EP3429539B1 - Device for cardiopulmonary massage and/or resuscitation - Google Patents

Description

• einem Auflagerbrett, auf dem der Patient mit seinem Rücken aufliegt;
• einer unmittelbar an dem Auflagerbrett angeschlossenen Massagevorrichtung, die aufweist:
• eine Portalstütze;
• einen an der Portalstütze angeordneten, oberhalb der Brust des Patienten vorragenden Ausleger;
• einen an dem freien Ende des Auslegers angeordneten, reversierend antreibbaren Massagestempel, wobei
  • der Massagestempel an einem Soll-Kontaktbereich am Brustkorb des Patienten zur Durchführung einer kardiopulmonalen Massage positionierbar ist.

The invention relates to a device for cardiopulmonary massage and/or resuscitation of a patient

• a support board on which the patient lies with his back;
• a massage device connected directly to the support board, which has:
• a portal support;
• an arm arranged on the portal support and projecting above the patient's chest;
• a reversibly drivable massage stamp arranged at the free end of the boom, wherein
  • the massage stamp can be positioned at a target contact area on the patient's chest for carrying out a cardiopulmonary massage.

From the DE 10 2013 100 943 A1 a device is known in which the massage device can be driven reversibly in an actuation direction by a drive device and on its pressure stamp one on the chest of a patient at a target contact area has a positionable printing surface. Deviations in the position of the pressure surface of the massage device from a target pressure point are determined by a position sensor device, with which it is possible to detect changes in the position of the massage device and / or its pressure surface relative to the target contact area on the patient's chest in a plane normal to the direction of actuation of the Determine massage device.

The known device, in which the pressure forces exerted by the massage stamp during the cardiac compression massage are introduced directly into the support board on which the patient lies by connecting the massage device to the support board, is well suited to performing a mechanical cardiac massage on a patient as long as the Device is essentially stationary, the position of the device relative to a base, for example a bed permanently mounted in an ambulance, does not change or at least not changes significantly. However, paramedics often face the problem that they first have to transport a patient, for example from an apartment or from the scene of an accident, to an emergency vehicle or a helicopter using suitable carrying aids, although it may well be that the chest compressions are not interrupted during this transport process shall be. The known device is certainly capable of continuing the massage with the pressure stamp even while the patient is being transported, for example using a stretcher or a sling. During such transport processes, however, it can easily happen that the patient lying on the support board changes his position - possibly very suddenly - relative to it, which in practice, for example when transporting the patient up a staircase, then leads to a somewhat continuous Operation of the massage device is not possible because large changes in the position of the massage device relative to the target contact area on the patient's chest occur too quickly and efficient resuscitation is therefore not possible. Under certain circumstances it may even endanger the patient.

From the DE 14 91 745 A like that too US 3,511,275 a device for stimulating and reviving the heart and lung activity of a patient is known, which has a massage unit which is connected to a support board-like shoulder support with straps which hold the massage unit on the chest of the patient lying on the shoulder support. With this device, the holding forces that occur as reaction forces during the cardiac massage are transferred to the shoulder support via the straps, which leads to very high holding forces in the straps because the straps do not run predominantly in the direction of actuation of the massage unit. Nevertheless, every time the massage unit presses on the patient's chest, the massage unit lifts a little away from the chest, which reduces the effectiveness of the chest compressions. The conditions are not much different from the US 4,060,079 known transport device for a patient, with which the patient can receive a cardiac massage during transport with a massage device attached by means of belts. Also with the one from the US 4,915,095 In a known arrangement, a cardiac massage unit is secured to the patient's chest by means of straps, which are wrapped around the patient's upper body and absorb the abutment forces during the downward movement of the pressure stamp.

The US 4,632,094 discloses an electro-mechanical cardiac compression system having upper and lower mounting plates vise-connected to each other by a plurality of connecting rods. A massage unit is provided on the upper fastening plate with a massage plunger passing through the plate, which can carry out a cardiac massage in a reciprocating manner on a patient clamped between the two plates.

From the US 2005/0015026 A1 an apparatus for cardiac massage is known, which is positioned and fixed by means of a simple strap that wraps around the patient's chest so that a pressure surface of a pressure stamp is at the desired treatment position on the patient.

From the US 3,985,126 a device of the generic type mentioned at the beginning is known, in which it can easily happen between the individual massage strokes, especially during the transport of the patient, that the desired pressure point of the massage stamp on the patient's chest is lost.

The object of the invention is to improve a device of the type mentioned in such a way that the mechanical cardiopulmonary massage can be maintained even during the difficult transport measures explained.

• ein am Brustkorb des Patienten an dem Soll-Kontaktbereich positionierbares Halteplattenelement, wobei
  • das Halteplattenelement mittels mindestens drei an seinem Umfang angreifenden Spannmitteln mit dem Auflagerbrett derart verbindbar und verspannbar ist, dass der Patient mit seinem Oberkörper zwischen dem Auflagerbrett und dem Halteplattenelement mittels der zwischen diesen wirkenden Spannmittel fixierbar ist, und wobei
  • das Halteplattenelement etwa kreisförmig mit einer zentralen Kontaktfläche für den Massagestempel oder ringförmig mit einer zentralen Öffnung für den Durchlass des Massagestempels ausgestaltet ist.

This task is solved with the invention

• a holding plate element that can be positioned on the patient's chest at the desired contact area, wherein
  • the holding plate element can be connected and clamped to the support board by means of at least three tensioning means acting on its circumference in such a way that the patient can be fixed with his upper body between the support board and the holding plate element by means of the tensioning means acting between them, and where
  • the holding plate element is designed approximately circular with a central contact surface for the massage stamp or ring-shaped with a central opening for the passage of the massage stamp.

The holding plate element provided according to the invention makes it possible to reliably fix the patient between itself and the support board in such a way that even during difficult transport, for example carrying the patient down a stairwell, the position of the patient's chest relative to the support board does not change, at least not suddenly changes significantly, so that the massage device connected to the support board also maintains its position in the target contact area and can continue to perform its massage task during transport. The patient's upper body is actually clamped between the support board and the holding plate element by means of the tensioning means acting between these two components of the rescue system, so that he is not to a relevant extent can slip relative to the support board, which would change the desired point of attack for the massage device to correctly carry out the chest compressions.

The holding plate element is designed either approximately circular with a central contact surface for the massage stamp or - which is particularly preferred - ring-shaped with a central opening for the passage of the massage stamp. If the holding plate element is circular with a closed central contact surface, this is aligned on the patient's chest so that it is located as precisely as possible above the target contact area for the massage device. The pressure stamp of the massage device then rests on the top of the contact surface on the holding plate element. It is also possible to fix the once set position of the pressure surface of the massage device relative to the contact surface on the holding plate element by a locking means between these two surfaces, for example by a Velcro connector with a fleece on one and a Velcro element on the other of the two surfaces. If, as is usually the case, it is preferred that the desired target contact area on the sternum remains accessible, in particular visible, to the doctor or paramedic during cardiac massage in order to allow visual control of the correct position of the stamp, this is with the ring-shaped design of the holding plate element is easily possible through the annular opening formed therein, through which the massage stamp can be placed on the patient's chest.

Preferably, the holding plate element is provided with fastening tabs arranged on its circumference, to which the clamping means can be releasably connected. This configuration makes it possible to apply the device quickly and precisely to the patient by first placing the patient on the support board and then arranging the holding plate element on his chest in order to then connect the clamping means to the fastening tabs, which are firmly attached with their other ends to the support board or but can also (at least partially) be connected to a sling or a stretcher carrying the support board. To fix the patient between the The support board and the holding plate element then only need to be tensioned with the clamping devices.

In an advantageous development of the invention, the holding plate element has four connecting elements, preferably evenly distributed on its circumference, for four clamping means acting on corner regions of the support board. It is particularly advantageous if the holding plate element has an additional connection for an additional tensioning device that can be inserted between the patient's legs. Such an additional tensioning device passed between the patient's legs, which can be connected to the support board with its other end either also to the support board or when using a sling, a stretcher or another carrying system, ensures even when the patient is in a very inclined position, which is the case, for example Transport can take place over stairs, a safe positioning of the patient, who then cannot slip to any significant extent relative to the support board. In conjunction with the sling or another carrying system, the system consisting of the patient, support board with holding plate element and massage device is also prevented from slipping relative to the sling or other carrying system.

In an advantageous embodiment of the invention, the tensioning means are tensioning straps with hook closure elements, which can be releasably connected to connecting elements arranged on the holding plate element. It is particularly advantageous if the hook closure elements snap into place on the associated connection elements with the aid of magnets.

The holding plate element is expediently designed to be at least largely inflexible in the radial and/or circumferential direction and deformable in a direction perpendicular to the patient's chest. As a result, on the one hand, it can well absorb the clamping forces that are exerted by the clamping means essentially in the radial direction on the holding plate element and, on the other hand, it can adapt well to the anatomical shape of the patient's chest. The holding plate element can, for example, be a central ring or disk element made of flexurally elastic material Have plastic material, which is preferably covered with a high-strength fabric, on which the connecting elements are provided.

The connection elements and/or the additional connection can be arranged on fastening tabs which are arranged approximately radially projecting from the holding plate element.

If you want to use the device according to the invention in combination with a sling, such that the support board is arranged on the top of the sling, the arrangement is preferably such that at least one tensioning means acting on the holding plate element is connected or connectable to the sling. It is then particularly preferred that the tensioning means connected or connectable to the sling is the additional tensioning means which can be passed between the legs of the patient and can be connected to the additional connection.

Fig.1

eine erfindungsgemäße Vorrichtung mit einem Patienten in einer schematisch vereinfachten Draufsicht;

Fig.2

eine bevorzugte Ausführungsform des bei der Vorrichtung nach Fig.1 zum Einsatz kommenden Halteplattenelements in einer Draufsicht; und

Fig. 3

den Gegenstand der Fig.2 in einem Schnitt längs der Linie III-III.

Further features and advantages of the invention result from the following description and the drawing, in which a preferred embodiment of the invention is shown in more detail using an example. It shows:

Fig.1

a device according to the invention with a patient in a schematically simplified top view;

Fig.2

a preferred embodiment of the device according to Fig.1 A plan view of the holding plate element used; and

Fig. 3

the subject of the Fig.2 in a section along line III-III.

Fig. 1 shows a device according to the invention, designated in its entirety by 10, with the help of which a patient 11 can be transported lying down while at the same time receiving chest compressions. For this purpose, the device 10 is provided with a support board 12 on which the patient rests with his back. A massage device 14 is arranged on the support board 12 at one of the corner areas located at the head end 13, which is located on a top view according to Fig. 1 The portal support, which cannot be seen in more detail, has an arm 15 which projects above the patient's chest and which carries a reversibly drivable massage stamp 16 at its free end. The massage stamp 16 can be positioned at a target contact area 17 in order to carry out the cardiopulmonary massage on the patient 11 by moving its print head up and down. The reaction forces, which act essentially perpendicular to the patient's chest and which occur as a result of the cardiac massage, are transferred directly from the massage device 14, which is directly connected to the support board 12. As far as described up to this point, the structure of the device essentially corresponds to that shown in the DE 10 2013 100 943 A1 is known, to which reference is hereby made and the disclosure content of which is hereby made the subject of the present application.

According to the invention, a holding plate element 19 is provided which can be positioned on the chest 18 of the patient 11 at the desired contact area 17 and which can be connected and clamped to the support board 12 in its corner areas with four tensioning means 20 acting on its circumference. For this purpose, the holding plate element 19 has four connecting elements 21 which are arranged approximately evenly distributed on its circumference, are diagonally opposite one another and are aligned with the corner regions of the support board 12, and which the four clamping means 20 attached to the corner regions of the support board can engage. The tensioning means 20 are tensioning straps which are provided with hook fastening elements 22 which can be releasably attached to the connecting elements 21 which are arranged on the holding plate element 19 and are assigned to them. In order to facilitate the connection of the hook closure elements 22 to the associated connection elements 21, it is preferably provided that the hook closure elements snap into place on the corresponding connection elements with magnet support.

You recognize in Fig. 1 that the holding plate element 19 has an additional connection 23 for an additional tensioning device 25 guided between the legs 24 of the patient 11, the other end 26 of which is firmly sewn to a sling 27 on which the support board 12 rests and with whose help the patient 11 can be carried by his rescuers even through difficult terrain such as a narrow stairwell.

The arrangement according to the invention makes it possible to position the patient 11 in a substantially constant position relative to the massage device 14 even during transport by holding the patient's upper body between the support board 12 and the holding plate element 19 by means of the clamping means 20 acting between these two device parts is clamped so that it cannot slip, or at least not noticeably, while the patient is being transported. The massage device can therefore carry out the cardiac massage even during transport without there being any risk that the massage stamp 16 will lose its position at the target contact area (i.e. at the patient's sternum). The additional connection 23 with the additional tensioning means 25 guided between the legs 24 of the patient, which is attached directly to the sling 27, ensures that the position of the patient relative to the sling remains largely the same and in particular the patient with the device applied to his upper body not forward (i.e. left in Fig.1 ) can slip out of the sling, for example if the patient is carried down a flight of stairs foot first by his rescuers.

The holding plate element 19 is more detailed in the Fig. 2 and 3 shown. As can be seen, in the preferred exemplary embodiment shown, it is designed in a ring shape with a central opening 28, which forms a passage for the massage stamp 16 when the holding plate element 19 is at the target contact area 17 of the patient, i.e. preferably concentric to the lower third of the sternum Chest 18 is positioned. The holding plate element 19 has an inner ring element 29 made of an approximately 2 to 5 mm thick, flexible plastic material, which is covered with a high-strength fabric 30. Due to the comparatively large width of the ring element 29 in its radial direction, which is preferably at least 35 mm and in the illustrated embodiment at least 50 mm, the holding plate element is largely inflexible in its radial direction and also in its circumferential direction, due to the relatively small Thickness, on the other hand, can be deformed in a direction perpendicular to the patient's chest, so that it can adapt to the individual anatomical conditions of the patient in question. In the exemplary embodiment described and shown here, the connection elements 21 and the additional connection 23 are arranged on fastening tabs 31, which are arranged in a radially projecting manner on the holding plate element 19. For this purpose, the fastening tabs 31 consist of strips 32 made of a high-strength fabric, which are wrapped around the covered ring element 29 and whose ends 33 then protruding radially on the outside are sewn to one another and to the connecting elements 21 or the additional connection 23 or connected in another suitable manner.

The annular design of the holding plate element 19 with the central opening 28 facilitates the positioning of the massage stamp for cardiac massage by first positioning the holding plate element correctly on the patient's chest and then firmly connecting it to the support board 12 lying under the patient using the clamping means 20, so that it can no longer move laterally and the patient's chest is firmly clamped between itself and the support board. It is possible, for example, to provide the ring element 29 with marking lines (not shown) in the area of the four fastening tabs, each offset by 90° to one another, for the clamping means 20 to be connected to the support board, or between them, which ensure the correct alignment of the holding plate element concentric to the target contact area 17 facilitate, which coincides with the center of the central opening 28, i.e. is concentric to the opening 28. After the holding plate element has been correctly attached, all that remains is to position the massage stamp 16 with its pressure surface centrally in the central opening 28 of the ring element 29. However, it is also possible to design the holding plate element not ring-shaped, but closed, and then to place the pressure surface of the massage stamp not directly on the patient's chest, but on the top of the holding plate element, which causes the up and down movement of the massage stamp due to its inherent flexibility in the direction perpendicular to the patient's chest. With such a design, it is also possible to use the massage stamp on its pressure surface, for example to be coupled to the holding plate element by means of a Velcro connector and in this way to create a firm connection between the massage stamp and the patient, who is practically clamped by the device, in a direction transverse to the direction of actuation of the massage stamp.

Claims (10)

1. Device for cardiopulmonary massage and/or resuscitation of a patient, with

   - a support board (12) on which the patient (1) lies on their back;

   - a massage device (14), connected directly to the support board (12), which has:

   - a gantry support;

   - a cantilever (15) arranged on the gantry support and protruding above the breast of the patient;

   - a reversingly driveable massage stamp (16) arranged at the free end of the cantilever, wherein

   - the massage stamp is positionable at a target contact region (17) at the thorax (18) of the patient (11) for carrying out a cardiopulmonary massage,

   - characterised by

   - a holding plate element (19) positionable on the thorax (18) of the patient (11) at the target contact region (17), wherein

   - the holding plate element is connectable and tensionable to the support board (12) by means of at least three tensioning means (20) engaging at its periphery, such that the patient (11) can be fixed with their upper body between the support board (12) and the holding plate element (19) by means of the tensioning means (20) acting between these, and wherein

   - the holding plate element (19) is approximately circular in design with a central contact surface for the massage stamp (16), or annular in design with a central opening (28) for the passage of the massage stamp (16).
2. Device according to claim 1, characterised in that the holding plate element (19) is equipped with fastening tabs (31) arranged at its periphery, to which the tensioning means (20) are connectable, preferably in a manner so as to be releasable.
3. Device according to claim 1 or 2, characterised in that the holding plate element (19) has four connecting elements (21), preferably evenly distributed at its periphery, for four tensioning means (20) engaging at corner regions of the support board (12).
4. Device according to any of claims 1 to 3, characterised in that the holding plate element (19) has an additional connection (23) for an additional tensioning means (25) which can be passed between the legs (24) of the patient (11).
5. Device according to any of claims 1 to 4, characterised in that the tensioning means (20) are tension belts with hook closure elements (22) which are releasably connectable to connection elements (21) arranged on the holding plate element (19).
6. Device according to any of claims 1 to 5, characterised in that the holding plate element (19) is designed to be at least to the main extent inflexible in radial and/or circumferential direction and to be deformable in a direction perpendicular to the thorax of the patient (11).
7. Device according to any of claims 1 to 6, characterised in that the holding plate element (19) has a central annular or disc element (29) made of flexible plastic material, which is preferably covered with a high-strength woven fabric (30) on which the connection elements (21) are provided.
8. Device according to any of claims 1 to 7, characterised in that the connection elements (21) are arranged on fastening tabs (31) which are arranged on the holding plate element (19) to be approximately radially protruding.
9. Device according to any of claims 1 to 8 in combination with a carrying cloth (27) serving for carrying a patient, on which the support board (12) rests, wherein at least one tensioning means engaging on the holding plate element (19) is connected with or connectable with the carrying cloth (27).
10. Device according to claim 9 and claim 4, characterised in that the tensioning means connected or connectable with the carrying cloth (27) is the additional tensioning means (25) which can be passed between the legs of the patient and connected with the additional connection (23).

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