischen zwei Massagehüben, also dem Teil der Bewegung des Druckstempels, in dem dieser entlastet ist und den Brustkorb 12 des Patienten 11 nicht mit Kraft komprimiert, die Verriegelung aufgehoben, was dazu führt, dass der Druckstempel in diesem Entlastungszustand zwischen zwei Massagehüben in der Ebene quer zur Betätigungsrichtung 23 (x-Y-Ebene) frei beweglich ist. According to the invention, in any case between two massage strokes, so the part of the movement of the plunger in which this is relieved and the chest 12 of the patient 11 is not compressed with force, the lock is released, which causes the plunger in this state of relief between two massage strokes in the plane transverse to the direction of actuation 23 (xY plane) is freely movable.
Hierdurch werden etwaige Änderungen der Relativlage zwischen dem Patienten und der Massagevorrichtung ausgeglichen, d.h. der Druckstempel, der ja am Brustkorb des Patienten fixiert ist, folgt den Lage¬ änderungen, die der Brustkorb beispielsweise infolge von äußeren Einflüssen erfährt. Der Druckstempel wird also in der X-Y-Ebene zwi¬ schen zwei Massagehüben von dem am Körper des Patienten angeklebten Haltepad zwangsgeführt und seine Druckfläche befindet sich zu Beginn eines nachfolgenden Massagehubs immer genau über dem gewünschten Druckpunkt am Thorax des Patienten. As a result, any changes in the relative position between the patient and the massage device are compensated, ie the plunger, which is indeed fixed on the patient's chest, follows the position ¬ changes, which experiences the chest, for example due to external influences. The plunger is therefore constrained in the XY plane Zvi ¬ rule two massage strokes of the adhered to the body of the patient support pad and its print area is located at the beginning of a subsequent Massagehubs exactly above the desired pressure point on the patient's chest.
Während des Massagehubs wird dann der Gelenkmechanismus der Massage¬ vorrichtung mit Hilfe des Verriegelungsmechanismus blockiert, so dass der Druckstempel während des Massagehubs sich nur in vertikaler Richtung (Z-Achse) bewegt, in den Richtungen senkrecht dazu aber verriegelt ist. Hierdurch wird sichergestellt, dass während der Druckphase ein seitliches Verlaufen des Druckstempels unterbunden wird, wozu es sonst durch infolge von Schubkräften kommen könnte, die aufgrund eines inhomogen ausgebildeten Thorax regelmäßig mehr oder weniger stark auftreten. During the Massagehubs the hinge mechanism of the massage ¬ device is then blocked by means of the locking mechanism, so that the plunger during the Massagehubs moves only in the vertical direction (Z-axis) perpendicular thereto, but locked in the directions. This ensures that during the printing phase, a lateral bleeding of the plunger is prevented, what else it could come through as a result of shear forces that regularly occur more or less due to an inhomogeneous trained thorax.
Um auch Verdrehungen zwischen Patient und der Massagevorrichtung einfach ausgleichen zu können, ist der Druckstempel 19 in der Stempeleinheit 17 um die Vertikalachse frei drehbar gelagert. Um einen möglichst guten Kontakt zwischen der Druckfläche 20 und dem am Brustkorb angeklebten Haltemittel 22 während der Thoraxkompression sicherzustellen, kann der Druckstempel 19 bzw. dessen unterer, die Druckfläche 20 bildender Stempelkopf 38 mit einem Kugelgelenk 39 (Fig. 4) angeschlossen sein, so dass die Druckfläche sich beliebig neigen und dadurch an die Form des Thorax optimal anpassen kann. Die bei dem beschriebenen, bevorzugten Ausführungsbeispiel zum Einsatz kommende Fixierung des Druckstempels 19 am Brustkorb 12 des Pa¬ tienten 11 mittels Klettverbindung bewirkt auch, dass der Druckstempel jedenfalls bis zum Erreichen der Lösekraft zum Öffnen des Klett¬ verschlusses zugfest an dem Klebepad befestigt ist. Da er auch in der Stempeleinheit der Massagevorrichtung - bevorzugt mit leichtem Spiel (beispielsweise 5 bis 15 mm) - zugfest aufgenommen ist und so¬ mit nach Beendigung einer Kompressionsphase von der Stempeleinheit aktiv wieder nach oben angehoben wird, übt er bei dieser Rückzugsbewegung auf den Brustkorb des Patienten eine Zugkraft aus, bewirkt also zusätzlich eine Dekompression (negative Kompression) und damit eine weitere Verbesserung der Effektivität der Massage. In order to easily compensate for twisting between the patient and the massage device, the plunger 19 is freely rotatably mounted in the punch unit 17 about the vertical axis. In order to ensure the best possible contact between the pressure surface 20 and the holding means 22 glued to the thorax during the thorax compression, the pressure stamp 19 or its lower punch head 38 forming the pressure surface 20 can be connected to a ball joint 39 (FIG. 4), so that the pressure surface can tilt freely and thereby optimally adapt to the shape of the thorax. The next in the described preferred embodiment, for use fixation of the plunger 19 at the chest 12 of the Pa ¬ tienten 11 by means of Velcro connection also causes the plunger at least until reaching the dissolving power tensile strength for opening the Velcro ¬ closure is secured to the adhesive pad. Since he is also in the stamper unit of the massage device - preferably with light play (for example 5 to 15 mm) - recorded tensile strength and so ¬ with actively lifted after completion of a compression phase of the stamp unit back up, he practices in this retraction movement on the chest the patient from a tensile force, so in addition causes a decompression (negative compression) and thus a further improvement in the effectiveness of the massage.
Der Verriegelungsmechanismus der Vorrichtung kann aktiv geregelt werden. Vorteilhafter Weise wird die Verriegelung automatisch in Abhängigkeit von der Feststellung eines Gegendrucks an der Stempeleinheit aktiviert oder freigegeben. Sobald also der Druckstempel wäh¬ rend eines Massagehubs in die Druckphase kommt und dabei eine Massa¬ gekraft auf den Brustkorb ausübt, führt dies zu einer entsprechend großen Gegenkraft in Z-Richtung in der Massagevorrichtung, die umgehend dafür sorgt, dass die Beweglichkeit der Massagevorrichtung, beim bevorzugten Ausführungsbeispiel mittels der elektromagnetisch betätigten Riegelschlösser (30), in X- und Y-Richtung blockiert wird . The locking mechanism of the device can be actively controlled. Advantageously, the lock is automatically activated or released in response to the detection of a back pressure on the stamp unit. Thus, once the plunger comes currency ¬ rend a Massagehubs in the printing phase, and thereby a massaging ¬ gekraft exerts on the thorax, this leads to a correspondingly large counter-force in the Z direction in the massage device, which ensures immediately that the mobility of the massage device, blocked in the preferred embodiment by means of electromagnetically actuated latch locks (30) in the X and Y directions.
Eine besonders vorteilhafte Weiterbildung des Verriegelungsmechanis¬ mus, die bei der Vorrichtung der erfindungsgemäßen Art zum Einsatz kommen kann, der aber eigene erfinderische Bedeutung zukommt, ist in Fig. 6 skizziert. Sie ergibt sich dann, wenn zur Verriegelung des Gelenkmechanismus 16 der Vorrichtung 10 mindestens eine Rastleiste 40 an dem einen der Getriebeelemente, beispielsweise an der Portal¬ stütze 16a angeordnet ist, wobei die Rastleiste 40 eine Vielzahl von in einem gleichbleibenden ersten Abstand A voneinander angeordneten Rastöffnungen 34 aufweist. An dem anderen Getriebeelement, hier also dem Ausleger 16b, ist bei dieser besonders vorteilhaften Gestaltung eine Mehrzahl n, im gezeigten Ausführungsbeispiel nämlich drei, von betätigbaren Verschlusselementen 33 mit jeweils einer in die Rastöffnungen 34 einrastbaren Rastnase 36 vorgesehen. Die Anordnung ist dabei so getroffen, dass die Rastnasen der Mehrzahl n (im Ausführungsbeispiel n=3) Verschlusselemente 33 in einem gleichbleiben¬ den zweiten Abstand a voneinander angeordnet sind, der den ersten Abstand A zwischen den Rastöffnungen 34 in einem Teilungsverhältnis T teilt, das der Bedingung A particularly advantageous embodiment of the Verriegelungsmechanis ¬ mechanism, which can be used in the device of the type according to the invention, but has its own inventive meaning is sketched in Fig. 6. It arises when the locking of the hinge mechanism 16 of the device 10 at least one locking strip at one of the transmission elements, for example on the portal ¬ support 16a is located 40, wherein the locking strip 40 a plurality of spaced apart at a constant first distance A latching openings 34 has. At the other transmission element, in this case the boom 16b, in this particularly advantageous embodiment, a plurality n, in the embodiment shown namely three, of actuatable closure elements 33, each with one in the Latching openings 34 snap-latch 36 is provided. The arrangement is made such that the latching noses of the plurality n (in the embodiment n = 3) closure elements 33 are arranged in a constant ¬ the second distance a from each other, which divides the first distance A between the latching openings 34 in a division ratio T, the the condition
T = ^ = - + k T = ^ = - + k
A n genügt. Dabei ist k eine ganzzahlige Konstante oder Null. Das Tei¬ lungsverhältnis T kann somit dem einer Noniusskala entsprechen, wenn neun Verschlusselemente 33 vorgesehen werden. Um eine besonders platzsparende Anordnung zu schaffen, können wie gezeigt mehrere Rastleisten 40 a,b,c parallel nebeneinander angeordnet sein, deren Rastöffnungen 34 phasenverschoben zu den Rastöffnungen 34 einer benachbarten Rastleiste angeordnet sind, wobei jeder Rastleiste min¬ destens ein Verschlusselement 33 zugeordnet ist, wie dies in Fig. 6 schematisch dargestellt ist. A n is enough. Where k is an integer constant or zero. The Tei ¬ division ratio T can thus correspond to a vernier scale when nine closure elements are provided 33rd In order to create a particularly space-saving arrangement, as shown, a plurality of locking strips 40 a, b, c may be arranged parallel to each other, the latching openings 34 are arranged out of phase with the latching openings 34 of an adjacent locking strip, each locking bar at least ¬ a closure element 33 is assigned as shown schematically in Fig. 6.

Claims

A n s p r ü c h e : Claims :
1. Vorrichtung zur kardiopulmonalen Massage und/oder Reanimation, mit einer Massagevorrichtung, die einen in einer Betätigungsrichtung (23) reversierend beweglichen, von einem Antrieb betätigbaren (15) und am Brustkorb (12) eines Patien¬ ten (11) an einem Soll-Kontaktbereich (21) positionierbaren Druckstempel (19) aufweist, dadurch gekennzeichnet, dass der Druckstempel (19) am Brustkorb (12) des Patienten (11) an dem Soll-Kontaktbereich (21) fixierbar ist und mindestens während eines Entlastungszustands zwischen zwei Massagehüben in einer Ebene quer zur Betätigungsrichtung (23) frei beweglich gelagert ist. 1. A device for cardiopulmonary massage and / or resuscitation, with a massage device, the one in an actuating direction (23) reversibly movable, actuated by a drive (15) and on the chest (12) of a Patien ¬ th (11) at a Soll- Contact area (21) positionable plunger (19), characterized in that the plunger (19) on the chest (12) of the patient (11) to the desired contact area (21) can be fixed and at least during a discharge state between two massage strokes in a Level transverse to the operating direction (23) is mounted freely movable.
2. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, dass der Druckstempel (19) in einem Belastungszustand während ei¬ nes Montagehubs in der Ebene quer zur Betätigungsrichtung2. Apparatus according to claim 1, characterized in that the plunger (19) in a load state during ei ¬ nes mounting stroke in the plane transverse to the actuation direction
(23) in seiner Position relativ zum Brustkorb des Patienten(23) in its position relative to the patient's thorax
(11) verriegelbar ist. (11) is lockable.
3. Vorrichtung nach Anspruch 1 oder 2, dadurch gekennzeichnet, dass die Massagevorrichtung (15) mindestens einen, um eine parallel zur Betätigungsvorrichtung (23) verlaufende Achse verstellbaren, ver- und entriegelbaren Gelenkmechanismus (16) aufweist. 3. A device according to claim 1 or 2, characterized in that the massage device (15) at least one to a parallel to the actuating device (23) extending axis adjustable, lockable and unlockable hinge mechanism (16).
Vorrichtung nach einem der Ansprüche 1 bis 3, gekennzeichnet, durch einen vorzugsweise von einem Kraft- und/oder Weg sensor beaufschlagten Verriegelungsmechanismus (29) zur Un¬ terbindung der Querbeweglichkeit des Druckstempels (19) wäh rend eines Massagehubs, insbesondere zur Verriegelung des mindestens einen Gelenkmechanismus (16) . Device according to one of claims 1 to 3, characterized by a preferably by a force and / or displacement sensor acted upon locking mechanism (29) for Un ¬ terbindung the transverse mobility of the plunger (19) currency end of a massage stroke, in particular for locking the at least one Joint mechanism (16).
5. Vorrichtung nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet, dass der Druckstempel (19) an einem am Brust¬ korb (12) des Patienten (11) festlegbaren Haltemittel (22) fixiert oder fixierbar ist. 5. Device according to one of claims 1 to 4, characterized in that the pressure stamp (19) on a breast ¬ basket (12) of the patient (11) fixable holding means (22) is fixed or fixable.
6. Vorrichtung nach Anspruch 5, dadurch gekennzeichnet, dass das6. Apparatus according to claim 5, characterized in that the
Haltemittel (22) als vorzugsweise mittels einer Klebeschicht am Brustkorb (12) anklebbares Haltepad (24) ausgebildet ist Holding means (22) as preferably by means of an adhesive layer on the rib cage (12) attachable holding pad (24) is formed
7. Vorrichtung nach Anspruch 5 oder 6, gekennzeichnet durch eine zwischen dem Druckstempel (19) und dem Haltemittel (22) wirksame Klettverbindung (27) . 7. Apparatus according to claim 5 or 6, characterized by a between the plunger (19) and the holding means (22) effective Velcro connection (27).
8. Vorrichtung nach einem der Ansprüche 3 bis 7, dadurch gekennzeichnet, dass das Haltemittel (22) eine Kontaktfläche (25) aufweist, die größer ist als eine vom Druckstempel (19) ge¬ bildete Druckfläche (20) . 8. Device according to one of claims 3 to 7, characterized in that the holding means (22) has a contact surface (25) which is larger than one of the plunger (19) GE ¬ formed pressure surface (20).
9. Vorrichtung nach einem der Ansprüche 1 bis 8, gekennzeichnet durch ein unter dem Körper des Patienten (11) positionierbares Widerlagerbrett (14), an dem die Massagevorrichtung (15) angeordnet ist. 9. Device according to one of claims 1 to 8, characterized by an under the body of the patient (11) positionable abutment board (14) on which the massage device (15) is arranged.
10. Vorrichtung nach Anspruch 9, dadurch gekennzeichnet, dass die10. Apparatus according to claim 9, characterized in that the
Massagevorrichtung (15) in ihrer Höhenlage relativ zum Widerlagerbrett (14) verstellbar ist. Massaging device (15) in its height position relative to the abutment board (14) is adjustable.
11. Vorrichtung nach Anspruch 10, dadurch gekennzeichnet, dass der11. The device according to claim 10, characterized in that the
Druckstempel (19) an der Massagevorrichtung (15) frei drehbar gelagert angeordnet ist. Pressure stamp (19) on the massage device (15) is arranged freely rotatably mounted.
12. Vorrichtung nach einem der Ansprüche 1 bis 11, dadurch gekennzeichnet, dass der Druckstempel (19) an der Massagevorrich¬ tung (19), vorzugsweise mit Spiel, zugfest in Betätigungs¬ richtung (23) angeordnet ist. 12. Device according to one of claims 1 to 11, characterized in that the pressure stamp (19) on the Massagevorrich ¬ device (19), preferably with play, tensile strength in the actuating ¬ direction (23) is arranged.
13. Vorrichtung nach einem der Ansprüche 1 bis 12, dadurch gekennzeichnet, dass der Druckstempel (19) an der Massagevorrich¬ tung (15) kugelgelenkig angeschlossen ist. 13. Device according to one of claims 1 to 12, characterized in that the pressure stamp (19) on the Massagevorrich ¬ device (15) is connected ball-jointed.
14. Vorrichtung nach einem der Ansprüche 1 bis 13, dadurch gekennzeichnet, dass der Verriegelungsmechanismus (29) mindestens ein vorzugsweise elektromotorisch betätigbares Riegelschloss (30) aufweist, das an einem Gelenk oder einer Linearführung des Gelenkmechanismus (16) in einer Vielzahl von Raststel¬ lungen verrastbar ist. 14. Device according to one of claims 1 to 13, characterized in that the locking mechanism (29) at least one preferably electromotive actuated bolt lock (30), which can be latched to a joint or a linear guide of the joint mechanism (16) in a plurality of Raststel ¬ lungs.
Verriegelungsmechanismus zur Blockierung einer Beweglichkeit zwischen zwei translatorisch und/oder rotatorisch miteinander verbundenen Getriebeelementen, insbesondere zur Verriegelung eines Gelenkmechanismus der Vorrichtung nach einem der Ansprüche 1 bis 14, mit mindestens einer an einem der Getriebeelemente (16a) angeordneten Rastleiste (40) mit ei¬ ner eine Vielzahl von in einem gleichbleibenden ersten Abstand A voneinander angeordneten Rastöffnungen (34) und mit einer an dem anderen Getriebeelement (16b) vorgesehenen Mehrzahl n von betätigbaren Verschlusselementen (33) mit jeweils einer in die Rastöffnungen (34) einrastbaren Rastnase (36), wobei die Rastnasen der Mehrzahl n Verschlusselemente (33) in einem gleichbleibenden zweiten Abstand a voneinander angeordnet sind, der den ersten Abstand A zwischen den Rastöffnungen (34) in einem Teilungsverhältnis (T) von teilt Locking mechanism for blocking a mobility between two translationally and / or rotationally interconnected transmission elements, in particular for locking a hinge mechanism of the device according to one of claims 1 to 14, with at least one on one of the transmission elements (16a) arranged locking bar (40) with egg ¬ ner a plurality of detent openings (34) arranged at a constant first distance A from one another and a plurality n of actuatable closure elements (33) provided on the other transmission element (16b), each with a latching nose (36) which can be latched into the detent openings (34) the latching noses of the plurality n closure elements (33) are arranged at a constant second distance a from each other, the first distance A between the latching openings (34) in a division ratio (T) of Splits
Verriegelungsmechanismus nach Anspruch 16, dadurch gekennzeichnet, dass das Teilungsverhältnis (T) dem einer Nonius- skala entspricht. Locking mechanism according to claim 16, characterized in that the division ratio (T) corresponds to that of a vernier scale.
Verriegelungsmechanismus nach Anspruch 16 oder 18, dadurch gekennzeichnet, dass mehrere Rastleisten (40 a,b,c) paralle nebeneinander angeordnet sind, deren Rastöffnungen (34), be vorzugt um das Teilungsverhältnis (T) , phasenverschoben zu den Rastöffnungen einer benachbarten Rastleiste angeordnet sind, wobei jeder Rastleiste (40) mindestens ein Verschlus¬ selement (33) zugeordnet ist. Locking mechanism according to claim 16 or 18, characterized in that a plurality of locking strips (40 a, b, c) are arranged parallel to each other, the latching openings (34), preferably be arranged by the division ratio (T), phase-shifted to the latching openings of an adjacent locking strip , wherein each locking strip (40) at least one Verschlus ¬ selement (33) is associated.
EP16701208.7A 2015-02-06 2016-01-14 Apparatus for cardiopulmonary massaging and/or resuscitation Active EP3253355B1 (en)

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DE102015101706.7A DE102015101706A1 (en) 2015-02-06 2015-02-06 Device for cardiopulmonary massage and / or resuscitation
PCT/IB2016/050168 WO2016125033A1 (en) 2015-02-06 2016-01-14 Apparatus for cardiopulmonary massaging and/or resuscitation

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EP3253355B1 EP3253355B1 (en) 2020-03-25

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JP (1) JP6837979B2 (en)
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CN107249544B (en) 2020-07-03
WO2016125033A1 (en) 2016-08-11
JP6837979B2 (en) 2021-03-03
ES2785570T3 (en) 2020-10-07
JP2018504975A (en) 2018-02-22
DE102015101706A1 (en) 2016-08-11
EP3253355B1 (en) 2020-03-25
US20180042811A1 (en) 2018-02-15
US10688018B2 (en) 2020-06-23
CN107249544A (en) 2017-10-13

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