EP3651716A1

EP3651716A1 - Device for a cardiopulmonary massaging and/or resuscitation

Info

Publication number: EP3651716A1
Application number: EP18743085.5A
Authority: EP
Inventors: Sarah DOPFER; Michael Heller; Christian Klimmer
Original assignee: GS Elektromedizinische Geraete G Stemple GmbH
Current assignee: GS Elektromedizinische Geraete G Stemple GmbH
Priority date: 2017-07-13
Filing date: 2018-06-25
Publication date: 2020-05-20
Anticipated expiration: 2038-06-25
Also published as: WO2019012355A1; US20210145693A1; DE102017115732A1; CN110891542B; JP2020527391A; US11590054B2; EP3651716B1; JP7173122B2; CN110891542A; ES2965873T3

Abstract

The device according to the invention is used for a cardiopulmonary massaging and/or resuscitation of a patient and is provided with a massage stamp (17) which can be reversibly driven by a drive device in an actuation direction (18) and which has a pressure surface (31) that can be positioned at a contact region on the chest (12) of a patient (11). In order to ensure that the chest compressions are interrupted upon reaching a specified compression force, - the massage stamp (17) has a stamp upper part (19) and a stamp lower part (20) which is operatively connected to the stamp upper part (19); - the stamp upper part (19) and the stamp lower part (20) can be adjusted relative to each other in the actuation direction (18) at least between a first position which defines a working length (L) and a second position in which an effective length (1) of the massage stamp (17) is shortened compared to the working length (L); - in the first position, the stamp upper part (19) is locked with the stamp lower part (20) by means of a releasable locking mechanism (21); and - the locking mechanism (21) is released upon reaching or exceeding a specified compression force transmitted by the massage stamp (17).

Description

The invention relates to a device for cardiopulmonary massage and / or resuscitation, comprising a massage punch which can be reversibly driven by a drive device in an actuation direction and which has a pressure surface which can be positioned on a contact region on the thorax of a patient.

Cardiovascular arrest means the greatest danger to a patient's life. Only if it is possible to initiate and maintain an "emergency cycle" within a very short time for cardiopulmonary resuscitation does the patient have a real chance of survival without permanent damage. Revitalization The practice 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 performed manually, ie, for example, by a paramedic, the thorax of the patient in the area of the sternum with frequencies compressed and relieved at the rate of 80-140 per minute and thereby causes a circulation of blood through the body of the patient and thus the oxygen supply to the organs.

The manual chest compression for resuscitation is very strenuous for the executing helper and can be performed only for a limited time with the required frequency. Since it is often to be continued even when transferring the patient to the hospital, mechanical devices for cardiopulmonary massage have been proposed, which supplement the technical equipment of ambulances, helicopters or the like, and with the help of the cardiac massage to patients are performed mechanically over virtually any time can, without the rescuers tire it. Instead, they can initiate complementary life-saving measures while the mechanical device performs chest compression to maintain the emergency cycle. For this purpose, such a device has a massage die which can be moved by a drive and which is moved up and down in the desired frequency, ie approximately 80-140 per minute. In this case, the pressure surface arranged at the bottom of the massage stamp transmits the force required for carrying out the cardiac pressure massage to the contact region on the patient's thorax and compresses it to the desired depth.

Important in the execution of the cardiac massage is not only that while the correct pressure point, namely directly above the sternum of the patient, used and maintained during the massage, as described in detail in the generic DE 10 2013 100 943 AI. It is also endeavored to avoid injury to the patient by the chest compression, which may be the result of too great compression force or depth in the cardiac massage. Even if, for example, rib fractures due to lack of thorax strength of a patient can not be avoided with certainty, such injuries should not occur as possible due to errors in cardiac massage, so too much compression force applied or the wrong point of compression. The risk of injury as a result of too high pressure force is relatively high in the case of (small) children and adolescents.

The object of the invention is to improve a device of the generic type to the effect that injury to the patient due to excessive compression force can be reliably avoided in the chest compressions of the chest. This object is achieved with the invention by the combination of the features of independent claim 1.

According to the invention, an automatic termination / interruption of the massage process upon reaching / exceeding the predetermined, maximum permissible compression force in the treatment of the respective patient is ensured with the two-part, consisting of stamp upper part and punch base arrangement of the massage punch and provided between these two punch parts locking mechanism. The locking mechanism releases upon reaching / exceeding the predetermined compression force and lifts the lock, resulting in an at least substantially force-free adjustment of the punch lower part relative to the punch upper part in a shortened relative to the working length length. The two stamp parts are so adjusted to each other, for example, pushed into each other, that the then effective (shortened) length of the massage temple compared to the working length is significantly lower, so that even with a continuation of the drive device and an associated up and down movement of the massage stamp this With the pressure surface, the patient's chest either does not touch at all or, in any case, only executes a significantly smaller compression path and thus also transmits a lower compression force than is the case with the full working length of the massage punch. In this way it is ensured that there are no injuries, such as rib fractures of the treated patient due to excessive compression forces.

In a particularly preferred embodiment of the invention, the locking mechanism is essentially formed by an effective between the punch upper part and the punch lower part magnetic holding device whose magnetic holding force corresponds to the predetermined compression force. If the predetermined, maximum permitted compression force is achieved in the direction of movement of the massage die, thereby the magnetic holding force of the magnet holding device is overcome, so that it comes directly to the locking mechanism forming magnetic holding device opens and repeals the previously existing, non-positive connection between the punch upper part and the punch base becomes. The punch base then stops moving the punch top, which is coupled to the drive means and is moved up and down, no longer, but rather is translated relative to the punch top to shorten the effective length of the massage punch.

But it is also possible that the locking mechanism is substantially formed by an effective between the punch upper part and the punch lower part ring or hook snap connection, which triggers force when reaching the predetermined, permissible compression and the connection between stamp upper and lower part releases. It has proved to be advantageous if the upper punch part and the lower punch part are aligned coaxially with one another and guided telescopically into one another. This arrangement is particularly space-saving. In addition, it is particularly suitable for transmitting the compression force acting essentially only in the Z direction (vertical direction). The Z-direction should be defined as the direction in which the cardiac massage is performed, that is, the direction in which the plunger is moved up and down to compress the chest of the (normally supine) patient in the downward motion and at to relieve the opposite upward movement again.

The punch top may include a top shelf and the punch bottom has a bottom cover located in the massage die above the top shelf, the lock mechanism engaging and / or being formed between the top shelf and the bottom lid. This embodiment has proven itself, in particular when using a magnetic holding device as a locking mechanism. It is then particularly preferred for the locking mechanism to comprise at least one holding magnet arranged on or formed on the upper part base and / or on the lower part cover, which then cooperates with a ferromagnetic surface on the respectively opposite part and / or a polar pole provided there in opposition to polarity.

If the magnet holding device has at least one interchangeable holding magnet, it is particularly easy to change the compressive force that can be transmitted with the magnet holding device, namely by simply replacing the respective holding magnet with another with a lower or higher holding force. It is also possible to change the holding force of an effective between the punch upper part and the punch bottom magnetic holding device in that the distance between the two attracting magnetic poles or a magnet and a cooperating ferromagnetic counterpart is variable. In constructive terms, an embodiment of the invention has proved useful in which the punch upper part and the punch lower part arranged in their peripheral walls, extending over substantially its entire height, extending complementary recesses for the passage of the upper part bottom in the punch base and the lower cover in the upper punch are. The recesses and between these remaining longitudinal webs of stamp lower and upper part then grasp claw-like into one another, whereby a stable, non-rotating arrangement of the two stamp parts is achieved, which are positively guided in triggering the locking mechanism and then taking place pushing the stamp parts in the longitudinal direction of the massage stamp. In this embodiment, it is preferably provided that the upper punch part and the lower punch part each have at least two recesses (and a quantity of longitudinal webs adapted in number and dimensions).

In order to be able to quickly and easily couple the massage stamp to the drive device and optionally to exchange it for another stamp with different dimensions, an adapter arranged at the upper end of the stamp upper part is provided for fast connection to the drive device in an advantageous development of the invention. Moreover, it is advantageous if the pressure surface is interchangeably arranged at the lower end of the stamp base, it can then be replaced with an element with a smaller or larger, effective compression surface and / or with a different geometric design, such as round, elliptical, spherical, etc. become .

It is particularly advantageous in the invention also when a preferably between the punch upper part and the punch lower part effective, after release of the locking mechanism and adjustment of the punch lower part relative to the punch upper part whose position in the second position holding each other securing mechanism is provided. Such a securing mechanism can advantageously be essentially formed by a retaining retaining magnet, which is preferably effective between the upper side of the lower part cover and a counter surface formed on the upper end of the upper punch part or on the drive device, and / or a preferably spring-loaded one. th snap hook connection. The safety mechanism ensures that after a single release of the holding mechanism and the subsequent displacement of the punch lower part relative to the punch upper part in the second (shortened) position of the massage die this shortened length can not give up again, because the locking mechanism keeps the punch base in the second position until the user of the device consciously releases the connection again, for example, after the parameters for carrying out the cardiac massage have been newly set up on the relevant patient, in order to prevent a renewed triggering of the locking mechanism. It is also possible to make sure with the aid of a spring or other suitable actuator that after triggering the locking mechanism, the punch base is actively retracted until it reaches the second position and is then locked in this by means of the safety mechanism.

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:

1 is a device applied to the thorax of a patient for cardiopulmonary massage according to the invention in a perspective view obliquely from above;

2a, b show a preferred embodiment of the massage punch used in the apparatus according to FIG. 1 in a first position, in two different side views, partly in section; FIG.

Fig. 3a, b, the subject of Figure 2 in a second position, which is shortened relative to the first position ..;

Fig. 4a-c, the punch upper part of the massage punch of Figure 2 and 3, in three different representations. and

Fig. 5, the punch base of the massage stamp of Fig. 2 and 3, also in three different representations. In FIG. 1, a device for cardiopulmonary massage and / or resuscitation of a patient 11, designated in its entirety by 10, is shown in its position applied to its thorax 12. The device 10 has an abutment board 14 placed under the back 13 of the patient 11, in whose corner region an upwardly projecting portal support 15 is arranged. The portal support 15 is pivotable relative to the abutment board 14 about a vertical axis and slidably mounted in height. It can be locked - preferably infinitely - at different altitudes. At its upper end it carries a boom 16, which is also articulated to the portal support 15 about a vertical axis. The boom 16 in turn is provided at its outer, free end with a massage punch 17, which is driven by a arranged in the interior of the boom housing drive means reversing in a substantially vertical actuation direction 18 up and down. The massage punch 17, which compresses the thorax of the patient in its downward movement while exerting a compressive force K and relieves the thorax with the upward movement, is shown in more detail in FIGS. 2 to 5.

The massage stamp 17 has a stamp upper part 19 and a stamp lower part 20, which is operatively connected to the stamp upper part 19. The two punch parts 19 and 20 are aligned coaxially with each other and guided telescopically so that they are adjustable relative to each other in the actuation direction 18 at least between a first, a working length L defining position and a second position in which an effective length of the massage punch 17th compared to the working length L is shortened. In the first position, in which the massage punch 17 has the (larger) working length L, the punch upper part 19 and the punch lower part 20 are locked together with a locking mechanism 21. Upon reaching a predetermined maximum allowable compression force K _max , which is exerted by the massage punch on the chest of the patient, the locking mechanism 21 triggers and thus lifts the operative connection of the two punch parts 19, 20 in the first position. The arrangement is such that when the locking mechanism is triggered, the punch lower part 20 and the punch upper part 19 collapse, so that the massage punch 17 at the end of this process only has the second position corresponding shortened length 1. This pushing together can be assisted by an actuating element acting between the upper die part and the lower die part, eg a biased tension spring (not shown) engaging the lower die part and upper die top part, which actively contracts or pushes the two die part into the short effective length 1 as soon as the locking mechanism has triggered.

In the embodiment, the locking mechanism 21 is substantially formed by a magnetic holding device 22 effective between the punch top 19 and the punch bottom 20, the magnet holding force M of which corresponds to the predetermined compression force K _max . The arrangement is made in the present case such that the stamp upper part 19 has a top part bottom 23 and the stamp bottom part 20 has a bottom part cover 24. This is located in the massage punch 17 above the top shelf 23. The magnet holder 22 has two holding magnets 25, 26, one of which is on the top 27 of the top shelf 23 and the other coaxial thereto on the bottom 28 of the bottom cover 24 are inserted so that they each other attract. The locking mechanism 21 in the form of the magnet holding device 22 thus engages between the upper part bottom 23 and the lower part cover 24 and pulls the two punch parts 19, 20 with the effective between the holding magnets 25, 26 magnetic holding force M in the first position, so the extended working length L, up to today.

In the drawing (Figures 4 and 5), it can be clearly seen that the punch upper part 19 and the punch base 20 are provided with mutually complementary recesses 29, 30 in their peripheral walls 31, 32 extending substantially over the entire height of the punch parts 19th , 20 extend. These recesses 29, 30 form on the one hand a passage for radially outer holding portions 33 of the upper part bottom 23 in the punch base 20 and on the other hand for corresponding holding portions 34 of the lower cover 24 in the upper punch part 19. In this way, the two punch parts 19, 20 in the direction 18 into each other move when in a cardiac massage the maximum compression force corresponding to the magnetic retention force in the first working position is reached, and then the locking mechanism triggers. The punch base 20, which is provided below with a pressure surface D, with which it rests on the chest 12 of the patient (Fig.l) loses when triggered by the locking mechanism 21 caused by the holding magnets, solid connection with the upper punch 19 and pushes without further exerting any appreciable force on the patient's thorax 12, into the upper punch 19 as it is further moved downwardly by the drive means. The standing between the two recesses 29 wall webs 35 of the punch upper part 19 slide thereby form-fitting in the recesses 30 in the punch base 19, while the wall webs 36 of the punch base 20 fit into the corresponding recesses 29 on the punch upper part 19 slide until the two punch parts 19, 20th are pushed together in the second, shortened position with the shorter length 1. The massage stamp 17 can then no longer exert compressive force on the patient thorax 12, the cardiac massage is thus automatically interrupted as soon as the compression force, which must be transmitted in the embodiment of the magnetic holding device, is exceeded or exceeded.

In order to hold the two stamp parts in the second position relative to the stamp upper part 19 after triggering the locking mechanism 21 and then retracting the stamp lower part 20, a securing mechanism 37 effective between the stamp upper part 19 and the stamp lower part 20 is provided. The securing mechanism 37 is essentially formed in the embodiment of the arranged in the lower cover 24 holding magnet 26, which also on the upper side 38 of the lower cover still generates a sufficiently large magnetic holding force in cooperation with an upper end 40 of the punch upper part 19 formed counter surface 41 to the Stamp lower part in the shortened length 1 of the massage stamp to keep when the punch base 20 enters and its bottom cover 24 abuts the upper end 40 of the punch upper part 19. The holding force exerted by the holding magnet 26 on the ferromagnetic mating surface 41 then ensures that the two punch parts 19, 20 do not move apart again when the punch upper part 19 of the massage punch 17 is lifted again by the drive device in the decompression stroke. Rather, then makes the stamp base 20 this upward movement of the punch upper part 19, since it from the on the counter surface 41 engaging holding magnet 39 is sufficiently firmly connected to the punch upper part 19.

With the invention it is ensured that the cardiac massage force is immediately interrupted upon reaching the predetermined compression force, because this causes the locking mechanism triggers and the two stamp parts are brought into the second position with shortened effective length 1. It is possible to detect the triggering of the locking mechanism and / or collapse of the stamp parts by means of a sensor, which then stops the drive means for the massage punch 17, expediently when this has again reached its highest position before the beginning of a subsequent compression stroke (movement down) ,

The invention is not limited to the illustrated and described embodiment, but various changes and additions are conceivable without departing from the scope of the invention. For example, it is conceivable that at least one of the holding magnets of the magnet holding device 22 is replaceable and can be replaced by a magnet with a larger or smaller holding force. In this way, the compression force can be adjusted, in which the locking mechanism triggers. This object can also be achieved by making the distance between the two holding magnets in the first position of the stamp parts mutually variable, e.g. with the help of an adjustable depth stop. The greater the distance between the two holding magnets is selected, the lower is then the holding force acting between them.

Instead of the magnetic holding device can also be used as a locking mechanism, a preferably spring-loaded snap connection, e.g. a ring snap connection or a hook snap connection. Similarly, the securing mechanism can be carried out, which holds the two stamp parts in the second position with a reduced length of the massage punch to each other.

The printing surface, which is formed at the bottom of the stamp base, can be made interchangeable, so that pressure surfaces of different Shape and size, if necessary, can also be used with different soft / hard coatings.

LIST OF REFERENCE NUMBERS

10 device

11 patient

12 thorax

13 backs

14 abutment board

15 gantry support

16 outriggers

17 massage stamps

18 actuating direction

19 stamp top

20 stamp base

21 locking mechanism

22 magnetic holding device

23 top shelf

24 base lid

25 first holding magnet

26 second holding magnet

27 top of 23

28 bottom of 24

29 recesses in 19

30 recesses in 20

31 peripheral walls of 19

32 peripheral walls of 20

33 holding sections on 23

34 holding sections on 24

35 wall bars from 19

36 wall bars of 20

37 safety mechanism

38 top of 24

39 retaining magnet

40 upper end of 19

41 counter surface L length of 17 in the first position (long)

L length of 17 in the second position (short)

K compression force

M magnetic holding force

D printing area

Claims

Claims :

Apparatus for cardiopulmonary massage and / or resuscitation, comprising a massage punch (17) which can be reversibly driven by a drive device in an actuation direction (18) and has a pressure surface (31) which can be positioned on the thorax (12) of a patient (11), characterized by the following features : the massage punch (17) has an upper punch part (19) and a lower punch part (20) operatively connected to the upper punch part;

the upper punch part (19) and the lower punch part (20) are adjustable in the actuating direction (18) relative to each other at least between a first, a working length (L) defining position and a second position in which an effective length (1) of the massage punch (17 ) is shortened compared to the working length (L);

in the first position, the punch upper part (19) is locked to the punch bottom part (20) by means of a releasable locking mechanism (21); and

the locking mechanism (21) triggers upon reaching / exceeding a predetermined, from the massage punch (17) transmitted compression force (K _max ).

Apparatus according to claim 1, characterized in that the

Locking mechanism (21) is substantially formed by a between the punch upper part (19) and the punch lower part (20) effective magnetic holding device (22) whose magnetic holding force (M) of the predetermined compression force (K _max ) corresponds.

Apparatus according to claim 1, characterized in that the

Locking mechanism (21) is essentially formed by an effective between the punch upper part (19) and the punch lower part (20) ring and / or hook snap connection.

Device according to one of claims 1 to 3, characterized in that the stamp upper part (19) and the lower punch part (20) aligned coaxially with each other and telescopically guided into each other.

5. Device according to one of claims 1 to 3, characterized in that the punch upper part (19) has a top part bottom (23) and the punch bottom part (20) has a bottom cover (34) located in the massage punch (17) above the top part bottom (23 ), and that the locking mechanism (21) engages between and / or is formed between the top shelf (23) and the bottom lid (24).

6. Apparatus according to claim 5, characterized in that the

Locking mechanism (21) comprises at least one holding magnet (25,26) arranged on the upper part bottom (23) and / or on the lower part cover (24) or formed therefrom.

7. Device according to one of claims 2 and 4 to 6, characterized in that the magnetic holding device (22) has at least one interchangeable holding magnet (25,26).

8. Device according to one of claims 4 to 7, characterized in that the punch upper part (19) and the punch lower part (20) arranged in their peripheral walls (31,32) extending substantially over the entire height, complementary recesses (29 , 30) are provided for the passage of the upper part bottom (23) in the lower punch part (20) and the lower part cover (24) in the upper punch part (19).

9. Apparatus according to claim 8, characterized in that the

Stamp upper part (19) and the punch base (20) each have at least two recesses (29,30).

10. Device according to one of claims 1 to 9, characterized

by a connection adapter arranged on the stamp upper part (19) at its upper end (40) for quick connection to the drive device.

11. Device according to one of claims 1 to 9, characterized in that the pressure surface (31) at the lower end of the stamp lower part (20) is arranged exchangeably.

12. Device according to one of claims 1 to 10, characterized by a between the punch upper part (19) and the punch lower part (20) effective, after release of the locking mechanism (21) and adjustment of the punch lower part (20) relative to the punch upper part (19) whose position in the second position holding each other securing mechanism (37).

13. The device according to claim 11, characterized in that the securing mechanism (37) is substantially formed by a preferably between the upper side (38) of the lower part cover (24) and one at the upper end (40) of the upper punch part (19) or on the Drive device formed counter surface (41) effective fuse retaining magnet (29) and / or a preferably spring-loaded snap hook connection.