EP3651716B1 - Vorrichtung zur kardiopulmonalen massage und/oder reanimation - Google Patents

Vorrichtung zur kardiopulmonalen massage und/oder reanimation Download PDF

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Publication number
EP3651716B1
EP3651716B1 EP18743085.5A EP18743085A EP3651716B1 EP 3651716 B1 EP3651716 B1 EP 3651716B1 EP 18743085 A EP18743085 A EP 18743085A EP 3651716 B1 EP3651716 B1 EP 3651716B1
Authority
EP
European Patent Office
Prior art keywords
stamp
massage
locking mechanism
holding
magnet
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.)
Active
Application number
EP18743085.5A
Other languages
German (de)
English (en)
French (fr)
Other versions
EP3651716A1 (de
Inventor
Sarah DOPFER
Michael Heller
Christian Klimmer
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
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Publication of EP3651716A1 publication Critical patent/EP3651716A1/de
Application granted granted Critical
Publication of EP3651716B1 publication Critical patent/EP3651716B1/de
Active legal-status Critical Current
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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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/01—Constructive details
    • A61H2201/0173—Means for preventing injuries
    • A61H2201/0176—By stopping operation
    • 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
    • A61H2201/018—By limiting the applied torque or force
    • 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
    • A61H2201/16—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

Definitions

  • the invention relates to a device for cardiopulmonary massage and/or resuscitation with the features of independent patent claim 1.
  • a cardiac arrest poses a serious threat to a patient's life. Only if it is possible to initiate and maintain an "emergency circuit" for cardiopulmonary resuscitation within a very short time does the patient have a real chance of survival without permanent damage.
  • a central component of cardiopulmonary resuscitation is the performance of cardiac massage to establish a replacement blood circulation so that vital organs, especially the brain, are supplied with oxygen.
  • the classic chest compression is carried out manually, i.e. for example by a paramedic who compresses and releases the patient's thorax in the sternum area at frequencies of the order of 80-140 per minute, thereby allowing the blood to circulate through the patient's body so that the oxygen supply to the organs occurs.
  • a device for direct manual cardiac massage which can be applied directly to the patient's heart through a comparatively small incision in the chest of a patient for cardiac massage during cardiac arrest.
  • the known device has a pressure surface which is connected to a lower pipe section, in which an upper inner pipe provided with a handle is telescopically received and locked in a working position by means of a locking element. If a triggering force of the locking element is exceeded, the locking connection opens and the inner tube pushes into the lower tube section, which signals to the surgeon handling the device that he should not put any more force on the pressure surface in order to avoid damage to the heart muscle.
  • the object of the invention is to provide a device for cardiopulmonary massage and/or resuscitation with a massage stamp that can be driven reversibly in an actuation direction by a drive device, whose pressure surface attacks the patient's chest, so that injuries to the patient as a result of excessive compression force during cardiac massage of the chest can be reliably avoided.
  • This problem is solved with the invention by combining the features of independent patent claim 1.
  • the massage stamp consisting of the upper stamp part and the lower stamp part and the locking mechanism provided between these two stamp parts
  • an automatic termination/interruption of the massage process is ensured when the specified, maximum permissible compression force is reached/exceeded during the treatment of the respective patient.
  • the locking mechanism is triggered when the predetermined compression force is reached/exceeded and cancels the locking, which results in an at least essentially force-free adjustment of the lower part of the stamp relative to the upper part of the stamp into a length that is shortened relative to the working length.
  • the two stamp parts are adjusted relative to one another, for example pushed into one another, so that the then effective (shortened) length of the massage stamp is significantly smaller compared to the working length, so that even when the drive device continues to run and the massage stamp moves up and down with it with the pressure surface either no longer touches the patient's chest at all or at least only performs 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 stamp. In this way it is ensured that injuries, such as rib fractures, do not occur to the patient being treated as a result of excessive compression forces.
  • the locking mechanism is essentially formed by a magnetic holding device acting between the upper part of the stamp and the lower part of the stamp, the magnetic holding force of which corresponds to the predetermined compression force.
  • the magnetic holding force of the magnetic holding device is overcome, so that the The magnetic holding device forming the locking mechanism opens and the previously existing, non-positive connection between the upper part of the stamp and the lower part of the stamp is removed.
  • the lower part of the stamp then no longer follows the movement of the upper part of the stamp, which is coupled to the drive device and is moved up and down by it, but is rather displaced relative to the upper part of the stamp in the sense of shortening the effective length of the massage stamp.
  • the upper stamp part and the lower stamp part are aligned coaxially to one another and telescopically guided into one another.
  • This arrangement is particularly space-saving.
  • it is particularly suitable for transmitting the compression force, which essentially only acts in the Z direction (vertical direction).
  • the Z direction should be defined as the direction in which the chest compressions are carried out, i.e. the direction in which the stamp is moved up and down in order to compress the chest of the patient (usually lying on his back) during the downward movement and at the opposite upward movement.
  • the upper part of the stamp can have an upper part base and the lower part of the stamp can have a lower part cover, which is located in the massage stamp above the upper part base, the locking mechanism engaging between the upper part base and the lower part cover and/or being formed by them.
  • This configuration has proven effective when using the magnetic holding device as a locking mechanism. It is then particularly preferably provided that the locking mechanism comprises at least one holding magnet arranged on or formed by the upper part base and/or on the lower part cover, which then interacts with a ferromagnetic surface on the opposite part and/or a magnetic pole provided there with opposite polarity.
  • the magnet holding device has at least one replaceable holding magnet, it is particularly easy to change the compression force that can be transmitted with the magnet holding device, namely simply by pressing the holding magnet in question against another with lower or higher holding force is replaced. It is also possible to change the holding force of a magnetic holding device acting between the upper part of the stamp and the lower part of the stamp by changing the distance between the two mutually attractive magnetic poles or a magnet and a ferromagnetic counterpart that interacts with it.
  • an embodiment of the invention has proven successful, in which the upper part of the stamp and the lower part of the stamp are provided with complementary recesses arranged in their peripheral walls and extending essentially over their entire height, for the passage of the bottom of the upper part in the lower part of the stamp and of the lower part cover in the upper part of the stamp.
  • the recesses and the longitudinal webs on the lower and upper parts of the stamp that remain between them then fit into one another like claws, whereby a stable, rotation-proof arrangement of the two stamp parts is achieved, which are guided in a form-fitting manner in the longitudinal direction of the massage stamp when the locking mechanism is triggered and the stamp parts are then pushed together.
  • the upper stamp part and the lower stamp part each have at least two recesses (and a number of longitudinal webs adapted in number and dimensions).
  • an advantageous development of the invention provides a connection adapter arranged at the upper end of the upper part of the stamp for quick connection to the drive device.
  • the pressure surface is arranged to be replaceable at the lower end of the lower part of the stamp; it can then be replaced with an element with a smaller or larger, effective compression surface and/or with a different geometric design, for example round, elliptical, spherical, etc become.
  • a securing mechanism can advantageously be essentially formed by a securing retaining magnet and/or a preferably spring-loaded snap hook connection, which preferably acts between the top of the lower part cover and a counter surface formed at the upper end of the upper part of the stamp or on the drive device.
  • the safety mechanism ensures that after the holding mechanism has been triggered once and the lower part of the stamp is then moved relative to the upper part of the stamp into the second (shortened) position, the massage stamp cannot give up this shortened length again on its own, because the safety mechanism holds the lower part of the stamp in the second position until the user of the device consciously releases the connection again, for example after the parameters for carrying out the chest compressions on the patient in question have been re-established in order to prevent the locking mechanism from being triggered again. It is also possible to use a spring or other suitable actuating element to ensure that after the locking mechanism is triggered, the lower part of the stamp is actively retracted until it reaches the second position and is then locked in this position by means of the safety mechanism.
  • the device 10 has an abutment board 14 placed under the back 13 of the patient 11, in the corner area of which an upwardly projecting portal support 15 is arranged.
  • the portal support 15 is arranged to be pivotable about a vertical axis relative to the abutment board 14 and to be displaceable in height. It can be locked - preferably continuously - at different heights.
  • the boom 16 in turn is provided at its outer, free end with a massage stamp 17, which is driven reversibly up and down in a substantially vertical actuation direction 18 by a drive device arranged inside the boom housing.
  • the massage stamp 17, which compresses the patient's thorax during its downward movement and thereby exerts a compression force K and relieves the chest again with the upward movement, is in the Fig. 2 to 5 presented in more detail.
  • the massage stamp 17 has an upper stamp part 19 and a lower stamp part 20, which is operatively connected to the upper stamp part 19.
  • the two stamp parts 19 and 20 are coaxially aligned with one another and telescopically guided into one another, so that they can be adjusted relative to one another in the actuation direction 18 at least between a first position defining 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.
  • the upper stamp part 19 and the lower stamp part 20 are locked together with a locking mechanism 21.
  • the locking mechanism 21 When a predetermined, maximum permitted compression force K max is reached, which is exerted by the massage stamp on the patient's chest, the locking mechanism 21 is triggered and thus cancels the operative connection of the two stamp parts 19, 20 in the first position.
  • K max maximum permitted compression force
  • the arrangement is such that when the locking mechanism is triggered, the lower part of the stamp 20 and the upper part of the stamp 19 push together, so that at the end of this process the massage stamp 17 only has the shortened length 1 corresponding to the second position.
  • This pushing together can be supported by an actuating element acting between the upper part of the stamp and the lower part of the stamp, for example a prestressed tension spring (not shown) which acts at the bottom of the lower part of the stamp and at the top of the upper part of the stamp, which actively pulls or pushes the two stamp parts together into the short effective length 1 as soon as the locking mechanism has triggered.
  • an actuating element acting between the upper part of the stamp and the lower part of the stamp for example a prestressed tension spring (not shown) which acts at the bottom of the lower part of the stamp and at the top of the upper part of the stamp, which actively pulls or pushes the two stamp parts together into the short effective length 1 as soon as the locking mechanism has triggered.
  • the locking mechanism 21 is essentially formed by a magnetic holding device 22 acting between the upper stamp part 19 and the lower stamp part 20, the magnet holding force M of which corresponds to the predetermined compression force K max .
  • the arrangement is such that the upper stamp part 19 has an upper part base 23 and the lower stamp part 20 has a lower part cover 24. This is located in the massage stamp 17 above the upper part base 23.
  • the magnet holding device 22 has two holding magnets 25, 26, one of which is embedded on the upper side 27 of the upper part base 23 and the other coaxially on the underside 28 of the lower part cover 24 so that they are in contact with each other put on.
  • the locking mechanism 21 in the form of the magnet holding device 22 therefore engages between the upper part bottom 23 and the lower part cover 24 and pulls the two stamp parts 19, 20 firmly in the first position, i.e. the extended working length L, with the magnetic holding force M effective between the holding magnets 25, 26. against each other.
  • the upper stamp part 19 and the lower stamp part 20 are provided with mutually complementary recesses 29, 30 in their peripheral walls 31, 32, which extend essentially over the entire height of the stamp parts 19, 20 extend.
  • These recesses 29, 30 form, on the one hand, a passage for radially outer holding sections 33 of the upper part base 23 in the lower part of the stamp 20 and, on the other hand, for corresponding holding sections 34 of the lower part cover 24 in the upper part of the stamp 19.
  • the two stamp parts 19, 20 can fit into one another in the direction 18 move when the maximum compression force, which corresponds to the magnet holding force in the first working position, is reached during chest compressions and then the locking mechanism is triggered.
  • the lower stamp part 20 which is provided with a pressure surface D at the bottom, with which it rests on the patient's chest 12 ( Fig.1 ), when the locking mechanism 21 is triggered, loses its firm connection to the upper punch 19 caused by the holding magnets and, without exerting any further significant force on the patient's thorax 12, pushes itself into the upper punch 19 when it is pushed further by the drive device is moved down.
  • the wall webs 35 of the upper stamp part 19 standing between the two recesses 29 slide in a form-fitting manner into the recesses 30 in the lower stamp part 19, while the wall webs 36 of the lower stamp part 20 slide fittingly into the corresponding recesses 29 on the upper stamp part 19 until the two stamp parts 19, 20 are pushed together into the second, shortened position with the shorter length 1.
  • the massage stamp 17 can then no longer exert any compression force on the patient's thorax 12, so the cardiac massage is automatically interrupted as soon as the compression force, which in the exemplary embodiment must be transmitted by the magnetic holding device, is reached or exceeded.
  • a securing mechanism 37 which is effective between the upper stamp part 19 and the lower stamp part 20 is provided.
  • the securing mechanism 37 is essentially formed by the holding magnet 26 arranged in the lower part cover 24, which also generates a sufficiently large magnetic holding force on the top side 38 of the lower part cover in cooperation with a counter surface 41 formed at the upper end 40 of the upper part of the stamp 19 in order to achieve this Lower part of the stamp in the shortened length 1 of the massage stamp hold when the lower part of the stamp 20 retracts and its lower part cover 24 abuts the upper end 40 of the upper part of the stamp 19.
  • the holding force exerted by the holding magnet 26 on the ferromagnetic counter surface 41 then ensures that the two stamp parts 19, 20 do not move apart again by themselves when the upper stamp part 19 of the massage stamp 17 is raised again by the drive device in the decompression stroke. Rather, the lower stamp part 20 then follows this upward movement of the upper stamp part 19, since it is sufficiently firmly connected to the upper stamp part 19 by the holding magnet 39 acting on the counter surface 41.
  • the invention ensures that the cardiac massage is immediately interrupted when the predetermined compression force is reached, because this causes the locking mechanism to be triggered and the two stamp parts to be brought into the second position with a shortened effective length l. It is possible to detect the triggering of the locking mechanism and/or pushing the stamp parts together using a sensor, which then stops the drive device for the massage stamp 17, expediently when it has reached its highest position again before the start of a subsequent compression stroke (downward movement). .
  • the invention is not limited to the exemplary embodiment shown and described, but various changes and additions are conceivable without departing from the scope of the invention.
  • at least one of the holding magnets of the magnet holding device 22 is interchangeable and can be exchanged for a magnet with a larger or smaller holding force.
  • the compression force at which the locking mechanism is triggered can be adjusted.
  • This goal can also be achieved by making the distance between the two holding magnets in the first position of the stamp parts variable, for example with the help of an adjustable depth stop. The greater the distance between the two holding magnets, the lower the holding force acting between them.
  • a preferably spring-loaded snap connection can also be used as a securing mechanism, for example a ring snap connection or a hook-snap connection that holds the two stamp parts in the second position with the massage stamp shortened in relation to each other.
  • the printing surface which is formed at the bottom of the lower part of the stamp, can be designed to be interchangeable, so that printing surfaces of different shapes and sizes, possibly also with different soft/hard coatings, can be used.

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)
EP18743085.5A 2017-07-13 2018-06-25 Vorrichtung zur kardiopulmonalen massage und/oder reanimation Active EP3651716B1 (de)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102017115732.8A DE102017115732A1 (de) 2017-07-13 2017-07-13 Vorrichtung zur kardiopulmonalen Massage und/oder Reanimation
PCT/IB2018/054654 WO2019012355A1 (de) 2017-07-13 2018-06-25 Vorrichtung zur kardiopulmonalen massage und/oder reanimation

Publications (2)

Publication Number Publication Date
EP3651716A1 EP3651716A1 (de) 2020-05-20
EP3651716B1 true EP3651716B1 (de) 2023-11-22

Family

ID=62976098

Family Applications (1)

Application Number Title Priority Date Filing Date
EP18743085.5A Active EP3651716B1 (de) 2017-07-13 2018-06-25 Vorrichtung zur kardiopulmonalen massage und/oder reanimation

Country Status (7)

Country Link
US (1) US11590054B2 (ja)
EP (1) EP3651716B1 (ja)
JP (1) JP7173122B2 (ja)
CN (1) CN110891542B (ja)
DE (1) DE102017115732A1 (ja)
ES (1) ES2965873T3 (ja)
WO (1) WO2019012355A1 (ja)

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Also Published As

Publication number Publication date
EP3651716A1 (de) 2020-05-20
CN110891542A (zh) 2020-03-17
ES2965873T3 (es) 2024-04-17
US20210145693A1 (en) 2021-05-20
JP2020527391A (ja) 2020-09-10
WO2019012355A1 (de) 2019-01-17
CN110891542B (zh) 2022-04-22
US11590054B2 (en) 2023-02-28
JP7173122B2 (ja) 2022-11-16
DE102017115732A1 (de) 2019-01-17

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