FR3099879A1 - Device for synchronizing cardiac massage and manual ventilation in the event of cardio-respiratory arrest - Google Patents

Abstract

Title of the invention Device for synchronizing cardiac massage and manual ventilation in the event of cardio-respiratory arrest The invention relates to a device (1) for synchronizing cardiac massage and manual assisted ventilation comprising first steps. signal supply means (2) configured to supply a first sensory signal (12) at a first frequency (F1); second signal supplying means (3) configured to supply a second sensory signal (13) at a second frequency (F2) different from the first frequency (F1); control means (4) for controlling the supply of the first and second sensory signals (12, 13) by the first and second signal supply means (2, 3); and power supply means (5) for supplying electric current at least to the control means. The first and second sensory signals (12) are auditory, tactile or visual. Abstract figure: Fig. 2

Description

Device for synchronizing cardiac massage and manual ventilation in the event of cardio-respiratory arrest

The invention relates to an autonomous synchronization device that can be used during cardiac massage with manual assisted ventilation implemented on a person in cardio-respiratory arrest, i.e. cardiac arrest.

An individual who is the victim of a cardio-respiratory arrest, more simply called cardiac arrest, requires the rapid intervention of caregivers or first aiders, such as doctors or the like, who must provide him with first aid, namely cardiac massage and assisted ventilation.

Cardiac massage consists of alternating chest contractions (CT) and relaxations applied to the chest of the individual in cardiac arrest, i.e. the patient.

On the other hand, assisted ventilation includes the administration of breathing gas to the patient, typically air which may be enriched with oxygen. The gas can be administered by a flexible emergency manual ventilation bag, also called BAVU for Self-filling Balloon with Unidirectional Valve, on which a rescuer exerts regular manual pressure to send gas to the patient, or by a ventilation device mechanical, such as the MONNAL ^TM T60 ventilator marketed by the Applicant.

To maximize the chances of resuscitation of the patient in cardiac arrest, the nursing staff must synchronize their actions, i.e. cardiac massage and emergency manual ventilation, in particular when a flexible bag of the BAVU type is used. .

In general, a rescuer performs the massage, while another is in charge of breathing gas into the patient using the BAVU, so that the cardiac massage is associated with appropriate artificial ventilation.

However, resuscitation of an individual in cardiac arrest is stressful for caregivers and therefore conducive to poor performance of actions.

Thus, the massage must be regular and carried out at a well-defined and sustained rhythm and this, for periods of up to 90 minutes, or even more. Similarly, assisted manual ventilation must also be regular and operated at a specific rhythm which is however different from that of massage.

In an emergency situation, it is generally found that assisted ventilation is practiced by rescuers too aggressively and too frequently, i.e. the manual pressure exerted by rescuers on the BAVU is not appropriate.

In other words, cardiac massage and manual artificial ventilation, i.e. air insufflation, have different sequences and must be synchronized for maximum efficiency in the resuscitation/ressuscitation of the patient.

Since the two operations are carried out by two different medical personnel, i.e. two rescuers, it is currently difficult to maintain good synchronization between them.

Some manual ventilation bags include a metronome-type system used only to pace the gas insufflations to the victim, i.e. to give the correct tempo to the first responder who is in charge of pressing the flexible bag.

However, in this case, the tempo of the chest contractions (CT) and relaxations operated during the cardiac massage by a second rescuer, is not indicated, which leads to the problems of non-synchronization mentioned above, which can negatively impact the effectiveness of the care provided.

In addition, the metronome system is not autonomous but fixed permanently on these balloons and it cannot therefore be used on another flexible balloon not equipped with this system, which is not practical.

The problem to be solved is therefore to propose an autonomous synchronization device making it possible to synchronize manual artificial ventilation implemented with a flexible balloon of the BAVU type and cardiac massage, performed by rescuers on a person in cardiac arrest in order to improve the effectiveness of the first aid given to that person, i.e. a patient.

The invention relates to a device for synchronizing cardiac massage and manual assisted ventilation, which can be used to assist rescuers during the performance of cardiac massage and manual assisted ventilation on a person in cardio-respiratory arrest, including:

• first signal supply means configured to supply a first sensory signal at a first frequency F1,
• second signal supply means configured to supply a second sensory signal at a second frequency F2 different from the first frequency F1,
• control means for controlling the supply of the first and second sensory signals by the first and second signal supply means,
• and electric power supply means for supplying electric current at least to the driving means.

According to the embodiment considered, the synchronization device of the invention may comprise one or more of the following characteristics:

• the control means are configured to control the supply of the first and second sensory signals at said first frequency F1 and second frequency F2.
• the first signal supply means are configured to supply the first sensory signal at a first frequency F1 corresponding to the frequency of performing chest compressions (CT) during cardiac massage.
• the first frequency F1 is between 70 and 130 c/minutes, preferably between 90 and 120 c/minutes, advantageously of the order of 110 c/min.
• the second signal supply means are configured to supply the second sensory signal at a second frequency F2 corresponding to the frequency of manual gas insufflations during cardiac massage.
• the second frequency (F2) is between 5 and 20 breaths/minute, advantageously of the order of 1 breath every 4 to 10 sec or 2 breaths every 10 to 20 sec.
• the first signal supply means and the second signal supply means are configured to supply first and second sensory signals of auditory types, e.g. sound, noise, ringtone, music ..., tactile, i.e. vibrations, or visual, that is i.e. bright, e.g. flash, scroll, rotate.
• the first signal providing means and the second signal providing means are configured to provide first and second sensory signals of the same type or of different types.
• the first signal supply means and the second signal supply means are configured to supply first and second sensory signals of different types, in particular a light signal and a sound signal.
• the first signal supply means and the second signal supply means comprise one (or more) light emitting system, one (or more) sound emitting system and/or one (or more) vibration delivering system.
• the first signal supply means and the second signal supply means comprise for example one or more light-emitting diodes, one or more loudspeakers and/or one or more vibrating motors, i.e. of the “buzzer” type.
• the control means comprise one (or more) microprocessor(s), preferably a microcontroller.
• the control means comprise a microprocessor arranged on an electronic card.
• the control means comprise a microprocessor implementing one (or more) algorithm(s).
• it comprises frequency adjustment means for adjusting, fixing, selecting or adjusting the first frequency F1 and/or the second frequency F2.
• the frequency adjustment means comprise one or more keys, buttons, selectors or the like.
• the frequency adjustment means cooperate with the control means to adjust, fix, select or adjust the first frequency F1 and/or the second frequency F2.

• it optionally comprises patient category selection means for selecting a given patient category from among several possible categories, for example adult or child.
• the patient category selection setting means comprises one or more keys, buttons, selectors or the like.
• it further comprises data storage means for recording data or the like, for example frequency ranges, patient categories, sensory signals, in particular sound signals or any other data, information or the like.
• the data storage means comprise a memory or the like, preferably carried by the electronic card.
• the control means cooperate with the electronic card.
• the electrical supply means comprise a battery or a battery, preferably rechargeable, and an electrical circuit.
• the electrical power supply means are configured to supply electrical current to the other components requiring electrical energy to operate, in particular to the electronic card, to the memory card,
• it optionally includes an information display, for example a digital screen, to display information or data for the attention of the user, in particular the first frequency F1 and/or the second frequency F2, in particular to allow their adjustment, selection or modification.
• according to a particular embodiment, it comprises a box within which all or part of the first and second signal supply means, control means and electrical power supply means, or even other components, are arranged.
• the case is made of a rigid material, for example a polymer.
• the box constitutes a carcass or external shell protecting the components which are there, i.e. means of supply of signal, means of piloting, means of electrical supply…
• it comprises fastening means making it possible to secure the device to a support, for example a bracelet or the like.
• it further comprises switch means for starting or stopping the operation of the device, that is to say an on/off device (i.e. on/off).
• the switch means comprise a manual actuator, for example a button, a key, a slider or the like, operable by a user, i.e. a rescuer.
• the switch means cooperate with the power supply means, in particular the electric circuit, to authorize or stop/prevent a power supply to the components using electricity to operate.
• the first signal delivering means and the second signal delivering means are configured to deliver the first and second sensory signals alternately such that the at least one breath does not overlap a massage sequence, i.e. say a series of chest compressions (CT).

In general, the synchronization device of the invention can take different forms:

• according to one embodiment, it takes the form of an autonomous device dedicated to the synchronization of cardiac massage and manual assisted ventilation.
• according to another embodiment, it takes the form of a digital mobile phone (i.e. a smartphone) configured to assist a user, i.e. rescuer or the like, to operate a synchronization of cardiac massage and manual assisted ventilation.
• according to another embodiment, it takes the form of a connected watch configured to assist a user, i.e. rescuer or the like, to operate a synchronization of cardiac massage and manual assisted ventilation.
• according to another embodiment, it takes the form of a portable computer configured to assist a user, i.e. rescuer or the like, to operate a synchronization of cardiac massage and manual assisted ventilation.

A synchronization device according to the invention can be used during a cardiac massage with manual assisted ventilation with insufflations by flexible balloon implemented by rescuers on a person in cardio-respiratory arrest, i.e. a patient in cardiac arrest.

The invention will now be better understood thanks to the following detailed description, given by way of illustration but not limitation, with reference to the appended figures, including:

outlines cardiac massage with concomitant manual assisted ventilation implemented on a person in cardio-respiratory arrest,

schematizes an embodiment of a synchronization device according to the invention,

schematizes a first example of synchronization of cardiac massages and assisted ventilation, and

schematizes a second example of synchronization of cardiac massages and assisted ventilation.

schematizes cardiac massage with concomitant manual assisted ventilation implemented on a person in cardio-respiratory arrest, ie cardiac arrest. A rescuer 25 carries out the cardiac massage by implementing an alternation of chest compressions (CT) applied manually on the thorax 31 of the individual 30 in cardiac arrest, ie the patient, and relaxations, i.e. stop compressions, as shown schematically by Arrow 26. During CT, the thorax 31 sinks by expelling gas from the lungs of the patient 30, whereas during relaxations, the thorax 31 rises and gas can then enter into the lungs of patient 30 and ventilate it. These movements of the thorax 31 make it possible above all to restore blood circulation in the patient 30 whose heart has stopped.

Another rescuer 20 operates concomitantly, assisted ventilation comprises the administration of respiratory gas to the patient, typically air, by means of a flexible balloon 21 for manual insufflation of the BAVU type, on which the rescuer 20 exerts pressure regular manual to send air to the patient 30, via a respiratory interface 22, such as a mask or a tracheal tube, and this, while the other rescuer performs cardiac massage. This restores pulmonary gas exchange as shown by Arrow 24.

However, as explained above, it is essential, in order to maximize the chances of resuscitation of the patient 30 who is in cardiac arrest, that the nursing staff, i.e. the two rescuers 20, 25, must synchronize their actions, i.e. i.e. manual cardiac massage and manual emergency ventilation using the flexible balloon 21.

According to the invention, such synchronization is permitted or facilitated through the use of an autonomous synchronization device 1, designed to provide caregivers, i.e. the two rescuers 20, 25, with two sensory signals having different rhythms, adapted and synchronized with each other, one being intended for cardiac massage, the other for artificial ventilation.

More precisely, schematizes an embodiment of such an autonomous synchronization device 1 according to the invention making it possible to synchronize the performance of cardiac massage and manual assisted ventilation carried out by two rescuers 20, 25 intervening on a person 30 in cardio-respiratory arrest, ie a patient.

The autonomous synchronization device 1 of the invention comprises first signal supply means 2 configured to supply a first sensory signal 12 at a first frequency F1 corresponding to a cardiac massage frequency, and second signal supply means 3 configured to supply a second sensory signal 13 at a second frequency F2 different from the first frequency F1, the second frequency F2 corresponding to a gas insufflation frequency by means of a flexible balloon 21 of the BAVU type.

The sensory signals 12, 13 can be of the same nature or of different natures, in particular auditory (noise, ringtones, music, etc.), tactile (vibrations, etc.) or visual (flashes, scrolls, rotations).

The first signal supply means 2 and the second signal supply means 3 may be or comprise one or more LEDs or other luminous device making it possible to emit light signals, such as flashes or the like; a loudspeaker for emitting auditory/audio signals, such as sounds (beeps, etc.); a vibration system, for example with a vibrating motor, making it possible to emit vibrations; Or other.

For example, the first sensory signal 12, also called cardiac massage signal, can be a high-pitched sound signal, such as a “beep”, delivered at a first frequency F1 corresponding to 110 c/min (ie strokes per minute), whereas the second sensory signal 13, also called a ventilation signal, can be a light signal, such as scrolling or light flashing, delivered at a second frequency F2 of 1 sec every 6 sec, that is to say the light signal occurs every 6 seconds and lasts 1 second, as shown in .

The first rescuer 25 performing the cardiac massage then only has to follow the rhythm given by the first sensory signal 12, while the second rescuer 20 performing the insufflation of gas by BAVU only has to follow the rhythm given by the second sensory signal 13 and in doing so, their synchronization will be (almost) perfect in the realization of the massage and the ventilation of the patient 30.

Furthermore, control means 4 are also provided, such as an electronic card 7 on which is arranged one (or more) microprocessor, typically a microcontroller implementing one or more algorithms, making it possible to control the supply of the first and second sensory signals 12, 13 by the first and second signal supply means 2, 3 at the desired frequencies F1, F2.

The frequencies F1, F2 can be preset and stored by storage means 14, such as a memory arranged on the electronic card 7. The frequencies F1, F2 can be chosen according to international or local medical recommendations.

Power supply means 5, such as a battery or a battery, preferably rechargeable, are used to supply electric current to the various parts or components of the synchronization device 1 needing electric current to operate, in particular to the control means 4 .

Preferably, it also comprises an external box 11 within which are arranged all or part of the first and second signal supply means, control means and electrical power supply means. The box 11 is made of rigid material, for example polymer and constitutes a carcass or outer shell protecting the components located therein, i.e. signal supply means, control means, power supply means, etc.

The synchronization device 1 of the invention is preferably autonomous, that is to say it is independent and not integrated into another device, for example it is not integrated into the ventilation balloon 21. However, it may optionally include fixing means making it possible to attach it to a support, to another device, to one of the rescuers, etc., for example to the ventilation bag 21. For example, the fixing means arranged on the box 11 can be or include a clamp, an adhesive or magnetic system, a ring, a bracelet, a neck cord or chain or the like...

Depending on the chosen embodiment, the first 12 and the second 13 sensory signal, and the means for fixing the device 1 can be for example the following:

• the massage signal 12 is a high-pitched sound signal at a first frequency F1 of 110 c/min and the ventilation signal is a scrolling light every 6 sec (i.e. frequency F2), and the device 1 is itself attached to the balloon ventilation 21 to be visible, in particular the light signal,
• the massage signal 12 is a high-pitched sound signal at a frequency of 110 c/min and the ventilation signal 13 consists of 2 low-pitched sound signals of 1 sec emitted every 30 chest compressions, and the device 1 is attached to the stethoscope of the rescuer 25, typically a doctor, performing cardiac massage,
• the massage signal 12 is a high-pitched sound signal and the ventilation signal 13 a vibration, and the device 1 is attached by a bracelet to the wrist of the rescuer 20, typically a doctor, performing the ventilation by means of the flexible balloon 21.

THE and [FIG. 4] are examples of synchronization of cardiac massage and assisted ventilation operated at different rhythms (ie different frequencies F1, F2) and synchronized.

Thus, the illustrates cardiac massage performed at an F1 frequency of 110 bpm (ie CT) and ventilation by insufflation every 6 sec (ie F2 frequency), ie approximately 10 breaths per minute, whereas [FIG. 4] illustrates cardiac massage performed at an F1 frequency of 110 bpm and ventilation performed in 2 manual breaths via a flexible balloon (ie BAVU) each lasting 1 sec and repeated every 30 CT.

It is understood that the first signal supply means 2 and the second signal supply means 3 are configured to deliver the first and second sensory signals 12, 13 in a synchronized and alternating manner, that is to say that the inflations of gases are not dispensed at the same time as the CT sequences but before or after a CT sequence.

In other words, the device 1 of the invention makes it possible to warn the rescuers and correctly pace their massage and ventilation actions so as to perfectly synchronize the massage and the insufflations of air and thus prevent the phases of inflations overlap those of massage, i.e. CT series, or are performed inappropriately.

Thus, on the , a rescuer 20 first insufflates (at t=0 sec) gas, typically air, to the patient for an insufflation duration of 1 sec, then the insufflation is stopped (at t=1 sec) and CTs are then performed for about 5 seconds by the first aider 25 in charge of the massage. They are then stopped and a new insufflation resumes at t=6 sec, as before, i.e. 10 insufflations per minute.

On the , a rescuer 25 first performs a series of 30 CTs, then stops them, and the other rescuer 20 then breathes air into the patient for an insufflation duration of 1 sec, then the first insufflation is stopped. After a one-second pause, a second insufflation identical to the previous one is operated, then stopped. A new series of 30 CT can then be undertaken by the rescuer 25 in charge of cardiac massage. It should be noted that a CT lasts about 0.55 sec so a series of 30 CT has approximately a duration of the order of 15 to 16 sec.

In all cases, the device 1 of the invention emits first and second signals 12, 13, preferably different signals, for example a sound/auditory signal and a light signal or else two different sound/auditory signals, for example one low and the other high, to warn one or the other of the rescuers 20, 25 that he must begin the sequence of insufflation or massage with which he is responsible.

In other words, the device 1 of the invention makes it possible to warn the rescuers 20, 25 that the time has come either to blow in the air, or to perform a series/succession of CT, which makes it possible to obtain a good synchronization between massage and insufflation of gas to the patient.

Claims (10)

Device for synchronizing (1) cardiac massage and manual assisted ventilation, comprising:

• first signal supply means (2) configured to supply a first sensory signal (12) at a first frequency (F1),
• second signal supply means (3) configured to supply a second sensory signal (13) at a second frequency (F2) different from the first frequency (F1),
• drive means (4) for controlling the supply of the first and second sensory signals (12, 13) by the first and second signal supply means (2, 3), and
• electric power supply means (5) for supplying electric current at least to the control means.

Device according to the preceding claim, characterized in that:

• the first signal supply means (2) are configured to supply the first sensory signal (12) at a first frequency (F1) corresponding to a frequency of performing chest compressions during cardiac massage, and
• the second signal providing means (3) is configured to provide the second sensory signal (13) at a second frequency (F2) corresponding to the frequency of manual gas insufflations during cardiac massage.

Device according to one of the preceding claims, characterized in that the first signal supply means (2) and the second signal supply means (3) are configured to supply first and second sensory signals (12) of auditory types , tactile or visual. Device according to Claim 3, characterized in that the first signal supply means (2) are configured to supply a first sensory signal (12, 13) of the auditory, tactile or visual type, and the second signal supply means ( 3) are configured to provide a second sensory signal (12, 13) of the auditory, tactile or visual type, the first signal and the second signal being signals of different types. Device according to one of the preceding claims, characterized in that the first signal supply means (2) and the second signal supply means (3) comprise a light emitting system, a sound emitting system and/or a system delivering vibrations. Device according to one of the preceding claims, characterized in that the first signal supply means (2) and the second signal supply means (3) are configured to deliver the first and second sensory signals (12, 13) of alternative way. Device according to one of the preceding claims, characterized in that the control means (4) comprise a microprocessor (6), preferably a microcontroller. Device according to one of the preceding claims, characterized in that the electrical supply means (5) comprise a cell or a battery. Device according to one of the preceding claims, characterized in that it comprises a box (11) within which are arranged all or part of the first and second signal supply means (2, 3), control means (4 ) and power supply means (5). Device according to one of the preceding claims, characterized in that it comprises frequency adjustment means for adjusting, fixing, selecting or adjusting the first frequency F1 and/or the second frequency F2.